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Imaging of the gastrointestinal tract-novel technologies

World Journal of Gastroenterology 2009年第2期15卷 160-168页

作者： jens brφndum frφkjr Asbjφrn Mohr Drewes Hans Gregersen Mech-Sence Aalborg HospitalDK-9000 Aalborg Denmark Department of radiology Aalborg Hospital DK-9000 Aalborg Denmark Mech-Sence Aalborg Hospital DK-9000 Aalborg Denmark Mech-Sense Department of Medical Gastroenterology Aalborg University Hospital DK-9000 Aalborg Denmark National Center for Ultrasound in Gastroenterology Haukeland University Hospital Bergen Norway Center for Sensory-Motor Interaction (SMI) Department of Health Science and Technology Aalborg University Denmark Center for Sensory-Motor Interaction (SMI) Department of Health Science and Technology Aalborg University DK-9000 Aalborg Denmark

Imaging of the gastrointestinal tract is very useful for research and clinical studies of patients with symptoms arising from the gastrointestinal tract and in visualising anatomy and pathology. Traditional radiological techniques played a leading role in such studies for a long time. However, advances in non-invasive modalities including ultrasound (US), computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MrI), etc, have in the last decades revolutionised the way in which the gastrointestinal tract is studied. The resolution of imaging data is constantly being improved and 3D acquisition, tools for fi ltering, enhancement, segmentation and tissue classif ication are continually being developed. Additional co-registration techniques allow multimodal data acquisition with improved classif ication of tissue pathology. Furthermore, new functional imaging techniques have become available. Altogether, the future of gastrointestinal imaging looks very promising which will be of great benef it in clinical and research studies of gastrointestinal diseases. The purpose of this review is to highlight the capabilities of the newest techniques to explore the detailed morphology, biomechanical properties, function and pathology of the gastrointestinal tract.

关键词： Computed tomography Gastrointestinaltract Imaging Magnetic resonance radiology Ultrasound

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Morphological and functional evaluation of chronic pancreatitis with magnetic resonance imaging

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World Journal of Gastroenterology 2013年第42期19卷 7241-7246页

作者： Tine Maria Hansen Matias Nilsson Mikkel Gram jens brφndum frφkjr Mech-Sense Department of RadiologyAalborg University Hospital9000 AalborgDenmark Mech-Sense Department of GastroenterologyAalborg University Hospital9000 AalborgDenmark

Magnetic resonance imaging(MrI)techniques for assessment of morphology and function of the pancreas have been improved dramatically the recent years and MrI is very often used in diagnosing and follow-up of chronic pancreatitis(CP)*** MrI including fat-suppressed T1-weighted and T2-weighted imaging techniques reveal decreased signal and glandular atrophy of the pancreas in *** contrast-enhanced MrI of the pancreas in CP the pancreatic signal is usually reduced and delayed due to decreased perfusion as a result of chronic inflammation and ***,morphological changes of the ductal system can be assessed by magnetic resonance cholangiopancreatography(MrCP).Furthermore,secretin-stimulated MrCP is a valuable technique to evaluate side branch pathology and the exocrine function of the pancreas and diffusion weighted imaging can be used to quantify both parenchymal fibrotic changes and the exocrine function of the *** standard and advanced MrI techniques are supplementary techniques to reveal morphological and functional changes of the pancreas in ***,spectroscopy has been used for assessment of metabolite concentrations in-vivo in different tissues and may have the potential to offer better tissue characterization of the ***,the purpose of the present review is to provide an update on standard and advanced MrI techniques of the pancreas in CP.

关键词： Magnetic resonance Chronic pancreatitis Secretin Diffusion weighted imaging Exocrine pancreatic function

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Impaired contractility and remodeling of the upper gastrointestinal tract in diabetes mellitus type-1

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World Journal of Gastroenterology 2007年第36期13卷 4881-4890页

作者： jens brΦndum frΦkjΦr SΦren Due Andersen Niels EjskjΦr Peter Funch-jensen AsbjΦrn Mohr Drewes Hans Gregersen Center for Visceral Biomechanics and Pain Aalborg Hospital Aalborg Denmark Department of radiology Aalborg Hospital Aalborg Denmark Department of Endocrinology M Aarhus University Hospital Aarhus Denmark Department of Surgical Gastroenterology L Aarhus University Hospital Aarhus Denmark Center for Sensory-Motor Interaction Department of Health Science and Technology Aalborg University Denmark Center for Sensory-Motor Interaction Department of Health Science and Technology Aalborg University Denmark National Center for Ultrasound in Gastro-enterology Haukeland University Hospital Bergen Norway

