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Mandatory criteria for the application of variability-based parameters of fluid responsiveness: a prospective study in different groups of ICU patients

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2018年第7期19卷 515-524页

作者： Wolfgang HUBER Uli MAYR ANDreas UMGELTER Michael FRANZEN Wolfgang REINDL RolAND M.SCHMID Florian ECKEL Ⅱ. medizinische klinik und Poliklinik Klinikum rechts der Isar der Technischen Universitat Munchen Ismaninger Straβe 22 D-81675 Miinchen Germany Universitatsklinik fur Innere Medizin I Salzburger Landeskliniken Universitatsklinikum Salzburg Mullner Hauptstraβe 48A-5020 Salzburg Austria Ⅱ. medizinische klinik Universitatsklinikum Mannheim Theodor-Kutzer-Ufer 1-3 D-68167 Mannheim Germany klinik fur Innere Medizin RoMed Klinik Bad Aibling Harthauser Straβe 16 D-83043 Bad Aibling Germany

Background and objective： Stroke volume variation（SVV） has high sensitivity and specificity in predicting fluid responsiveness. However, sinus rhythm（SR） and controlled mechanical ventilation（CV） are mandatory for their application. Several studies suggest a limited applicability of SVV in intensive care unit（ICU） patients. We hypothesized that the applicability of SVV might be different over time and within certain subgroups of ICU patients. Therefore, we analysed the prevalence of SR and CV in ICU patients during the first 24 h of Pi CCO-monitoring（primary endpoint） and during the total ICU stay. We also investigated the applicability of SVV in the subgroups of patients with sepsis, cirrhosis, and acute pancreatitis. Methods： The prevalence of SR and CV was documented immediately before 1241 thermodilution measurements in 88 patients. Results： In all measurements, SVV was applicable in about 24%. However, the applicability of SVV was time-dependent： the prevalence of both SR and CV was higher during the first 24 h compared to measurements thereafter（36.1% vs. 21.9%; P0.001）. Within different subgroups, the applicability during the first 24 h of monitoring ranged between 0% in acute pancreatitis, 25.5% in liver failure, and 48.9% in patients without pancreatitis, liver failure, pneumonia or sepsis. Conclusions： The applicability of SVV in a predominantly medical ICU is only about 25%–35%. The prevalence of both mandatory criteria decreases over time during the ICU stay. Furthermore, the applicability is particularly low in patients with acute pancreatitis and liver failure.

关键词： Hemodynamic monitoring Preload Fluid responsiveness Stroke volume variation Pulse pressure variation

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Surgical-interventional hybrid orchestra consisting of Potts shunt, transcatheter tricuspid valve repair by Edwards-valve in a 26-year-old patient with pulmonary hypertension and right ventricular failure

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World Journal of Cardiovascular Diseases 2013年第6期3卷 1-4页

作者： Sabine Recla Blanka Steinbrenner Jennifer Schreier Stephan Fichtlscherer Dorle Schmidt Christian Apitz Matthias Muller Juergen Bauer Hakan Akintuerk Dietmar Schranz Hessiches Kinderherzzentrum Universitatskliniken GiessenFrankfurtGermany medizinische klinik III Kardiologie UniversitatsklinikumFrankfurtGermany

Reported here is a 26-year-old patient with corrected congenital interrupted aortic arch admitted with massive hemoptysis and severe suprasystemic pul-monary hypertension provided him for heart-lung transplantation. Initial closure of a small aorto-pulmonary collateral remained ineffective. Persistent life-threatening hemoptysis led to the decision for a modified Potts shunt with the aim of decompressing the right ventricle and avoiding pulmonary-hypertensive crisis. The hemoptysis did not recur. However, the patient’s oxygen transport condition deteriorated and necessitated an orchestra of interventional-surgical approaches from re-coarctation stenting, Potts shunt flow reducing to surgical and transcatheter tricuspid valve repair with transient ECMO before the patient could be discharged home.

关键词： Pulmonary Hypertension Potts Shunt Edwards Tricuspid Valve Hybrid-Procedure

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Resveratrol decreases oxidative stress in the cardiovascular system by modifying redox genes

Resveratrol decreases oxidative stress in the cardiovascular...

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第14届国际自由基学术大会

作者： Andreas Daiber Alice Habermeier Gerrit Spanier Matthias Oelze Ellen I. Closs Thomas Münzel Ulrich Frstermann II. medizinische klinik Johannes Gutenberg University Mainz Germany Department of Pharmacology

＜正＞Resveratrol, a naturally occurring phytoalexin found in grapes and wine, is likely to contribute to the potential of red wine in preventing human cardiovascular disease. In addition to its （moderate） direct antioxidant effect, we have found that resveratrol also regulates pro- oxidative and anti-oxidative enzymes in cardiovascular system

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Endoscopic stent therapy in patients with chronic pancreatitis:A 5-year follow-up study

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World Journal of Gastroenterology 2013年第5期19卷 715-720页

