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von Bargen MF, Glienke M, Wilhelm K, Neubauer J, Weiß J, Kotter E, Mager R, Jorg T, Mildenberger P, Pinto Dos Santos P, Gratzke C, Schoenthaler M. [Report template from the German Society of Urology and the German Radiological Society for standardized, structured reporting of native computed tomography scans in the diagnosis of urinary stones]. Urologie 2023; 62:1169-1176. [PMID: 37755575 DOI: 10.1007/s00120-023-02199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/28/2023]
Abstract
Standardized structured radiological reporting (SSRB) has been promoted in recent years. The aims of SSRB include that reports be complete, clear, understandable, and stringent. Repetitions or superfluous content should be avoided. In addition, there are advantages in the presentation of chronological sequences, tracking and correlations with structured findings from other disciplines and also the use of artificial intelligence (AI)-based methods. The development of the presented template for SSRB of native computed tomography for urinary stones followed the "process for the creation of quality-assured and consensus-based report templates as well as subsequent continuous quality control and updating" proposed by the German Radiological Society (DRG). This includes several stages of drafts, consensus meetings and further developments. The final version was published on the DRG website ( www.befundung.drg.de ). The template will be checked annually by the steering group and adjusted as necessary. The template contains 6 organ domains (e.g., right kidney) for which entries can be made for a total of 21 different items, mostly with selection windows. If "no evidence of stones" is selected for an organ in the first query, the query automatically jumps to the next organ, so that the processing can be processed very quickly despite the potentially high total number of individual queries for all organs. The German, European, and North American Radiological Societies perceive the establishment of a standardized structured diagnosis of tomographic imaging methods not only in oncological radiology as one of the current central tasks. With the present template for the description of computed tomographic findings for urinary stone diagnostics, we are presenting the first version of a urological template. Further templates for urological diseases are to follow.
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Affiliation(s)
- M F von Bargen
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland.
| | - M Glienke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland
| | - K Wilhelm
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland
| | - J Neubauer
- Medizinische Fakultät, Klinik für Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - J Weiß
- Medizinische Fakultät, Klinik für Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - E Kotter
- Medizinische Fakultät, Klinik für Radiologie, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - R Mager
- Klinik für Urologie, Universitätsklinikum Mainz, Mainz, Deutschland
| | - T Jorg
- Klinik für Radiologie, Universitätsklinikum Mainz, Mainz, Deutschland
| | - P Mildenberger
- Klinik für Radiologie, Universitätsklinikum Mainz, Mainz, Deutschland
| | | | - C Gratzke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland
| | - M Schoenthaler
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland
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Höck A, Herwig-Carl MC, Holz FG, Wilhelm K, Loeffler KU. [Unusual colonization in the lacrimal drainage system]. Ophthalmologie 2023; 120:123. [PMID: 36547670 DOI: 10.1007/s00347-022-01788-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Andrea Höck
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
| | - Martina C Herwig-Carl
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.,Sektion Ophthalmopathologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Frank G Holz
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - Kai Wilhelm
- Abteilung für Radiologie, Johanniter-Kliniken Bonn, Bonn, Deutschland
| | - Karin U Loeffler
- Klinik für Augenheilkunde, Universitätsklinikum Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.,Sektion Ophthalmopathologie, Universitätsklinikum Bonn, Bonn, Deutschland
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Thaeren J, Muschler E, Ko YD, Winnesberg A, Wilhelm K. [Atypical acromion fracture after fall of an 18-year-old patient]. Radiologie (Heidelb) 2022; 62:1075-1078. [PMID: 36125523 DOI: 10.1007/s00117-022-01070-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Jennifer Thaeren
- Radiologie, Johanniter-Krankenhaus Bonn, Johanniter Str. 3-5, 53113, Bonn, Deutschland.
| | - Eugen Muschler
- Radiologie, Johanniter-Krankenhaus Bonn, Johanniter Str. 3-5, 53113, Bonn, Deutschland
| | - Yon-Dschun Ko
- Innere Medizin/Internistische Onkologie, Johanniter-Krankenhaus Bonn, Bonn, Deutschland
| | - Arnd Winnesberg
- Unfallchirurgie, Johanniter-Krankenhaus Bonn, Bonn, Deutschland
| | - Kai Wilhelm
- Radiologie, Johanniter-Krankenhaus Bonn, Johanniter Str. 3-5, 53113, Bonn, Deutschland
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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5
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Metzen M, Kowar M, Solleder G, Wilhelm K, Jacobs AH. [BCG-therapy as a rare reason for postrenal failure]. Dtsch Med Wochenschr 2022; 147:403-406. [PMID: 35345047 DOI: 10.1055/a-1766-3235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
HISTORY AND CLINICAL FINDINGS In the following case report, we describe a patient with acute renal failure due to an urinary congestion level II-III under BCG-(Bacillus Calmette-Guérin)-therapy because of bladder cancer. Cystoscopy revealed the diagnosis of BCG-induced intramural narrowing of distal ureters bilaterally. THERAPY AND FURTHER DEVELOPMENT After receiving a double-J-catheter the renal function returned to normal. CONCLUSIONS Although postrenal failure is relatively rare (5 %), also seldom causes such as medication-induced (e. g. BCG) ureter stenosis has to be included into the differential diagnosis.
