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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

Arterial thrombosis in the context of HCV-associated vascular disease can be prevented by protein C

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Cellular & Molecular immunology 2017年第12期14卷 986-996页

作者： Philipp Blüm Joachim Pircher Monika Merkle Thomas Czermak Andrea Ribeiro Hanna Mannell Florian Krötz Alexander Hennrich Michael Spannagl Simone Köppel Erik Gaitzsch Markus Wörnle medizinische klinik und poliklinik iV InnenstadtKlinikum der Universität München80336 MünchenGermany Walter Brendel Centre of Experimental Medicine and Munich Heart Alliance Ludwig Maximilians University München80336 MünchenGermany medizinische klinik und poliklinik i Klinikum der Universität München80336 MünchenGermany Abteilung für Transfusionsmedizin Zelltherapeutika und HämostaseologieKlinikum der Universität München80336 MünchenGermany

Hepatitis C virus(HCV)infection is a major problem *** is not limited to liver disease but is frequently complicated by immune-mediated extrahepatic manifestations such as glomerulonephritis or vasculitis.A fatal complication of HCV-associated vascular disease is ***:polyribocytidylic acid(poly(i:C)),a synthetic analog of viral RNA,induces a Toll-like receptor 3(TLR3)-dependent arteriolar thrombosis without significant thrombus formation in venules in *** procoagulant effects are caused by increased endothelial synthesis of tissue factor and PAi-1 without platelet *** addition to human umbilical endothelial cells(HUVEC),human mesangial cells(HMC)produce procoagulatory factors,cytokines and adhesion molecules after stimulation with poly(i:C)or HCV-containing cryoprecipitates from a patient with a HCV infection as *** protein C(APC)is able to prevent the induction of procoagulatory factors in HUVEC and HMC in vitro and blocks the effects of poly(i:C)and HCV-RNA on the expression of cytokines and adhesion molecules in HMC but not in *** vivo,protein C inhibits poly(i:C)-induced arteriolar ***,endothelial cells are de facto able to actively participate in immune-mediated vascular thrombosis caused by viral ***,we provide evidence for the ability of protein C to inhibit TLR3-mediated arteriolar thrombosis caused by HCV infection.

关键词： hepatitis C thrombosis toll-like receptor 3

速激肽对大鼠小肠上行及下行反射通路的作用(英文)

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Acta Pharmacologica Sinica 2002年第4期23卷 3-9页

作者： Andreas HAHN, Martin STORR, Hans-Dieter ALLESCHER(// medizinische klinik und poliklinik der Technischen Universitat Munchen, 81675 Munchen, Germany) ll medizinische klinik und poliklinik der Technischen Universitat München 81675 Mtnchen 德国 ll medizinische klinik und poliklinik der Technischen Universitat München 81675 Mtnchen1 德国

AiM: To examine the effect of tachykinins on the ascending reflex pathway in rat small intestine, we used different selective neurokinin (NK) receptor antagonists (RA); a) NK1-RA; GR-82334 and CP-96.345, b) NK2-RA: MEN-10.376 and L-659.877. The aim was further to investigate the effect of substance P (SP) on the ascending excitatory and descending inhibitory reflex pathway. METHODS: The whole segments of rat ileum (10 cm in length) were studied in an organ bath. Ascending contraction of circle muscle was elicited by anal electrical stimulation (3 Hz, 1ms, 20 V) and measured as change of intraluminal pressure by a perfused manometric system 2 cm and 4 cm orad of the stimulation site. RESULTS: GR-82334 and CP-96.345 (NK1-RA) caused a significant dose-related inhibition of the oral contraction at a distance of 4 cm: GR-82334 [area: -10 % ± 8 % (10 nmol/L); - 29 %±10 % (1000 nmol/L). P il

关键词：速激肽类神经激肽-1受体神经激肽-2受体 P物质

Open label trial of granulocyte apheresis suggests therapeutic efficacy in chronically active steroid refractory ulcerative colitis

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World Journal of Gastroenterology 2005年第44期11卷 7001-7006页

作者： Wolfgang Kruis Axel Dignass Elisabeth Steinhagen-Thiessen Julia Morgenstern Joachim M(o|¨)ssner Stephan Schreiber Maurizio Vecchi Alberto Malesci Max Reinshagen Robert L(o|¨)fberg Evangelisches Krankenhaus Kalk medizinische klinik für Hepatologie und Gastroenterologie medizinische klinik und poliklinik Ⅱ medizinische klinik Dep of int Medicine iRCCS Ospedale Policlinico istituto Clinico Humanitas innere Medizin Karolinska institute at the iBD unit

