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Assessment of stricturing Crohn's disease:Current clinicalpractice and future avenues

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World Journal of Gastroenterology 2016年第3期22卷 1008-1016页

作者： dominik bettenworth Tobias M Nowacki Friederike Cordes Boris Buerke Frank Lenze Department of Medicine B University Hospital of Muenster48149 MuensterGermany Department of Clinical Radiology University Hospital of Muenster48149 MuensterGermany

Crohn's disease(CD) is a chronic remittent idiopathic disease. Although the early phase of the disease is commonly characterized by inflammation-driven symptoms, such as diarrhea, the frequency of fibrostenotic complications in patients with CD increases over the long-term course of the disease. This review presents the current diagnostic options for assessing CD-associated strictures. In addition to the endoscopic evaluation of CD strictures, this review summarizes the currently available imaging modalities, including ultrasound and cross-sectional imaging techniques. In addition to stricture detection, differentiating between the primarily inflammatory strictures and the predominantly fibrotic ones is essential for selecting the appropriate treatment strategy(anti-inflammatory medical treatment vs endoscopical or surgical approaches). Therefore, recent imaging advances, such as contrast-enhanced ultrasound and ultrasound elastography, contribute to the development of noninvasive non-radiating imaging of CD-associated strictures. Finally, novel magnetic resonance imaging techniques, such as diffusion-weighted, motility and magnetization transfer imaging, as well as 18F-FDG PET/CT, molecular imaging approaches and biomarkers, are critically reviewed with regard to their potential role in assessing stricturing CD.

关键词： Crohn's disease Inflammatory bowel disease Intestinal stricture Endoscopy Magnetic resonanceimaging Ultrasound Computed tomography 18F-FDGPET/CT CEUS Elastography

Crohn's disease complicated by intestinal infection with methicillin-resistant Staphylococcus aureus

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World Journal of Gastroenterology 2013年第27期19卷 4418-4421页

作者： dominik bettenworth Tobias M Nowacki Alexander Friedrich Karsten Becker Johannes Wessling Jan Heidemann Department of Medicine B University of Münster Institute of Hygiene University of Münster Institute of Medical Microbiology University of Münster Department of Clinical Radiology University of Münster

We report on a 24-year-old male patient with history of bloody diarrhea, abdominal pain and vomiting. Endoscopy revealed massive ulcerative discontinuous proctosigmoiditis with deep, sharply demarcated epithelial denudations and enterotoxigenic methicillin-resistant Staphylococcus aureus (MRSA) was detected in mucosal biopsies. After treatment with linezolide and steroids, a significant amelioration of colitis was detected and testing for MRSA became negative. In face of the case presented here, we suggest that in patients with refractory inflammatory bowel disease (IBD), microbiological assessment should be performed to detect a possible Staphylococcus aureus infection in order to initiate an antimicrobial treatment in addition to IBDspecific treatment.

关键词： Inflammatory bowel disease Crohn’s disease Infectious colitis Staphylococcus aureus Methicillin-resistant Staphylococcus aureus

Diagnostic imaging advances in murine models of colitis

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World Journal of Gastroenterology 2016年第3期22卷 996-1007页

作者： Markus Brückner Philipp Lenz Marcus M Mücke Faekah Gohar Peter Willeke Dirk Domagk dominik bettenworth Department of Medicine B University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Paediatric Rheumatology and Immunology University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine D University Hospital of MünsterAlbert-Schweitzer-Campus 1D-48149 MünsterGermany Department of Medicine I Josephs-Hospital WarendorfAcademic Teaching HospitalUniversity of MünsterAm Krankenhaus 2D-48231 WarendorfGermany