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Affiliation(s)
- Maike Metzen
- Klinik für Geriatrie mit Neurologie und Tagesklinik, Johanniter-Krankenhaus Bonn
| | - Michael Kowar
- Klinik für Geriatrie mit Neurologie und Tagesklinik, Johanniter-Krankenhaus Bonn
| | | | - Kai Wilhelm
- Altersmedizinisches Zentrum der Johanniter-Kliniken Bonn
| | - Andreas H Jacobs
- Klinik für Geriatrie mit Neurologie und Tagesklinik, Johanniter-Krankenhaus Bonn
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6
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Handke NA, Koch DC, Muschler E, Thomas D, Luetkens JA, Attenberger UI, Kuetting D, Pieper CC, Wilhelm K. Bleeding management in computed tomography-guided liver biopsies by biopsy tract plugging with gelatin sponge slurry. Sci Rep 2021; 11:24506. [PMID: 34969958 PMCID: PMC8718535 DOI: 10.1038/s41598-021-04155-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/13/2021] [Indexed: 01/12/2023] Open
Abstract
To evaluate the safety and impact of biopsy tract plugging with gelatin sponge slurry in percutaneous liver biopsy. 300 consecutive patients (158 females, 142 males; median age, 63 years) who underwent computed tomography-guided core biopsy of the liver in coaxial technique (16/18 Gauge) with and without biopsy tract plugging were retrospectively reviewed (January 2013 to May 2018). Complications were rated according to the common criteria for adverse events (NCI-CTCAE). The study cohort was dichotomized into a plugged (71%; n = 214) and an unplugged (29%; n = 86) biopsy tract group. Biopsy tract plugging with gelatin sponge slurry was technically successful in all cases. Major bleeding events were only observed in the unplugged group (0.7%; n = 2), whereas minor bleedings (4.3%) were observed in both groups (plugged, 3.6%, n = 11; unplugged, 0.7%, n = 2). Analysis of biopsies and adverse events showed a significant association between number of needle-passes and overall (P = 0.038; odds ratio: 1.395) as well as minor bleeding events (P = 0.020; odds ratio: 1.501). No complications associated with gelatin sponge slurry were observed. Biopsy tract plugging with gelatin sponge slurry is a technically easy and safe procedure that can prevent major bleeding events following liver biopsy.
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Affiliation(s)
- Nikolaus A Handke
- Department of Radiology, Johanniter-Hospital Bonn, Bonn, Germany.
- Department of Radiology, University Hospital Bonn, Bonn, Germany.
| | - Dennis C Koch
- Department of Radiology, Johanniter-Hospital Bonn, Bonn, Germany
| | - Eugen Muschler
- Department of Radiology, Johanniter-Hospital Bonn, Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | | | | | - Daniel Kuetting
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Claus C Pieper
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, Johanniter-Hospital Bonn, Bonn, Germany
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7
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Recker F, Thudium M, Strunk H, Tonguc T, Dohmen S, Luechters G, Bette B, Welz S, Salam B, Wilhelm K, Egger EK, Wüllner U, Attenberger U, Mustea A, Conrad R, Marinova M. Multidisciplinary management to optimize outcome of ultrasound-guided high-intensity focused ultrasound (HIFU) in patients with uterine fibroids. Sci Rep 2021; 11:22768. [PMID: 34815488 PMCID: PMC8611035 DOI: 10.1038/s41598-021-02217-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/08/2021] [Indexed: 12/22/2022] Open
Abstract
Little is known about the specific anaesthesiological and multidisciplinary management of high-intensity focused ultrasound (HIFU) in uterine fibroids. This observational single-center study is the first reporting on an interdisciplinary approach to optimize outcome following ultrasound (US)-guided HIFU in German-speaking countries. A sample of forty patients with symptomatic uterine fibroids was treated by HIFU. Relevant treatment parameters such as total treatment time for intervention, anaesthesia, and sonication time as well as total energy, body temperature, peri-interventional medication and complications were analyzed. Interventional variables did not correlate significantly either with opioid dose or with body temperature. The average fibroid volume reduction rate was 37.8% ± 23.5%, 48.5% ± 22.0% and 70.2% ± 25.5% after 3, 6 and 12 months, respectively. No major anaesthesiological complications occurred apart from an epileptic seizure prior to HIFU treatment in one patient. Peri-procedural hyperthermia (> 37.5 °C) occurred in two patients. Post-procedural two patients experienced a sciatic nerve irritation up to one year; one patient with very large treated fibroid experienced strong short-lasting post-procedural pain. There were two complication-free pregnancies of HIFU-treated patients. Multidisciplinary management is crucial to optimize safety and outcome of US-guided HIFU for uterine fibroids. Peri-procedural pain and temperature management are critical points where an adequate collaboration between anesthesiologist and interventionalist is mandatory.
