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991.
Nina Sauer Thomas Rösch Jennifer Pezold Franziska Reining Mario Anders Stefan Groth Guido Schachschal Oliver Mann Jens Aberle 《Obesity surgery》2013,23(11):1727-1733
Background
The endoluminal mechanical device SatiSphere is a new endoscopically implantable device designed to delay transit time of nutrients through the duodenum. It consists of a 1-mm nitinol wire with pigtail ends and several mesh spheres mounted along its course, released in the duodenum and gastric antrum to conform to the duodenal C loop configuration and thereby self-anchor.Methods
The objective is to test the safety, efficacy, and effect on body weight in a 2:1 randomized study, as well as incretin secretion in a subgroup.Results
Of 31 included cases (11 men, mean age 42.9 years, mean BMI 41.3 kg/m2), 21 patients treated with endoscopic device insertion with scheduled device removal after 3 months were compared with 10 controls. In 10 of 21 patients, device migration occurred, in two cases necessitating emergency surgery, which led to termination of the trial. Weight loss after 3 months was 6.7, 4.6, and 2.2 kg in the groups completing therapy, all treatment cases using intention to treat (ITT) analysis and controls. Excess weight loss was significantly increased by endoluminal mechanical device insertion (18.4, 12.2, and 4.4 % in completers, ITT analysis group and controls; p?=?0.02 for completers vs. controls). Measuring glucose, insulin, and glucagon-like peptide 1 (GLP-1) following a mixed-meal test with the device in place and after removal (n?=?7), the device delayed glucose absorption and insulin secretion and altered kinetics in GLP-1 levels.Conclusions
The device might be short-term effective in reducing body weight, which might be mediated through alterations in incretin metabolism. However, frequent device migration necessitates device modifications. 相似文献992.
TCRs with segment TRAV9-2 or a CDR3 histidine are overrepresented among nickel-specific CD4+ T cells
993.
Michel Adamina Rene Warschkow Franziska Näf Bianka Hummel Thomas Rduch Jochen Lange Thomas Steffen 《Surgical endoscopy》2014,28(10):2939-2948
Background
Early detection of infectious complications is urgently needed in the era of DRG-based compensation. This work assessed the diagnostic accuracy of c-reactive protein (CRP) level in the detection of infectious complications after laparoscopic colorectal resection.Methods
Laparoscopic colorectal resections were identified from a prospective database. Complications were graded according to the Dindo–Clavien classification. Surgical site infections were defined according to the Centers of Disease Control. CRP level was routinely measured until postoperative day (POD) 7. Uni- and multivariate analysis were performed. Diagnostic accuracy was evaluated using receiver operating curves.Results
355 patients were operated for diverticulosis (88.7 %), neoplasia (6.8 %), and other causes (4.5 %). Mean age and body mass index were 59.8 ± 13.7 years and 26.5 ± 15 kg/m2. Left, right, and total laparoscopic colectomies were performed in 316, 33, and 6 patients. Complications occurred in 85 patients and 16 patients (4.5 %) were reoperated. Fifty-one patients (14.4 %) suffered from infectious complications at a median of 6 POD, while 9 anastomoses leaked (2.7 %). In multivariate analysis, presence of an abscess at surgery was predictive of an infectious complication (OR 2.5, 95 % CI 1.1–5.3), as were a body mass index >30 kg/m2 and operative time >160 min in a bootstrap analysis. Overall, CRP peaked on POD 2 and declined thereafter. Most infectious complications were apparent starting on POD 6. A CRP <56 mg/l on POD 4 had a negative predictive value of 100 % (95 % CI 94.9–100 %) to rule out infectious complications. Above 56 mg/l, sensitivity was 100 % (95 % CI 0.8–1) and specificity 49 % (95 % CI 0.4–0.6) for the development of infectious complications in the absence of clinical signs. This translated into a remarkable diagnostic accuracy of 78 % (95 % CI 0.7–0.9).Conclusion
Monitoring CRP level in laparoscopic colorectal surgery demonstrated a high diagnostic accuracy for infectious complications, thus allowing for safe and early discharge. 相似文献994.
