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21.
Wasmeier GH Asmussen S Voigt JU Flachskampf FA Daniel WG Nixdorff U 《Ultrasound in medicine & biology》2008,34(11):1724-1731
In myocardial contrast echocardiography (MCE), power modulation technique may quantify myocardial perfusion in real-time. However, constant infusion of the contrast agent (CA) complicates handling. This pilot study sought for the clinical feasibility of quantitative MCE by a CA bolus application during Adenosine stress echocardiography to diagnose coronary artery disease (CAD). Twenty-four consecutive patients (pts) with contemporary coronary angiography underwent rest and maximum Adenosine stress. Signal intensity could be calculated in 316/348 left ventricular (LV) segments (91%) (18-segment model). At rest, gamma-variate (alpha) as well as saturation function (beta) was not significantly different in healthy men (n = 268) as well as CAD pts (n = 48) (alpha: 0.34 s(-1) versus 0.40 s(-1), n.s.; beta: 0.31 s(-1) versus 0.35 s(-1), n.s.). During Adenosine infusion both values increased in healthy men (alpha: 0.34 +/- 0.37 s(-1) versus 0.44 +/- 0.45 s(-1), p < 0.05; beta: 0.31 +/- 0.33 s(-1) versus 0.40 +/- 0.40 s(-1), p < 0.01), but not in CAD (alpha: 0.40 +/- 0.35 s(-1) versus 0.29 +/- 0.29 s(-1), n.s.; beta: 0.35 +/- 0.32 s(-1) versus 0.27 +/- 0.30 s(-1), n.s.). Sensitivity of alpha/beta reserve 相似文献
22.
Stolzenburg JU Rabenalt R Do M Schwalenberg T Winkler M Dietel A Liatsikos E 《European urology》2008,53(5):931-940
OBJECTIVES: Based on our recently published anatomic studies, we present the most recent refinement of the endoscopic extraperitoneal radical prostatectomy (EERPE), the intrafascial nerve-sparing EERPE (nsEERPE). METHODS: As part of the intrafascial technique, the dissection plane is directly on the prostatic capsule, freeing the prostate laterally from its thin surrounding fascia that contains small vessels and nerves. The technique enables puboprostatic ligament preservation, leaving intact endopelvic fascia, periprostatic fascia, and neurovascular bundles. The operation was performed in 150 patients with indications for nerve-sparing procedure. RESULTS: The mean operative time was 131 min (range: 50-210 min) and the mean catheterization time was 5.9 d (range: 4-20 d). Twelve months postoperatively, 94.3% of the patients were continent (no need for pads), 4.6% had minimal stress incontinence, and one patient required >2 pads/d. At the 12-mo follow-up, the potency rates (erections sufficient for intercourse with or without the use of phosphodiesterase 5 [PDE5] inhibitors) of the patients who underwent bilateral intrafascial nsEERPE were 89.7% (age: 44-55 yr), 81.1% (age: 56-65 yr), and 61.9% (age: >65 yr). Positive surgical margins in pT2 and pT3 tumors were 4.5% and 29.4%, respectively. CONCLUSIONS: The intrafascial nsEERPE enables the dissection of the prostate with limited trauma to the surrounding fascias and the enclosed neurovascular bundles. We propose that the preserved neurovascular bundles with intrafascial nsEERPE are more viable. The results advocate this proposition. 相似文献
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Weisshaar E Radulescu M Soder S Apfelbacher CJ Bock M Grundmann JU Albrecht U Diepgen TL 《International archives of occupational and environmental health》2007,80(6):477-484
OBJECTIVES: Due to increased occupational dermatoses in certain professions such as health care workers (HCW), cleaning and kitchen employees (CKE), measures of prevention and skin protection are of high significance. Skin protection courses focus on educational aims (e.g. improving skin care habits, influencing the participants' attitudes towards health) and medical aims (e.g. optimising diagnostic procedures, complementing individual therapy). METHODS: Participants are patients who have been suspected to suffer from an occupational skin disease and are insured with the German Accident Prevention & Insurance Association (BGW). Teaching units of the skin protection courses focus on basics of skin