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Affiliation(s)
- Florian Recker
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Marcus Thudium
- Department of Anaesthesiology, University Hospital Bonn, Bonn, Germany
| | - Holger Strunk
- Department of Radiology, Städtisches Klinikum Solingen, Solingen, Germany
| | - Tolga Tonguc
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Sara Dohmen
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Guido Luechters
- Center for Development Research (ZEF), University Bonn, Bonn, Germany
| | - Birgit Bette
- Department of Anaesthesiology, University Hospital Bonn, Bonn, Germany
| | - Simone Welz
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Babak Salam
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, Johanniter Krankenhaus Bonn, Bonn, Germany
| | - Eva K Egger
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany
| | - Alexander Mustea
- Department of Gynaecology and Gynaecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Rupert Conrad
- Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Milka Marinova
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany. .,Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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8
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Kowar M, Wilhelm K, Jacobs AH. Polycythämia vera in der differenzialdiagnostischen Abklärung kognitiver Defizite. Dtsch Med Wochenschr 2020; 145:1625-1627. [DOI: 10.1055/a-1219-9564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Anamnese Es erfolgt die Aufnahme einer 82-jährigen Patientin zur weiteren Abklärung zunehmender kognitiver Defizite und Gangunsicherheit.
Diagnostik und Befunde In der durchgeführten Computertomografie des Kopfes zeigten sich die Zeichen einer fortgeschrittenen subkortikalen arteriosklerotischen Enzephalopathie (SAE). Laborchemisch fiel ein erhöhter Hämoglobinwert von 19,9 g/dl auf. Bei zusätzlicher Mutation in der JAK-2-Analyse wurde die Diagnose einer Polycythämia vera (Pv) gestellt. Nach Aderlass-Therapie zeigte sich eine Verbesserung der Kognition.
Diskussion Die progredienten kognitiven Defizite sind bei vorbestehender SAE im Zusammenhang mit der neu diagnostizierten Pv zu sehen. Nach entsprechender Therapie der Pv ist auch langfristig eine Besserung der Kognition zu beobachten, sodass in diesem Fallbericht die Wichtigkeit einer Abklärung sekundärer, potenziell behandelbarer Ursachen von kognitiven Defiziten hervorgehoben wird.
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Affiliation(s)
- Michael Kowar
- Johanniter-Kliniken Bonn, Bonn, Klinik für Geriatrie mit Neurologie und Tagesklinik
| | - Kai Wilhelm
- Johanniter-Kliniken Bonn, Bonn, Abteilung für Radiologie
| | - Andreas H Jacobs
- Johanniter-Kliniken Bonn, Bonn, Klinik für Geriatrie mit Neurologie und Tagesklinik
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9
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Suarez-Ibarrola R, Braun L, Pohlmann P, Becker W, Bergmann A, Gratzke C, Miernik A, Wilhelm K. Metabolic imaging of urothelial carcinoma by simultaneous autofluorescence lifetime imaging of NAD(P)H and FAD. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Frackowiak M, Kowar M, Sippel C, Wilhelm K, Ko YD, Jacobs AH. [Paraneoplastic subacute degeneration of the cerebellum in non-small cell lung cancer and positive anti-Tr3 antibodies]. Nervenarzt 2020; 91:156-160. [PMID: 31900515 DOI: 10.1007/s00115-019-00859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Neurological disorders can occur before the diagnosis of a malignoma is set. These disorders are induced by a misguided immune response with antibodies against intracellular or cell surface antigens. One of the most common paraneoplastic diseases is the subacute degeneration of the cerebellum. In most of the cases antibodies against Anti Hu, CRMP5/CV2, Amphiphysin and Ma/Ta are found and small cell bronchial carcinoma, breast cancer and lymphoma are diagnosed. We report about a 67 years old man with cerebellar symptoms and a weight loss of 10 kg who was treated in our clinic. After our diagnostic work up we found a non small cell cancer and diagnosed a subacute degeneration of the cerebellum as a paraneoplastic disorder. We found a high positive titer for Anti-Tr3 antibodies while the rest of the paraneoplastic antibodies described as typically associated with the subacute degeneration of the cerebellum were negative. The Anti-Tr3 antibodies are usually found in patients with Hodgkin and less often Non-Hodgkin disease. After initiation of a tumor specific therapy and intravenous immunoglobulin therapy the cerebellar symptoms decreased. In future follow up examinations we will see if the anti-Tr3 antibodies were associated with the non small cell bronchial carcinoma or if a lymphoma will occur in our patient.
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Affiliation(s)
- M Frackowiak
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland
| | - M Kowar
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland.
| | - Ch Sippel
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland
| | - K Wilhelm
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland
| | - Y-D Ko
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland
| | - A H Jacobs
- Johanniter-Krankenhaus Bonn, Johanniterstr. 3-5, 53113, Bonn, Deutschland
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11
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Affiliation(s)
- K Wilhelm
- Department Chirurgie, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland.
