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22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses

world Journal of Gastroenterology 2016年第39期22卷 8820-8830页

作者： william Sterlacci Athanasios D Sioulas Lothar Veits Pervin G?nüllü Guido Schachschal Stefan Groth Mario Anders Christos K Kontos Theodoros Topalidis Andrea Hinsch Michael Vieth Thomas R?sch ulrike w denzer Institute of Pathology Clinic of Bayreuth Department of Interdisciplinary Endoscopy University Hospital Hamburg-Eppendorf Department of Biochemistry and Molecular Biology University of Athens Institute of Pathology Institute of Pathology University Hospital Hamburg-Eppendorf

AIM To compare the aspiration needle(AN) and core biopsy needle(PC) in endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) of abdominal *** Consecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge(G) AN(Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22 G PC(Echo Tip Pro Core; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and *** Fifty six consecutive patients(29 men; mean age 68 years) with pancreatic lesions(n = 38), lymphadenopathy(n = 13), submucosal tumors(n = 4), or others lesions(n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy(AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy(AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes(AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score(AN: 1.7 vs PC: 1.1, P = 0.058), and complications(none). A diagnosis on the basis of histology was achieved in the PC group in 36(64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN(AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical *** Both needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

关键词： Endoscopic ultrasound Cytology Fine needle aspiration Abdominal tumors Core biopsy needle

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Prospective evaluation of the short access cholangioscopy for stone clearance and evaluation of indeterminate strictures

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Hepatobiliary & Pancreatic Diseases International 2017年第1期16卷 96-103页

作者： Athanasios D Sioulas Muhammad A El-Masry Stefan Groth Guido Schachschal Mario Anders Thomas Rosch ulrike denzer Department of Interdisciplinary Endoscopy University Hospital Hamburg-Eppendorf MartinistraBe 52 20246 Hamburg Germany Division of Gastroenterology Department of Internal Medicine Assiut University Hospital Al Walideyah Al Qebleyah Qesm Than Asyut Assiut Governorate Egypt

BACKGROUND： Peroral cholangioscopy facilitates diagnosis and therapy of biliary disorders. This study prospectively evaluated a new short access cholangioscopy. METHODS： Consecutive patients were included as follows： difficult stones （group 1） underwent cholangioscopy with electrohydraulic lithotripsy and indeterminate biliary strictures （group 2） were evaluated with macroscopic assessment and cholangioscopy guided biopsy sampling. we evaluated the complete stone clearance rate （group 1） and diagnostic accu- racy （group 2）. Follow-up was performed over a median of 13 and I6 months, respectively. RESULTS： Group 1 （n=21）： complete stone clearance defined as lack of stones in cholangiography and stone removal dur- ing cholangioscopy was achieved in 15 （71.4%） patients. Clini- cal stone clearance defined as lack of symptoms, laboratory abnormalities and hospital visits during follow-up, irrespec- tive of stone clearance was evident in 17 （81.0%） patients. One serious adverse event occurred （bile duct perforation）. Group 2 （n=28）： malignancy was confirmed in 15 patients. Sensitiv- ity, specificity and diagnostic accuracy of cholangioscopy were 85.7%, 75.0% and 80.7%, respectively. Sensitivity, specificity and diagnostic accuracy of biopsies were 54.5%, 100.0% and 72.2%, respectively. No serious adverse events occurred, and one patient was lost to ***： The novel system enabled complex stone treatment and biliary stricture diagnosis. Cholangioscopy outperformed direct biopsy regarding characterization of in- determinate strictures.

关键词： biliary tract diseases novel cholangioscopy feasibility

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Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

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world Journal of Gastroenterology 2020年第37期26卷 5693-5704页

作者： Petros Stathopoulos Anika Pehl Lutz Philipp Breitling Christian Bauer Tobias Grote Thomas Mathias Gress Carsten Denkert ulrike walburga denzer Department of Gastroenterology EndocrinologyMetabolism and Clinical InfectiologyUniversity Hospital MarburgMarburg 35043HessenGermany Institute of pathology University Hospital MarburgMarburg 35043HessenGermany

BACKGROUND The introduction of fine needle biopsies(FNB)to clinical practice presents a changing trend towards histology in the endoscopic ultrasound-guided tissue acquisition(EUS-TA).AIM To evaluate the clinical performance of a new FNB needle,the 22-gauge(22G)Franseen needle,when sampling pancreatic solid *** Consecutive patients with an indication for EUS-TA for the assessment of pancreatic solid lesions were included in this prospective,single-center,singlearm *** patient underwent a puncture of the lesion two times using the 22G Franseen needle and the obtained samples were directly placed into formalin for histological *** primary study endpoint was the rate of high-quality obtained *** endpoints included the length and diameter of the core specimen,the diagnostic accuracy and the complication *** From June 2017 to December 2018,forty patients with pancreatic solid lesions(22 females;mean age 67.2 years)were *** acquisition was achieved in all ***-quality histology,rated with Payne score 3,was obtained in 37/40 cases(92.5%)after two needle *** mean size of the acquired histological core tissue was 1.54 mm×0.39 *** diagnostic accuracy for the correct diagnosis was 85%(34/40).Only one adverse event was occurred,consisting of a self-limiting bleeding in the puncture *** The 22G Franseen needle achieved according to our standardized protocol a high rate of histological core procurement,and a high diagnostic accuracy,with one minor adverse event reported.

