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Prevalence of hepatitis B virus precore stop codon mutations in chronically infected children

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World Journal of Gastroenterology 2006年第14期12卷 2235-2238页

作者： Philip Wintermeyer Patrick Gerner Stephan Gehring Afshin Karimi Stefan Wirth Children's Hospital Helios Klinikum Wuppertal Witten-Herdecke UniversityGermany Children's Hospital university of Mainz Germany

AIM： To find out whether there is a significant difference in the prevalence of the precore stop codon mutation between HBeAg positive and anti-HBe positive children. METHODS： We investigated a large pediatric population of 155 European children （mean age 10.9 years） with chronic hepatitis B by PCR and direct sequencing. Ninety were HBeAg positive and 65 had seroconversion to anti-HBe. Additionally genotyping was performed. RESULTS： Seventy-four （48%） of the sequenced HBV strains were attributed to genotype D and 81 （52%） to genotype A. In the group of 90 HBeAg positive patients, 2 （2.2%） 1896-G-to-A transitions leading to precore stop codon mutation were found, and in the group of 65 anti-HBe positive children, 5 （7.7%） were identified harbouring HBeAg-minus mutants. The difference was not statistically significant （P= 0.13）. CONCLUSIONS： HBeAg minus variants as predominant viral HB strains play a minor role in the course of chronic hepatitis B in European children.

关键词： Hepatitis B Precore mutants Children HBeAg minus variants

Cartilage repair techniques of the talus: An update

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World Journal of Orthopedics 2014年第3期5卷 171-179页

作者： Mike H Baums Wolfgang Schultz Tanja Kostuj Hans-Michael Klinger university of G?ttingen Medical Centre Aukamm Klinik Gmb HD-65191 WiesbadenGermany Department of Orthopaedic Surgery University of G?ttingen Medical Centre (UMG)Georg-August-UniversityD-37099 G?ttingenGermany Institute of Medical Biometrics and Epidemiology University of Witten/HerdeckeD-58448 WittenGermany

Symptomatic chondral or osteochondral defects of the talus reduce the quality of life of many *** their pathomechanism is well understood,it is well known that different aetiologic factors play a role in their ***,it is well recognised that the talar articular cartilage strongly differs from that in the *** this fact,many recommendations for the management of talar cartilage defects are based on approaches that were developed for the *** treatment seems to work best in paediatric and adolescent patients with osteochondritis ***,depending on the size of the lesions,surgical approaches are necessary to treat many of these *** marrow stimulation techniques may achieve good results in small *** lesions may be treated by open procedures such as osteochondral autograft transfer or allograft *** chondrocyte transplantation,as a restorative procedure,is well investigated in the knee and has been applied in the talus with increasing popularity and promising results but the evidence to date is *** goals of the current article are to summarise the different options for treating chondral and osteochondral defects of the talus and review the available literature.

关键词： Cartilage defect Talus Repair techniques Arthroscopy Marrow stimulation Mosaicplasty Autologous chondrocyte implantation

Deepening trochleoplasty combined with balanced medial patellofemoral ligament reconstruction for an adequate graft tensioning

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World Journal of Orthopedics 2017年第12期8卷 935-945页

作者： Lars V von Engelhardt Pia Weskamp Matthias Lahner Gunter Spahn Joerg Jerosch Faculty of Health University of Witten/Herdecke Depart-ment of Orthopedics Trauma Surgery and Sports MedicineJohanna Etienne Hospital Joint Center Hilden and Ruhr-university Bochum Center of Trauma and Orthopedic Surgery Jena University Hospital