- UroEvidence, Deutsche Gesellschaft für Urologie, Nestorstraße 8/9, 10709, Berlin, Deutschland.
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12
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Schoeb DS, Wullich B, Dürschmied D, Heimbach B, Heupel-Reuter M, Gross AJ, Wilhelm K, Gratzke C, Miernik A. [Treatment of benign prostatic hyperplasia in geriatric patients-use and limitations of existing guidelines]. Urologe A 2019; 58:1029-1038. [PMID: 31451881 DOI: 10.1007/s00120-019-0988-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The demographic developments of western society and the resulting increase in the number of very old patients in urology represents a challenge for the design of clinical studies and, consequently, recommendations of guidelines. While in internal medicine there is already a subspecialization with a focus on the treatment of elderly and multimorbid patients, in urology there is hardly any subspecialization into the problems of geriatric patients. Thus, using a case study as an example, the treatment decisions for benign prostatic hyperplasia (BPH) in geriatric patients are discussed. In addition the available evidence from the literature and guidelines are presented in order to assiste in daily management of geriatric patients with lower urinary tract symptoms and to critically discuss potential fields of application and limitations of the existing guidelines. In this context, we also examine the challenges when choosing a drug therapy and in deciding which of the many surgical options should be used.
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Affiliation(s)
- D S Schoeb
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.
| | - B Wullich
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91054, Erlangen, Deutschland
| | - D Dürschmied
- Medizinische Fakultät, Klinik für Kardiologie und Angiologie, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - B Heimbach
- Medizinische Fakultät, Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland
| | - M Heupel-Reuter
- Medizinische Fakultät, Zentrum für Geriatrie und Gerontologie Freiburg, Universitätsklinikum Freiburg, Lehener Straße 88, 79106, Freiburg, Deutschland
| | - A J Gross
- Abteilung für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
| | - K Wilhelm
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - C Gratzke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
| | - A Miernik
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland
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13
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Lim R, Sugino T, Nolte H, Andrade J, Zimmermann B, Shi C, Doddaballapur A, Ong YT, Wilhelm K, Fasse JWD, Ernst A, Kaulich M, Husnjak K, Boettger T, Guenther S, Braun T, Krüger M, Benedito R, Dikic I, Potente M. Deubiquitinase USP10 regulates Notch signaling in the endothelium. Science 2019; 364:188-193. [PMID: 30975888 DOI: 10.1126/science.aat0778] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/14/2019] [Indexed: 12/15/2022]
Abstract
Notch signaling is a core patterning module for vascular morphogenesis that codetermines the sprouting behavior of endothelial cells (ECs). Tight quantitative and temporal control of Notch activity is essential for vascular development, yet the details of Notch regulation in ECs are incompletely understood. We found that ubiquitin-specific peptidase 10 (USP10) interacted with the NOTCH1 intracellular domain (NICD1) to slow the ubiquitin-dependent turnover of this short-lived form of the activated NOTCH1 receptor. Accordingly, inactivation of USP10 reduced NICD1 abundance and stability and diminished Notch-induced target gene expression in ECs. In mice, the loss of endothelial Usp10 increased vessel sprouting and partially restored the patterning defects caused by ectopic expression of NICD1. Thus, USP10 functions as an NICD1 deubiquitinase that fine-tunes endothelial Notch responses during angiogenic sprouting.
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Affiliation(s)
- R Lim
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - T Sugino
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - H Nolte
- Institute for Genetics and Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, D-50931 Cologne, Germany
| | - J Andrade
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - B Zimmermann
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - C Shi
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - A Doddaballapur
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - Y T Ong
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - K Wilhelm
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - J W D Fasse
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - A Ernst
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, D-60590 Frankfurt am Main, Germany.,Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Project Group Translational Medicine and Pharmacology TMP, D-60590 Frankfurt am Main, Germany
| | - M Kaulich
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, D-60590 Frankfurt am Main, Germany
| | - K Husnjak
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, D-60590 Frankfurt am Main, Germany
| | - T Boettger
- Department of Cardiac Development and Remodeling, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - S Guenther
- Department of Cardiac Development and Remodeling, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - T Braun
- Department of Cardiac Development and Remodeling, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany
| | - M Krüger
- Institute for Genetics and Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, D-50931 Cologne, Germany
| | - R Benedito
- Molecular Genetics of Angiogenesis Laboratory, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
| | - I Dikic
- Institute of Biochemistry II, Faculty of Medicine, Goethe University, D-60590 Frankfurt am Main, Germany.,Buchmann Institute for Molecular Life Sciences, Goethe University, D-60438 Frankfurt am Main, Germany
| | - M Potente
- Angiogenesis and Metabolism Laboratory, Max Planck Institute for Heart and Lung Research, D-61231 Bad Nauheim, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Frankfurt Rhine-Main, D-13347 Berlin, Germany.,International Institute of Molecular and Cell Biology, 02-109 Warsaw, Poland
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Pohlmann PF, Kunzelmann M, Wilhelm K, Miernik A, Gratzke C, Jud A, Pisarski P, Jänigen B. Magnetic Ureteral Stents Are Feasible in Kidney Transplant Recipients: A Single-Center Experience. Int J Organ Transplant Med 2019; 10:162-166. [PMID: 33312460 PMCID: PMC7722514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Insertion of ureteral catheters is a common procedure in kidney transplantation. The stent is usually removed by cystoscope. Magnetic ureteral stents may be an alternative to conventional stents. OBJECTIVE To assess the functional efficacy and feasibility of magnetic double J (DJ) stents in kidney transplant recipients. METHODS We used 6 Fr (diameter), 22 cm (length) magnetic DJs. We examined 7 cases of exclusively AB0-identical living donations. Stent were removed 10-12 days after transplantation. Ureteral Stent Symptoms Questionnaire (USSQ) and visual analog scale (VAS) were used to determine quality of life and pain of the recipients. The total removal time was recorded and cost reduction was calculated. RESULTS Removal of the magnetic DJ was successful in all cases. The mean±SD duration of the removal was 3.4±1.6 min. The mean±SD overall pain score on the VAS during the procedure was 2.6±1.1. Using this technique was associated with a cost reduction of € 130. CONCLUSION Using magnetic ureteral stents is a feasible option for living donation AB0-identical kidney transplant recipients.
