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Clinical outcome and predictors of survival after TIPS insertion in patients with liver cirrhosis

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World Journal of Gastroenterology 2012年第37期18卷 5211-5218页

作者： Hauke S Heinzow Philipp Lenz Michael Khler Frank Reinecke Hansjrg Ullerich Wolfram Domschke Dirk Domagk tobias meister Department of Medicine B University of Muenster Institute of Radiology University of Muenster Department of Medicine Ⅱ Helios Albert-Schweitzer-Hospital

AIM： To determine the clinical outcome and predictors of survival after transjugular intrahepatic portosystemic stent shunt （TIPS） implantation in cirrhotic patients. METHODS： Eighty-one patients with liver cirrhosis and consequential portal hypertension had TIPS implanta- tion （bare metal） for either refractory ascites （RA）（n = 27） or variceal bleeding （VB）（n = 54）. Endpoints for the study were： technical success, stent occlusion and stent stenosis, rebleeding, RA and mortality. Clini- cal records of patients were collected and analysed. Baseline characteristics [e.g., age, sex, CHILD score and the model for end-stage liver disease score （MELD score）, underlying disease] were retrieved. The Kaplan- Meier method was employed to calculate survival from the time of TIPS implantation and comparisons were made by log rank test. A multivariate analysis of factors influencing survival was carried out using the Cox pro- portional hazards regression model. Results were ex- pressed as medians and ranges. Comparisons between groups were performed by using the Mann-Whitney U-test and the4,2 test as appropriate. RESULTS： No difference could be seen in terms of age, sex, underlying disease or degree of portal pressure gradient （PPG） reduction between the ascites and the bleeding group. The PPG significantly decreased from 23.4 ± 5.3 mmHg （VB） vs 22.1± 5.5 mmHg （RA） be- fore TIPS to 11.8 ±4.0 vs 11.7 ± 4.2 after TIPS im- plantation （P = 0.001 within each group）. There was a tendency towards more patients with stage CHILD A in the bleeding group compared to the ascites group （24 vs 6, P = 0.052）. The median survival for the ascites group was 29 mo compared to 〉 60 mo for the bleed- ing group （P = 0.009）. The number of radiological con- trols for stent patency was 6.3 for bleeders and 3.8 for ascites patients （P = 0.029）. Kaplan-Meier calculation indicated that stent occlusion at first control （P = 0.027）, ascites prior to TIPS implantation （P = 0.009）, CHILD stage （P = 0.013）, M

关键词： Transjugular intrahepatic portosystemicstent shunt Liver cirrhosis Ascites Gastrointestinalhemorrhage Treatment outcome

Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology

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World Journal of Gastroenterology 2013年第6期19卷 874-881页

作者： tobias meister Hauke S Heinzow Carina Woestmeyer Philipp Lenz Josef Menzel Torsten Kucharzik Wolfram Domschke Dirk Domagk Department of Medicine B University of Münster Department of Medicine Ⅱ HELIOS AlbertSchweitzer University Teaching Hospital Department of MedicineⅡ Klinikum IngolstadtD-85049 IngolstadtGermany Department of Medicine University Teaching Hospital Lüneburg

AIM:To report the largest patient cohort study investigating the diagnostic yield of intraductal ultrasound (IDUS) in indeterminate strictures of the common bile ***:A patient cohort with bile duct strictures of unknown etiology was examined by ***,specificity and accuracy rates of IDUS were calculated relating to the definite diagnoses proved by histopathology or long-term follow-up in those patients who did not undergo *** of the endosonographic report allowed drawing conclusions with respect to the T and N staging in 147 *** staging was compared to the postoperative histopathological staging data allowing calculation of sensitivity,specificity and accuracy rates for T and N *** endoscopic retrograde cholangio-pancreatography and IDUS procedures were performed under fluoroscopic guidance using a side-viewing duodenoscope (Olympus TJF 160,Olympus,Ltd.,Tokyo,Japan).All procedures were performed under conscious sedation (propofol combined with pethidine) according to the German *** IDUS,a 6 F or 8 F ultrasound miniprobe was employed with a radial scanner of 15-20 MHz at the tip of the probe (Aloka Co.,Tokyo,Japan).RESULTS:A total of 397 patients (210 males,187 females,mean age 61.43 ± 13 years) with indeterminate bile duct strictures were *** hundred and sixty-four patients were referred to the department of surgery for operative exploration,thus surgical histopathological correlation was available for those *** of 264 patients,174 had malignant disease proven by surgery,in 90 patients benign disease was *** these patients decision for surgical exploration was made due to suspicion for malignant disease in multimodal diagnostics (computed tomography scan,endoscopic ultrasound or magnetic resonance imaging).Twenty benign bile duct strictures were misclassified by IDUS as malignant while 14 patients with malignant strictures were initially misdiagnosed by IDUS as benign resulting in s