AIM To evaluate our modified deepening trochleoplasty com-bined with a balanced medial patellofemoral ligament(MPFL) reconstruction for soft tissue alignement. METHODS Thirty-three knees with with recurrent patellar dislocations and a trochlear dysplasia in 30 patients(m/f = 12/21, mean age 24 ± 9 years) underwent a combination of a modified deepening trochleoplasty and a balanced MPFL reconstruction for a medial soft tissue alignement. After a mean follow-up period of 29 ± 23 mo, patients' return to sports, possible complications as well as the clinical outcomes using the Kujala, International Knee Documentation Committee(IKDC) and Lysholm scoring were evaluated. Moreover, patients' satisfaction with the general outcome, the cosmetic outcome, the pre-and postoperative pain and a potential avoidance behaviour were assessed with additional standardized questionnaires which also included different visual analog scales. RESULTS There were no signs of a persistent instability. The Kujala score improved from a mean of 64 ± 16 points to 94 ± 9 points, the Lysholm score improved from a mean of 63 ± 17 to 95 ± 6 points and the IKDC score from 58 ± 11 to 85 ± 12 points, P < 0.0001, respectively. The assessment of pain using a visual analog scale showed a significant pain reduction from a mean of 4.8 ± 2.0 to 1.3 ± 3.4 points(P < 0.0001). Two of 26 cases(92%) who were engaged in regular physical activity before surgery did not return to full sporting activities. One patient felt that his sport was too risky for his knee and reported an ongoing avoidance behaviour. The other patient preferred to wait for surgery of her contralateral knee. Of the eight patients who were not engaged in sporting activities before surgery, three started regular sporting activities after surgery. In 31 of the 33 cases(94%), the patients were very satisfied with the clinical outcome of the surgery. Regarding the cosmetic results, no patients felt impaired in their self-confidence and in their clothi

关键词： Trochlea dysplasia Medial-patellofemoral ligament Patellofemoral instability Patella dislocation Trochleoplasty

用SpREUK-SF10问卷快速测评慢性病患者的精神追求和宗教信仰(英文)

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中西医结合学报 2010年第9期8卷 832-841页

作者： Arndt Bssing Center of Integrative Medicine Quality of Live Spirituality and Coping university of witten/herdecke

背景:越来越多的证据表明精神因素对健康有一定影响。测评精神状况的方法要适合所研究的人群。SpREUK问卷的设计便是为了更好地研究世俗社会中的慢性病患者如何看待精神因素对其健康的影响及其如何对待疾病。目的:本文描述可能适用于生... 详细信息

背景:越来越多的证据表明精神因素对健康有一定影响。测评精神状况的方法要适合所研究的人群。SpREUK问卷的设计便是为了更好地研究世俗社会中的慢性病患者如何看待精神因素对其健康的影响及其如何对待疾病。目的:本文描述可能适用于生活在世俗社会中的病人的SpREUK问卷这一评价工具的产生背景及其心理测量功能,并总结在德国病人中的验证结果。设计和受试者:采用横断面研究,对496位平均年龄(53.5±14.4)岁的慢性病患者(84%为慢性疼痛,6%为癌症,10%为其他疾病)进行问卷调查,问卷由受试者自行完成。结局指标:我们旨在设计一种SpREUK问卷的缩减版(SpREUK-SF10),并检测其因子结构及概念效度,同时使用该问卷测评患者的精神实践参与度(SpREUK-P)、生活满意度(BMLSS)及对疾病的理解(IIQ)。结果:这一问卷具有良好的心理测量功能,区分了3个心理因素,分别是:(1)信仰;(2)寻求精神/宗教支持;(3)对疾病的积极理解。其中,对疾病的积极理解与信仰和寻求支持有一定关联,揭示了其在精神层面的内涵。结论:SpREUK-SF10问卷对于不单一信仰或反对某一宗教的世俗社会中人们的精神因素有较好的测评作用。适合其他文化背景的问卷还有待进一步研究开发。

关键词：精神宗教世俗社会生活质量慢性病问卷效度

Globalised world, globalised diseases: A case report on an amoebiasis-associated colon perforation

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World Journal of Clinical Cases 2013年第2期1卷 79-81页

作者： Marcus Redaèlli Jawad Mahmoohdzad Rahim Lang Martin Schencking Institute of General Practice University of Düsseldorf’s Medical School Institute for General Practice and Family Medicine University of Witten/Herdecke’s Medical School Department for Visceral Surgery Elbe Klinik Buxtehude 21614 Buxtehude Germany

In 2010 the World Health Organisation estimated the number of infections with Entamoeba histolytica at about 50 million cases including 100000 fatal courses. In most cases this infection is a subclinical event with few or none symptoms noticeable for the patient. Courses of this disease and incidence of this parasite in industrialised nations are not yet fully investigated. Our case reports about a 68-year-old male patient from Turkey who lives for more than 30 years in Germany and had not been abroad during the past 2 years. Resistant asymptomatic amoebic dormant bodies caused an emergency-laparoscopy and revealed the seldom complication of a colon perforation. In the age of globalisation all providers in the health care systems are urged to acquaint themselves also with non-typical syndromes for the countries they work in order to reduce preventable morbidity respectively mortality rates.