Inflammatory bowel diseases(IBD) such as Crohn's disease and ulcerative colitis are chronic-remittent inflammatory disorders of the gastrointestinal tract still evoking challenging clinical diagnostic and therapeutic situations. Murine models of experimental colitis are a vital component of research into human IBD concerning questions of its complex pathogenesis or the evaluation of potential new drugs. To monitor the course of colitis, to the present day, classical parameters like histological tissue alterations or analysis of mucosal cytokine/chemokine expression often require euthanasia of animals. Recent advances mean revolutionary noninvasive imaging techniques for in vivo murine colitis diagnostics are increasingly available. These novel and emerging imaging techniques not only allow direct visualization of intestinal inflammation, but also enable molecular imaging and targeting of specific alterations of the inflamed murine mucosa. For the first time, in vivo imaging techniques allow for longitudinal examinations and evaluation of intra-individual therapeutic response. This review discusses the latest developments in the different fields of ultrasound, molecularly targeted contrast agent ultrasound, fluorescence endoscopy, confocal laser endomicroscopy as well as tomographic imaging with magnetic resonance imaging, computed tomography and fluorescence-mediated tomography,discussing their individual limitations and potential future diagnostic applications in the management of human patients with IBD.

关键词： confocal laser endomicroscopy contrastenhanced ultrasound Dextran Sodium Sulphate colitis experimental colitis fluorescence imaging endoscopy Imaging Inflammatory bowel disease Tomography

Detection and characterization of murine colitis and carcinogenesis by molecularly targeted contrast-enhanced ultrasound

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World Journal of Gastroenterology 2017年第16期23卷 2899-2911页

作者： Markus Brückner Jan Heidemann Tobias M Nowacki Friederike Cordes Jorg Stypmann Philipp Lenz Faekah Gohar Andreas Lügering dominik bettenworth Department of Medicine B University Hospital of MünsterD-48149 MünsterGermany Department of Gastroenterology Klinikum Bielefeld MitteAcademic Teaching HospitalUniversity of MünsterD-33604 BielefeldGermany Department of Cardiology and Angiology University Hospital of MünsterD-48149 MünsterGermany Department of Palliative Care University Hospital of MünsterD-48149 MünsterGermany Department of Paediatric Rheumatology and Immunology University Hospital of MünsterD-48149 MünsterGermany Medical Care Center Portal 10 D-48155 MünsterGermany

AIM To study mucosal addressin cellular adhesion molecule-1(MAd CAM-1) and vascular endothelial growth factor(VEGF)-targeted contrast enhanced ultrasound(CEUS) for the assessment of murine colitis and carcinogenesis. METHODS C57BL/6 mice were challenged with 3% dextran sodium-sulfate(DSS) for three, six or nine days to study the development of acute colitis. Ultrasound was performed with and without the addition of unspecific contrast agents. MAd CAM-1-targeted contrast agent was used to detect and quantify MAd CAM-1 expression. Inflammatory driven colorectal azoxymethane(AOM)/DSS-induced carcinogenesis was examined on day 42 and 84 using VEGF-targeted contrast agent. Highly specific tissue echogenicity was quantified using specialized software. Sonographic findings were correlated to tissue staining, western blot analysis and immunohistochemistry to quantify the degree of inflammation and stage of carcinogenesis. RESULTS Native ultrasound detected increased general bowel wall thickening that correlated with more progressed and more severe DSS-colitis(healthy mice: 0.3 mm ± 0.03 vs six days DSS: 0.5 mm ± 0.2 vs nine days DSS: 0.6 mm ± 0.2, P < 0.05). Moreover, these sonographic findings correlated well with clinical parameters such as weight loss(r2 = 0.74) and histological damage(r2 = 0.86)(P < 0.01). In acute DSS-induced murine colitis, CEUS targeted against MAd CAM-1 detected and differentiated stages of mild, moderate and severe colitis via calculation of mean pixel contrast intensity in decibel(9.6 d B ± 1.6 vs 12.9 d B ± 1.4 vs 18 d B ± 3.33, P < 0.05). Employing the AOM/DSSinduced carcinogenesis model, tumor development was monitored by CEUS targeted against VEGF and detected a significantly increased echogenicity in tumors as compared to adjacent healthy mucosa(healthy mucosa, 1.6 d B ± 1.4 vs 42 d, 18.2 d B ± 3.3 vs 84 d, 18.6 d B ± 4.9, P < 0.01). Tissue echogenicity strongly correlated with histological analysis and immunohistochemistry findings(VEGF-posi

关键词： Colitis Dextran sodium-sulfate AOMDSS Carcinogenesis Ultrasound Contrast-enhanced ultrasound Vascular endothelial growth factor Mucosal addressin cellular adhesion molecule-1

A typical presentation of a rare cause of obscure gastrointestinal bleeding

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World Journal of Gastrointestinal Endoscopy 2011年第2期3卷 40-45页