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Affiliation(s)
- P. F. Pohlmann
- Department of Urology, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - M. Kunzelmann
- Department of Urology, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - K. Wilhelm
- Department of Urology, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - A. Miernik
- Department of Urology, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - C. Gratzke
- Department of Urology, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - A. Jud
- Transplantation Centre, Department of General and Visceral Surgery, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - P. Pisarski
- Transplantation Centre, Department of General and Visceral Surgery, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
| | - B. Jänigen
- Transplantation Centre, Department of General and Visceral Surgery, Faculty of Medicine, University of Freiburg–Medical Centre, Freiburg, Germany
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Sangro B, Maini CL, Ettorre GM, Cianni R, Golfieri R, Gasparini D, Ezziddin S, Paprottka PM, Fiore F, Van Buskirk M, Bilbao JI, Salvatori R, Giampalma E, Geatti O, Wilhelm K, Hoffmann RT, Izzo F, Iñarrairaegui M, Urigo C, Cappelli A, Vit A, Ahmadzadehfar H, Jakobs TF, Sciuto R, Pizzi G, Lastoria S. Radioembolisation in patients with hepatocellular carcinoma that have previously received liver-directed therapies. Eur J Nucl Med Mol Imaging 2018. [PMID: 29516130 PMCID: PMC6097757 DOI: 10.1007/s00259-018-3968-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records. Results Most radioembolisation candidates were Child-Pugh class A (82.5%) with multinodular HCC (75.9%) invading both lobes (53.1%); 56.3% were advanced stage. Radioembolisation was used first-line in 57.5% of patients and second-line in 34.2%. Common prior procedures were transarterial (chemo)embolisation therapies (27.1%), surgical resection/transplantation (17.2%) and ablation (8.6%). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95% confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976. Conclusions Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.
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Affiliation(s)
- Bruno Sangro
- Liver Unit, Clinica Universidad de Navarra, and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Avda. Pio XII, 36, 31008, Pamplona, Spain.
| | | | | | - Roberto Cianni
- Interventional Radiology, Ospedale S.M.Goretti, Latina, Italy
| | - Rita Golfieri
- Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Daniele Gasparini
- Diagnostic and Interventional Radiology, Azienda Ospedaliera S. M. della Misericordia, Udine, Italy
| | - Samer Ezziddin
- Nuclear Medicine, Universitätsklinik Bonn, Bonn, Germany
| | - Philipp M Paprottka
- Interventional Radiology, LMU Klinikum der Universität München, Munich, Germany
| | - Francesco Fiore
- Onco Interventional Radiology, Istituto Tumori Pascale, Naples, Italy
| | | | | | | | | | - Onelio Geatti
- Nuclear Medicine, Azienda Ospedaliera S. M. della Misericordia, Udine, Italy
| | - Kai Wilhelm
- Department of Radiology, University of Bonn, Bonn, Germany
| | | | - Francesco Izzo
- Hepatobiliary Surgery, Istituto Tumori Pascale, Naples, Italy
| | - Mercedes Iñarrairaegui
- Liver Unit, Clinica Universidad de Navarra, and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Avda. Pio XII, 36, 31008, Pamplona, Spain
| | - Carlo Urigo
- Interventional Radiology, Ospedale S.M.Goretti, Latina, Italy
| | | | - Alessandro Vit
- Interventional Radiology, IFO Regina Elena National Cancer Institute, Rome, Italy
| | | | - Tobias Franz Jakobs
- Interventional Radiology, LMU Klinikum der Universität München, Munich, Germany
| | - Rosa Sciuto
- Nuclear Medicine, IFO Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Pizzi
- Interventional Radiology, IFO Regina Elena National Cancer Institute, Rome, Italy
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Wilhelm J, Fürll M, Wilhelm K. Vergleichende Betrachtung ausgewählter Blutparameter von Hochleistungskühen bei unterschiedlichen Entnahmestellen. Tierarztl Prax Ausg G Grosstiere Nutztiere 2018. [DOI: 10.1055/s-0038-1623149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Zusammenfassung