关键词： Endosonography Fine needle biopsy Histology Pancreatic lesions Franseen needle

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THE LIMITATIONS OF LEED: A CASE STUDY

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Journal of Green Building 2011年第1期6卷 25-33页

作者： Anthony S.denzer Keith E.Hedges University of wyoming Dept.32951000 E.University AvenueLaramieWY 82071 Hammons School of Architecture Drury University.

The Xanterra houses are situated against the backdrop of one of America’s most spectacular natural landscapes,just a few hundred yards from the north entrance to Yellowstone National *** project consists of two single-family homes for seasonal workers,approximately 2000 square feet *** are mirrored east-to-west but otherwise identical(see Figure 1).The project was completed in 2003,and certified under LEED-NC v2.0,project#1353 on December 10,2004-the first building project in the National Park system to receive LEED(Leadership in Energy and Environmental Design)certification from the USGBC(United States Green Building Council).1 The houses were built with the explicit intent that they would become a model for future green building projects at Yellowstone and other national parks,2 and the project team felt it was fitting that these houses be situated in the nation’s first national ***,they were fundamentally well-designed and constructed,and they incorporated some of the latest technologies for saving energy and water,authentically earning the label“high-performance.”Yet the project only earned the lowest possible rating(“certified”)from LEED,meaning it is barely considered *** paper documents the green design strategies through the design and construction process,with special attention paid to the influence of the LEED scorecard on collaborative decision-making and to the difficulties this project encountered during the LEED assessment *** academic studies have examined the process of LEED self-reporting and scoring within a professional setting,3 even though contingencies such as common business practices and human limitations clearly affect a project’s LEED *** paper will show that the LEED scorecard turned out to be a poor assessment tool in this case study,because the reporting procedure inaccurately reflected the architectural design and ***,there have been a few important papers that conclude that

关键词： LEED energy modeling insulated concrete passive solar heating construction waste management

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Isogeometric Analysis of Soil Plasticity

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Geomaterials 2017年第3期7卷 96-116页

作者： Alex Spetz Erika Tudisco Ralf denzer Ola Dahlblom Geotechnical Engineering Department of Construction Sciences Faculty of Engineering Lund University Lund Sweden Solid Mechanics Department of Construction Sciences Faculty of Engineering Lund University Lund Sweden

In this paper we present numerical simulations of soil plasticity using isogeometric analysis comparing the results to the solutions from conventional finite element method. Isogeometric analysis is a numerical method that uses nonuniform rational B-splines (NURBS) as basis functions instead of the Lagrangian polynomials often used in the finite element method. These functions have a higher-order of continuity, making it possible to represent complex geometries exactly. After a brief outline of the theory behind the isogeometric concept, we give a presentation of the constitutive equations, used to simulate the soil behavior in this work. The paper concludes with numerical examples in two- and three-dimensions, which assess the accuracy of isogeometric analysis for simulations of soil behavior. The numerical examples presented show, that for drained soils, the results from isogeometric analysis are overall in good agreement with the conventional finite element method in two- and three-dimensions. Thus isogeometric analysis is a good alternative to conventional finite element analysis for simulations of soil behavior.

关键词： Isogeometric Analysis NURBS Numerical Methods Soil Plasticity

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Efficient Simulation of Nonlinear Heat Transfer during Thermal Spraying of Complex workpieces

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world Journal of Mechanics 2014年第9期4卷 289-301页

作者： Rolf Berthelsen Thomas wiederkehr Ralf denzer Andreas Menzel Heinrich Müller Institute of Mechanics TU Dortmund Leonhard-Euler-Stra&szlig e 5 Dortmund Germany Lehrstuhl Informatik VII TU Dortmund Otto-Hahn-Stra&szlig e 16 Dortmund Germany

The quality of coatings, produced by thermal spraying processes, considerably decreases with the occurrence of higher residual stresses, which are especially pronounced for complex workpiece geometries. To understand the occurring effects and to aid in the planning of coating processes, simulations of the highly transient energy flux of the HVOF spray gun into the substrate are of great value. In this article, a software framework for the simulation of nonlinear heat transfer during (HVOF) thermal spraying is presented. One part of this framework employs an efficient GPU-based simulation algorithm to compute the time-dependent input boundary conditions for a spray gun that moves along a complex workpiece of arbitrary shape. The other part employs a finite-element model for a rigid heat conductor adhering to the computed boundary conditions. The model is derived from the fundamental equations of continuum thermodynamics where nonlinear temperature-depending heat conduction is assumed.