AIM: To investigate that both the neuronal function of the contractile system and structural apparatus of the gastrointestinal tract are affected in patients with longstanding diabetes and auto mic neuropathy. METHODS: The evoked esophageal and duodenal contractile activity to standardized bag distension was assessed using a specialized ultrasound-based probe. Twelve type-1 diabetic patients with autonomic neuropathy and severe gastrointestinal symptoms and 12 healthy controls were studied. The geometry and biomechanical parameters (strain, tension/stress, and stiffness) were assessed. rESULTS: The diabetic patients had increased frequency of distension-induced contractions (6.0 ± 0.6 vs 3.3 ± 0.5, P reased reactivity was correlated with the duration of the disease (P = 0.009). Impaired coordination of the contractile activity in diabetic patients was demonstrated as imbalance between the time required to evoke the first contraction at the distension site and proximal to it (1.5 ± 0.6 vs 0.5 ± 0.1, P = 0.03). The esophageal wall and especially the mucosa-submucosa layer had increased thickness in the patients (P radial compressive stretch was less in diabetics (P rcumferential deformation induced by the distensions were not affected in the patients (all P > 0.14). CONCLUSION: The impaired contractile activity with an imbalance in the distension-induced contractions likely reflects neuronal abnormalities due to autonomic neuropathy. However, structural changes and remodeling of the gastrointestinal tract are also evident and may add to the neuronal changes. This may contribute to the pathophysiology of diabetic gut dysfunction and impact on future management of diabetic patients with gastrointestinal symptoms.

关键词： Diabetes Autonomic Neuropathy Bio- mechanics Contractility Ultrasound Esophagus Duodenum Deformation Stress

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Pain and chronic pancreatitis: A complex interplay of multiple mechanisms

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World Journal of Gastroenterology 2013年第42期19卷 7282-7291页

作者： Jakob Lykke Poulsen Sφren Schou Olesen Lasse Paludan Malver jens brφndum frφkjr Asbjφrn Mohr Drewes Mech-Sense Department of Gastroenterology and HepatologyAalborg University HospitalDK-9000 AalborgDenmark Mech-Sense Department of RadiologyAalborg University HospitalDK-9000 AalborgDenmark Center for Sensory-Motor Interactions (SMI) Department of Health Science and TechnologyAalborg UniversityDK-9000 AalborgDenmark

Despite multiple theories on the pathogenesis of pain in chronic pancreatitis,no uniform and consistently successful treatment strategy exists and abdominal pain still remains the dominating symptom for most patients and a major challenge for *** theories focussed on a mechanical cause of pain related to anatomical changes and evidence of increased ductal and interstitial *** observations form the basis for surgical and endoscopic drainage procedures,but the outcome is variable and often *** underscores the fact that other factors must contribute to pathogenesis of pain,and has shifted the focus towards a more complex neurobiological understanding of pain *** other explanations for pain,experimental and human studies have provided evidence that pain perception at the peripheral level and central pain processing of the nociceptive information is altered in patients with chronic pancreatitis,and resembles that seen in neuropathic and chronic pain ***,pain due to e.g.,complications to the disease and adverse effects to treatment must not be overlooked as an additional source of *** review outlines the current theories on pain generation in chronic pancreatitis which is crucial in order to understand the complexity and limitations of current therapeutic ***,it may also serve as an inspiration for further research and development of methods that can evaluate the relative contribution and interplay of different pain mechanisms in the individual patients,before they are subjected to more or less empirical treatment.

关键词： Chronic pancreatitis Abdominal pain Pain mechanisms Neuropathy Sensitization

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Long-term survival following radiofrequency ablation of colorectal liver metastases: A retrospective study

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World Journal of Gastrointestinal Surgery 2015年第3期7卷 33-38页

作者： Simeon Niyi Babawale Thomas MandФe jensen jens brФndum frФkjr Department of radiology Aalborg University Hospital Department of Clinical Medicine Aalborg University

