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| 1 | Pain sensation in pancreatic diseases is not uniform: The different facets of pancreatic pain显示文摘AIM: To systematically characterize specific pain patterns in the most frequent pancreatic diseases.METHODS: Pain in patients with chronic pancreatitis(n = 314), pancreatic cancer(n = 469), and other pancreatic tumors(n = 249) including mucinous(n = 20) and serous cystadenoma(n = 31), invasive(n = 37) and non-invasive intraductal papillary mucinous neoplasia(IPMN; n = 48), low stage(n = 18) and high stage neuroendocrine neoplasia(n = 44), and ampullary cancer(n = 51) was registered and correlated with clinicopathological data. Survival times were estimated by the Kaplan-Meier method. Patients alive at the follow-up time were censored. Survival curves were compared statistically using the log-rank test.RESULTS: Forty-nine point one percent of pancreatic cancer patients revealed no pain, whereas in chronic pancreatitis only 18.3% were pain free. In contrary, moderate/severe pain was registered in 15.1% in pancreatic cancer patients that was increased in chronic pancreatitis with up to 34.2%. Serous cystadenoma was asymptomatic in most cases(58.1%), whereas 78.9% of all mucinous cystadenoma patients suffered pain. In neuroendocrine neoplasia pain was not a key clinical symptom since 64% of low stage neuroendocrine neoplasia and 59% of high stage neuroendocrine neoplasia patients were pain free. Cancer localization in the pancreatic body and patients with malignant pancreatic neoplasms were associated with more severe pain. Tumor grading and stage did not show any impact on pain. Only in pancreatic cancer, pain was directly associated with impaired survival.CONCLUSION: Pancreatic pain depicts different patterns of abdominal pain sensation according to the respective pancreatic disorder and does not allow a unification of the term pancreatic pain. | Jan G D'Haese Mark Hartel Ihsan Ekin Demir Ulf Hinz Frank Bergmann Markus W Büchler Helmut Friess Güralp O Ceyhan | 2014 | World Journal of Gastroenterology2014，20，27： | 8 |
| 2 | Orthotopic liver transplantation for giant liver haemangioma: A case report显示文摘In liver haemangiomas, the risk of complication rises with increasing size, and treatment can be obligatory. Here we present a case of a 46-year-old female who suffered from a giant haemangioma causing severe portal hypertension and vena cava compression, leading to therapy refractory ascites, hyponatremia and venostasis-associated thrombosis with pulmonary embolism. The patients did not experience tumour rupture or consumptive coagulopathy. Surgical resection was impossible because of steatosis of the non-affected liver. Orthotopic liver transplantation was identified as the only treatment option. The patient's renal function remained stable even though progressive morbidity and organ allocation were improbable according to the patient's lab model for end-stage liver disease(lab MELD) score. Therefore, non-standard exception status was approved by the European organ allocation network 'Eurotransplant'. The patient underwent successful orthotopic liver transplantation 16 mo after admission to our centre. Our case report indicates the underrepresentation of