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Combination of repeated single-session percutaneous ethanol injection and transarterial chemoembolisation compared to repeated single-session percutaneous ethanol injection in patients with non-resectable hepatocellular carcinoma

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World Journal of Gastroenterology 2006年第23期12卷 3707-3715页

作者： Arne Dettmer Timm D Kirchhoff Michael Gebel Lars Zender Nisar P Malek Bernhard Panning Ajay Chavan Herbert Rosenthal stefan Kubicka susanne Krusche sonja Merkesdal Michael Galanski Michael P Manns joerg s bleck Department of Gastroenterology Hepatology and EndocrinologyHannover Medical SchoolGermany Department of Diagnostic Radiology Hannover Medical SchoolGermany Department of Anaesthesiology Hannover Medical SchoolGermany Department of Diagnostic and Interventional Radiology Klinikum OldenburgGermany s bleck Department of GastroenterologyHepatology and EndocrinologyHannover Medical SchoolGermany Division of Rheumatology Hannover Medical SchoolGermany

AIM： To evaluate the treatment effect of percutaneous ethanol injection （PEI） for patients with advanced, non-resectable HCC compared with combination of transarterial chemoembolisation （TACE） and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. METHODs： All patients who received PEI treatment during the study period were included and stratified to one of the following treatment modalities according to physical status and tumor extent： combination of TACE and repeated single-session PEI, repeated single-session PEI alone, repeated TACE alone, or best supportive care. Prognostic value of clinical parameters including Okuda-classification, presence of portal vein thrombosis, presence of ascites, number of tumors, maximum tumor diameter, and serum cholinesterase （CHE）, as well as Child-Pugh stage, α-fetoprotein （AFP）, fever, incidence of complications were assessed and compared between the groups. survival was determined using Kaplan-Meier and multivariate regression analyses.

关键词： HCC single-session PEI TACE survival Prediction

Transarterial chemoembolization using degradable starch microspheres and iodized oil in the treatment of advanced hepatocellular carcinoma: evaluation of tumor response, toxicity, and survival

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Hepatobiliary & Pancreatic Diseases International 2007年第3期6卷 259-266页

作者： Timm D Kirchhoff joerg s bleck Arne Dettmer Ajay Chavan Herbert Rosenthal sonja Merkesdal Bernd Frericks Lars Zender Nisar P Malek Tim F Greten stefan Kubicka Michael P Manns Michael Galanski Department of Diagnostic Radiology Hannover Medical school Germany Department of Gastroenterology Hepatology and Endocrinology Hannover Medical School Germany Department of Diagnostic and Interventional Radiology Klinikum Oldenburg Germany Division of Rheumatology Hannover Medical School Germany Department of Radiology and Nuclear Medicine Campus B.F-Charité-University Medicine Berlin Germany

BACKGROUND: In a multidisciplinary conference patients with advanced non-resectable hepatocellular carcinoma (HCC) were stratified according to their clinical status and tumor extent to different regional modalities or to best supportive care. The present study evaluated all patients who were stratified to repeated transarterial chemoembolization (TACE) from 1999 until 2003 in terms of tumor response, toxicity, and survival. A moderate embolizing approach was chosen using a combination of degradable starch microspheres (DsM) and iodized oil (Lipiodol) in order to combine anti-tumoral efficiency and low toxicity. METHODs: Fourty-seven patients were followed up prospectively. TACE treatment consisted of cisplatin (50 mg/m2), doxorubicin (50 mg/m2), 450-900 mg DsM, and 5-30 ml Lipiodol. DsM and Lipiodol were administered according to tumor vascularization. Patient characteristics,toxicity, and complications were outlined. In multivariate regression analyses of pre-treatment variables from a prospective database, predictors for tumor response and survival after TACE were determined. REsULTs: 112 TACE courses were performed (2.4±1.5 courses per patient). Mean maximum tumor size was 75 (± 43) mm, in 68% there was bilobar disease. Best response to TACE treatment was: progressive disease (PD) 9%, stable disease (sD) 55%, partial remission (PR) 36%, and complete remission (CR) 0%. Multivariate regression analyses identified tumor size ≤75 mm, tumor number ≤5, and tumor hypervascularization as predictors for PR. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, respectively, and the median survival was 26 months. Low α-fetoprotein levels (s ratio=3.3) and PR as best response to TACE (Odds ratio=6.7) were significantly associated with long term survival (>30 months, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in terms of reversible leukopenia and thrombocytopenia. The incidence of major