关键词： Amoebiasis Entamoeba histolytica Colon perforation Surgical treatment

Stapled Trans-Anal Rectal Resection (STARR) for Obstructive Defecation Syndrome—Functional Outcome and Quality of Life after Two Years

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International Journal of Clinical Medicine 2016年第3期7卷 217-224页

作者： Mike Ralf Langenbach Alexandre Berengolts Helios St. Elisabeth Klinik Oberhausen Department of Surgery II University of Witten/Herdecke Oberhausen Germany

Background: Stapled transanal rectal resection (STARR) has been shown to improve patients’ functional and quality of life outcomes in several studies. Although it is a safe and effective treatment for obstructive defecation syndrome, still data on long-term follow-up are missing. Methods: From January 2010 to July 2014, 46 consecutive patients undergoing STARR using the CONTOUR® TRANSTAR™ device, shortly named TRANSTAR (transanal stapler assisted resection), were prospectively followed. Recurrence rate, quality of life (Patient Assessment of Constipation-Quality of Life (PAC-Qol)) and complication were documented at baseline, 12 and 24 months after operation. Two subgroups of patients were compared to assess the impact of resection length on outcome. Results: We included 46 patients (89% female) in the study. The mean age was 65 ± 16 years and the duration of the operation was 48 ± 4 min. Total PAC-QoL score improved from 2.0 (SD 0.3) to 0.9 (1.4) after 12 months, but deteriorated to 1.2 (0.3) after 24 months (p < 0.001 for both comparisons). Complications were noted in 7% of the patients: Urinary retention (2 patients), postoperative bleeding (1 patient). No major complications or mortality were seen. After one year, we had one prolapse recurrence and after 24 month we had another. There was no significant relation between the length of the specimen and the improvement of life quality. Conclusions: The STARR procedure seems to be a safe and fast therapeutic option for patients with ODS and/or rectal prolapse. It is a tailored transanal full-thickness rectal resection improving the patients’ quality of life still two years after the operation.

关键词： STARR Obstructive Defecation Syndrome External Rectal Prolapse Transanal Approach Constipation

Evaluation of a Barrier Repair Cream Containing Pseudo-Ceramide for Practical Use by Hairdressers with Hand Skin Disorders Due to Daily Exposure to Chemical Irritants

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Journal of Cosmetics, Dermatological Sciences and Applications 2013年第4期3卷 263-270页

作者： Akihiko Takahashi Annette Kirst Ulrike Heinrich Akira Kiyomine Koichi Ishida Hagen Tronnier Heintz Theis Takahiro Nishizaka Hisateru Tanabe Derma Tronnier University of Witten-Herdecke Witten Germany Kao Corporation Skin Beauty Laboratories Tokyo Japan Kao Germany European Research Laboratories Darmstadt Germany

Hairdressers are exposed to numerous skin-damaging factors, such as wet work, skin irritants, and thermal changes. Skin protection is a very important factor for the prevention of occupational skin disorders. Therefore, we evaluated a hand cream that was specially formulated for highly stressed skin with regard to its capability to reduce dry, rough, and scaly skin. The objective of this study was to conduct a controlled use test of a barrier repair cream containing pseudo-ceramide and demonstrate its efficacy for hairdressers with dry, sensitive hands and/or occupational skin disorders. A total of 30 hairdressers (29 females and 1 male, aged 20 - 67) participated in the study. All subjects suffered from dry hands. Subjects applied the test cream on their hands for 28 days (four weeks). For each subject, the skin surface topography of the hands was measured by the Surface Evaluation of Living Skin (SELS) system at day 14 (week 2) and day 28 (week 4). Dryness, scaling, cracking, redness, and itchiness were evaluated and graded by experts at week 2 and week 4, and then compared to baselines. All 30 subjects completed the study. A comparison of the changes from baseline to endpoint revealed a statistically significant reduction in skin roughness, scaling, and volume measured according to SELS. These data were confirmed by photographic documentation. The results were further supported by the expert evaluation. For the symptoms dryness and scaling, improvement could be observed in almost all regions of the hands. In addition, according to subjective assessments of overall hand skin condition and the hand cream, subjects reported clear improvement over time (p value below 0.001) and good efficacy of the product. In this study, the test hand cream showed excellent skin compatibility. Therefore, the hand cream may be effective for hairdressers with dry, sensitive hands and/or occupational skin disorders.