morbidity associated with refractory ascites in the lab MELD-based transplant allocation system, and it indicates the necessity of promptly applying for non-standard exception status to enable transplantation in patients with a severe clinical condition but low lab MELD score. Our case highlights the fact that liver transplantation should be considered early in patients with non-resectable, symptomatic benign liver tumours. | Undine G Lange Julian N Bucher Markus B Schoenberg Christian Benzing Moritz Schmelzle Tanja Gradistanac Steffen Strocka Hans-Michael Hau Michael Bartels | 2015 | World Journal of Transplantation2015，5，4： | 6 |
| 3 | 胰腺癌外科治疗的进展显示文摘作为2013年西方国家第四大癌症死亡原因,胰腺癌在新发癌症病例中已上升至女性第9位和男性第10位.由于早期检出率低,胰腺癌患者确诊时仅20%可手术,30%~40%为局部晚期,50%已全身转移,总体5年生存率仅6%.为提高早期检出率,内镜超声引导下穿刺活检是获得组织诊断的最佳方式,但准确率不高,故国际诊疗指南建议如有以下几点即可考虑外科手术:①囊性肿物直径〉2~3cm;②MRI和内镜超声中检出可疑结节;③导管内乳头状黏液瘤(IPMN)和黏液性囊腺瘤等癌前病变.1995年至2004年美国国家癌症数据库研究显示,手术患者的5年生存率为24.6%,而非手术患者仅为2.9%.因此,手术切除是患者获得长期生存和潜在治愈的唯一机会.外科手术技术和围手术期管理进步使胰腺手术更加安全,特别是围手术期疗效的进展,外科医生可以实施更加复杂的手术切除.因此,可切除标准亦有所放宽:①血管切除:过去视为不可切除,如今只要适合重建,肿瘤侵犯肝动脉、门静脉和肠系膜上静脉均可行边界性切除,但若肿瘤完全包绕腹腔干或者肠系膜上动脉则视为不可切除;②多脏器切除:对于侵犯了邻近器官(例如结肠系膜、结肠、胃)的局部浸润肿瘤均可行多脏器切除术;③扩大的淋巴结清扫术:扩大的淋巴清扫术并不能提高生存率,反而增加并发症率,因此,不推荐常规施行胰腺癌扩大的淋巴结清扫术;④腹腔镜胰腺切除术在胰腺癌中的应用:腹腔镜胰体尾切除术是可行且安全的,但目前仍缺乏腹腔镜胰头部切除术的肿瘤学长期效果的数据.研究报道,胰腺术后并发症发生率在小规模医院为16.3%,大规模医疗中心为3.8%,但病死率却控制在5%以下.最主要的并发症是术后胰瘘(POPF),在此基础上,POPF增加了其他并发症的发生率,如腹腔脓肿、胰腺切除术后出血(PPH)和胃排空延迟(DGE).对此,胰腺手术国际研究小组(ISGPS)认为减少POPF发病率的外科策略包括选择最安全的胰肠吻合或胰腺残端闭合技术、胰肠吻合的支架和通过生长激素抑制剂来减少胰腺外分泌,具体如下:①胰腺吻合:主要是胰空肠吻合和胰胃吻合,目前两种方式仍然没有结论 性的数据显示有差异,大多数大规模的胰腺外科中心采用胰空肠吻合术,但对于规模较小的机构而言,技术不太复杂的胰胃吻合术可能是更好的选择.②远端胰腺切除术的残端处理:为减少POPF的发生,已经探讨了若干项治疗策略,包括薄壁组织横断、胰腺残端闭合、胰腺残端额外覆盖和胰肠吻合的不同技术,但仍然是一个尚未解决的难题.③胰腺吻合时支架管的应用:不支持常规放置支架.④生长激素抑制剂:理论上会降低POPF的风险,但有研究报道生长抑素类似物尚不能有效治疗POPF.此外,术前胆汁引流显著增加了术后并发症率,而在病死率、住院时间和生存效果方面没有效果.故不推荐常规地施行术前胆道支架植入术,但以下患者除外:与凝血功能障碍有关的高胆红素血症患者,需要行新辅助治疗或姑息性化疗的局部浸润性肿瘤或者出现转移的患者.对于不可行手术切除的患者,有一种可以选择的方法 是施行新辅助治疗并尝试在肿瘤降期后行手术切除.原则上讲,放化疗可以更加有效地使局部降期,研究表明,吉西他滨(Gemcitabine)是辅助治疗的金标准,可增加术后生存率,但单独应用化疗还是放化疗联合应用仍存在争议.然而,由于大多数患者在手术切除后两年内发生了全身性的疾病进展,胰腺癌患者的长期疗效仍然不理想,故即便是可切除的胰腺癌也要视为一种全身性疾病.因此,将来手术技术发展可能不会给长期疗效带来可观的效果.为了提高长期效果,我们迫切地需要新的和更加有效的系统性治疗. | Oliver Strobel Thilo Hackert Markus Büchler | 2014 | 临床外科杂志2014，22，1： | 5 |
| 4 | Pancreatic Cancer Surgery in the New Millennium: Better Prediction of Outcome显示文摘 | Werner Hartwig Thilo Hackert Ulf Hinz Alexander Gluth Frank Bergmann Oliver Strobel Markus W. Büchler Jens Werner | 2011 | Annals of Surgery2011，，2： | 5 |
| 5 | Arterial Resection During Pancreatectomy for Pancreatic Cancer: A Systematic Review and Meta-Analysis显示文摘 | Nathan Mollberg Nuh N. Rahbari Moritz Koch Werner Hartwig Yumiko Hoeger Markus W. Büchler Jürgen Weitz | 2011 | Annals of Surgery2011，，6： | 5 |
| 6 | TG13 flowchart for the management of acute cholangitis and cholecystitis显示文摘 | Fumihiko Miura Tadahiro Takada Steven M. Strasberg Joseph S. Solomkin Henry A. Pitt Dirk J. Gouma O. James Garden Markus W. Büchler Masahiro Yoshida Toshihiko Mayumi Kohji Okamoto Harumi Gomi Shinya Kusachi Seiki Kiriyama Masamichi Yokoe Yasutoshi Kimura | 2013 | Journal of Hepato-Biliary-Pancreatic Sciences2013，，1： | 4 |