AIM: To retrospectively evaluate the long-term survivalof patients that received radiofrequency ablation(rFA) therapies of colorectal liver metastases. METHODS: In 2005 to 2008, rFA of 105 colorectal liver metastases(CrLM) were performed on 49 patients in our institution. The liver metastases were evaluated, both before and after ablation therapies, with contrast enhanced computerised tomography and contrast enhanced ultrasonography. Histological evidence of malignant liver metastases was obtained in the few instances where contrast enhanced ultrasonography gave equivocal results. Accesses to the CrLM were guided ultrasonically in all patients. The data obtained from records of these ablations were retrospectively analysed and survival data were compared with existing studies in the ***: 1-, 2-, 3-, 4- and 5-year survival rates, when no stringent selection criteria were applied, were 92%, 65%, 51%, 41% and 29% respectively. To explore the impact of the number and size of CrLM on patients' survival, an exclusion of 13 patients(26.5%) with number of CrLM ≥ 5 and tumour size ≥ 40 mm resulted in 1-, 2-, 3-, 4- and 5-year survival rates improving to 94%, 69%, 53%, 42% and 31% respectively. It is of note that 9 of 49 patients developed extra-hepatic metastases, not visible or seen on pretreatment scans, just after rFA treatment. These patients had poorer survival. The development of extra-hepatic metastases in nearly 20% of the patients included in our study can partly account for modestly lower survival rates as compared with earlier studies in the ***: Our study underscores the fact that optimum patients' selection before embarking on rFA treatment is vitally important to achieving a superior outcome.

关键词： Colorectal cancer Liver metastasis radiofrequency ablation Long-term survival Ablation success

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糖尿病性上消化道感觉和运动功能异常

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医学综述 2008年第23期14卷 3537-3542页

作者：赵静波 jens brφndum frφkjr Asbjφrn Mohr Drewes Niels Ejskjaer 丹麦奥尔堡医院内脏生物力学和疼痛研究中心丹麦奥尔胡斯大学医院内科

糖尿病患者胃肠感觉运动功能异常非常常见,其可涉及胃肠道各个部位。糖尿病性胃肠异常经常是亚临床的,庆幸的是罕有严重和危及生命的问题发生。人们尚未完全了解糖尿病性上消化道感觉运动功能异常的发病机制,但是其机制似乎是多源性的... 详细信息

糖尿病患者胃肠感觉运动功能异常非常常见,其可涉及胃肠道各个部位。糖尿病性胃肠异常经常是亚临床的,庆幸的是罕有严重和危及生命的问题发生。人们尚未完全了解糖尿病性上消化道感觉运动功能异常的发病机制,但是其机制似乎是多源性的。研究表明,糖尿病性自主神经病变和急性血糖异常可损伤感觉运动功能。糖尿病发展过程中胃肠道结构和生物力学特性的重构也可能与感觉运动功能异常有关。本综述只讨论糖尿病性上消化道感觉运动功能异常,同时结合讨论胃肠道结构和生物力学特性的重构在糖尿病性上消化道感觉运动功能异常发展中的作用。

关键词：糖尿病食管胃小肠动力疼痛糖尿病性神经病变高血糖重构

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Upper gastrointestinal sensory-motor dysfunction in diabetes mellitus

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World Journal of Gastroenterology 2006年第18期12卷 2846-2857页

作者： Jingbo Zhao jens brφndum frφkjaer Asbjφrn Mohr Drewes Niels Ejskjaer Center of Excellence in Visceral Biomechanics and Pain Aalborg Hospital Sφndre Skovvej 15 DK-9000 Aalborg Denmark & Center for Sensory-Motor Interactions Department of Health Science Aalborg University Fredrik Bajers Vej 7 D-3 DK-9220 Aalborg Denmark Department of Medicine M (Diabetes & Endocrinology) Aarhus University Hospital Norrebrogade 44 DK 8000 Aarhus C Denmark

Gastrointestinal （GI） sensory-motor abnormalities are common in patients with diabetes mellitus and may involve any part of the GI tract. Abnormalities are frequently sub-clinical, and fortunately only rarely do severe and life-threatening problems occur. The pathogenesis of abnormal upper GI sensory-motor function in diabetes is incompletely understood and is most likely multi-factorial of origin. Diabetic autonomic neuropathy as well as acute suboptimal control of diabetes has been shown to impair GI motor and sensory function. Morphological and biomechanical remodeling of the GI wall develops during the duration of diabetes, and may contribute to motor and sensory dysfunction. In this review sensory and motility disorders of the upper GI tract in diabetes is discussed; and the morphological changes and biomechanical remodeling related to the sensory-motor dysfunction is also addressed.

