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| 1 | Measurement of calprotectin in ascitic fluid to identify elevated polymorphonuclear cell count显示文摘AIM: To evaluate the diagnostic capability of calprotectin in ascitic fluid for detecting a polymorphonuclear (PMN) cell count > 250/μL ascites. METHODS: In this prospective observational study, a total of 130 ascites samples were analysed from 71 consecutive patients referred for paracentesis. Total and differential leukocyte cell counts were determined manually with a Neubauer chamber and gentianviolet stain. Calprotectin was measured in 1 mL ascetic fluid by enzyme-linked immunosorbent assay (ELISA) and a point-of-care (POC) lateral flow assay with the Quantum Blue Reader (Bühlmann Laboratories). All measurements were carried out in a central laboratory by senior personnel blinded to patient history. A PMN count > 250/μL was the primary endpoint of the study. The diagnostic value of ascitic calprotectin measurement was assessed by comparing to the final diagnosis of each patient that had been adjudicated by investigators blinded to calprotectin values. RESULTS: The PMN count was > 250/μL in 19 samples (14.6%) from 15 patients (21.1%) and varied widely among the study population (range 10-19 800/mL and 1-17 820/mL, respectively). Spontaneous bacterial peritonitis (SBP) was the final diagnosis in four patients (5.6%). All patients with PMN ≤ 250/μL had negative bacterial culture. PMN count was elevated in five patients with peritoneal carcinomatosis, three with lymphoma, one with neuroendocrine carcinoma, and two with secondary peritonitis due to abdominal perforation. PMN cell counts correlated with ascitic calprotectin values (Spearman's rho; r = 0.457 for ELISA, r = 0.473 for POC). A considerable range of ascitic calprotectin concentrations was detected by ELISA [median 0.43 μg/mL, interquartile range (IQR) 0.23-1.23 (range 0.10-14.93)] and POC [median 0.38 μg/mL, IQR 0.38-0.56 (range 0.38-13.31)]. Ascitic calprotectin levels were higher in samples with PMN > 250/μL, by both ELISA [median (IQR) 2.48 μg/mL (1.61-3.65) vs 0.10 μg/mL (0.10-0.36), P < 0.001] and POC [2.78 μg/mL (2.05-5.37) vs 0.38 μg/mL (0.38-0.41), P < 0.001]. The area under the receiver operating characteristics curve for identifying an elevated PMN count was 0.977 (95%CI: 0.933 to 0.995) for ELISA and 0.982 (95%CI: 0.942 to 0.997) for POC (P = 0.246 vs ELISA). Using the optimal cut-off value for ELISA (0.63 μg/mL), ascitic calprotectin had 94.8% sensitivity, 89.2% specificity, positive and negative likelihood ratios of 8.76 and 0.06 respectively, positive and negative predictive values of 60.0% and 99.0% respectively, and 90.0% overall accuracy. Using the optimal cut-off value for POC (0.51 μg/mL), the respective values were 100.0%, 84.7%, 6.53, 0.00, 52.8%, 100% and 87.7%. Correlation between ELISA and POC was excellent (r = 0.873, P < 0.001). The mean ± SD of the difference was -0.11 ± 0.48 μg/mL with limits of agreement of + 0.8 μg/mL (95%CI: 0.69 to 0.98) and -1.1 μg/mL (95%CI: -1.19 to -0.91). CONCLUSION: Ascitic calprotectin reliably predicts PMN count > 250/μL, which may prove useful in the diagnosis of SBP, especially with a readily available bedside testing device. | Emanuel Burri Felix Schulte Jürgen Muser Rémy Meier Christoph Beglinger | 2013 | World Journal of Gastroenterology2013，19，13： | 10 |
| 2 | Clinical and histopathological correlations of fecal calprotectin release in colorectal carcinoma显示文摘AIM:To determine calprotectin release before and after colorectal cancer operation and compare it to tumor and histopathological parameters.METHODS:The study was performed on patients with diagnosed colorectal cancer admitted for operation.Calprotectin was measured in a single stool sample before and three months after the operation using an enzymelinked immunosorbent assay(ELISA).Calprotectin levels greater than or equal to 50μg/g were considered positive.The compliance for collecting stool samples was assessed and the value of calprotectin was