| 7 | Ruptured angiosarcoma of the liver treated by emergency catheter-directed embolization显示文摘血管肉瘤是有差的预后的肝的一个稀罕的主要的恶意的瘤。这里,我们与被紧急情况对待的一个破裂的肝的血管肉瘤报导一个病人的一个案例指导导管的 embolization,由左边的偏身出汗列在后面。 | Christine Leowardi Yura Hormann UIf Hinz Moritz N Wente Peter Hallscheidt Christa Flechtenmacher Markus W Büchler Helmut Friess Matthias HM Schwarzbach | 2006 | World Journal of Gastroenterology2006，12，5： | 4 |
| 8 | Delayed gastric emptying (DGE) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)显示文摘 | Moritz N. Wente Claudio Bassi Christos Dervenis Abe Fingerhut Dirk J. Gouma Jakob R. Izbicki John P. Neoptolemos Robert T. Padbury Michael G. Sarr L. William Traverso Charles J. Yeo Markus W. Büchler | 2007 | Surgery2007，，5： | 4 |
| 9 | A systematic review and meta-analysis of laparoscopic versus open distal pancreatectomy for benign and malignant lesions of the pancreas: It’s time to randomize显示文摘 | Arianeb Mehrabi Mohammadreza Hafezi Jalal Arvin Majid Esmaeilzadeh Camelia Garoussi Golnaz Emami Julia K?ssler-Ebs Beat Peter Müller-Stich Markus W. Büchler Thilo Hackert Markus K. Diener | 2014 | Surgery2014，，： | 4 |
| 10 | Ischemia/Reperfusion Injury in Liver Surgery and Transplantation: Pathophysiology显示文摘 | Kilian Weigand Sylvia Brost Niels Steinebrunner Markus Büchler Peter Schemmer Martina Müller John J. Lemasters | 2012 | HPB Surgery2012，，： | 4 |
| 11 | 胰腺癌细胞株对氟尿嘧啶存在固有不敏感性显示文摘目的 研究胰腺癌细胞株是否对氟尿嘧啶 ( 5 - FU )具有固有或获得性不敏感。方法 用 SRB方法检测5 - FU对胰腺癌细胞株 As PC- 1、Capan- 1、Mia- Pa Ca- 2、Panc- 1和 T3 M4的毒性作用。结果 5 - FU对所有胰腺癌细胞株的 IC50 都很高 ,其中 Mia- Pa Ca- 2和 Panc- 1细胞株对 5 - FU最不敏感 ( IC50 =12 ,13 nmol/ L )。即使是在 5 - FU最敏感的 Capan- 1细胞株 ,其 IC50 仍相当高 ( 473 pm ol/ L)。这些细胞株对 5 - FU的 IC50 甚至高出其临床常用剂量给药时血浆药物浓度的 1~ 5 6倍。结论 大多数胰腺癌细胞株对 5 - FU固有不敏感 ,这些发现也许能作为临床上 5 - | 刘胜利 Helmut Friess Jorg Kleeff Markus W Bchler | 2002 | 中国药科大学学报2002，33，6： | 3 |
| 12 | The Neurotrophic Factor Artemin Promotes Pancreatic Cancer Invasion显示文摘 | Güralp O. Ceyhan Nathalia A. Giese Mert Erkan Annika G. Kerscher Moritz N. Wente Thomas Giese Markus W. Büchler Helmut Friess | 2006 | Annals of Surgery2006，，2： | 3 |
| 13 | Small (Sendai Negative) Branch-Duct IPMNs: Not Harmless显示文摘 | Stefan Fritz Miriam Klauss Frank Bergmann Thilo Hackert Werner Hartwig Oliver Strobel Bogata D. Bundy Markus W. Büchler Jens Werner | 2012 | Annals of Surgery2012，，2： | 3 |
| 14 | Distal Pancreatectomy: Risk Factors for Surgical Failure in 302 Consecutive Cases显示文摘 | J?rg Kleeff Markus K. Diener Kaspar Z?graggen Ulf Hinz Markus Wagner Jeannine Bachmann J?rg Zehetner Michael W. Müller Helmut Friess Markus W. Büchler | 2007 | Annals of Surgery2007，，4： | 3 |
| 15 | Favorable lifestyle before diagnosis associated with lower risk of screen-detected advanced colorectal neoplasia显示文摘AIM: To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia(ACN) in colorectal cancer(CRC) screening.METHODS: A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero(poorest) to six(best). Odds ratios(ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ACN.RESULTS: In all 6315 women and men completed the lifestyle questionnaire, 3323(53%) in the FIT arm and 2992(47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311(5%) participants of which 25(8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs(95%CI) for the probability of ACN detection were 0.82(0.45-1.16), 0.43(0.28-0.73), 0.41(0.23-0.64), and 0.41(0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53(0.42-0.68) and 0.63(0.43-0.93) respectively.CONCLUSION: Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening. | Markus D Knudsen Thomas de Lange Edoardo Botteri Dung-Hong Nguyen Helge Evensen Chloé B Steen Geir Hoff Tomm Bernklev Anette Hjartaker Paula Berstad | 2016 | World Journal of Gastroenterology2016，22，27： | 3 |