作者： Andreas Weber Jochen Schneider Bruno Neu Alexander Meining Peter Born Stefan von Delius Monther Bajbouj Roland M Schmid Hana Algül Christian Prinz II medizinische klinik und Poliklinik Klinikum Rechts der IsarTechnische Universitt München81675 MünchenGermany II medizinische klinik Gastroenterologie und HepatologieHelios Klinikum WuppertalUniversitt Witten/Herdecke42283 WuppertalGermany

AIM:This study analyzed clinical long-term outcomes after endoscopic therapy,including the incidence and treatment of relapse. METHODS:This study included 19 consecutive patients(12 male,7 female,median age 54 years)with obstructive chronic pancreatitis who were admitted to the 2nd Medical Department of the Technical University of *** patients presented severe chronic pancreatitis(stageⅢ°)according to the Cambridge *** majority of the patients suffered intermittent pain attacks.6 of 19 patients had strictures of the pancreatic duct;13 of 19 patients had strictures and *** first endoscopic retrograde pancreatography(ERP)included an endoscopic sphincterotomy, dilatation of the pancreatic duct,and stent *** first control ERP was performed 4 wk after the initial intervention,and the subsequent control ERP was performed after 3 mo to re-evaluate the clinical and morphological *** follow-up was performed annually to document the course of pain and the management of *** course of pain was assessed by a pain scale from 0 to *** date and choice of the therapeutic procedure were documented in case of relapse. RESULTS:Initial endoscopic intervention was successfully completed in 17 of 19 *** 17 patients reported partial or complete pain relief after endoscopic *** therapy failed in 2 patients. Both patients were excluded from further *** failed patient underwent surgery,and the other patient was treated conservatively with pain *** of 19 patients were followed after the successful completion of endoscopic stent *** of 17 patients were lost to *** patient was not avail-able for interviews after the 1st year of *** patients died during the 3rd year of *** both patients chronic pancreatitis was excluded as the cause of *** patient died of myocardial infarction, and one patient succumbed to *** three patient

关键词： Chronic pancreatitis Pain Stent therapy Endoscopic retrograde cholangiopancreatography Pancreaticolithiasis

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Electroencephalogram response in premature infants to different odors: a feasibility study

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World Journal of Pediatrics 2022年第12期18卷 845-848页

作者： Janine Gellrich Sandy Schlage Veronika Messer Valentin A.Schriever Abteilung Neuropädiatrie medizinische Fakultät Carl Gustav Carus Technische UniversitätDresdenGermany klinik und Poliklinik für Kinder-und Jugendmedizin Medizinische Fakultät Carl Gustav CarusTechnische Universität DresdenFetscherstrasse 7401307DresdenGermany Center for Chronically Sick Children(Sozialpädiatrisches Zentrum SPZ)Charité-Universitätsmedizin BerlinBerlinGermany Department of Pediatric Neurology Charité-Universitätsmedizin BerlinBerlinGermany

The importance of olfaction for newborns,especially for mother-associated odors is well *** receptor neurons were found in preterm infants as early as 24–27 weeks of gestation[1].Therefore,it can be assumed that the olfactory sense is functioning in preterm infants[2],but only very little is known about olfactory processing at this *** studies dealing with the processing of olfactory stimuli have been conducted on mature ***,in 2001 a research group demonstrated,using near-infrared spectroscopy,that a change in blood oxygenation of premature infants could be detected in the orbitofrontal cortex after olfactory stimulation with disinfectant and detergent[3].Electroencephalogram(EEG)techniques have broadly been used to measure central odor processing in adults and children[4,5,6].

关键词： mother stimulation cortex

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预防脑卒中高危患者应该接受雷米普利治疗而不必考虑血压

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英国医学杂志中文版 2002年第4期5卷 171-172页

作者： Joachim Schrader Stephan Lüders 慕朝伟 medizinische klinik StJosefs Hospital

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Case Report: Bilateral Pneumothoraces due to Targeted Tumor Therapy with Regorafenib in a Young Woman with Metastatic Colorectal Cancer

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Case Reports in Clinical Medicine 2022年第5期11卷 139-145页

作者： Tobias Rachow Tim Sandhaus Thomas Ernst Helmut Schiffl Susanne M. Lang klinik für Innere Medizin II Universit&auml tsklinikum Jena Jena Germany klinik für Innere Medizin V Universit&auml tsklinikum Jena Jena Germany klinik für Herz- und Thoraxchirurgie Universit&auml tsklinikum Jena Jena Germany medizinische klinik IV LMU München München Germany