correlated to tumor and histopathological parameters of intra-and peri-tumoral inflammation.Surgical specimens were fixed in neutral buffered formalin and stained with hematoxylin and eosin.Staging was performed according to the Dukes classification system and the 7th edition tumor node metastasis classification system.Intra-and peri-tumoral inflammation was graded according to the Klintrup criteria.Immunohistochemical quantification was performed for MPO,CD45R0,TIA-1,CD3,CD4,CD8,CD57,and granzyme B.Statistical significance was measured using Wilcoxon signed rank test,Kruskal Wallis test and Spearman’s rank correlation coefficient as appropriate.RESULTS:Between March 2009 and May 2011,80 patients with colorectal cancer(46 men and 34 women,with mean age of 71±11.7 years old)were enrolled in the study.Twenty-six patients had rectal carcinoma,29 had left-side tumors,23 had right-side tumors,and2 had bilateral carcinoma.In total,71.2%of the patients had increased levels of calprotectin before the operation(median 205μg/g,range 50-2405μg/g)and experienced a significant decrease three months after the operation(46μg/g,range 10-384μg/g,P<0001).The compliance for collecting stool samples was 89.5%.Patients with T3 and T4 tumors had significantly higher values than those with T1 and T2 cancers(P=0.022).For all other tumor parameters(N,M,G,L,V,Pn)and location,no significant difference in calprotectin concentration was found.Furthermore,the calprotectin levels and histological grading of both peri-and intra-tumoral inflammation was not correlated.Additional testing with specific markers for lymphocytes and neutrophils also revealed no statistically significant correlation.CONCLUSION:Fecal calprotectin decreases significantly after colorectal cancer operation.Its value depends exclusively on the individual T-stage,but not on other tumor or histopathological parameters. | Frank Serge Lehmann Francesca Trapani Ida Fueglistaler Luigi Maria Terracciano Markus von Flüe Gieri Cathomas Andreas Zettl Pascal Benkert Daniel Oertli Christoph Beglinger | 2014 | World Journal of Gastroenterology2014，20，17： | 6 |
| 3 | Carbon dioxide accumulation during analgosedated colonoscopy: Comparison of propofol and midazolam显示文摘AIM: To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS: Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation (SpO 2 ) was measured by pulse oximetry (POX), and capnography (PcCO 2 ) was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points: baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. The number of patients in both study groups who regained baseline PcCO 2 values (± 1.5 mmHg) five minutes after the procedure was determined.RESULTS: A total of 97 patients entered this study. The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. Therefore, 83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n = 42) or midazolam (n = 41) for sedation. Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups, respectively]. A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms. The mean SpO 2 at baseline (%) was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of hypoxemia (SpO 2 < 85%) or apnea were recorded. However, an increase in PcCO 2 that indicated alveolar hypoventilation occurred in both groups after administration of the first drug and was not detected with pulse oximetry alone. The mean interval between the initiation of sedation and the time when the PcCO 2 value increased to more than 2 mmHg was 2.8 ± 1.3 min for midazolam and 2.8 ± 1.1 min for propofol. The mean maximal rise was similar for both drugs: 8.6 ± 3.7 mmHg for midazolam and 7.4 ± 3.2 mmHg for propofol. Five minutes after the end of the procedure, the mean difference from the baseline values was significantly lower for the propofol treatment compared with midazolam (0.9 ± 3.0 mmHg vs 4.3 ± 3.7 mmHg, P = 0.0000169), and significantly more patients in the propofol group had regained their baseline value ± 1.5 mmHg (32 of 41vs 12 of 42,P = 0.0004). CONCLUSION: A significantly higher number of patients sedated with propofol had normalized PcCO 2 values five minutes after sedation when compared with patients sedated with midazolam. | Ludwig T Heuss Shajan Peter Sugandha Christoph Beglinger | 2012 | World Journal of Gastroenterology2012，18，38： | 3 |
