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| 1 | Diagnosis of biliary strictures after liver transplantation:Which is the best tool?显示文摘AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS: In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS: Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9%in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. InMRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL.CONCLUSION: Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method. | Thomas Zoepf Evelyn J. Maldonado-Lopez Philip Hilgard Alexander Dech■ne Massimo Malago Christoph E. Broelsch Joerg Schlaak Guido Gerken | 2005 | World Journal of Gastroenterology2005，11，19： | 32 |
| 2 | Prospective observational multicenter study to define a diagnostic algorithm for biliary candidiasis显示文摘AIM:To develop an algorithm to improve the diagnosis and treatment of patients with biliary candidiasis.METHODS:We performed a prospective study of 127patients who underwent endoscopic retrograde cholangiopancreatography,for various biliary disorders,at 3 tertiary referral centers in Germany from July 2011through July 2012(ClinicalTrials.gov:NCT01109550).Bile,buccal,and stool samples were collected.When indicated,endoscopic transpapillary bile duct biopsies were performed to clarify the etiology of bile duct strictures and to prove invasive fungal infections.RESULTS:Candida species were detected in 38 of the 127 bile samples(29.9%).By multivariate analysis patients’age and previous endoscopic sphincterotomy were independent risk factors for biliary candidiasis(P<0.05).Patients with immunosuppression(P=0.058)and recent long-term antibiotic therapy(>7 d)(P=0.089)tend to be at risk for biliary candidiasis.One patient was negative in mycological culture of bile fluid but invasive biliary candidiasis was diagnosed histologically.Of Candida subspecies detected,36.7%were azole-resistant,such as C glabrata.Eight patients received anti-mycotic therapy,based on our algorithm.Of these,3 had cancer with biliary tract involvement,2had secondary sclerosing cholangitis,1 had retroperitoneal fibrosis,and 5 had septicemia.In all patients contamination was ruled out by smears of the endoscope channel.CONCLUSION:Gastroenterologists should be aware of frequent candida colonization in patients with cholangitis and biliary disorders.Our suggested algorithm facilitates the further clinical management. | Philipp Lenz Franziska Eckelskemper Thomas Erichsen Tim Lankisch Alexander Dechêne Gabriele Lubritz Frank Lenze Torsten Beyna Hansjorg Ullerich Andre Schmedt Dirk Domagk | 2014 | World Journal of Gastroenterology2014，20，34： | 2 |
| 3 | Endoscopic treatment of pediatric post‐transplant biliary complications is safe and effective显示文摘 | Alexander Dechêne Cathrin Kodde Simone Kathemann Jürgen Treckmann Elke Lainka Andreas Paul Guido Gerken Ariel E. Feldstein Peter F. Hoyer Ali Canbay | 2015 | Digestive Endoscopy2015，，4： | 2 |
| 4 | Optimized endoscopic treatment of ischemic-type biliary lesions after liver transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado de Dechêne Alexander Dechêne Massimo Malágo Susanne Beckebaum Andreas Paul Guido Gerken Philip Hilgard | 2012 | Gastrointestinal Endoscopy2012，，3： | 2 |
| 5 | Polycystic ovary syndrome: a major unrecognized cardiovascular risk factor in women 显示文摘 | Alexander C J Tangchimob EP Lepor NE | 2009 | Rev Obstet Gynecoll2009，2，4： | 1 |
| 6 | Community outbreak of Mycoplasma pneumoniae infection:school-based cluster of neurologic disease associated with household transmission of respiratory illness显示文摘 | Walter ND Grant GB Bandy U Alexander NE Winchell JM Jordan HT Sejvar JJ Hicks LA Gifford DR Alexander NT Thurman KA Schwartz SB Dennehy PH Khetsuriani N Fields BS Dillon MT Erdman DD Whitney CG Moore MR | 2008 | J Infect Dis2008，198，8： | 1 |