关键词： Intraductal ultrasound Bile duct strictures Accuracy

Ileal gallstone obstruction:Single-balloon enteroscopic removal

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World Journal of Gastrointestinal Endoscopy 2010年第9期2卷 321-324页

作者： Hauke Sebastian Heinzow tobias meister Johannes Wessling Wolfram Domschke Hansjoerg Ullerich Department of Medicine B University of Muenster Department of Radiology University of Muenster

Gallstone-induced ileus is a rare complication of *** localization of gallstones impacted in the small bowel,especially in the ileum,prevents access by conventional endoscopy in most cases,the mainstay of treatment remains *** invention of double-and single-balloon enteroscopy has added much to the ability of imaging the small bowel and enables endoscopically directed ***,for the first time,we report a successful endoscopic calculus removal via peroral single-balloon enteroscopy in an 81-year-old woman suffering from gallstone ileus of the ileum.

关键词： Gallstone ileus Small bowel obstruction Single-balloon enteroscopy Cholelithiasis

Calcium channels caught in peripheral glia’s tug-of-war on axon regeneration in Drosophila

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Neural Regeneration Research 2025年第2期20卷 475-476页

作者： Jackson Powell tobias Steinschaden Rose Horowitz Yuanquan Song Raymond G.Perelman Center for Cellular and Molecular Therapeutics The Children’s Hospital of PhiladelphiaPhiladelphiaPAUSA The Neuroscience Graduate Group University of PennsylvaniaPhiladelphiaPAUSA Department of Pathology and Laboratory Medicine University of PennsylvaniaPhiladelphiaPAUSA Medical University of Vienna Center for Brain ResearchDepartment of NeuroimmunologyViennaAustria

Neural damage or degeneration is at the crux of many diseases,and treatment of these diseases will require the development of therapeutics to enhance and guide neural *** intrinsic and extrinsic factors dictate a neuron’s ability to regenerate,and the combination of these factors results in the great regenerative capacity of the peripheral nervous system(PNS)and the poor regenerative capacity of the central nervous system(CNS)following *** the core of a neuron’s function is its ability to relay electrochemical signals,and a neuron’s excitability is a key factor in its ability to *** works have focused on the changes in neuronal electrophysiological properties,firing patterns,and ion flux after injury,which differentially activate signaling pathways at the core of *** role of glia in neuron regeneration has long been studied.

关键词： degeneration firing system

Effect of fish oil enriched enteral diet on inflammatory bowel disease tissues in organ culture: Differential effects on ulcerative colitis and Crohn's disease

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World Journal of Gastroenterology 2005年第47期11卷 7466-7472页

作者： Doris meister Subrata Ghosh Gastrointestinal Unit University of EdinburghWestern General HospitalEdinburgh EH4 2XUUnited Kingdom