Franziska St?ber Kathrin Baldauf Iryna Ziabreva Denise Harhausen Marietta Zille Jenni Neubert Klaus G Reymann Henning Scheich Ulrich Dirnagl Ulrich H Schr?der Andreas Wunder Jürgen Goldschmidt 《Journal of cerebral blood flow and metabolism》2014,34(1):144-152
Neuronal damage shortly after onset or after brief episodes of cerebral ischemia has remained difficult to assess with clinical and preclinical imaging techniques as well as with microscopical methods. We here show, in rodent models of middle cerebral artery occlusion (MCAO), that neuronal damage in acute focal cerebral ischemia can be mapped with single-cell resolution using thallium autometallography (TlAMG), a histochemical technique for the detection of the K+-probe thallium (Tl+) in the brain. We intravenously injected rats and mice with thallium diethyldithiocarbamate (TlDDC), a lipophilic chelate complex that releases Tl+ after crossing the blood–brain barrier. We found, within the territories of the affected arteries, areas of markedly reduced neuronal Tl+ uptake in all animals at all time points studied ranging from 15 minutes to 24 hours after MCAO. In large lesions at early time points, areas with neuronal and astrocytic Tl+ uptake below thresholds of detection were surrounded by putative penumbral zones with preserved but diminished Tl+ uptake. At 24 hours, the areas of reduced Tl+uptake matched with areas delineated by established markers of neuronal damage. The results suggest the use of 201TlDDC for preclinical and clinical single-photon emission computed tomography (SPECT) imaging of hyperacute alterations in brain K+ metabolism and prediction of tissue viability in cerebral ischemia. 相似文献
995.
Franziska Gamma Jill M. Goldstein Larry J. Seidman Garrett M. Fitzmaurice Ming T. Tsuang Stephen L. Buka 《Schizophrenia bulletin》2014,40(5):992-1000
Identifying early developmental indicators of risk for schizophrenia is important for prediction and possibly illness prevention. Disturbed intermodality has been proposed as one important neurodevelopmental risk for schizophrenia. Early intermodal integration (EII) is the infant’s ability to link motility and perception and to relate perception across modalities. We hypothesized that infants of parents with schizophrenia would have more EII abnormalities than infants of healthy parents and that infants of parents with affective psychosis would be intermediate in severity. The New England Family Study high-risk sample, ascertained from community populations, was utilized. Eight-month-old infants of parents with schizophrenia (n = 58), affective psychoses (n = 128), and healthy controls (n = 174) were prospectively assessed. Diagnoses of parents were determined 30 years later blind to offspring data. EII measures were grouped into 3 domains characterizing different aspects of infant development: (1) one’s own body, (2) objects, and (3) social interactions. Results demonstrated that body- and object-related EII abnormalities were significantly increased for infants of parents with schizophrenia compared with control infants and not significantly increased for infants of parents with affective psychoses. EII abnormalities in relation to social interactions were significantly increased in infants of parents with schizophrenia and affective psychoses. Thus, body- and object-related EII abnormalities were most severe in infants of parents with schizophrenia, supporting the importance of intermodality dysfunction as an early indicator of the vulnerability to schizophrenia. Future research should evaluate how this dysfunction evolves with development and its associations with other psychopathological and neurodevelopmental deficits in youth at risk for psychosis.Key words: schizophrenia, high-risk study, developmental psychology 相似文献
996.
997.