关键词： Nonlinear Heat Conduction Continuum Thermodynamics GPU Computing

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圣基利安高架桥的设计构思与实现

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中外公路 2017年第2期37卷 67-71页

作者：侯健杜芳 Gundolf denzer Ulrich weyer Christof Dieckmann 中铁大桥勘测设计院集团有限公司湖北武汉430050

该文介绍了德国苏尔(Suhl)附近A73公路上圣基利安高架桥的设计构思与实现。该桥采用柔性桥墩,在三角形桁架的基础上设置了带有纵向预应力的混凝土翼缘板,形成了连续的组合梁结构。

关键词：组合梁三角形桁架铸钢节点整孔吊装

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Linking Numerical water Quality Models in an Environmental Information System for Integrated Environmental Assessments

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Journal of Environmental Protection 2013年第7期4卷 126-137页

作者： Franklin Torres-Bejarano Hermilo Ramirez Ralf denzer Steven Frysinger Thorsten Hell Sascha Schlobinski Cismet GmbH Saarbrücken Germany. Department of Postgraduates Studies Mexican Petroleum Institute Mexico City Mexico Environmental Informatics Group (EIG) Saarbrücken Germany Environmental Informatics Group (EIG) Saarbrücken Germany 3Cismet GmbH Saarbrücken Germany.

Decision makers involved in prevention of water contamination often lack the technical knowledge of water quality evaluation or the comprehension of complex software for environmental information management required to make effective decisions. Providing information about the environment is not an easy task due to its complex structure, relationships, and dynamic processes. Because environmental models play an important role in environmental decision support systems, the integration of models into user-friendly integrated information systems is a key factor in the support of such users. This paper presents an environmental information system which supports water protection of Coatzacoalcos River in Mexico, having as a main building block water quality assessments supported by mathematical modeling through the two-dimensional Saint Venant and Advection-Diffusion-Reaction equations to calculate the river hydrodynamics and the contaminant transport, respectively. The mathematical modeling solution yields appropriate results representing the river contaminant distribution when compared with field measurements. But the direct use of these models by decision makers is difficult at best, meaning they are not likely to be used in making practical decisions. The system described in this paper integrates these models, and several other tools, into a seamless, user-centered application, improving model usability, initial configuration, and results visualization.

关键词： Environmental Information Systems Environmental Decision Support Systems water Quality Modeling Integrated Modeling

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技术发展促进了SCADA系统的广泛互联

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军用航油（国外部分） 1999年第1期 38-41页

作者： denzer,D 李延龙

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清醒镇静状态下行诊断性微型腹腔镜和结肠镜检查期间发生心肺事件的前瞻性比较研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 20-21页

作者： denzer U. MollenhauerM. Kanzler S. 陈瑜 First Dept. of Medicine Johannes Gutenberg University Langenbeckstrasse 1 55131 Mainz Germany Dr.

Background and study aims: Cardiorespiratory parameters were examined throughout diagnostic minilaparoscopy procedures. The same parameterswere analyzed during colonoscopy, and the data were compared. Patients and methods: Sixty-five consecutive unselected patients undergoing minilaparoscopy (group 1: ASA I, n = 34; group 2: ASA II/III, n = 31) and 61 consecutive unselected patients undergoing colonoscopy (group 3: ASA I, n = 31; group 4: ASA II/III, n = 30)-were included. Oxygen saturation (Sao2), heart rate (HR) and mean arterial pressure (RRm) weremeasured continuously, and 12-lead electrocardiography (ECG) recordings were made at specific times during each procedure. Results: Minor differenceswere observed, particularly after premedication, probably due to different dosage regimens and timing in the two examination techniques. After premedication, testing for differences from baseline values showed a minor decrease in Sao2 and RRm in the minilaparoscopy groups in comparison with the colonoscopy groups (median Sao2, group 1: 99.9%±0 vs. group 3: 100%-1, P = 0.0078; median RRm, group 1: 99.5-4 mm Hg vs. group 3:96 -16 mm Hg, P = 0.046, and median RRm, group 2: 110 +1 mm Hg vs. group 4:101 -13.5 mmHg, P = 0.0007). HR increased in minilaparoscopy in comparison with colonoscopy (median HR: group 2:77 +4 beats/min vs. group 4:75.5 ±0 beats/min; P = 0.01). Comparison of defined relevant pathological changes in Sao2, RRm, HR, and ECG showed no significant differences. Discussion: These data indicate that diagnostic minilaparoscopy under conscious sedation is only associated with limited risk in patients with compensated cardiopulmonary diseases. This is probably due to the low insufflation pressure used.

关键词：结肠镜检查微型腹腔镜清醒镇静术前麻醉随机入选腹腔镜检氧饱和度导联心电图心肺疾病中位值

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