| 16 | Management of infection in acute pancreatitis显示文摘 | Werner Hartwig Jens Werner Waldemar Uhl Markus W. Büchler | 2002 | Journal of Hepato - Biliary - Pancreatic Surgery2002，，4： | 3 |
| 17 | Hepatocellular Carcinoma: Current Management and Perspectives for the Future显示文摘 | Nuh N. Rahbari Arianeb Mehrabi Nathan M. Mollberg Sascha A. Müller Moritz Koch Markus W. Büchler Jürgen Weitz | 2011 | Annals of Surgery2011，，3： | 3 |
| 18 | Sodium glucose co-transporter 2 inhibition reduces succinate levels in diabetic mice显示文摘BACKGROUND Type 1 diabetes(T1D) is associated with major chronic microvascular complications which contribute significantly to diabetes associated morbidity.The protein primarily responsible for glucose reabsorption in the kidney is sodium glucose co-transporter 2(SGLT2). Presently, SGLT2 inhibitors are widely used in diabetic patients to improve blood glucose levels and prevent cardiovascular and renal complications. Given the broad therapeutic application of SGLT2 inhibitors, we hypothesised that SGLT2 inhibition may exert its protective effects via alterations of the gut microbiome and tested this in a type 1 diabetic mouse model of diabetic retinopathy.AIM To determine whether the treatment with two independent SGLT2 inhibitors affects gut health in a type 1 diabetic mouse model.METHODS The SGLT2 inhibitors empagliflozin or dapagliflozin(25 mg/kg/d) or vehicle dimethylsulfoxide(DMSO) were administered to C57 BL/6 J, Akita, Kimba and Akimba mice at 10 wk of age for 8 wk via their drinking water. Serum samples were collected and the concentration of succinate and the short chain fatty acid(SCFA) butyric acid was measured using gas chromatography-mass spectrometry. Enzyme-linked immunosorbent assay(ELISA) was performed to determine the concentration of insulin and leptin. Furthermore, the norepinephrine content in kidney tissue was determined using ELISA. Pancreatic tissue was collected and stained with haematoxylin and eosin and analysed using brightfield microscopy.RESULTS Due to the presence of the Akita allele, both Akita and Akimba mice showed a reduction in insulin production compared to C57 BL/6 J and Kimba mice.Furthermore, Akita mice also showed the presence of apoptotic bodies within the pancreatic islets. The acinar cells of Akita and Akimba mice showed swelling which is indicative of acute injury or pancreatitis. After 8 wk of SGLT2 inhibition with dapagliflozin, the intermediate metabolite of gut metabolism known as succinate was significantly reduced in Akimba mice when compared to DMSO treated mice. In addition, empagliflozin resulted in suppression of succinate levels in Akimba mice. The beneficial SCFA known as butyric acid was significantly increased in Akita mice after treatment with dapagliflozin when compared to vehicle treated mice. The norepinephrine content in the kidney was significantly reduced with both dapagliflozin and