|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology显示文摘AIM:To report the largest patient cohort study investigating the diagnostic yield of intraductal ultrasound (IDUS) in indeterminate strictures of the common bile duct.METHODS:A patient cohort with bile duct strictures of unknown etiology was examined by IDUS.Sensitivity,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 surgery.Analysis of the endosonographic report allowed drawing conclusions with respect to the T and N staging in 147 patients.IDUS staging was compared to the postoperative histopathological staging data allowing calculation of sensitivity,specificity and accuracy rates for T and N stages.The 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 guidelines.For 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 included.Two hundred and sixty-four patients were referred to the department of surgery for operative exploration,thus surgical histopathological correlation was available for those patients.Out of 264 patients,174 had malignant disease proven by surgery,in 90 patients benign disease was found.In 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 sensitivity,specificity and accuracy ratesof 93.2%,89.5% and 91.4%,respectively.In the subgroup analysis of malignancy prediction,IDUS showed best performance in cholangiocellular carcinoma as underlying disease (sensitivity rate,97.6%) followed by pancreatic carcinoma (93.8%),gallbladder cancer (88.9%) and ampullary cancer (80.8%).A total of 133 patients were not surgically explored.32 patients had palliative therapy due to extended tumor disease in IDUS and other imaging modalities.Ninety-five patients had benign diagnosis by IDUS,forceps biopsy and radiographic imaging and were followed by a surveillance protocol with a follow-up of at least 12 mo;the mean follow-up was 39.7 mo.Tumor localization within the common bile duct did not have a significant influence on prediction of malignancy by IDUS.The accuracy rate for discriminating early T stage tumors (T1) was 84% while for T2 and T3 malignancies the accuracy rates were 73% and 71%,respectively.Relating to N0 and N1 staging,IDUS procedure achieved accuracy rates of 69% for N0 and N1,respectively.Limitations:Pretest likelihood of 52% may not rule out bias and overinterpretation due to the clinical scenario or other prior performed imaging tests.CONCLUSION:IDUS shows good results for accurate diagnostics of bile duct strictures of uncertain etiology thus allowing for adequate further clinical management. | Tobias Meister Hauke S Heinzow Carina Woestmeyer Philipp Lenz Josef Menzel Torsten Kucharzik Wolfram Domschke Dirk Domagk | 2013 | World Journal of Gastroenterology2013，19，6： | 19 |
| 2 | Clinical outcome and predictors of survival after TIPS insertion in patients with liver cirrhosis显示文摘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 implantation (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. Clinical 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 proportional hazards regression model. Results were expressed as medians and ranges. Comparisons between groups were performed by using the Mann-Whitney Utest and the χ 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) before TIPS to 11.8 ± 4.0 vs 11.7 ± 4.2 after TIPS implantation (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 bleeding group (P = 0.009). The number of radiological controls 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), MELD score (P = 0.001) and those patients not having undergone liver transplantation (P = 0.024) were significant predictors of survival. In the Cox regression model, stent