Ziel der Arbeit war, die zum Einfluss des Entnahmeortes auf verschiedene Blutparameter vorliegenden unterschiedlichen Angaben in der Literatur an einer größeren Tierzahl zu überprüfen. Ferner sollte die praktische Nutzbarkeit der Blutentnahme aus der Eutervene oder anderer zugänglicher Venen (z. B. Unterschenkel- oder Schwanzvene) im Vergleich zur Halsvene für Stoffwechseluntersuchungen verifiziert werden. Material und Methoden: Blutproben von 92 Kühen und Färsen wurden zu vier unterschiedlichen Zeitpunkten von 3 Wochen ante partum bis 8 Wochen post partum aus der V. jugularis (Halsvene), der V. subcutanea abdominis (Eutervene) sowie den Vv. saphenae externae (Unterschenkelvene) der linken und rechten Hintergliedmaße vergleichend untersucht. Ergebnisse: Für fünf der 16 untersuchten Parameter (freie Fettsäuren, β-Hydroxybutyrat Glukose, Kreatinkinase und Kalzium) zeigten sich abhängig vom Untersuchungszeitpunkt zum Teil hochsignifikante Unterschiede zwischen den Entnahmestellen. Schlussfolgerung und klinische Relevanz: Bei Stoffwechseluntersuchungen, die die oben genannten Parameter einschließen, hat der Blutentnahmeort entscheidenden Einfluss und muss bei der Auswertung berücksichtigt werden. Die Eutervene stellt bei hochleistenden Milchkühen keine Alternative zur Blutentnahme für Stoffwechseluntersuchungen dar. Um aussagekräftige Ergebnisse zu erhalten, muss hierfür trotz des größeren arbeitstechnischen Aufwandes die Halsvene zur Blutentnahme genutzt werden. Eine Ausnahme bildet die Bestimmung der Kreatinkinaseaktivität. Da Abwehrbewegungen im Halsbereich des Tieres die lokale Aktivität zu beeinflussen scheinen, ist hier der Eutervene als Entnahmeort Vorzug zu geben.
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Liehr T, Acquarola N, Pyle K, St-Pierre S, Rinholm M, Bar O, Wilhelm K, Schreyer I. Next generation phenotyping in Emanuel and Pallister-Killian syndrome using computer-aided facial dysmorphology analysis of 2D photos. Clin Genet 2017; 93:378-381. [DOI: 10.1111/cge.13087] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/22/2017] [Accepted: 06/22/2017] [Indexed: 01/25/2023]
Affiliation(s)
- T. Liehr
- Jena University Hospital; Friedrich Schiller University, Institute of Human Genetics; Jena Germany
| | - N. Acquarola
- Pallister-Killian Syndrome Foundation of Australia; Myaree Australia
| | - K. Pyle
- Jena University Hospital; Friedrich Schiller University, Institute of Human Genetics; Jena Germany
| | | | - M. Rinholm
- Chromosome 22 Central; Fuquay-Varina North Carolina
| | - O. Bar
- FDNA Inc.; Boston Massachusetts
| | - K. Wilhelm
- Jena University Hospital; Friedrich Schiller University, Institute of Human Genetics; Jena Germany
| | - I. Schreyer
- Jena University Hospital; Friedrich Schiller University, Institute of Human Genetics; Jena Germany
- Center for Ambulant Medicine; Human Genetics; Jena Germany
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Kuetting D, Thomas D, Wilhelm K, Pieper CC, Schild HH, Meyer C. Endovascular Management of Malignant Inferior Vena Cava Syndromes. Cardiovasc Intervent Radiol 2017; 40:1873-1881. [PMID: 28685383 DOI: 10.1007/s00270-017-1740-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/29/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Malignant obstructions of the inferior vena cava (IVC) are a common cause of the IVC syndrome. As reports on interventional treatment of malignant inferior caval obstructions are very sparse, the purpose of this study was to retrospectively assess the outcome of endovascular treatment of symptomatic, malignant IVC syndromes. MATERIALS AND METHODS Between 2000 and 2015, 19 patients (six women; mean age 59 years ± 14) received endovascular treatment of malignant IVC obstruction/occlusion. Patients' demographics as well as interventional and clinical outcome data were collected. RESULTS All 19 patients underwent stenting of the IVC. Technical success was 100%. Clinical success was 79% (15/19). Three patients (16%) required early re-intervention (days 1-8) due to stent compression. Three patients (16%) with initially good post-interventional results required late repeated intervention due to tumor progression, and repeated intervention could alleviate symptoms in all cases. Best results were achieved when choosing a stent diameter between 16 and 20 mm and a stent length approximately 15-20 mm longer than the lesion length. Too large stent diameters (>28 mm) can lead to stent compression, too small stent diameters (<14 mm) can lead to stent migration, and too short stent lengths can lead to a reoccurrence of symptoms with obstruction of a non-treated segment. CONCLUSION Endovascular treatment of malignant IVC syndromes is a safe and effective approach enabling immediate relief of inferior inflow congestions. Recurrent venous obstruction is common but can be avoided when stent diameter and stent length are adapted to the degree of IVC compression as well as expected progression of the underlying malignancy.