empagliflozin therapy in Akita mice and was significantly reduced in Akimba mice treated with empagliflozin.In non-diabetic C57 BL/6 J and Kimba mice, serum leptin levels were significantly reduced after dapagliflozin therapy.CONCLUSION The inhibition of SGLT2 reduces the intermediate metabolite succinate, increases SCFA butyric acid levels and reduces norepinephrine content in mouse models of T1 D. Collectively, these improvements may represent an important mechanism underlying the potential benefits of SGLT2 inhibition in T1 D and its complications. | Lakshini Y Herat Natalie C Ward Aaron L Magno Elizabeth P Rakoczy Marcio G Kiuchi Markus P Schlaich Vance B Matthews | 2020 | World Journal of Gastroenterology2020，26，23： | 3 |
| 19 | Reduced anoctamin 7(ANO7) expression is a strong and independent predictor of poor prognosis in prostate cancer显示文摘Objective:Anoctamin 7(ANO7)is a calcium2+-dependent chloride ion channel protein.Its expression is restricted to prostate epithelial cells.The exact function is unknown.This study aimed to analyze ANO7 expression and its clinical significance in prostate cancer(PCa).Methods:ANO7 expression was assessed by immunohistochemistry in 17,747 clinical PCa specimens.Results:ANO7 was strongly expressed in normal prostate glandular cells but often less abundant in cancer cells.ANO7 staining was interpretable in 13,594 cancer tissues and considered strong in 34.4%,moderate in 48.7%,weak in 9.3%,and negative in 7.6%.Reduced staining was tightly linked to adverse tumor features[high classical and quantitative Gleason grade,lymph node metastasis,advanced tumor stage,high Ki67 labeling index,positive surgical margin,and early biochemical recurrence(P<0.0001 each)].The univariate Cox hazard ratio for prostate-specific antigen(PSA)recurrence after prostatectomy in patients with negative vs.strong ANO7 expression was 2.98(95%confidence interval 2.61–3.38).The prognostic impact was independent of established pre-or postoperatively available parameters(P<0.0001).Analysis of annotated molecular data showed that low ANO7 expression was linked to TMPRSS2:ERG fusions(P<0.0001),elevated androgen receptor expression(P<0.0001),as well as presence of 9 of 11 chromosomal deletions(P<0.05 each).A particularly strong association of low ANO7 expression with phosphatase and tensin homolog(PTEN)deletion may indicate a functional relationship with the PTEN/AKT pathway.Conclusions:These data identify reduced ANO7 protein expression as a strong and independent predictor of poor prognosis in PCa.ANO7 measurement,either alone or in combination,might provide clinically useful prognostic information in PCa. | Andreas Marx Lena Koopmann Doris Hoflmayer Franziska Büscheck Claudia Hube-Magg Stefan Steurer Till Eichenauer Till S.Clauditz Waldemar Wilczak Ronald Simon Guido Sauter Jakob R.Izbicki Hartwig Huland Hans Heinzer Markus Graefen Alexander Haese Thorsten Schlomm Christian Bernreuther Patrick Lebok Sarah Bonk | 2021 | Cancer Biology & Medicine2021，18，1： | 3 |
| 20 | Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis with inflammatory mass in the head显示文摘 | Hans G. Beger M.D. F.A.C.S. Markus Büchler M.D | 1990 | World Journal of Surgery1990，，1： | 3 |
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