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| 1 | Epidural anesthesia improves pancreatic perfusion and decreases the severity of acute pancreatitis显示文摘AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP. | Samira M Sadowski Axel Andres Philippe Morel Eduardo Schiffer Jean-Louis Frossard Alexandra Platon Pierre-Alexandre Poletti Leo Bühler | 2015 | World Journal of Gastroenterology2015，21，43： | 21 |
| 2 | Preeclampsia from a renal point of view:Insides into disease models,biomarkers and therapy显示文摘Proteinuria is a frequently detected symptom,found in 20% of pregnancies.A common reason for proteinuria in pregnancy is preeclampsia.To diagnose preeclampsia clinically and to get new insights into the pathophysiology of the disease it is at first essential to be familiar with conditions in normal pregnancy.Animal models and biomarkers can help to learn more about disease conditions and to find new treatment strategies.In this article we review the changes in kidney function during normal pregnancy and the differential diagnosis of proteinuria in pregnancy.We summarize different pathophysiological theories of preeclampsia with a special focus on the renal facets of the disease.We describe the current animal models and give a broad overview of different biomarkers that were reported to predict preeclampsia or have a prognostic value in preeclampsia cases.We end with a summary of treatment options for preeclampsia related symptoms including the use of plasmapheresis as a rescue therapy for so far refractory preeclampsia.Most of these novel biomarkers for preeclampsia are not yet implemented in clinical use.Therefore,we recommend using proteinuria(measured by UPC ratio) as a screening parameter for preeclampsia.Delivery is the only curative treatment for preeclampsia.In earlypreeclampsia the primary therapy goal is to prolong pregnancy until a state were the child has an acceptable chance of survival after delivery. | Janina Müller-Deile Mario Schiffer | 2014 | World Journal of Nephrology2014，3，4： | 10 |
| 3 | Portopulmonary hypertension and hepatopulmonary syndrome显示文摘Portopulmonary hypertension(POPH) and hepatopulmonary syndrome(HPS) are two frequent complications of liver disease, with prevalence among liver transplant candidates of 6% and 10%, respectively. Both conditions result from a lack of hepatic clearance of vasoactive substances produced in the splanchnic territory. Subsequently, these substances cause mainly pulmonary vascular remodeling and some degree of vasoconstriction in POPH with resulting elevated pulmonary pressure and right ventricular dysfunction. In HPS the vasoactive mediators cause intrapulmonary shunts with hypoxemia. Medical treatment is disappointing overall. Whereas liver transplantation(LT) results in the disappearance of HPS within six to twelve months, its effect on POPH is highly unpredictable. Modern strategies in managing HPS and POPH rely on a thorough screening and grading of the disease's severity, in order to tailor the appropriate therapy and select only the patients who will benefit from LT. The anesthesiologist plays a central role in managing these high-risk patients. Indeed, the important hemodynamic and respiratory modifications of the perioperative period mustbe avoided through continuation of the preoperatively initiated drugs, appropriate intraoperative monitoring and proper hemodynamic and respiratory therapies. | Florence Aldenkortt Marc Aldenkortt Laurence Caviezel Jean Luc Waeber Anne Weber Eduardo Schiffer | 2014 | World Journal of Gastroenterology2014，20，25： | 7 |
| 4 | A novel role for the adaptor molecule CD2-associated protein in transforming growth factor-betainduced apoptosis显示文摘 | Schiffer M Mundel P Shaw AS | 2004 | J Biol Chem2004，279，37： | 1 |
| 5 | Smad proteins and transforming growth factor-beta signaling显示文摘 | Schiffer M von Gersdorff G Bitzer M | 2000 | Kidney Int Suppl2000，77，25： | 1 |
| 6 | Evidence for functional relevance of an enhanced expression of the Na^+ -Ca^2+ exchanger in failing human myocardium显示文摘 | Flesch M Schwinger RH Schiffer F | 1996 | Circulation1996，94，5： | 1 |
| 7 | Brain response to visual sexual stimuli in heterosexual and homosexual males显示文摘 | Paul T Schiffer B Zwarg T | 2008 | Hum Brain Mapp2008，29，： | 1 |
| 8 | Clinical description of 44 patients with acute promyelocytic leukemia who developed the retinoic acid syndrome显示文摘 | Tallman MS Andersen JW Schiffer CA | | 0，，01： | 1 |
| 9 | BCR-ABL tyrosine kinase inhibitors for chronic myelogenous leukemia 显示文摘 | Schiffer CA | 2007 | N Engl J Med2007，357，3： | 1 |
| 10 | Hyperleukocytosis in adult acute nonlymphoeytic leukemia:Impact on remission rate and duration,and survival显示文摘 | Dutcher JP Schiffer CA Wiernik PH | 1987 | J Clin Onco1987，15，： | 1 |
| 11 | Parkinsons disease and depression: evidence for an atypical affective disorder 显示文摘 | Schiffer RB | 1998 | Am J Psychiatry1998，145，5： | 1 |
| 12 | Activatedrenal macrophages are markers of disease onset and diseaseremission in lupus nephritis 显示文摘 | Schiffer L Bethunaickan R Ramanujam M | 2008 | J Immunol2008，180，： | 1 |
| 13 | Contextualist Solutions to Skepticism显示文摘 | Stephen Schiffer | | 0，，96： | 1 |
| 14 | N-terminal polyglutaminecontaining fragments inhibit androgen receptor transactivation function显示文摘 | Schiffer NW Ceraline J Haiti FU | 2008 | Biol Chem2008，389，： | 1 |
| 15 | Platelet transfusion for patients with cancer:clinical practice guidelines of the American Society of Clinical Oncology显示文摘 | SCHIFFER C A ANDERSON K C BENNETT C L | 2001 | J Clin Oncol2001，19，： | 1 |
| 16 | Direct materials deposition: designed macro and microstructure显示文摘 | Mazumder J Schifferer A Choi J | 1999 | Materials Research Innovations1999，，3： | 1 |
| 17 | Glucose-induced reactive oxygen species cause apoptosis of podocytes and podocyte depletion at the onset of diabetic nephropathy 显示文摘 | SUSZTAK K RAFF AC SCHIFFER M | 2006 | Diabetes2006，55，1： | 1 |
| 18 | All-trans retinoic acid in acute promyelocytic leukemia:long-term outcome and prognostic factor analysis from the North American Intergroup Procotol显示文摘 | Tallman MS Andersen JW Schiffer CA | 2002 | Blood2002，100，13： | 1 |
| 19 | Elastic stable intraraedul-lary nailing ofmidclavicular fractures with a titanium nail显示文摘 | Jubel A Andermahr J Schiffer G | | 0，，08： | 1 |
| 20 | Agnathia- otocephaly complex : report of three cases with involvement of two different Carnegie stages 显示文摘 | Schiffer C Tariverdian G Sehiesser M | 2002 | Am J Med Genet2002，112，2： | 1 |
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