| 4 | Budesonide Is Effective in Adolescent and Adult Patients With Active Eosinophilic Esophagitis显示文摘 | Alex Straumann Sebastien Conus Lukas Degen Stephanie Felder Mirjam Kummer Hansjürg Engel Christian Bussmann Christoph Beglinger Alain Schoepfer Hans–Uwe Simon | 2010 | Gastroenterology2010，，： | 2 |
| 5 | Long-Term Budesonide Maintenance Treatment Is Partially Effective for Patients With Eosinophilic Esophagitis显示文摘 | Alex Straumann Sebastien Conus Lukas Degen Cornelia Frei Christian Bussmann Christoph Beglinger Alain Schoepfer Hans–Uwe Simon | 2011 | Clinical Gastroenterology and Hepatology2011，，： | 2 |
| 6 | Glucagon-like peptide 1 receptor expression in primary porcine proximal tubular cells显示文摘 | P. Schlatter C. Beglinger J. Drewe H. Gutmann | 2007 | Regulatory Peptides2007，，1： | 2 |
| 7 | Two molecular forms of peptide Y(PYY) are abundant in human blood:characterization of a radioimmunoassay recognizing PYY1-36 and PYY3-36显示文摘 | GRANDT D SEHIMIEZEK M BEGLINGER C | | 0，，02： | 1 |
| 8 | Changing patterns of sedationand monitoring practrice during endoscopy:results of ana tionwide survey in Switzerland显示文摘 | Heuss LT Froehlich F Beglinger C | 2005 | Endosco()2005，1，2： | 1 |
| 9 | Loxiglumide, a CCK- A receptor antagonist, stimulates calorie intake and hunger feelings in humans 显示文摘 | Beglinger C Degen L Matzinger D | 2001 | Am J Physiol Regul Integr2001，280，4： | 1 |
| 10 | Metabolic and Hormonal Changes After Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: a Randomized, Prospective Trial显示文摘 | Ralph Peterli Robert Steinert Bettina Woelnerhanssen Thomas Peters Caroline Christoffel-Courtin Markus Gass Beatrice Kern Markus Fluee Christoph Beglinger | 2012 | Obesity Surgery2012，，5： | 1 |
| 11 | Effects of budesonide on P-glycoprotein expression in intestinal cell lines 显示文摘 | MAIER A ZIMMERMANN C BEGLINGER C | 2007 | Br J Pharmo~ol2007，150，3： | 1 |
| 12 | Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn's disease (SES-CD) than CRP, blood leukocytes, and the CDAI显示文摘 | Schoepfer AM Beglinger C Straumann A | 2010 | Am J Gastroenterol2010，105，1： | 1 |
| 13 | A critical competency: determining and communicating the number of nurses you must hire显示文摘 | Beglinger JE | 2007 | Nurs Econ2007，25，3： | 1 |
| 14 | Pseudotumor of the pancreatic hlead associated with idiopathic retroperitoneal fihrosis显示文摘 | Wiesner W Kocher T Beglinger C | 2001 | Dig Surg2001，18，5： | 1 |
| 15 | Fragility of the esophageal mucosa: A pathognomonic endoscopic sign of primary eosinophilic esophagitis?显示文摘 | Alex Straumann Livio Rossi Hans-Uwe Simon Pius Heer Hans-Peter Spichtin Christoph Beglinger | 2003 | Gastrointestinal Endoscopy2003，，： | 1 |
| 16 | SPINK1/PSTI mutations are associated with tropical pancreatitis and type II diabetes mellitus in Bangladesh显示文摘 | Alexander Schneider Amitabh Suman Livio Rossi M.Michael Barmada Christoph Beglinger Shahana Parvin Soheli Sattar Liaquat Ali A.K.Azad Khan Niklaus Gyr David C. Whitcomb | 2002 | Gastroenterology2002，，4： | 1 |
| 17 | Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years显示文摘 | Alex Straumann Hans-peter Spichtin Leticia Grize Kathleen A Bucher Christoph Beglinger Hans-uwe Simon | 2003 | Gastroenterology2003，，： | 1 |
| 18 | The role of octreotide in the treatment of gastroenteropancreatic endocrine tumors 显示文摘 | Degen L Beglinger C | 1999 | Digestion1999，60，2： | 1 |
| 19 | Fecal cal- protectin correlates more closely with the Simple Endo- scopic Score for Crohnrs disease (SES-CD) than CRP, blood leukocytes,and the CDAI显示文摘 | Schoepfer AM Beglinger C Straumann A | 2010 | Am J Gastroenterol2010，105，1： | 1 |
| 20 | Nutrition in pancreatic diseases 显示文摘 | Meier RF Beglinger C | 2006 | Best Practiceand Research Clinical Gastroenterology2006，20，3： | 1 |
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