AIM： To investigate the influence of fish oil enriched enteral diet on intestinal tissues taken from Crohn＇s disease （CD）, ulcerative colitis （UC） and non-inflamed non-IBD control patients in vitro. METHODS： Colonoscopic biopsies from patients with active CD （n = 4）, active UC （n = 7）, and non-inflamed non-IBD control patients （n = 4） were incubated （three dilutions of 1：20, 1：10, and 1：5） with Waymouth＇s culture medium and enteral elemental diet （EO28, SHS, Liverpool, UK） modified in the fatty acid composition with fish oil （EF） in an organ culture system for 24 h. In each experimental set-up, incubation with Waymouth＇s medium alone as control was included. Tissue viability was assessed by adding bromodeoxyuridine （BrdU） to the culture fluid and immunohistochemically staining for BrdU uptake. Cytokine ratio of IL-1ra/IL-1β （low ratio indicative of inflammation） and production of those cytokines as a percentage of medium control were assayed in the culture supernatant. RESULTS： Incubation of CD-affected tissue with EF （1：20, 1：10, and 1：5） modestly and non-significantly increased IL-1ra/IL-1β ratio as compared with medium control （CD 39.1±16.1; 26.5±7.8, 47.1±16.8 vs control 13.0±2.2）, but incubation of UC-affected tissues increased IL-1ra/IL-1β ratio significantly in all three dilutions （UC 69.1±32.2, P〈0.05; 76.1±36.4, P = 0.05; 84.5±37.3, P〈0.02; vs control 10.2±3.7）. Incubation of non-inflamed non-IBD control tissue did not increase the IL-1ra/IL-1β ratio in any dilution compared to medium control （69.3±47.0, 54.1±30.6, 79.4±34.0 vs control 76.1±37.3）. Average percentage production of IL-1β indexed against medium control was significantly less in UC after EF incubation as compared with CD （UC 24.0±4.8 vs CD 51.8±8.1; P〈0.05）. Average percentage production of IL-tra was markedly higher in UC （135.9±3.4） than that in control patients （36.5±4.3）（p〈0.0001）. CONCLUSION： IBD tissues, after incubation with elemental diet modified in its fatty acid composition wi

关键词： Inflammatory bowel disease ω-3 fatty acids Cytokine ratio IL-1ra/IL-1β In vitro

Attitude maneuvers avoiding forbidden directions

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Astrodynamics 2023年第3期7卷 351-362页

作者： David Ailabouni Andreas meister Karlheinz Spindler Institute of Mathematics University of KasselHeinrich-Plett-Straße 4034132KasselGermany Department of Enigeering RheinMain University of Applied SciencesKurt-Schumacher-Ring 1865197WiesbadenGermany

Many space missions require the execution of large-angle attitude slews during which stringent pointing constraints must be *** example,the pointing direction of a space telescope must be kept away from directions to bright objects,maintaining a prescribed safety *** this paper we propose an open-loop attitude control algorithm which determines a rest-to-rest maneuver between prescribed attitudes while ensuring that any of an arbitrary number of body-fixed directions of light-sensitive instruments stays clear of any of an arbitrary number of space-fixed *** approach is based on an application of a version of Pontryagin’s Maximum Principle tailor-made for optimal control problems on Lie groups,and the pointing constraints are ensured by a judicious choice of the cost *** existence of up to three first integrals of the resulting system equations is established,depending on the number of light-sensitive and forbidden *** first integrals can be exploited in the numerical implementation of the attitude control algorithm,as is shown in the case of one light-sensitive and several forbidden *** results of the test cases presented confirm the applicability of the proposed algorithm.

关键词： attitude control pointing constraints optimal control on Lie groups Pontryagin’s Maximum Principle

Analysis of diurnal boundary layer development in boreal forests: measurements and simulations

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Journal of Plant Ecology 2012年第2期5卷 191-205页

作者： Jiarui Dong Wenge Ni-meister NOAA/NCEP/EMC and IMSG 5200 Auth RoadCamp Springs20746 MDUSA Department of Geography Hunter CollegeThe City University of New York695 Park AvenueNew York10065 NYUSA