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Affiliation(s)
- Daniel Kuetting
- Department of Radiology, University of Bonn, Sigmund-Freud-Str.25, 53127, Bonn, Germany.
| | - Daniel Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Str.25, 53127, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, Johanniter Krankenhaus, Bonn, Germany
| | - Claus C Pieper
- Department of Radiology, University of Bonn, Sigmund-Freud-Str.25, 53127, Bonn, Germany
| | - Hans H Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Str.25, 53127, Bonn, Germany
| | - Carsten Meyer
- Department of Radiology, University of Bonn, Sigmund-Freud-Str.25, 53127, Bonn, Germany
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Abstract
Analysis of the composition of a urinary stone is one of the most important steps in the clinical management of patients with urolithiasis. Fourier transform infrared spectroscopy, X-ray diffractometry and petrographic microscopy are the techniques currently used. Novel technical developments in recent years - such as Raman spectroscopy and hyperspectral imaging - have resulted in new approaches to improve urinary stone analysis. In future, table-top portable systems may be used that allow stones to be rapidly examined directly after the operation. These systems may even be integrated into lithotripsy laser systems.
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Affiliation(s)
- A. Miernik
- Klinik für Urologie, Department Chirurgie, Universitätsklinikum Freiburg
| | - S. Hein
- Klinik für Urologie, Department Chirurgie, Universitätsklinikum Freiburg
| | - K. Wilhelm
- Klinik für Urologie, Department Chirurgie, Universitätsklinikum Freiburg
| | - M. Schoenthaler
- Klinik für Urologie, Department Chirurgie, Universitätsklinikum Freiburg
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Pieper C, Wilhelm K, Lampe N, Matuschek E, Maschke T, Ahmadzadehfar H, Willinek W, Schild H, Meyer C. Radioembolisation von nicht operablen hepatozellulären Karzinomen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Pieper
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - K Wilhelm
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - N Lampe
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - E Matuschek
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - T Maschke
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | | | - W Willinek
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - H Schild
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
| | - C Meyer
- Universitätsklinikum Bonn, Radiologische Klinik, Bonn
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Hamiko M, Endlich M, Krämer C, Probst C, Welz A, Wilhelm K, Schiller W. Dilatation of Vascular Prostheses in Ascending Aortic Position: A Long-Term Follow-Up Computed Tomography Study with Comparison of Different Measurement Methods. Thorac Cardiovasc Surg 2016; 66:206-214. [PMID: 27960216 DOI: 10.1055/s-0036-1597116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to evaluate long-term dilatation of Hemashield Gold and Hemashield Platinum vascular prostheses in ascending aortic position using different measurement methods to obtain precise results. METHODS Between 1999 and 2007, 73 patients with Stanford type A dissection received ascending aortic replacement with Hemashield Gold and Hemashield Platinum prostheses. Measurements were performed using multiplanar reconstruction mode of electrocardiogram (ECG)-gated, multislice spiral computed tomography (MSCT) in strictly orthogonal cross-sectional planes. Different methods of measurement were compared and maximum dilatation was estimated for different time spans. RESULTS Diameters calculated from the measured circumference showed a significant (p = 0.037) but clinically not relevant difference (0.1 mm) to the mean between the largest and the shortest cross-sectional diameter of the prosthesis. Dilatation after 24.2 ± 10.2 months was 8.5 ± 4.5%. Long-term dilatation after 91.8 ± 34 months amounted to 11.8 ± 4.2%. CONCLUSION Based on ECG-gated MSCT images, the presented methods of measurement provided reliable results. Long-term analysis shows low dilatation rates for Hemashield prostheses, which therefore can be considered as safe from this point of view. Nevertheless, a maximal dilatation of 20% could be relevant in valve sparing root replacement. It remains unclear if a dilatation like this contributes to the formation of suture aneurysms.