occlusion (P = 0.022), RA (P = 0.043), CHILD stage (P = 0.015) and MELD score (P = 0.004) turned out to be independent prognostic factors of survival. The anticoagulation management (P = 0.097), the porto-systemic pressure gradient (P= 0.460) and rebleeding episodes (P = 0.765) had no significant effect on the overall survival. CONCLUSION:RA, stent occlusion, initial CHILD stage and MELD score are independent predictors of survival in patients with TIPS, speaking for a close follow-up in these circumstances. | Hauke S Heinzow Philipp Lenz Michael Khler Frank Reinecke Hansjrg Ullerich Wolfram Domschke Dirk Domagk Tobias Meister | 2012 | World Journal of Gastroenterology2012，18，37： | 17 |
| 3 | Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease显示文摘AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion. | Deha Erdogan Otto M van Delden Erik AJ Rauws Olivier RC Busch Johan S Lameris Dirk J Gouma Thomas M van Gulik | 2007 | World Journal of Gastroenterology2007，13，22： | 15 |
| 4 | Comparative analysis of ERCP,IDUS,EUS and CT in predicting malignant bile duct strictures显示文摘AIM:To compare endoscopic retrograde cholangio-pancreatography(ERCP),intraductal ultrasound(IDUS),endosonography(EUS),endoscopic transpapillary forceps biopsies(ETP)and computed tomography(CT)with respect to diagnosing malignant bile duct strictures.METHODS:A patient cohort with bile duct strictures of unknown etiology was examined by ERCP and IDUS,ETP,EUS,and CT.The sensitivity,specificity,and accuracy rates of the diagnostic procedures were calculated based on the definite diagnoses proved by histopathology or long-term follow-up in those patients who did not undergo surgery.For each of the diagnostic measures,the sensitivity,specificity,and accuracy rates were calculated.In all cases,the gold standard was the histopathologic staging of specimens or long-term follow-up of at least 12 mo.A comparison of the accuracy rates between the localization of strictures was performed by using the Mann-Whitney U-test and theχ2test as appropriate.A comparison of the accuracy rates between the diagnostic procedures was performed by using the McNemar’s test.Differences were considered statistically significant if P<0.05.RESULTS:A total of 234 patients(127 males,107 females,median age 64,range 20-90 years)with indeterminate bile duct strictures were included.A total of 161patients underwent operative exploration;thus,a surgical histopathological correlation was available for those patients.A total of 113 patients had malignant disease proven by surgery;in 48 patients,benign disease was surgically found.In these patients,the decision for surgical exploration was made due to the suspicion of malignant disease in multimodal diagnostics(ERCP,CT,or EUS).Fifty patients had a benign diagnosis and were followed by a surveillance protocol with a followup of at least 12 mo;the median follow-up was 34 mo.Twenty-three patients had extended malignant disease,and thus were considered palliative.A comparison of the different diagnostic tools for detecting bile duct malignancy resulted in accuracy rates of 91%(ERCP/IDUS),59%(ETP),92%(IDUS+ETP),74%(EUS),and 73%(CT),respectively.In the subgroup analysis,the accuracy rates(%,ERCP+IDUS/ETP/IDUS+ETP;EUS;CT)for each tumor entity were as follows:cholangiocellular carcinoma:92%/74%/92%/70%/79%;pancreatic carcinoma:90%/68%/90%/81%/76%;and ampullary carcinoma:88%/90%/90%/76%/76%.The detection rate of malignancy by ERCP/IDUS was superior to ETP(91%vs 59%,P<0.0001),EUS(91%vs74%,P<0.0001)and CT(91%vs 73%,P<0.0001);EUS was comparable to CT(74%vs 73%,P=0.649).When analyzing accuracy rates with regard to localization of the bile duct stenosis,the accuracy rate of EUS for proximal vs distal stenosis was significantly higher for distal stenosis(79%vs 57%,P<0.0001).CONCLUSION:ERCP/IDUS is superior to EUS and CT in providing accurate diagnoses of bile duct strictures of uncertain etiology.Multimodal diagnostics is recommended. | Hauke S Heinzow Sara Kammerer Carina Rammes Johannes Wessling Dirk Domagk Tobias Meister | 2014 | World Journal of Gastroenterology2014，20，30： | 14 |