AiM： To study the efficacy, safety, and feasibility of a granulocyte adsorptive type apheresis system for the treatment of patients with chronically active ulcerative colitis despite standard therapy. METHODS： An open label multicenter study was carried out in 39 patients with active ulcerative colitis （CAi 6-8） despite continuous use of steroids （a minimum total dose of 400 mg prednisone within the last 4 wk）. Patients received a total of five aphereses using a granulocyte adsorptive technique （Adacolumn, Otsuka Pharmaceutical Europe, UK）. Assessments at wk 6 and during follow-up until 4 mo comprised clinical （CAi） and endoscopic （Ei） activity index, histology, quality of life （iBDQ）, and laboratory tests. RESULTS： Thirty-five out of thirty-nine patients were qualified for intent-to-treat analysis. After the apheresis treatment at wk 6, 13/35 （37.1%） patients achieved clinical remission and 10/35 （28.6%） patients had endoscopic remission （CAi〈4, Ei〈4）. Quality of life （iBDQ） increased significantly （24 points, P〈0.01） at wk 6. Apheresis could be performed in all but one patient. Aphereses were well tolerated, only one patient experienced anemia. CONCLUSiON： in patients with steroid refractory ulcerative colitis, five aphereses with a granulocyte/ monocyte depleting filter show potential short-term efficacy. Tolerability and technical feasibility of the procedure are excellent.

关键词： Steroid Refractory colitis Ulcerative colitis Granulocyte Apheresis

Management of occluded self-expanding biliary metal stents in malignant biliary disease

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Hepatobiliary & Pancreatic Diseases international 2018年第1期17卷 49-54页

作者： Simon Nennstiel isolde Tschurtschenthaler Bruno Neu Hana Algül Monther Bajbouj Roland M. Schmid Stefan von Delius Andreas Weber klinik und poliklinik fur innere Medizin Ⅱ Klinikum rechts der Isar der Technischen Universitar Manchen Ismaninger Straβe 22 Munich 81675 Germany medizinische klinik ii Krankenhaus Landshut-Achdorf Academic Teaching Hospital Technische Universitar Munchen Achdorferweg 3 Landshut 84036Germany

Background: Occlusion of self-expanding metal stents(SEMS) in malignant biliary obstruction occurs in up to 40% of patients. This study aimed to compare the different techniques to resolve stent occlusion in our collective of ***: Patients with malignant biliary obstruction and occlusion of biliary metal stent at a tertiary referral endoscopic center were retrospectively identified between April 1, 1994 and May 31, 2014. The clinical records were further analyzed regarding the characteristics of patients, malignant strictures, SEMS,management strategies, stent patency, subsequent interventions, survival time and case ***: A total of 108 patients with biliary metal stent occlusion were identified. Seventy-nine of these patients were eligible for further analysis. Favored management was plastic stent insertion in 73.4% patients. Second SEMS were inserted in 12.7% patients. Percutaneous transhepatic biliary drainage and mechanical cleansing were conducted in a minority of patients. Further analysis showed no statistically significant difference in median overall secondary stent patency(88 vs. 143 days, P = 0.069), median survival time(95 vs. 192 days, P = 0.116), median subsequent intervention rate(53.4% vs. 40.0%, P = 0.501)and median case charge(€5145 vs. €3473, P = 0.803) for the treatment with a second metal stent insertion compared to plastic stent insertion. in patients with survival time of more than three months,significantly more patients treated with plastic stents needed re-interventions than patients treated with second SEMS(93.3% vs. 57.1%, P = 0.037).Conclusions: in malignant biliary strictures, both plastic and metal stent insertions are feasible strategies for the treatment of occluded SEMS. Our data suggest that in palliative biliary stenting, patients especially those with longer expected survival might benefit from second SEMS insertion. Careful patient selection is important to ensure a proper decision for either management

关键词： Self-expanding metal stents Biliary tract neoplasms Endoscopic retrograde cholangiopancreatography Biliary tract diseases Complications

Targeting metabolic rewiring might decrease spread of tumor cells: Mitochondrial tRNA modifications promote cancer metastasis

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Signal Transduction and Targeted Therapy 2022年第11期7卷 3987-3988页

作者： Maik Luu Alexander Visekruna Lehrstuhl für Zelluläre immuntherapie Medizinische Klinik und Poliklinik IIUniversitätsklinikum WürzburgWürzburgGermany institute for Medical Microbiology and Hygiene Philipps-UniversityMarburgGermany

in a recent study published in Nature,Delaunay and colleagues demonstrate that tRNA modifications in mitochondria have the potential to affect the synthesis of mitochondrial proteins involved in oxidative phosphorylation(OXPHOS),which drives the invasive spread of cancer *** inhibition of one particular RNA-modifying enzyme was sufficient to prevent the cancer cell invasion and dissemination.