作者： Stefan Reuter dominik bettenworth Sren Torge Mees Jrg Neumann Torsten Beyna Wolfram Domschke Johannes Wessling Hansjrg Ullerich Department of Internal Medicine D University Hospital Münster Albert-Schweitzer Str. 33 Münster 48149 Germany Department of Internal Medicine B University Hospital Münster Albert-Schweitzer Str. 33 Münster 48149 Germany Department of General and Visceral Surgery University Hospital Münster Albert-Schweitzer Str. 33 Münster 48149 Germany Gerhard Domagk Institute of Pathology University Hospital Münster Albert-Schweitzer Str. 33 Münster 48149 Germany Department of Radiology University Hospital Münster Albert-Schweitzer Str. 33 Münster 48149 Germany

A 52-year-old white woman had suffered from intermittent gastrointestinal (GI) bleeding for one year. Upper GI endoscopy, colonoscopy and peroral doubleballoon enteroscopy (DBE) did not detect any bleeding sour ce, suggesting obscure GI bleeding. However, in video capsule endoscopy a jejunal ulceration without blee ding signs was suspected and this was endoscopically conf irmed by another peroral DBE. After transfusion of packed red blood cells, the patient was discharged from our hospital in good general *** weeks later she was readmitted because of another episode of acute bleeding. Multi-detector row computed tomography with 3D reconstruction was performed revealing a jejunal tumor causing lower gastrointestinal bleeding. The patient underwent exploratory laparotomy with partial jejunal resection and end-to-end jejunostomy for reconstruction. Histological examination of the specimen confirmed the diagnosis of a low risk gastrointestinal stromal tumor (GIST). Nine days after surgery the patient was discharged in good health. No signs of gastrointestinal rebleeding occurred in a followup of eight months. We herein describe the comp lex presentation and course of this patient with GIST and also review the current approach to treatm ent.

关键词： Gastrointestinal stromal tumor Gastrointestinal neoplasms Gastrointestinal hemorrhage Computed tomography

Remote sensing of bark beetle damage in Norway spruce individual tree canopies using thermal infrared and airborne laser scanning data fusion

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Forest Ecosystems 2022年第5期9卷 710-723页

作者： Agata Zakrzewska dominik Kopec Department of Biogeography Paleoecology and Nature ProtectionFaculty of Biology and Environmental ProtectionUniversity of LodzŁodzPoland MGGP Aero Sp.z o.o. TarnowPoland

Background:Increasing threat to Central Europe’s forests from the growing population of the European spruce bark beetle Ips typographus (L.) calls for developing highly effective methods of detection of the infestation spots. The main goal of this study was to establish an automatic workflow for detection of dead trees and trees in poor condition of Picea abies using Middle Wave Infrared spectral range obtained from the ***:The studies were conducted in Wigry National Park (Poland) in 2020. A fusion of aircraft thermal data and laser scanning was used. Synchronous with thermal data acquisition ground reference data were obtained for P. abies in different health conditions. Determination of the range of canopy temperatures characteristic of the three condition states (‘healthy’,‘poor condition’,‘dead’) was performed using K-mean clustering. The accuracy of the method was evaluated on two validation sets:(1) individual tree canopies determined by photointerpretation, and (2) automatic segmentation of laser scanning ***:The results showed that the average temperature of ‘healthy’trees was 27.70℃, trees in ‘poor condition’28.57℃, and ‘dead’trees 30.17℃. High temperature differences between ‘healthy’and ‘dead’P. abies made it possible to distinguish these two condition classes with high accuracy. Lower accuracies were obtained for the class of ‘poor condition’, which was found to be confusing with both ‘healthy’and ‘dead’trees. According to results from the first validation set, a high overall accuracy of 0.60 was obtained. For the second validation set, the overall accuracy was reduced by 11%.Conclusions:This study indicates that canopy temperature recorded from the airborne level is a variable that differentiates ‘healthy’spruces from those in ‘poor condition’and the ‘dead’trees. The results confirmed that thermal and airborne laser scanning data fusion allows for creating a quick and simple workflow, which can successfully separate individual tre

关键词： Infrared thermography Picea abies Ips typographus Middle wave infrared Forest invasion Forest health K-mean clustering