| 5 | 单绒毛膜双羊膜囊性双胎妊娠的合并症及处理方式(Ⅱ)显示文摘综述目的与双绒双胎妊娠相比,单绒双胎妊娠有非常高的胎儿丢失率、围产期死亡率和发病率。这是因为双胎间无法预料的血管交通吻合及单个胎盘的不均衡分配。最新发现尽管某些特定的血流动力学因素和激素可能参与双胎输血综合征(TTTS)的病理生理过程,但通常认为TTTS的病理生理过程是以血管构建为基础的。关于减少羊水、胎儿镜下激光凝固术和造口术的大规模随机试验仍无结果。随着胎儿镜激光治疗所需的硬件和仪器进一步完善,单绒双胎在妊娠早期出现严重的生长不协调问题已得到解决。已提出几个TTTS的发病机制,但对于其发生过程仍知之甚少。而且脐动脉多普勒波形对双胎妊娠并无和单胎妊娠同样的预测价值。对双胎间的血管吻合进行预防性激光阻塞可以预防单胎胎死宫内这类不良事件的发生。但这一预防措施至今对改善妊娠结局并无任何益处。最后本文讨论了关于单绒双胎妊娠生长不协调和染色体异常的病理生理学机制及处理。通过针孔导入的激光和单极凝固术可以用来在妊娠早期进行选择性减胎或改善血流动力学情况。妊娠晚期或血流动力学正常时,双极凝固术似乎更有效。总结近几年来,对单绒双胎妊娠合并症的理解已进一步深入。希望这些进步可以指导这类高危妊娠进行更好的检测,最终改善妊娠结局。 | Liesbeth Lewi Dominique Van Schoubroeck Eduard Gratacós Ingrid Witters Dirk Timmerman Jan Deprest 赵德鹏 刘丹 樊佳丽 | 2010 | 中国产前诊断杂志(电子版)2010，，2： | 8 |
| 6 | 单绒毛膜双羊膜囊性双胎妊娠合并症及处理方式(Ⅰ)显示文摘综述目的与双绒双胎妊娠相比,单绒双胎妊娠有非常高的胎儿丢失率、围产期死亡率和发病率。这是因为双胎间无法预料的血管交通吻合及单个胎盘的不均衡分配。最新发现尽管某些特定的血流动力学因素和激素可能参与双胎输血综合征(TTTS)的病理生理过程,但通常认为TTTS的病理生理过程是以血管构建为基础的。关于减少羊水、胎儿镜下激光凝固术和造口术的大规模随机试验仍无结果。随着胎儿镜激光治疗所需的硬件和仪器进一步完善,单绒双胎在妊娠早期出现严重的生长不协调问题已得到解决。已提出几个TTTS的发病机制,但对于其发生过程仍知之甚少。而且脐动脉多普勒波形对双胎妊娠并无和单胎妊娠同样的预测价值。对双胎间的血管吻合进行预防性激光阻塞可以预防单胎胎死宫内这类不良事件的发生。但这一预防措施至今对改善妊娠结局并无任何益处。最后本文讨论了关于单绒双胎妊娠生长不协调和染色体异常的病理生理学机制及处理。通过针孔导入的激光和单极凝固术可以用来在妊娠早期进行选择性减胎或改善血流动力学情况。妊娠晚期或血流动力学正常时,双极凝固术似乎更有效。总结近几年来,对单绒双胎妊娠合并症的理解已进一步深入。希望这些进步可以指导这类高危妊娠进行更好的检测,最终改善妊娠结局。 | Liesbeth Lewi Dominique Van Schoubroeck Eduard Gratacós Ingrid Witters Dirk Timmerman Jan Deprest 赵德鹏 刘丹 樊佳丽 | 2010 | 中国产前诊断杂志(电子版)2010，，1： | 7 |
| 7 | Axitinib plus gemcitabine versus placebo plus gemcitabine in patients with advanced pancreatic adenocarcinoma: a double-blind randomised phase 3 study显示文摘 | Hedy L Kindler Tatsuya Ioka Dirk J Richel Jaafar Bennouna Richard Létourneau Takuji Okusaka Akihiro Funakoshi Junji Furuse Young Suk Park Shinichi Ohkawa Gregory M Springett Harpreet S Wasan Peter C Trask Paul Bycott Alejandro D Ricart Sinil Kim Eric Van | 2011 | Lancet Oncology2011，，3： | 4 |
| 8 | Systematic analysis of the safety and benefits of transvaginal hybrid-NOTES cholecystectomy显示文摘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 studies.RESULTS: 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). Furthermore,the TVC-patients had a better quality of life on POD 10 than did the LC-patients(GIQLI,124/144 vs 107/144,P = 0.028). The complication rates were comparable and no specific problems were detected in the long-term follow-up for sexual intercourse for either group. The TVC-patients were more satisfied with the aesthetic result in the long-term course in the matched cohort analysis(1.00 vs 1.88,P < 0.001) as well as in the randomized clinical trial(1.00 vs 1.70,P < 0.001) when compared with the LC-patients.CONCLUSION: TVC is a feasible procedure with a high safety profile and has advantages in regard to postoperative pain and aesthetic results when compared with LC or NC. | Dirk R Bulian Jurgen Knuth Kai S Lehmann Axel Sauerwald Markus M Heiss | 2015 | World Journal of Gastroenterology2015，21，38： | 3 |
