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| 1 | Hemostasis in liver transplantation:Pathophysiology,monitoring,and treatment显示文摘Recent findings in the pathophysiology and monitoring of hemostasis in patients with end stage liver disease have major impact on coagulation management during liver transplantation. There is increasing evidence, that the changes in both coagulation factors and platelet count regularly observed in patients with liver cirrhosis cannot be interpreted as a reliable indicator of diffuse bleeding risk. Instead, a differentiated view on hemostasis has led to the concept of a rebalanced coagulation system: While it is important to recognize that procoagulant factors are reduced in liver cirrhosis, it is also evident that synthesis of anticoagulant factors and fibrinolytic proteins produced in the liver is also diminished. Similarly, the decreased platelet count may be counterbalanced by increased platelet aggregability caused by highly active von Willebrand multimeres. The coagulation system is therefor stated to be rebalanced. While under normal 'unstressed' conditions diffuse bleeding is rarely observed, however both diffuse bleeding or thrombus formation may occur when compensation mechanisms are exhausted. While most patients presenting for liver transplantation have severe cirrhosis, liver function and thus production of pro- and anticoagulant factors can be preserved especially in cholestatic liver disease. During liver transplantation, profound changes in the hemostasis system can occur. Surgical bleeding can lead to diffuse bleeding as coagulation factors and platelets are already reduced. Ischemia and tissue trauma can lead to alterations of hemostasis comparable to trauma induced coagulopathy. A further common disturbance often starting with the reperfusion of the transplanted organ is hyperfibrinolysis which can eventually precipitate complete consumption of fibrinogen and an endogenous heparinization by glycocalyx shedding. Moreover, thrombotic events inliver transplantations are not uncommon and contribute to increased mortality. Besides conventional laboratory methods, bed-side monitoring of hemostasis(e.g., thrombelastography, thrombelastometry) is often used during liver transplantation to rapidly diagnose decreases in fibrinogen and platelet count as well as hyperfibrinolysis and to guide treatment with blood products, factor concentrates, and antifibrinolytics. There is also evidence which suggests when algorithms based on bed-side hemostasis monitoring are used a reduction of blood loss, blood product use, and eventual mortality are possible. Notably, the bed-side monitoring of anticoagulant pathways and the thrombotic risk is not possible at time and thus a cautious and restrictive use of blood products is recommended. | Matthias Hartmann Cynthia Szalai Fuat H Saner | 2016 | World Journal of Gastroenterology2016，22，4： | 11 |
| 2 | Self-expanding metal stents for the palliation of malignant gastric outlet obstruction in patients with peritoneal carcinomatosis显示文摘AIM To evaluate the efficacy of self-expanding metal stents(SEMS) for the palliation of malignant gastric outlet obstruction in patients with and without peritoneal carcinomatosis(PC).METHODS We performed a retrospective analysis of 62 patients who underwent SEMS placement for treatment of malignant gastroduodenal obstruction at our hospital over a six-year period. Stents were deployed through the scope under combined fluoroscopic and endoscopic guidance. Technical success was defined as successful stent placement and expansion. Clinical success was defined as an improvement in the obstructive symptoms and discharge from hospital without additional parenteral nutrition. According to carcinomatosis status, patients were assigned into groups with or without evidence of peritoneal disease.RESULTS In most cases, obstruction was caused by pancreatic(47%) or gastric cancer(23%). Technical success was achieved in 96.8%(60/62), clinical success in 79%(49/62) of all patients. Signs of carcinomatosis were identified in 27 patients(43.5%). The diagnosis was confirmed by pathology or previous operation in 7 patients(11.2%) and suspected by CT, MRI or ultrasound in 20 patients(32.2%). Presence of carcinomatosis was associated with a significantly lower clinical success rate compared to patients with no evidence of peritoneal disease(66.7% vs 88.6%, P = 0.036). There was no significant difference in overall survival between patients with or without PC(median 48 d vs 70 d, P = 0.21), but patients showed significantly longer survival after clinical success of SEMS placement compared to those experiencing clinical failure(median 14.5 d vs 75 d, P = 0.0003).CONCLUSION Given the limited therapeutic options and a clinical success rate of at least 66.7%, we believe that SEMS are a reasonable treatment option in patients with malignant gastric outlet obstruction with peritoneal carcinomatosis. | Christoph Rademacher Matthias Bechtler Steffen Schneider Bettina Hartmann Johannes Striegel Ralf Jakobs | 2016 | World Journal of Gastroenterology2016，22，43： | 2 |