functioning and important aspects of occupational skin diseases. Practical parts include information and instructions about the correct implementation of skin protection, skin care and skin cleansing. Every participant is seen by a dermatologist obtaining a precise patient's history and performing a skin examination. All this results in working out individually adapted and professional skin protection strategies. RESULTS: In total, 791 participants (93 men and 698 women) completed the skin protections courses. Six hundred and sixty-seven patients (mean age: 36.9 years, SD = 11.6) were HCW and 124 patients (mean age: 40.4 years, SD = 10.8) were CKE. In HCW 82.5% (n = 550) and in CKE 86.3% (n = 107) suffered from hand eczema of the atopic, irritant or allergic type. Irritant contact dermatitis as a single diagnosis was the most frequent one in both groups (HCW: 34.5.%, n = 230; CKE: 49.2% n = 61). According to regularly performed evaluations, the participants rated the course as good to excellent. Nearly 80% of the participants had skin lesions while attending the course, in 27% the dermatosis was severe. CONCLUSIONS: There is a high need for health education, advisory services, diagnostics and additional therapy in occupational dermatology. Prevention of occupational skin diseases and maintenance of health through educational programmes are important complementary measures for dermatological care but still missing in endangered professions. 相似文献
26.
Caterina Fontanella Bianca Lederer Stephan Gade Mieke Vanoppen Jens Uwe Blohmer Serban Dan Costa Carsten Denkert Holger Eidtmann Bernd Gerber Claus Hanusch Jörn Hilfrich Jens Huober Andreas Schneeweiss Stefan Paepke Christian Jackisch Keyur Mehta Valentina Nekljudova Michael Untch Patrick Neven Gunter von Minckwitz Sibylle Loibl 《Breast cancer research and treatment》2015,150(1):127-139
27.
Oana Mirea Efstathios D. Pagourelias Jurgen Duchenne Jan Bogaert James D. Thomas Luigi P. Badano Jens-Uwe Voigt 《JACC: Cardiovascular Imaging》2018,11(1):25-34
Objectives
The purpose of this study was to compare the accuracy of vendor-specific and independent strain analysis tools to detect regional myocardial function abnormality in a clinical setting.Background
Speckle tracking echocardiography has been considered a promising tool for the quantitative assessment of regional myocardial function. However, the potential differences among speckle tracking software with regard to their accuracy in identifying regional abnormality has not been studied extensively.Methods
Sixty-three subjects (5 healthy volunteers and 58 patients) were examined with 7 different ultrasound machines during 5 days. All patients had experienced a previous myocardial infarction, which was characterized by cardiac magnetic resonance with late gadolinium enhancement. Segmental peak systolic (PS), end-systolic (ES) and post-systolic strain (PSS) measurements were obtained with 6 vendor-specific software tools and 2 independent strain analysis tools. Strain parameters were compared between fully scarred and scar-free segments. Receiver-operating characteristic curves testing the ability of strain parameters and derived indexes to discriminate between these segments were compared among vendors.Results
The average strain values calculated for normal segments ranged from ?15.1% to ?20.7% for PS, ?14.9% to ?20.6% for ES, and ?16.1% to ?21.4% for PSS. Significantly lower values of strain (p < 0.05) were found in segments with transmural scar by all vendors, with values ranging from ?7.4% to ?11.1% for PS, ?7.7% to ?10.8% for ES, and ?10.5% to ?14.3% for PSS. Accuracy in identifying transmural scar ranged from acceptable to excellent (area under the curve 0.74 to 0.83 for PS and ES and 0.70 to 0.78 for PSS). Significant differences were found among vendors (p < 0.05). All vendors had a significantly lower accuracy to detect scars in the basal segments compared with scars in the apex (p < 0.05).Conclusions
The accuracy of identifying regional abnormality differs significantly among vendors. 相似文献28.