关键词： carcinoma, hepatocellular transarterial chemoembolization degradable starch microspheres Lipiodol tumor response survival

New insights into the properties of high-manganese steel

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International Journal of Minerals,Metallurgy and Materials 2021年第5期28卷 782-796页

作者： Wolfgang bleck steel Institute RWTH Aachen UniversityGermany

In the Collaborative Research Centre 761’s“steel ab initio-quantum mechanics guided design of new Fe based materials,”scientists and engineers from RWTH Aachen University and the Max Planck Institute for Iron Research conducted research on mechanism-controlled material development with a particular focus on high-manganese alloyed *** 2007 to 2019,a total of 55 partial projects and four transfer projects with industrial participation(some running until 2021)have studied material and process design as well as material *** basic idea of the Collaborative Research Centre was to develop a new methodological approach to the design of structural *** paper focuses on selected results with respect to the mechanical properties of high-manganese steels,their underlying physical phenomena,and the specific characterization and modeling tools used for this new class of *** steels have microstructures that require characterization by the use of modern methods at the *** the process routes,the generation of segregations must be taken into ***,the mechanical properties show a characteristic temperature dependence and peculiarities in their fracture *** mechanical properties and especially bake hardening are affected by short-range ordering *** strain hardening can be adjusted in a never-before-possible range,which makes these steels attractive for demanding sheet-steel applications.

关键词： high-manganese steels stacking fault energy twinning short-range ordering mechanical properties

Initial experience from a combination of systemic and regional chemotherapy in the treatment of patients with nonresectable cholangiocellular carcinoma in the liver

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World Journal of Gastroenterology 2005年第8期11卷 1091-1095页

作者： Timm Kirchhoff Lars Zender sonja Merkesdal Bernd Frericks Nisar Malek joerg bleck stefan Kubicka stefan Baus Ajay Chavan Michael P.Manns Michael Galanski Department of Diagnostic Radiology Department of Gastroenterology Division of Rheumatology Department of Radiology and Nuclear Medicine

AIM: In nonresectable cholangiocellular carcinoma (CCC)therapeutic options are limited. Recently, systemic chemotherapy has shown response rates of up to 30%.Additional regional therapy of the arterially hyper vascularized hepatic tumors might represent a rational approach in an attempt to further improve response and palliation. Hence, a protocol combining transarterial chemoembolization and systemic chemotherapy was applied in patients with CCC limited to the ***: Eight patients (6 women, 2 men, mean age 62 years) with nonresectable CCC received systemic chemotherapy (gemcitabine 1 000 mg/m2) and additional transarterial chemoembolization procedures (50 mg/m2cisplatin, 50 mg/m2 doxorubicin, up to 600 mg degradable starch microspheres). Clinical follow-up of patients, tumor markers, CT and ultrasound were performed to evaluate maximum response and ***: Both systemic and regional therapies were tolerated well; no severe toxicity (WHO Ⅲ/Ⅳ) was encountered. Nausea and fever were the most commonly observed side effects. A progressive rarefication of the intrahepatic arteries limited the maximum number of chemoembolization procedures in 4 patients. A median of 2 chemoembolization cycles (range, 1-3) and a median of 6.5 gemcitabine cycles (range, 4-11) were *** responses were not achieved. As maximum response, partial responses were achieved in 3 cases,stable diseases in 5 cases. Two patients died from progressive disease after 9 and 10 mo. six patients are still alive. The current median survival is 12 mo (range, 9-18); the median time to tumor progression is 7 mo (range, 3-18). seven patients suffered from tumor-related symptoms prior to therapy, 3 of these experienced a treatment-related clinical relief. In one patient the tumor became resectable under therapy and was successfully removed after 10 ***: The present results indicate that a combination of systemic gemcitabine therapy and repeated regional chemoembolizati

关键词： Cholangiocellular carcinoma Gemcitabine Intraarterial chemoembolization

Correlates of long-term physical activity adherence in women

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Journal of sport and Health science 2017年第4期6卷 434-442页

作者： Haichun sun Cheryl A. Vamos sara s.B. Flory Rita DeBate Erika L. Thompson Jennifer bleck Department of Teaching and Learning College of Education University of South Florida Tampa FL 33620 USA Department of Community and Family Health College of Public Health University of South Florida Tampa FL 33612 USA