| 7 | A Multipathogen Bile Sample-based PCR Assay Can Guide Empirical Antimicrobial Strategies in Cholestatic Liver Diseases显示文摘Background and objectives:Polymerase chain reaction(PCR)techniques provide rapid detection of pathogens.This pilot study evaluated the diagnostic utility and clinical impact of multiplex real-time PCR(mRT-PCR,SeptiFast)vs.conventional microbial culture(CMC)in bile samples of patients with chronic cholestatic liver diseases(cCLDs),endoscopic retrograde cholangio-pancreatography(ERCP),and peri-interventional-antimicrobial-prophylaxis(pAP).Methods:We prospectively collected bile samples from 26 patients for microbiological analysis by CMC and mRT-PCR.Concordance of the results of both methods was determined by Krippendorff's alpha(α)for inter-rater reliability and the Jaccard index of similarity.Results:mRT-PCR_(bile)and CMC_(bile)results were concordant for only Candida albicans(α=0.8406;Jaccard index=0.8181).mRT-PCR_(bile)detected pathogens in 8/8 cases(100%),CMC_(bile)in 7/8(87.5%),and CMCblood in 5/8(62.5%)with clinical signs of infection.mRTPCR_(bile),CMC_(bile),and CMCblood had identical detection results in 3/8(37.5%)with clinical signs of infection(two Klebsiella spp.and one Enterococcus faecium).The total pathogen count was significantly higher with mRT-PCR_(bile)than with CMC_(bile)(62 vs.31;χ^(2)=30.031,p<0.001).However,pathogens detected by mRT-PCR_(bile)were more often susceptible to pAP according to the patient infection/colonization history(PI/CH)and surveillance data for antibiotic resistance in our clinic(DARC).Pathogens identified by mRT-PC_(Rbile)and resistant to pAP by PI/CH and DARC were likely to be clinically relevant.Conclusions:mRT-PCR in conjunction with CMCs for bile analysis increased diagnostic sensitivity and may benefit infection management in patients with cholestatic diseases.Implementation of mRT-PCR in a bile sample-based diagnostic routine can support more rapid and targeted use of antimicrobial agents in cCLD-patients undergoing ERCP and reduce the rate/length of unnecessary administration of broad-spectrum antibiotics. | Michael Jahn Mustafa KÖzçürümez Sebastian Dolff Hana Rohn Dominik Heider Alexander Dechêne Ali Canbay Peter M.Rath Antonios Katsounas | 2022 | Journal of Clinical and Translational Hepatology2022，10，5： | 1 |
| 8 | Anticarcinogenesis pathways activated by bovine lactoferrin inthe murine small intestine显示文摘 | Masaaki Iigo David B Alexander Ne Long | 2009 | Biochimie2009，，91： | 1 |
| 9 | Mechanisms and future directions for prevention of vein graft failure in coronary bypass surgery显示文摘 | Jefrey HS Alexander NE Malek GM | 2002 | Eur J Cardio-Thorac Surgery2002，22，： | 1 |
| 10 | Optimized endoscopic treatment of ischemic-type biliary lesions after liver transplantation显示文摘 | Thomas Zoepf Evelyn J. Maldonado de Dechêne Alexander Dechêne Massimo Malágo Susanne Beckebaum Andreas Paul Guido Gerken Philip Hilgard | 2012 | Gastrointestinal Endoscopy2012，，3： | 1 |
| 11 | Polycystic ovary syndrome: a major unrecognized cardiovascular risk factor inwomen 显示文摘 | Alexander CJ Tangehitnob EP Lepor NE | 2009 | Rev Obstet Gynecol2009，2，4： | 1 |
| 12 | Polycystic Ovary Syndrome:A major unrecognized cardiovascular risk factor in women显示文摘 | Alexander CJ Tangchitnob EP Lepor NE | 2009 | Rev Obstet Gyneco12009，2，4： | 1 |
| 13 | Recommenda-tions for the diagnosis of Neisseria gonorrhoeae andChlamydia trachomatis,including extra-genital sites显示文摘 | Chan PA Janvier M Alexander NE | 2012 | MedHealth RI2012，95，8： | 1 |
| 14 | Polycystic ovarg syndrome:a major unrecognized cardiovascular risk factor in woman显示文摘 | Alexander CJ Tangchitnob EP Lepor NE | 2009 | Rev Obstet Gynecol2009，2，4： | 1 |
| 15 | In intermediate stage hepatocellular carcinoma: radioembolization with yttrium 90 or chemoembolization?显示文摘 | Amr El Fouly Judith Ertle Ahmed El Dorry Mohamed K. Shaker Alexander Dechêne Heba Abdella Stefan Mueller Eman Barakat Thomas Lauenstein Andreas Bockisch Guido Gerken Joerg F. Schlaak | 2015 | Liver Int2015，，2： | 1 |
| 16 | Polycystic ovary syndrome:a major unrecognized cardiovascular risk factor in women显示文摘 | Alexander CJ Tangchitnob EP Lepor NE | | 0，，： | 1 |
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