Aims Combining field data analysis and modeling,this study investigates factors influencing the diurnal boundary layer(BL)development in boreal *** Field data analysis used both air sounding and surface flux measurements collected during the Boreal Ecosystem–Atmosphere Study field campaigns in central *** study applied a non-local transilient turbulence theory(TTT)to simulate the impact of the heterogeneous boundary conditions together with initial conditions on the BL development at the Candle Lake and Thompson release sites over boreal *** conditions were characterized by the integrated surface flux measurements from different forest *** lake effect was included in constructing the surface fluxes at Candle Lake release *** Findings Analyses of serial upper air sounding data and tower flux data indicate strong linear impacts of surface sensible heat forcing on the diurnal BL development above boreal *** regression slopes on the relationship between the BL development and the surface fluxes reflect the influences of initial boundary conditions to the BL *** the modeled and the measured diurnal BLs show that lakes reduce sensible heat flux,leading to a shallower boundary in Candle Lake than in *** of the model results and field measurements on the BL profiles indicates that the TTT model has the capability to simulate the BL development above boreal forests for sunny,rainfall or cloudy *** study demonstrates the importance of lake on surface fluxes and BL *** modeling effort shows the potential to couple the transilient theory with a land surface process model to study land surface and atmosphere interaction in boreal forest.

关键词： BOREAS transilient turbulence theory lake effects initial patterns surface fluxes

Assessing the impacts of vegetation heterogeneity on energy fluxes and snowmelt in boreal forests

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Journal of Plant Ecology 2011年第1期4卷 37-47页

作者： Wenge Ni-meister Huilin Gao Department of Geography Hunter College of The City University of New York695 Park AvenueNew YorkNY 10065USA Department of Civil and Environmental Engineering University of WashingtonSeattleWA 98195USA

Aims In the mid-and high-latitude regions,three quarters of the land surface is covered by boreal conifer forests,and snow lasts for 6–8 months of the *** modeling surface energy balance and snowmelt at mid-and high-latitudes has a significant influence on climate and hydrological ***,the heterogeneous and clumped forest structure exerts important control over the radiative energy at the forest floor,which results in large variations of underneath snow cover and snowmelt *** goal of this study is to investigate the impact of hierarchically clumped vegetation structure in boreal forest on snowmelt and exchanges of energy and *** We used a simple Clumped Canopy Scheme(CCS)for canopy radiation transfer to characterize the impact of the clumped forest structure on net radiation at the snow surface underneath *** CCS was integrated with the Variable Infiltration Capacity macroscale hydrological model(herein referred to as VIC-CCS)to characterize the impact of clumped vegetation structure on surface energy balance and snowmelt during the snow season.A twin simulation,VICCCS and the standard VIC model,was performed to isolate the impact of CCS on the energy and water fluxes and snowmelt *** simulation results were compared to in situ measurements at four different forest stands:old aspen forest in the Southern Study Area(SOA),black spruce forests in the Southern and Northern Study Areas(SOBS and NOBS)and fen wetland in the Northern Study Area(NFEN)within the Boreal Ecosystem–Atmosphere Study(BOREAS)region in central Canada during 1994 *** Findings Simulations showed that the implementation of CCS has reduced incoming long-wave radiation at the underlying snow surface and,thereby,lowered the snowmelt *** against ground observations of net radiation and surface flux rates showed a reasonable agreement while demonstrating implementation of CCS can markedly improve model surface energy budget and en

关键词： clumping snowmelt VIC boreal forests

Modularization of adhesion G protein-coupled receptor(aGPCR)structure:how alternative splicing regulates synaptogenesis

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Signal Transduction and Targeted Therapy 2024年第5期9卷 1793-1795页

作者： tobias Langenhan Rudolf Schönheimer Institute of Biochemistry Division of General BiochemistryMedical FacultyLeipzig UniversityLeipzigGermany Comprehensive Cancer Center Central Germany(CCCG) Leipzig UniversityLeipzigGermany Institute of Biology Faculty of Life SciencesLeipzig UniversityLeipzigGermany

A recent report has uncovered a fascinating aspect of how neurons utilize alternative splicing of transcripts of an adhesion G protein-coupled receptor(aGPCR)gene to serve specific functions in the life of a synapse.1 The work provides significant insight into the ability of cells to support distinct biochemical and physiological operations through post-transcriptional processing of genetic information that is encoded in a single aGPCR locus.

关键词： GPCR utilize operations