| 9 | Quality of life after laparoscopic and open colorectal surgery: A systematic review显示文摘This study was a systematic review of the available evidence on quality of life in patients after laparoscopic or open colorectal surgery. A systematic review was performed of all randomized clinical trials (RCTs) that compared laparoscopic with open colorectal surgery. Study selection, quality assessment and data extraction were carried out independently by two reviewers. Primary endpoint was quality of life after laparoscopic and open colorectal surgery, as assessed by validated questionnaires. The search resulted in nine RCTs that included 2263 patients. Shortand long-term results of these RCTs were described in 13 articles. Postoperative follow-up ranged from 2 d to 6.7 years. Due to clinical heterogeneity, no meta-analysis could be conducted. Four RCTs did not show any difference in quality of life between laparoscopic or open colorectal surgery. The remaining five studies reported a better quality of life in favor of the laparoscopic group on a few quality of life scales at time points ranging from 1 wk to 2 years after surgery. In conclusion, based on presently available high-level evidence, this systematic review showed no clinically relevant differences in postoperative quality of life between laparoscopic and open colorectal surgery. | Sanne AL Bartels Malaika S Vlug Dirk T Ubbink Willem A Bemelman | 2010 | World Journal of Gastroenterology2010，16，40： | 3 |
| 10 | Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial显示文摘 | Claus R?del Torsten Liersch Heinz Becker Rainer Fietkau Werner Hohenberger Torsten Hothorn Ullrich Graeven Dirk Arnold Marga Lang-Welzenbach Hans-Rudolf Raab Heiko Sülberg Christian Wittekind Sergej Potapov Ludger Staib Clemens Hess Karin Weigang-K?hler G | 2012 | Lancet Oncology2012，，7： | 2 |
| 11 | Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke: A Statement for Health Care Professionals From the CRP Pooling Project Members显示文摘 | Mario Di Napoli Markus Schwaninger Roberto Cappelli Elena Ceccarelli Giacinto Di Gianfilippo Cristina Donati Hedley C.A. Emsley Sandro Forconi Stephen J. Hopkins Luca Masotti Keith W. Muir Anna Paciucci Francesca Papa Sabina Roncacci Dirk Sander Kerstin S | 2005 | Stroke2005，，6： | 2 |
| 12 | Activity of phenylalanine ammonialyase, peroxidase and polyphenol oxidase in roots of banana(Musa acuminata AAA, cvs Grande Naine and Yangambi km5) before and after infection with Radophotus similes显示文摘 | Nathalie W Dirk D Rony S | 2006 | Nematology2006，8，2： | 1 |
| 13 | Elevated C - reactive protein levels and impaired endothelial vasoreactivity in patients with coronary artery disease 显示文摘 | Fichtlscherer S Rosenberer G Dirk H | 2000 | Circulation2000，102，： | 1 |
| 14 | Tbx3controls the fate of hepaticprogenitor cells in liver development by suppressing p19ARF expres-sion显示文摘 | Atsushi S Sayaka S Dirk B | 2008 | Development2008，135，9： | 1 |
| 15 | Tumor necrosis factor receptor-associated factor(TRAF)4 is a new binding partner for the p70S6 serine/threonine kinase显示文摘 | Fleckenstein D S Dirks W G Drexler H G | 2003 | Leuk Res2003，27，8： | 1 |
| 16 | Nitric oxide contribute to the but does not modulate O^2 - consumption in exercising swine 显示文摘 | Dirk JD Rene S Pim AL et regulation of vasomotor tone al | 2000 | Cardiovascular Research2000，47，： | 1 |
| 17 | comparison of different transformation for Aspergillus giganteus显示文摘 | Vera M Dirk M Till S | 2003 | Curr Genet2003，43，： | 1 |
| 18 | Breast cancer care: Patient in- formation and communication as a preventive educational process 显示文摘 | Sabine HK Dirk OB Gotz S | 2006 | Breast Care2006，1，6： | 1 |
| 19 | Regorafenib for cancer显示文摘 | Dirk S Beate S | | 0，，06： | 1 |
| 20 | An atmospheric pressure self- pulsing micro thin-cathode discharge显示文摘 | Du B Mohr S Dirk L | 2011 | Journal of Physics D: Applied Physics2011，44，12： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员