关键词： Occupational Skin Disorder Hairdresser Dermatological Controlled Use Test Pseudo-Ceramide Barrier Cream Topical Hand Care

Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy

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World Journal of Gastroenterology 2015年第38期21卷 10915-10925页

作者： Dirk R Bulian Jurgen Knuth Kai S Lehmann Axel Sauerwald Markus M Heiss Department of Abdominal Vascular and Transplant SurgeryCologne-Merheim Medical CenterWitten/Herdecke University Department of General VisceralVascular and Thoracic SurgeryHospital of Kempten Department of General Visceral and Vascular SurgeryCharite? University Medical Center BerlinCampus Benjamin Franklin Department for Obstetrics and Gynaecology Holweide Holweide Hospital

AIM: To evaluate transvaginal hybrid-NOTES cholecystectomy(TVC) during its clinical establishment and compare it with the traditional laparoscopic technique(LC).METHODS: The specific problems and benefits of TVC were reviewed using a registry analysis,a comparative cohort study and a randomized clinical trial. At first,feasibility,safety and specific complications of the TVC were analyzed based on the first 488 data sets of the German NOTES Registry(GNR). Hereafter,we compared the early postoperative results of our first 50 TVC-patients with those of 50 female LCpatients matched by age,BMI and ASA classification. The same cohort was contacted an average of two years later to evaluate long-term results concerning pain and satisfaction with the aesthetic results and the overall postoperative results as well as sexual intercourse by means of two domains of the German version of the Female Sexual Function Index(FSFI-d). Consequently,we performed a randomized clinical trial comparing 20 TVC-patients with 20 needlescopic/3-trocar cholecystectomies(NC) also concerning the early postoperative results as well as pain,satisfaction and quality of life by means of the Eypasch Gastrointestinal Quality of Life Index(GIQLI) in the later course. Finally,we discussed the results in accordance with other published ***: The complication(3.5%) and conversion rates(4.1%) for TVC were low in the GNR and comparable to those of the LC. Access related intraoperative complications included injuries to the bladder(n = 4; 0.8%) and bowel(n = 3; 0.6%). The study cohort revealed less postoperative pain after TVC comparing to the LC-patients on the day of surgery(NRS,1.5/10 vs 3.1/10,P = 0.003),in the morning(NRS,1.9/10 vs 2.8/10,P = 0.047) and in the evening(NRS,1.1/10 vs 1.8/10,P = 0.025) of postoperative day(POD) one. The randomized clinical trial consistently found less cumulative pain until POD 2(NRS,8/40 vs 14/40,P = 0.043),as well as until POD 10(NRS,22/190 vs 41/190,P = 0.010)

关键词： NOTES Cholecystolithiasis Postoperative complicati

Acute acalculous cholecystitis due to infectious causes

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World Journal of Clinical Cases 2021年第23期9卷 6674-6685页

作者： Ioulia Markaki Afroditi Konsoula Lamprini Markaki Nikolaos Spernovasilis Marios Papadakis Department of Emergency General Hospital of Kythira“Trifyllio”Kythira 80200Greece Department of Emergency General Hospital of Mytilene"Vostaneio"Lesvos 81132Greece Department of Pediatrics "Agia Sofia"Children's HospitalAthens 11527Greece School of Medicine University of CreteHeraklion 71003Greece Department of Surgery II University of Witten-HerdeckeWuppertal 40235NRWGermany

Acute acalculous cholecystitis(AAC)is an inflammation of the gallbladder not associated with the presence of *** usually occurs in critically ill patients but it has also been implicated as a cause of cholecystitis in previously healthy *** this subgroup of patients,infectious causes comprise the primary ***,herein,discuss the pathophysiological mechanisms involved in AAC,focusing on the infectious *** associated with critical medical conditions is caused by bile stasis and gallbladder *** mechanisms are reported to be involved in AAC in patients without underlying critical illness including direct invasion of the gallbladder epithelial cells,gallbladder vasculitis,obstruction of the biliary tree,and *** emphasize that multiple pathogenic mechanisms may concurrently contribute to the development of AAC in varying *** of the implicated pathogens is essential since it will allow a more focused examination of the histopathological *** conclusion,additional research and a high degree of clinical suspicion are needed to clarify the complex spectrum of mechanisms that are involved in the pathogenesis of AAC.

关键词： Cholecystitis Infectious causes Vasculitis Sequestration Epstein-Barr virus