Background: Colorectal cancer is one of the most common cancer types, frequently metastasizing into the lungs. Treatment options have been vastly improved over the last years. With the increasing use of targeted therapies, novel and rare adverse effects can be seen. Case Presentation: A 43-year-old woman presented in our oncology department with chest pain and dyspnea. The patient was diagnosed with colorectal cancer seven years earlier and had received chemoradiation, surgery, and multiple chemotherapies before she was started on regorafenib because of progressive pulmonary metastases. Computed tomography scans demonstrated cavitation of former nodular bilateral pulmonary metastases. After drainage and resolution of the right-sided pneumothorax, the patient returned eleven days later with recurrent symptoms caused by left-sided tension pneumothorax. Video-assisted thoracoscopy and bilateral pleurodeses were performed. Persistent air leaks with severe pain and pulmonary infiltrates led to the death of the patient. Conclusions: This case demonstrates the efficacy of oral antiangiogenetic therapy in advanced metastatic colorectal cancer. Nevertheless, it also depicts an important potential side effect by transforming multiple solid lung metastases into cavitations which led to recurrent pneumothoraces. Special attention should be paid to this phenomenon as treatment of these complications can be challenging.

关键词： Regorafenib Pneumothorax Pulmonary Metastases Colorectal Cancer

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Extent of Myocardial Damage in Patients after Emotional Stress-Induced Myocardial Infarction during Euro Cup Soccer 2008

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World Journal of Cardiovascular Diseases 2015年第12期5卷 388-396页

作者： Andreas Eigenwillig Korbinian Lackermair Veronika Deffner Helmut Küchenhoff Thomas Nickel Ute Wilbert-Lampen medizinische klinik und Poliklinik I Campus Grosshadern LMU Munich Germany Statistisches Beratungslabor Institut für Statistik LMU Munich Germany

Background: The World Cup soccer 2006 has been shown to provoke levels of stress sufficient to increase the incidence of acute coronary syndrome. However, the clinical outcome of these patients remains elusive. We sought to assess whether emotional stress-induced myocardial infarction might increase myocardial damage compared to non-stress-induced events. Design and Methods: We prospectively analysed the extent of left ventricular damage after emotional stress-induced myocardial infarction occurred during Euro Cup Soccer 2008 (study group, n = 51). Data were compared to a matched reference group (n = 55). The primary endpoint was a composite of cardiac troponin-T/I and the left ventricular ejection fraction at day 4th after the initial event. Results: Compared to standard values of troponin T and troponin I, concentrations were increased in both the study group and the reference group (troponin T: 4.7 ± 8.5 ng/ml vs. 2.4 ± 4.3 ng/ml;troponin I: 13.1 ± 16.5 ng/ml vs. 8.7 ± 13.9 ng/ml). The difference, adjusted for confounding variables, between both groups did not reach statistical significance (p = 0.33). Likewise, left ventricular ejection fraction (EF) was decreased in both the study patients and the reference group (51% ± 12% EF vs. 55% ± 10% EF), the difference between both groups was just not significant (p = 0.12). Discussion: In conclusion, because of the lack of significance, we cannot testify at present, weather emotional stress, e.g. induced by soccer matches of the national team, influences the extent of myocardial damage following myocardial infarction. However, a positive correlation can be assumed, because the troponin levels are considerably higher in the study group than in the control group.

关键词： Emotional Stress Myocardial Infarction Ventricular Damage Troponin-T/I

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Blastoids:a new model for human blastocyst development

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Signal Transduction and Targeted Therapy 2021年第7期6卷 1946-1947页

作者： Heiner Niemann Bob Seamark medizinische Hochschule Hannover(MHH) HannoverGermany Flinders University College of Medicine and Public HealthAdelaideSAAustralia

Recently,two research groups report in Nature1,'2 the ex-vivo production of blastocyst-like structures,called blastoids,that exhibit many of the landmarks in human early development found in viable blastocysts(Fig.1).The formation of a blastocyst is a critical step in early embryo development denoting a key change from the early cleavage stages to ***,the blastocyst,differentiated from the early cleavage stages,is a fluid filled vesicular structure comprised of cells of now,three distinct cell lineages,namely those of the trophoblast,the outer enclosing cell layer,and those of the inner cell mass(ICM)with the hypoblast and epiblast,found in the central fluid filled cavity(the blastocoel).

关键词： filled cavity outer

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Synthesis　of　Glycoproteins　by　Mucosa　of　Gastric　Antrum　in　Chronic　GastritisB

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1994年第2期14卷 76-76页

作者： TIAN De-an(Department of Gastroenterolegy, Tongji Hospital, Tongji Medical University, WuhanPeter MalfertheinerDepartment of Gastroenterolegy and Metabolism, Internal Medicine H ,Ulm University, Germany) Abteilung für Gastroenterologie Tongji Klinik Tongji medizinische Universität.

The tissue culture and autoradiography techniques were used to study the effect of infiltration by inflammatory cells and of HP infection on the synthesis of glycoproteins by the gastric antrum. The results showed that in active phase of gastritis, the synthesis of glycoprotein was increased but no correlation between HP infection and synthesis of glycoprotein was noted. The machanism of increased synthesis in chronic gastritis was discussed. It is suggested that the inflammatory cells and media released by them may play important role.

关键词： gastritis glycoproteinshelicobacter pylori

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