|
|
|
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 | Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings 显示文摘 | Domschke K Stevens S Pfleiderer B | 2010 | Clin Psychol Rev2010，30，1： | 1 |
| 4 | Muhiple center capacitated arc routing problems:a tabu search algorithm using capacitated trees显示文摘 | Domschke A A W VoB S | 2000 | European Journal of Operational Research2000，124，： | 1 |
| 5 | Longer relapse free period after sucralfate than after H2-bloker treatment of duodenal and gastric ulcers显示文摘 | DOMSCHKEW | 1991 | Am J Med1991，91，2： | 1 |
| 6 | Longer relapse freeperiod after sucralfate than after H2-bloker treatmentof duodenal and gastric ulcers显示文摘 | DOMSCHKE S DOMSHKE W | 1991 | Am J Med1991，91，2： | 1 |
| 7 | Comparison of CA 72-4with CA 19-9 and carcinoembryonic antigen in the serodiagnostics ofgastrointestinal malignanciesH 显示文摘 | Heptner G Domschke S Domschke W | 1989 | Scand J Gastroenterol1989，24，： | 1 |
| 8 | Comparison of CA724 with CA19-9 and CEA in the serodiagnostics of gastrointestinal matignancies显示文摘 | Heptner G Domschke S | 1989 | Sca Gastroenterology1989，24，6： | 1 |
| 9 | Chronic pancrea- titis and diabetes mellitus: plasma and gastroduodenal mucosal profiles of regulatory peptides ( gastrin, motilin, secretin, cho-lecystokinin, gastric inhibitory polypeptide, somatostatin, VIP, substance P, pancreatic polypeptide, glucagon, enterogluea- gon, neurotensin) 显示文摘 | Domschke S Bloom S R Adrian T E | 1988 | Hepatogastroenterology1988，35，5： | 1 |
| 10 | Greentea polyphenol epigallocatechin - 3 - gallate shows therapeuticantioxidative effects in a murine model of colitis 显示文摘 | BRUCKNER M WESTPHAL S DOMSCHKE W | 2012 | J CrohnsColitis2012，6，2： | 1 |
| 11 | Dynamics and localization of activin A expression in rat gastric ulcers 显示文摘 | Hertel M Markmann A Shahin M Werner S Domschke W Pohle T | 2003 | Scand J Gastroenterol2003，38，3： | 1 |
| 12 | Free fatty acids in serum of patients with acute necrotizing or edematous pancreatitis 显示文摘 | Domschke S Malfertheiner P Uhl W | 1993 | Int J Pancreatol1993，13，2： | 1 |
| 13 | Longer relapse - free period after sucralfate than after H2 - blocker treatment of duodenal and gastric ulcers显示文摘 | Domschke S Domschke W | 1991 | Am JMed1991，91，28： | 1 |
| 14 | Green tea polyphenol epigallocat echin-3-gallate shows therapeutic antioxidative effects in a murine model of colitis显示文摘 | Brtickner M Westphal S Domschke W | 2012 | J Crohns Colitis2012，6，2： | 1 |
| 15 | Interoceptive sensitivity in anxiety and anxiety disorders : an overview and integration of neu- robiologlcal findings 显示文摘 | Domschke K Stevens S Pfleiderer B et ai | 2010 | Clin Psychol Rev2010，30，： | 1 |
| 16 | Interoceptive sensitivity in anxiety and anxiety disorders:an overview and integration of neurobiological findings显示文摘 | Domschke K Stevens S Pfleiderer B | | 0，，： | 1 |
| 17 | Efficacy and toxic- ity profile of pegylated liposomal doxorubicin (Caelyx) in patients with advanced breast cancer 显示文摘 | Rom J Bechstein S Domschke C | 2014 | Anti-Cancer Drugs2014，25，： | 1 |
| 18 | The role of tumor mak- ers in the diagnosis and management of gastrointestinal cancer显示文摘 | Heptner G Domschke S Domschke W | 1986 | Hepatogastroenterology1986，33，4： | 1 |
| 19 | Gastroduodenal motor response to natural motilin and synthetic position 13 -substituted motilin analogues: a comparative in vitro study 显示文摘 | Strunz U Domschke W Domschke S | 1976 | Scand J Gastroenterol1976，11，2： | 1 |
| 20 | The role of tumorm aker in the diagnosis and management of gastrointestinal cancer显示文摘 | Heptner G Domschke S Domschke W | 1996 | Hepatogastroenterology1996，33，4： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员