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| 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 | Helicobacter pylori vac A genotype is a predominant determinant of immune response to Helicobacter pylori CagA显示文摘AIM To evaluate the frequency of Helicobacter pylori(H. pylori) Cag A antibodies in H. pylori infected subjects and to identify potential histopathological and bacterial factors related to H. pylori Cag A-immune response.METHODS Systematic data to H. pylori isolates, blood samples, gastric biopsies for histological and molecular analyses were available from 99 prospectively recruited subjects. Serological profile(anti-H. pylori, anti-Cag A) was correlated with H. pylori isolates(cag A, EPIYA, vac A s/m genotype), histology(Sydney classification) and mucosal interleukin-8(IL-8) m RNA and protein expression. Selected H. pylori strains were assessed for H. pylori Cag A protein expression and IL-8 induction in co-cultivation model with AGS cells.RESULTS Thirty point three percent of microbiologically confirmed H. pylori infected patients were seropositive for Cag A. Majority of H. pylori isolates were cag A gene positive(93.9%) with following vac A polymorphisms: 42.4% vac A s1m1, 23.2% s1m2 and 34.3% s2m2. Anti-Cag AIg G seropositivity was strongly associated with atrophic gastritis, increased mucosal inflammation according to the Sydney score, IL-8 and cag A m RNA expression. V a c A s a n d m p o l y m o r p h i s m s w e r e t h e m a j o r determinants for positive(vac A s1m1) or negative(vac A s2m2) anti-Cag A serological immune response, which also correlated with the in vitro inflammatory potential in AGS cells. In vitro co-cultivation of representative H. pylori strains with AGS cells confirmed functional Cag A translocation, which showed only partial correlation with Cag A seropositivity in patients, supporting vac A as major co-determinant of the immune response.CONCLUSION Serological immune response to H. pylori cag A + strain in H. pylori infected patients is strongly associated with vac A polymorphism, suggesting the crucial role of bacterial factors in immune and clinical phenotype of the infection. | Alexander Link Cosima Langner Wiebke Schirrmeister Wiebke Habendorf Jochen Weigt Marino Venerito Ina Tammer Dirk Schlüter Philipp Schlaermann Thomas F Meyer Thomas Wex Peter Malfertheiner | 2017 | World Journal of Gastroenterology2017，23，26： | 12 |
| 4 | Consensus and Future Directions on the Definition of High On-Treatment Platelet Reactivity to Adenosine Diphosphate显示文摘 | Laurent Bonello Udaya S. Tantry Rossella Marcucci Ruediger Blindt Dominick J. Angiolillo Richard Becker Deepak L. Bhatt Marco Cattaneo Jean Philippe Collet Thomas Cuisset Christian Gachet Gilles Montalescot Lisa K. Jennings Dean Kereiakes Dirk Sibbing Die | 2010 | Journal of the American College of Cardiology2010，，12： | 3 |
| 5 | 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 |
| 6 | Double- vs. single-balloon vs. spiral enteroscopy显示文摘 | Philipp Lenz Dirk Domagk | 2012 | Best Practice & Research Clinical Gastroenterology2012，，3： | 2 |
| 7 | Complete reversal of paraplegia after thoracic endovascular aortic repair in a patient with complicated acute aortic dissection using immediate cerebrospinal fluid drainage显示文摘 | Holger Eggebrecht Dirk B?se Thomas Gasser Jaroslav Benedik Petra Mummel Oliver Müller Philipp Kahlert Konstantinos Tsagakis Heinz G. Jakob Raimund Erbel | 2009 | Clinical Research in Cardiology2009，，12： | 1 |
| 8 | Luminescent afterglow behavior in the M2 Sis N8 : Eu familly (M=Ca, Sr, Ba) 显示文摘 | Koen Van den Eeckhout Philippe F Smet Dirk Poelman | 2011 | Materials2011，，4： | 1 |
| 9 | 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 |