关键词： Diabetes Esophagus Stomach Intestine Motility Pain Diabetic neuropathy Hyperglycemia remodeling

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Ontogeny of the mammalian kidney:expression of aquaporins 1,2,3,and 4

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World Journal of Pediatrics 2014年第4期10卷 306-312页

作者： Lu Xing Jian-Guo Wen Jørgen frøkiær jens Christian Djurhuus rikke Nørregaard Department of Clinical Medicine Aarhus UniversityDenmark Institute of Clinical Medicine Pediatric Urodynamic CenterUrologyFirst Affi liated Hospital of Zhengzhou UniversityChina

Background:Determining the expression and functions of aquaporins(AQPs)in the adult kidney has generated important information about the roles of this protein family in the renal regulation of water ***,limited information describes the expression of AQPs in fetal kidneys,and most reports on fetal renal AQPs originate from animal *** there are the maturation and regulation of the renalconcentrating mechanism,the ways in which changes in the expression of AQPs contribute to the formation of urine during the perinatal period remain *** sources:This review summarizes current knowledge about the spatial and temporal expression patterns of AQP1,AQP2,AQP3,and AQP4 in the fetal and postnatal kidneys in different animal species and in human ***:AQP1 and AQP2 expression can be detected earlier in gestation in human beings and sheep compared with mice and ***1 expression is detected earlier in the proximal tubules than the expression of AQP2,AQP3,and AQP4 in the collecting ***:Further studies investigating the regulation of AQPs during kidney development may provide insights into normal water-handling mechanisms and the pathophysiology of fetal kidneys,which may determine new directions for the clinical treatment of kidney diseases.

关键词： aquaporin developing kidney fetal

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Three-dimensional surface model analysis in the gastrointestinal tract

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World Journal of Gastroenterology 2006年第18期12卷 2870-2875页

作者： Donghua Liao jens B frφk r Jian Yang Jingbo Zhao Asbjφrn M Drewes Odd H Gilja Hans Gregersen Center of Excellence in Visceral Biomechanics and Pain Aalborg Hospital and Institute of Health Technology Aalborg University Denmark National Center of Ultrasound in Gastroenterology Bergen University and Haukeland Hospital Bergen Norway

The biomechanical changes during functional loading and unloading of the human gastrointestinal （GI） tract are not fully understood. GI function is usually studled by introducing probes in the GI lumen. Computer modeling offers a promising alternative approach in this regard, with the additional ability to predict regional stresses and strains in inaccessible locations. The tension and stress distributions in the GI tract are related to distensibility （tension-strain relationship） and smooth muscle tone. lore knowledge on the tension and stress on the GI tract are needed to improve diagnosis of patients with gastrointestinal disorders. A modeling framework that can be used to integrate the physiological, anatomical and medical knowledge of the GI system has recently been developed. The 3-D anatomical model was constructed from digital images using ultrasonography, computer tomography （CT） or magnetic resonance imaging （IrI）. Different mathematical algorithms were developed for surface analysis based on thin-walled structure and the finite element method was applied for the mucosa-folded three layered esophageal model analysis. The tools may be useful for studying the geometry and biomechanical properties of these organs in health and disease. These studies will serve to test the structurefunction hypothesis of geometrically complex organs.

关键词： GI tract Surface Tension Stress Three-dimensional

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Misconceptions about falling sperm counts and fertility in Europe

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Asian Journal of Andrology 2013年第2期15卷 195-198,I0005页

作者： Egbert r te Velde jens Peter Bonde Department of Public Health Erasmus University MC Rotterdam GE 3015 The Netherlands reproductive Medicine Utrecht University Utrecht CM 3584 The Netherlands Department of Occupational and Environmental Medicine Bispebjerg Hospital University of Copenhagen Copenhagen NV 24C0 Denmark

The Science Policy briefing on male reproductive health pubfished by the authoritative European Science Foundation （ESF） in 2010 echoes the views expressed in the famous paper by *** et al, suggesting that mean sperm counts decreased by 50%. The authors are convinced that the male reproductive system in industrialized countries is under attack from envi- ronmental chemicals. This may have farreaching consequences for the reproductive capacity of future generations. Their arguments, however, contain some misconceptions about declining sperm quality and fertifity. Although there is reason for concern about the effect of environmental pollution, the authors＇ pessimism is not justified.

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