Multimodel assessment of water scarcity under climate change 总被引:1,自引:0,他引:1
Jacob Schewe Jens Heinke Dieter Gerten Ingjerd Haddeland Nigel W. Arnell Douglas B. Clark Rutger Dankers Stephanie Eisner Balázs M. Fekete Felipe J. Colón-González Simon N. Gosling Hyungjun Kim Xingcai Liu Yoshimitsu Masaki Felix T. Portmann Yusuke Satoh Tobias Stacke Qiuhong Tang Yoshihide Wada Dominik Wisser Torsten Albrecht Katja Frieler Franziska Piontek Lila Warszawski Pavel Kabat 《Proceedings of the National Academy of Sciences of the United States of America》2014,111(9):3245-3250
Water scarcity severely impairs food security and economic prosperity in many countries today. Expected future population changes will, in many countries as well as globally, increase the pressure on available water resources. On the supply side, renewable water resources will be affected by projected changes in precipitation patterns, temperature, and other climate variables. Here we use a large ensemble of global hydrological models (GHMs) forced by five global climate models and the latest greenhouse-gas concentration scenarios (Representative Concentration Pathways) to synthesize the current knowledge about climate change impacts on water resources. We show that climate change is likely to exacerbate regional and global water scarcity considerably. In particular, the ensemble average projects that a global warming of 2 °C above present (approximately 2.7 °C above preindustrial) will confront an additional approximate 15% of the global population with a severe decrease in water resources and will increase the number of people living under absolute water scarcity (<500 m3 per capita per year) by another 40% (according to some models, more than 100%) compared with the effect of population growth alone. For some indicators of moderate impacts, the steepest increase is seen between the present day and 2 °C, whereas indicators of very severe impacts increase unabated beyond 2 °C. At the same time, the study highlights large uncertainties associated with these estimates, with both global climate models and GHMs contributing to the spread. GHM uncertainty is particularly dominant in many regions affected by declining water resources, suggesting a high potential for improved water resource projections through hydrological model development. 相似文献
998.
Stephan Kreher M. Amine Bouhlel Pierre Cauchy Bj?rn Lamprecht Shuang Li Michael Grau Franziska Hummel Karl K?chert Ioannis Anagnostopoulos Korinna J?hrens Michael Hummel John Hiscott S?ren-Sebastian Wenzel Peter Lenz Markus Schneider Ralf Küppers Claus Scheidereit Maciej Giefing Reiner Siebert Klaus Rajewsky Georg Lenz Peter N. Cockerill Martin Janz Bernd D?rken Constanze Bonifer Stephan Mathas 《Proceedings of the National Academy of Sciences of the United States of America》2014,111(42):E4513-E4522
999.
Christian Schneider Franziska Bucher Claus Cursiefen Gereon R. Fink Ludwig M. Heindl Helmar C. Lehmann 《Journal of the peripheral nervous system : JPNS》2014,19(4):322-327
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune‐mediated peripheral neuropathy with multifocal involvement. Reliable biomarkers for diagnosis, disease progression, and treatment response remain to be developed. We assessed the utility of corneal confocal microscopy (CCM) as a diagnostic marker for CIDP in 16 patients. CCM parameters including corneal nerve fiber density (NFD), nerve fiber length, number of main nerve trunks, number of nerve branches, nerve tortuosity, and dendritic cell density (DCD) were compared to those from 15 healthy controls and correlated with clinical and electrophysiological findings. CIDP patients had a significantly lower corneal NFD compared to healthy controls. The total nerve fiber length and the number of nerve branches were significantly decreased, whereas nerve tortuosity was increased in patients with CIDP. There was no positive correlation between corneal NFD and clinical or electrophysiological assessments. The average DCD was not significantly different in CIDP patients and controls. CCM measures suggest damage to small sensory afferents in the cornea in CIDP patients. Further studies are needed to compare different neuropathic conditions and to explore longitudinal changes of CCM parameters. 相似文献
1000.
Andreas J. Forstner F. Buket Basmanav Manuel Mattheisen GROUP Investigators Anne C. B?hmer Mads V. Hollegaard Esther Janson Eric Strengman Lutz Priebe Franziska Degenhardt Per Hoffmann Stefan Herms Wolfgang Maier Rainald M?ssner Dan Rujescu Roel A. Ophoff Susanne Moebus Preben B. Mortensen Anders D. B?rglum David M. Hougaard Josef Frank Stephanie H. Witt Marcella Rietschel Andreas Zimmer Markus M. N?then Xavier Miró Sven Cichon 《Journal of psychiatry & neuroscience : JPN》2014,39(6):386-396