Background: Little is known about the factors that may influence women's adherence to moderate-to-vigorous physical activity(MVPA) using longitudinal data. The purpose of this study was to examine the correlates of long-term physical activity(PA) participation among ***: Female data from Waves I, III, and IV(n = 5381) of the National Longitudinal study of Adolescent to Adult Health(Add Health) were used for the analysis. The outcome of PA adherence was operationalized as(1) consistently physically active(at least 5 instances during the week)in both Waves III and IV(during adulthood), and(2) consistently not physically active or only physically active in either Wave III or IV. Predictor variables from Wave I(during adolescence) included race/ethnicity, PA level, self-perception of being physically fit, general health status, attempt to change weight, parents' income level, parents' education, well-being, depression, access to PA resources, days of physical education(PE), and grade level. Crude and adjusted logistic regression models were utilized to estimate the adjusted odds ratio(a OR) and 95% confidence interval(95%CI) for the outcome ***: PA levels during adolescence significantly predicted PA adherence(a OR = 1.67, 95%CI: 1.35–2.05). Additionally, wanting to lose weight(a OR = 1.49, 95%CI: 1.20–1.85), using fitness center in the neighborhood(a OR = 1.29, 95%CI: 1.05–1.58), and having 5 days of PE a week(a OR = 1.48, 95%CI: 1.09–2.02) were significant predictors. Women who did not perceive being physically fit(a OR = 0.65, 95%CI: 0.44–0.95)and Black, non-Hispanics(a OR = 0.60, 95%CI: 0.44–0.82) were less likely to adhere to ***: The findings suggested that physically active adolescents were more likely to become active adults. Future research should address interventions(e.g., PE program, community resources) that may promote lifetime PA in women, with the goal of decreasing morbidity and mortality.

关键词： Females Longitudinal Moderate-to-vigorous physical activity social ecological frameworks

sequence diversity of hepatitis C virus: Implications for immune control and therapy

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World Journal of Gastroenterology 2007年第36期13卷 4807-4817页

作者： joerg Timm Michael Roggendorf University of Essen Instituteof Virology Essen 45122 Germany

With approximately 3% of the world’s population (170 million people) infected with the hepatitis C virus (HCV), the WHO has declared HCV a global health problem. Upon acute infection about 50%-80% of subjects develop chronic hepatitis with viral persistence being at risk to develop liver cirrhosis and hepatocellular carcinoma. One characteristic of HCV is its enormous sequence diversity, which represents a significant hurdle to the development of both effective vaccines as well as to novel therapeutic interventions. Due to a polymerase that lacks a proofreading function HCV presents with a high rate of evolution, which enables rapid adaptation to a new environment including an activated immune system upon acute infection. similarly, novel drugs designed to specifically inhibit viral proteins will face the potential problem of rapid selection of drug resistance mutations. This review focuses on the sequence diversity of HCV, the driving forces of evolution and the impact on immune control and treatment response. An important feature of any therapeutic or prophylactic intervention will be an efficient attack of a structurally or functionally important region in the viral protein. The understanding of the driving forces, but also the limits of viral evolution, will be fundamental for the design of novel therapies.

关键词： Hepatitis C Virus Evolution Escape Drug resistance selection

Influence of rotating wakes on separation in turbine exhaust diffusers

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Journal of Thermal science 2008年第1期17卷 42-49页

作者： Olaf sieker joerg R.seume Department of Turbomachinery and Fluid Dynamics Leibniz University HannoverAppelstr.9DE-30167 HannoverGermany Dipl.-Ing. Department of Turbomachinery and Fluid Dynamics Leibniz University HannoverAppelstr.9DE-30167 HannoverGermany