| 3 | Differential equation based constraned reinitialization for level set methods显示文摘 | Daniel Hartmann Matthias Meinke Wolfgang Schroder | 2008 | Journal of Computational Physics2008，227，： | 1 |
| 4 | PillCamColon2 after incomplete colonoscopy-A prospective multicenter study显示文摘AIM To evaluate the ability of PillCamColon2 to visualize colonic segments missed by incomplete optical colonoscopy(OC) and to assess the diagnostic yield.METHODS This prospective multicentre study included 81 patients from nine centres who underwent second-generation colon capsule endoscopy(CCE) following incomplete OC performed by an experienced gastroenterologist(> 1000 colonoscopies). Patients with stenosis were excluded. According to patient preferences, CCE was performed the following day(protocol A) after staying on clear liquids and 0.75 L Moviprep in the morning or within 30 d after new split-dose Moviprep(protocol B). Boosts consisted of 0.75 L and 0.25 L Moviprep, and phospho-soda was given as a rescue if the capsule was not excreted after seven hours.RESULTS Seventy-four patients were analysed(51% of them in group A; 49% in group B). Bowel cleansing was adequate in 67% of cases, and CCE could visualize colonic segments missed by incomplete colonoscopy in 90% of patients under protocol A and 97% of patients under protocol B(P = 0.35, n.s.). Significant polyps including adenocarcinoma were detected in 24% of cases. Detection rates for all polyps and significant polyps per patient were similar in both protocols. Polyps were found predominantly in the right colon(86%) in segments that were not reached by OC. Extracolonic findings-such as reflux esophagitis, suspected Barrett esophagus, upper GI-bleeding, gastric polyps, gastric erosions and angiectasia-were detected in eight patients. Pill Cam Colon2 capsule was retained in the ileum of one patient(1.4%) without symptoms and removed during an uneventful resection for unknown Crohn's disease that was diagnosed as the cause of anemia, which was the indication for colonoscopy. CCE was well tolerated. One patient suffered from selflimiting vomiting after consuming the phospho-soda.CONCLUSION Second-generation CCE using a low-volume preparation is useful after incomplete OC, and it allows for the detection of additional relevant findings, but cleansing efficiency could be improved. | Peter Baltes Marc Bota Jorg Albert Michael Philipper Hans-Georg Horster Friedrich Hagenmüller Ingo Steinbrück Ralf Jakobs Matthias Bechtler Dirk Hartmann Horst Neuhaus Jean-Pierre Charton Rupert Mayershofer Horst Hohn Thomas Rosch Stefan Groth Tanja Nowak Peter Wohlmuth Martin Keuchel | 2018 | World Journal of Gastroenterology2018，24，31： | 1 |
| 5 | Deletions at chromosome 2q and 12p are early and frequent molecularalterations in bronchial epithelium and NSCLC of long-term smokers显示文摘 | Ulrike Grepmeier Wolfgang Dietmaier Johannes Merk Peter Wild Ellen Obermann Michael Pfeifer Ferdinand Hofstaedter Arndt Hartmann Matthias Woenckhaus | 2005 | International Journal of Oncology2005，，2： | 1 |
| 6 | Sustained treatment response of metastatic hepatocellular carcinoma with bevacizumab and sorafenib显示文摘The overall survival for patients with advanced hepatocellular carcinoma(HCC)is still limited.Although the multi-kinase inhibitor sorafenib has recently been approved for this disease,response rates are still low and patients often face dose-limiting toxicities which lead to a reduction in prognosis and treatment success.We here report a patient with metastasized HCC who shows a sustained response for more than 30 mo to sorafenib therapy after failure of a first line therapy with gemcitabine,oxaliplatin and bevacizumab. | Christina Wich Abbas Agaimy Deike Strobel Thaddaus Till Wissniowski Arndt Hartmann Matthias Ocker | 2010 | World Journal of Gastroenterology2010，16，28： | 1 |
| 7 | Ki-67 as a prognostic molecular marker in routine clinical use in breast cancer patients显示文摘 | Folkward G. Wiesner Achim Magener Peter A. Fasching Julia Wesse Mayada R. Bani Claudia Rauh Sebastian Jud Michael Schrauder Christian R. Loehberg Matthias W. Beckmann Arndt Hartmann Michael P. Lux | 2009 | The Breast2009，，2： | 1 |
| 8 | Verification of IMRT: Techniques and Problems显示文摘 | Priv.-Doz. Dr. Ludwig Bogner PhD Josef Scherer Marius Treutwein Matthias Hartmann Franz Gum Axel Amediek | 2004 | Strahlentherapie und Onkologie2004，，6： | 1 |
| 9 | Microsatellite Analysis of Pleural Supernatants Could Increase Sensitivity of Pleural Fluid Cytology显示文摘 | Matthias Woenckhaus Ulrike Grepmeier Bernhard Werner Christian Schulz Felix Rockmann Peter J. Wild Georg R?ckelein Hagen Blaszyk Marion Schuierer Ferdinand Hofstaedter Arndt Hartmann Wolfgang Dietmaier | 2005 | The Journal of Molecular Diagnostics2005，，4： | 1 |
| 10 | Sorafenib perpetuates cellular anticancer effector functions by modulating the crosstalk between macrophages and natural killer cells显示文摘 | Martin Franz Sprinzl Florian Reisinger Andreas Puschnik Marc Ringelhan Kerstin Ackermann Daniel Hartmann Matthias Schiemann Arndt Weinmann Peter Robert Galle Marcus Schuchmann Helmut Friess Gerd Otto Mathias Heikenwalder Ulrike Protzer | 2013 | Hepatology2013，，： | 1 |
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