| 10 | Endometrial cancer显示文摘 | Frederic Amant Philippe Moerman Patrick Neven Dirk Timmerman Erik Van Limbergen Ignace Vergote | 2005 | The Lancet2005，，9484： | 1 |
| 11 | Association of echocardiographic atrial size and atrial fibrosis in a sequential model of congestive heart failure and atrial fibrillation显示文摘 | Christian Knackstedt Felix Gramley Thomas Schimpf Karl Mischke Markus Zarse Jurgita Plisiene Michael Schmid Johann Lorenzen Dirk Frechen Philipp Neef Peter Hanrath Malte Kelm Patrick Schauerte | 2008 | Cardiovascular Pathology2008，，5： | 1 |
| 12 | Timing of chest radiotherapy in patients with limited stage small cell lung cancer: A systematic review and meta-analysis of randomised controlled trials显示文摘 | Madelon Pijls-Johannesma Dirk De Ruysscher Johan Vansteenkiste Arnold Kester Isabelle Rutten Philippe Lambin | 2007 | Cancer Treatment Reviews2007，，5： | 1 |
| 13 | Double- vs. single-balloon vs. spiral enteroscopy显示文摘 | Philipp Lenz Dirk Domagk | 2012 | Best Practice & Research Clinical Gastroenterology2012，，3： | 1 |
| 14 | Surgical multimodality treatment for baseline resectable stage IIIA-N2 non-small cell lung cancer. Degree of mediastinal lymph node involvement and impact on survival ☆显示文摘 | Herbert Decaluwé Paul De Leyn Johan Vansteenkiste Christophe Dooms Dirk Van Raemdonck Philippe Nafteux Willy Coosemans Toni Lerut | 2009 | European Journal of Cardio-Thoracic Surgery2009，，3： | 1 |
| 15 | What to choose as radical local treatment for lung metastases from colo-rectal cancer: Surgery or radiofrequency ablation?显示文摘 | Roel C.J. Schlijper Janneke P.C. Grutters Ruud Houben Anne-Marie C. Dingemans Joachim E. Wildberger Dirk Van Raemdonck Eric Van Cutsem Karin Haustermans Guido Lammering Philippe Lambin Dirk De Ruysscher | 2013 | Cancer Treatment Reviews2013，，： | 1 |
| 16 | Consensus and Future Directions on the Definition of High On-Treatment Platelet Reactivity to Adenosine Diphosphate显示文摘 | Laurent Bonello Udaya S. Tantry Rossella Marcucci Ruediger Blindt Dominick J. Angiolillo Richard Becker Deepak L. Bhatt Marco Cattaneo Jean Philippe Collet Thomas Cuisset Christian Gachet Gilles Montalescot Lisa K. Jennings Dean Kereiakes Dirk Sibbing Die | 2010 | Journal of the American College of Cardiology2010，，12： | 1 |
| 17 | Minimally invasive esophagectomy for cancer显示文摘 | Georges Decker Willy Coosemans Paul De Leyn Herbert Decaluwé Philippe Nafteux Dirk Van Raemdonck Toni Lerut | 2009 | European Journal of Cardio-Thoracic Surgery2009，，1： | 1 |
| 18 | Advances in sulfide phosphors for displays and lighting显示文摘 | Dirk Poelman Jo E. Haecke Philippe F. Smet | 2009 | Journal of Materials Science: Materials in Electronics2009，，1： | 1 |
| 19 | Singal-Adapted Multiresolution Transform for image coding显示文摘 | PHILIPPE DESARTE BENOIT MACQ SLOCK DIRK T M | 1992 | IEEE Trans on information Theory1992，38，2： | 1 |
| 20 | 口服和静脉铁剂替代治疗对于炎性肠病患者肠道微生物和代谢组学的改变截然不同显示文摘目的缺铁是炎性肠病(IBD)患者常见的并发症,但口服铁剂治疗被认为可能加重IBD症状。我们进行一项开放临床研究,比较口服铁剂治疗与静脉铁剂治疗的作用。方法人选31例克罗恩病(CD)、22例溃疡性结肠炎(UC)和19例非炎性病变患者作为对照。受试者随机接受口服硫酸亚铁治疗(PO)或者静脉注射蔗糖铁剂治疗(Iv)3个月,评价干预前后的临床指标、肠道菌群及代谢组学变化。结果口服和静脉治疗都能改善缺铁,静脉治疗后铁蛋白水平更高。疾病的活动度与铁剂治疗方法无关。IBD的肠道菌群有明显的个体间差异,梭菌属丰度和比例降低。代谢物分析也能明显区分CD、UC和对照组。约有一半的受试者在接受铁剂替代治疗后出现明显的细菌种属的多样性转变,其中CD者最为敏感。除铁剂替代治疗可导致个体.菌种属的特异性变化外,口服铁剂治疗还引起普氏粪杆菌、布氏瘤胃球菌、多利亚芽孢杆菌和产气柯氏杆菌属的操作分类单元(operationaltaxonomicunits,OTUs)丰度下降。代谢组学分析发现,Iv和PO治疗后胆固醇代谢相关的宿主底物水平有明显的改变。结论铁剂治疗可以导致IBD的肠道菌群结构和代谢产物改变。虽然临床结局类似,口服与静脉铁剂治疗对肠道菌群种属和代谢产物的改变有所不同。 | Thomas Lee Thomas Clavel Kirill Smirnov Annemarie Schmidt Ilias Lagkouvardos Aiesia Walker Marianna Lucio Bernhard Michalke Philippe Schmitt-Kopplin Richard Fedorak Dirk Hailer 毛玲娜 宋震亚 | 2017 | 英国医学杂志中文版2017，20，7： | 1 |
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