关键词： invasion metastasis cancer

Diagnostische Bedeutung von pentavalenter ^(99m)Tc-Dimercaptobern-steinsure ([V]-DMSA) bei Kopf-Hals-Tumoren

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2000年第4期20卷 303-307页

作者：安锐 Abteilung für Nuklearmedizin Xiehe Hospital Tongji Medizinische Universität Wuhan klinik und poliklinik für Nuklearmedizin Universität Bonn Bonn Deutschland

The purpose of this investigation was to assess the biodistribution of 99mTc-[V]-DMSA in human being, and its di- agnostic value in patients with head and neck tumours. 20 patients with histologically confirmed head and neck tumours were ex- amined with planar as well as SPECT scintigraphy. Whole body scintigraphy in different time after injection of 99mTc-[V]-DM- SA was performed to assess the major sequential organ biodistribution. Our results showed that the blood clearance of 99mTc- [V]-DMSA was bi-exponential. All organs except kidneys showed a relatively rapid elimination of 99mTc-[V]-DMSA. The kid- neys showed a increasing accumulation in the first 2 h, which is probably due to the tubular reabsorption of 99mTc-[V]-DMSA. in 15 of 20 patients, 19 lesions could be proven by means of planar scintigraphy (corresponding sensitivity of 75%). 29 lesions in 18 patients could however be detected by the application of SPECT (corresponding sensitivity of 90%). Except primary tumours and local lymphadenmetastases in 5 patients distant metastases (3 thorax wall, 1 liver and 1 inguinal/paravesicle) were found. Altogether a sensitivity of 76. 9% and a specificity of 71. 4% were calculated for the detection of primary tumour. The sensitivi- ty and specificity for the exploration of lymphadenmetastases were 75% and 100%. in conclusion, this study shows that 99m Tc-[V]-DMSA, particularly with SPECT imaging, is useful in localising the primary tumours and lymphadenmetastases as well as distant metastases of head and neck tumours. The possible therapeutic application of 188/186Re-[V]-DMSA is also evaluated.

关键词： mTc-[V]-DMSA head and neck tumour: diagnosis

Gastrointestinal side effects in children with Wilson's disease treated with zinc sulphate

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World Journal of Gastroenterology 2013年第27期19卷 4356-4362页

作者： Anna Wiernicka Wojciech Jańczyk Maciej Dαdalski Yesim Avsar Hartmut Schmidt Piotr Socha Department of Gastroenterology Hepatology and Malnutritionthe Children's Memorial Health Institute klinik und poliklinik für Transplantationsmedizin University Hospital of Muenster

AiM:To investigate the side effects of a zinc sulphate therapy in a cohort of Polish pediatric patients with Wilson's disease. METHODS:We retrospectively analyzed a cohort of 53 pediatric patients with Wilson's disease treated at the Children's Memorial Health institute in Warsaw, Poland between the years 1996 and 2011 with zinc sulphate. Patients were diagnosed with Wilson's disease according to the scoring system of Ferenci, with 49 cases confirmed by mutation analysis. Data about the dosage scheme of zinc sulphate, side effects and efficacy and toxicity of the treatment were collected and recorded in the patient's medical chart at each visit to the hospital. RESULTS:Mean age of diagnosis for the entire cohort was 10 years (range, 2.5-17 years). Duration of treatment with zinc sulfate was 83.3 wk (range, 8-344 wk). Side effects, all of gastrointestinal origin, were observed in 21 patients (40% 9 males and 12 females), irrespective of the duration of therapy. Thirteen out of 21 patients were over the age of 10 years. The most common ATP7B mutation was p.H1069Q. Esophagogastroduodenoscopy, performed in 7 patients (33.3%) suffering from persistent and severe abdominal pain, revealed gastrointestinal ulcerations or erosions with negative Helicobacter pylori tests in all subjects investigated. The above mentioned 7 patients were treated with proton pump inhibitors. Three of those experienced resolution of symptoms, whereas proton-pump inhibitors failed to alleviate symptoms of the remaining four children and conversion of therapy to D-penicillamine was needed. CONCLUSiON:Zinc sulphate appears to cause significant gastrointestinal side effects, which children on therapy for Wilson's disease should be closely monitored for.

关键词： Wilson’s disease Zinc Abdominal pain Gastrointestinal ulcer Therapy

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