Highly efficient turbine exhaust diffuser cannot be designed without taking into account the unsteady interactions with the last rotating row of the turbine. Former investigations described in the literature show a very high potential compared to that of other parts of turbomachines for improving the diffuser. A scale model of a typical gas turbine exhaust diffuser is investigated experimentally. To investigate the influence of rotating wakes, measurements without a spoke wheel as well as measurements with a variable-speed rotating cylindrical spoke wheel with 2 mm- or 10 mm-spokes simulating turbine rotor wakes were made. Miniaturized 3-hole pneumatic probes as well as a 2D-Laser-Doppler-Velocimeter （LDV） were used to investigate velocity profiles. 122 static pressure tapings were used to measure several axial and circumferential static pressure distributions. Without a spoke-wheel the annular diffuser separates at the shroud for all swirl configurations. For the measurements with the 2 mm spoke wheel, the separating diffuser was unstable while keeping the test rig operating parameters constant. For a non-rotating 10 mm spoke wheel and at rotational speeds less than 1,000 rpm, the annular diffuser separated at the shroud. Increasing the rotational speed of the 10mm spoke wheel, flow did not separate at the shroud and much higher pressure recovery than without spoke wheel has achieved.

关键词： turbine exhaust diffuser rotating wakes separation LDV

Extended stribeck curves for food samples

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Biosurface and Biotribology 2018年第1期4卷 34-37页

作者： Kartik s.Pondicherry Florian Rummel joerg Laeuger Anton Paar GmbH Anton-Paar Strasse 20A-8054 GrazAustria Anton Paar Germany GmbH Helmuth-Hirth-Strasse 6D-73760 OstfildernGermany

stribeck curves have long been used for understanding the lubricating behaviour of oils and greases,and inthe recent years for applications ranging from ball point inks to synovial *** the current work,an attempt is madeto show as to what one can read from stribeck curves of food samples such as chocolate spread,sauce ***,the effect of saliva-human and artificial-on the frictional behaviour has also been *** were carried out on an MCR Tribometer with a ball-on-three-pin *** and glasswere used to simulate soft contact conditions that exist in the human *** from the tribological testsare plotted in the form of extended stribeck curves,wherein,the friction coefficient is plotted as a function of *** the tribometer is capable of speeds as low as a few nanometres per second,it is also possible toobserve the build-up of static friction and its transition into the kinetic regime of *** indicate that certainaspects of the stribeck curve can offer an insight into the correlation between the frictional behaviour of food to theirsensory feel.

关键词： friction behaviour curves

Transcutaneous perianal sonography:A sensitive method for the detection of perianal inflammatory lesions in Crohn's disease

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World Journal of Gastroenterology 2004年第19期10卷 2859-2863页

作者： Jochen Wedemeyer Timm Kirchhoff Gernot sellge Oliver Bachmann Joachim Lotz Michael Galanski Michael P.Manns Michael J.Gebel Jrg s.bleck Department of Gastroenterology Hepatology and EndocrinologyMedical School of HannoverCarl Neuberg Str.130623 HannoverGermany M.D. Department of Diagnostic Radiology Medical School of HannoverCarl Neuberg Str.130623 HannoverGermany Department of Gastroenterology Hepatology and EndocrinologyMedical School of HannoverCarl Neuberg Str.130623 HannoverGermany

AIM:Pelvic magnetic resonance imaging(MRI)and endoanal ultrasound which are established imaging methods for perianal inflammatory lesions in patients with Crohn's disease require expensive specialized equipments and *** investigated the feasibility and sensitivity of transcutaneous perianal ultrasound(PAUs)using regular ultrasound probes in the imaging of perianal inflammatory *** sonographic findings were correlated to pelvic MR]-scans. METHODs:We performed PAUs in 25 patients with Crohn's disease and clinical signs of perianal inflammatory disease. Wibhin a median of 10 d(range 0-75)these patients underwent MRI of the *** convex and linear high resolution probes were used for *** sonographic findings were correlated to the MRI findings by blinded investigators. REsULTs:The sonographic investigations were well tolerated by all *** typically presented as hypoechoic ***-nine fistulae were detected in 22 *** were detected in 7 patients and presented as hypo-or anechoic ***-six of 29 fistulae and 6 of 7 abscesses could be confirmed by *** statistics showed an excellent agreement (kappa>0.83)between the two imaging methods. CONCLUsION:PAUs is a simple,painless,feasible,real- time method that can be performed without specific patient preparation which is comparable in its sensitivity to pelvic MRI in the detection of perianal fistulae and/or abscesses. PAUs can especially be recommended as a screening tool in acute perianal disorders such as perianal abscess and for follow-up studies of perianal inflammatory disease.

关键词： Anal Canal histology Anus Diseases Crohn Disease Humans Inflammation Ultrasonography, Doppler, Color