Neuhaus J Schulte-Baukloh H Stolzenburg JU Speroni di Fenizio P Horn LC Rüffert H Hartenstein S Burger M Schulze M Schwalenberg T 《World journal of urology》2012,30(5):693-700
Purpose
Dysregulation of neurotransmitter receptors may contribute to bladder overactivity (OAB) symptoms. To address the question whether specific receptor expression patterns are associated with bladder pain syndrome/interstitial cystitis (BPS/IC), we examined the expression of muscarinic, purinergic and histamine receptors in the detrusor.Methods
Detrusor receptor expression was investigated in bladder biopsies of female BPS/IC patients (n?=?44; age 60.64?±?13.78, mean?±?SD) and carcinoma patients (n?=?11; age 58.91?±?12.72) undergoing cystectomy. Protein expression of muscarinic (M2, M3), purinergic (P2X1–3) and histamine receptors (H1, H2) was analysed by confocal immunofluorescence, and gene expression was quantified by real-time polymerase chain reaction (qPCR).Results
M2, P2X1, P2X2 and H1 receptor immunoreactivity (-IR) was significantly enhanced in BPS/IC compared to the control group, while there was no difference for M3-, P2X3- and H2-IR. We calculated a score, which separated BPS/IC from control patients with an AUC of 89.46%, showing 84.09% sensitivity and 90.91% specificity. Patients had a 9.25 times enhanced calculated risk for BPS/IC. In addition, two patient subgroups (M2?>?M3 and M3?>?M2) were observed, which differed in associated purinergic and histamine receptor expression.Conclusions
M2, P2X1, P2X2 and H1 were significantly upregulated in BPS/IC patients, and H2 was occasionally highly overexpressed. There was no significant correlation between receptor protein and gene expression, implying posttranslational mechanisms being responsible for the altered receptor expressions. On the basis of individual receptor profiles, upregulated receptors could be targeted by monotherapy or combination therapy with already approved receptor inhibitors, thereby promoting tailored therapy for patients suffering from BPS/IC-like symptoms. 相似文献29.
Maximized reduction of primary breast tumor size using preoperative chemotherapy with doxorubicin and docetaxel. 总被引:9,自引:0,他引:9
G von Minckwitz S D Costa W Eiermann J U Blohmer A H Tulusan C Jackisch M Kaufmann 《Journal of clinical oncology》1999,17(7):1999-2005
PURPOSE: To assess the toxicity and efficacy of preoperative chemotherapy with doxorubicin and docetaxel in patients with primary operable breast cancer. PATIENTS AND METHODS: Forty-two patients with histologically confirmed primary breast cancer tumors of at least 2 cm in diameter received doxorubicin (50 mg/m(2) intravenously [IV] over 15 minutes) and docetaxel (75 mg/m(2) IV over 1 hour) every 14 (24 patients) or 21 (18 patients) days for four cycles. RESULTS: The median size of the primary tumor decreased significantly, from 4 cm (range, 2 to 10 cm) to 2 cm (range, 0 to 5 cm) on physical examination and from 3.4 cm (range, 1 to 8 cm) to 1. 8 cm (range, 0 to 4 cm) on sonography (P <.001). The overall response rate as assessed by physical examination was 93%, and complete remission of the primary tumor occurred in 33% of patients. The remission rate as assessed by sonographic measurement was 67%. Two patients (5%) had histologically confirmed complete responses. Sonography was more reliable than palpation in predicting histologically determined response. No grade 4 toxicity was noted, and grade 3 toxicity was reported with alopecia (95%), lethargy (17%), loss of appetite (10%), stomatitis (7%), leukopenia (5%), skin desquamation (5%), infection (5%), motor neuropathy (2%), and nausea (2%). The 3-week schedule was associated with less toxicity than the 2-week schedule. CONCLUSION: Preoperative combination chemotherapy with doxorubicin and docetaxel is highly effective and feasible in primary operable breast cancer. 相似文献
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