A High-Order Discontinuous Galerkin Solver for Helically Symmetric Flows

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Communications in Computational Physics 2021年第6期30卷 288-320页

作者： dominik Dierkes Florian Kummer dominik Plumacher Department of Mechanical Engineering Technische Universitat DarmstadtOtto-Berndt-Straße 264287 DarmstadtGermany

We present a high-order discontinuous Galerkin(DG)scheme to solve the system of helically symmetric Navier-Stokes equations which are discussed in[28].In particular,we discretize the helically reduced Navier-Stokes equations emerging from a reduction of the independent variables such that the remaining variables are:t,r,ξwithξ=az+bϕ,where r,ϕ,z are common cylindrical coordinates and t the *** this,all three velocity components are kept non-zero.A new non-singular coordinateηis introduced which ensures that a mapping of helical solutions into the three-dimensional space is well *** that,periodicity conditions for the helical frame aswell as uniqueness conditions at the centerline axis r=0 are *** the sector near the axis of the computational domain a change of the polynomial basis is implemented such that all physical quantities are uniquely defined at the *** the temporal integration,we present a semi-explicit scheme of third order where the full spatial operator is splitted into a Stokes operator which is discretized implicitly and an operator for the nonlinear terms which is treated *** are conducted for a cylindrical shell,excluding the centerline axis,and for the full cylindrical domain,where the centerline is *** all cases we obtain the convergence rates of order O(hk+1)that are expected from DG *** addition to the first DG discretization of the system of helically invariant Navier-Stokes equations,the treatment of the central axis,the resulting reduction of the DG space,and the simultaneous use of a semi-explicit time stepper are of particular novelty.

关键词： Discontinuous Galerkin(DG) helical flows

Multimodal Integration Processes in Plan-Based Service Robot Control

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Tsinghua Science and Technology 2011年第1期16卷 1-6页

作者： dominik Off TAMS Department of InformaticsUniversity of Hamburg

Cross-modal integration processes are essential for service robots to reliably perceive relevant parts of the partially known unstructured environment, We demonstrate how multimodal integration on different abstraction levels leads to reasonable behavior that would be difficult to achieve with unimodal approaches. Sensing and acting modalities are composed to multimodal robot skills via a fuzzy multisensor fusion approach. Single modalities constitute basic robot skills that can dynamically be composed to appropriate behavior by symbolic planning. Furthermore, multimodal integration is exploited to answer relevant queries about the partially known environment. All these approaches are successfully implemented and tested on our mobile service robot platform TASER,

关键词： service robotic multimodal integration plan-based robot control

Predetermination of potential plastic hinges on reinforced concrete frames using GFRP reinforcement

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Frontiers of Structural and Civil Engineering 2022年第5期16卷 624-637页

作者： dominik KUERES Dritan TOPUZI Maria Anna POLAK Department of Civil and Environmental Engineering University of WaterlooWaterlooON N2L 3G1Canada Schoeck Canada Inc. OttawaON K1P 5G3Canada

In the past,glass fiber-reinforced polymer(GFRP)-reinforcement has been successfully applied in reinforced concrete(RC)structures where corrosion resistance,electromagnetic neutrality,or cuttability were *** investigations suggest that the application of GFRP in RC structures could be advantageous in areas with seismic activity due to their high deformability and ***,especially the low modulus of elasticity of GFRP limited its wide application as GFRP-reinforced members usually exhibit considerably larger deformations under service loads than comparable steel-reinforced *** overcome the aforementioned issues,the combination of steel and GFRP reinforcement in hybrid RC sections has been investigated in the *** on this idea,this paper presents a novel concept for the predetermination of potential plastic hinges in RC frames using GFRP *** analyze the efficiency of the concept,nonlinear finite element simulations were *** results underscore the high efficiency of hybrid steel-GFRP RC sections for predetermining potential plastic hinges on RC *** results also indicate that the overall seismic behavior of RC structures could be improved by means of GFRP as both the column base shear force during the seismic activity as well as the plastic deformations after the earthquake were considerably less pronounced than in the steel-reinforced reference structure.

关键词： glass fiber-reinforced polymer GFRP hybrid section plastic hinge seismic design reinforced concrete