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Affiliation(s)
- Marwan Hamiko
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Matthias Endlich
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Christian Krämer
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Chris Probst
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Armin Welz
- Department of Cardiac Surgery, University of Bonn, Bonn, Germany
| | - Kai Wilhelm
- Department of Radiology, University of Bonn, Bonn, Germany
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Wilhelm K, Barcellona D. 193 A Systematic Review of Hyaluronidase-Assisted Subcutaneous Fluid Administration in Pediatrics and Geriatrics and its Potential Application in Low-Resource Settings. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jha S, Hannu M, Newton P, Wilhelm K, Hayward C, Jabbour A, Kotlyar E, Keogh A, Dhital K, Granger E, Jansz P, Spratt P, Montgomery E, Harkess M, Tunnicliff P, Macdonald P. Cognitive Frailty in Heart-Transplant Eligible Patients: A Better Predictor of Mortality. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shiban E, von Lehe M, Simon M, Clusmann H, Heinrich P, Ringel F, Wilhelm K, Urbach H, Meyer B, Stoffel M. Evaluation of degenerative disease of the lumbar spine: MR/MR myelography versus conventional myelography/post-myelography CT. Acta Neurochir (Wien) 2016; 158:1571-8. [PMID: 27255654 DOI: 10.1007/s00701-016-2849-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 05/17/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND To compare the use of magnetic resonance (MR)/MR myelography (MRM) with conventional myelography/post-myelography CT (convM) for detailed surgery planning in degenerative lumbar disease. METHODS Twenty-six patients with suspected complex lumbar degenerative disease underwent MRM in addition to convM as preoperative workup. Surgery was planned based on convM-as usual at our department. Post hoc, surgical planning was repeated planned again-now based on MRM. Furthermore, the MRM-based planning was performed by six independent neurosurgeons (three groups) of different degrees of specialisation. RESULTS In only 31 % of the patients, post hoc MRM-based planning resulted in the same surgical decision as originally performed, whereas in 69 % (n = 18) a different procedure was indicated. In patients with non-concurring convM- and MRM-based surgical plans, a less extended procedure was the result of MRM in six patients (23 %), a more extended one in five (19 %), and a related to side/level of decompression or nucleotomy different plan in six patients (23 %). In one patient (4 %), the MRM-based planning would have led to a completely different surgery compared to convM. Overall interobserver agreement on the MRM-based planning was substantial. CONCLUSIONS Detailed planning of operative procedures for complex lumbar degenerative disease is highly dependent on the image modality used.
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Ahmadzadehfar H, Muckle M, Sabet A, Wilhelm K, Kuhl C, Biermann K, Haslerud T, Biersack HJ, Ezziddin S. The significance of bremsstrahlung SPECT/CT after yttrium-90 radioembolization treatment in the prediction of extrahepatic side effects. Eur J Nucl Med Mol Imaging 2016; 39:309-15. [PMID: 21975832 DOI: 10.1007/s00259-011-1940-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 09/09/2011] [Indexed: 01/06/2023]
Abstract
Purpose Unwanted deposition of 90Y microspheres in organs other than the liver during radioembolization of liver tumours may cause severe side effects such as duodenal ulcer. The aim of this study was to evaluate the significance of posttherapy bremsstrahlung (BS) SPECT/CT images of the liver in comparison to planar and SPECT images in the prediction of radioembolization-induced extrahepatic side effects.Methods A total of 188 radioembolization procedures were performed in 123 patients (50 women, 73 men) over a 2-year period. Planar, whole-body and BS SPECT/CT imaging were performed 24 h after treatment as a part of therapy work-up.Any focally increased extrahepatic accumulation was evaluated as suspicious. Clinical follow-up and gastroduodenoscopy served as reference standards. The studies were reviewed to evaluate whether BS SPECT/CT imaging was of benefit.Results In the light of anatomic data obtained from SPECT/CT, apparent extrahepatic BS in 43% of planar and in 52% of SPECT images proved to be in the liver and hence false positive.The results of planar scintigraphy could not be analysed further since 12 images were not assessable due to high scatter artefacts. On the basis of the gastrointestinal (GI)complications and the results of gastroduodenoscopy, true positive,true-negative, false-positive and false-negative results of BS SPECT and SPECT/CT imaging in the prediction of GI ulcers were determined. The sensitivity, specificity, positive and negative predictive values and the accuracy of SPECT and SPECT/CT in the prediction of GI ulcers were 13%, 88%, 8%,92% and 82%, and 87%, 100%, 100%, 99% and 99%,respectively.Conclusion Despite the low quality of BS images, BSSPECT/CT can be used as a reliable method to confirm the safe distribution of 90Y microspheres and in the prediction of GI side effects.
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Jha S, Hannu M, Wilhelm K, Newton P, Chang S, Chang S, Montgomery E, Harkess M, Tunnicliff P, Smith A, Hayward C, Jabbour A, Keogh A, Kotlyar E, Dhital K, Granger E, Jansz P, Spratt P, Macdonald P. Frailty Measures in Advanced Heart Failure Patients Listed for Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jha S, Hannu M, Wilhelm K, Newton P, Chang S, Montgomery E, Harkess M, Tunnicliff P, Smith A, Hayward C, Jabbour A, Keogh A, Kotlyar E, Dhital K, Granger E, Jansz P, Spratt P, Macdonald P. Reversibility of Frailty in Advanced Heart Failure Patients Listed for Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Pieper C, Willinek W, Thomas D, Ahmadzadehfar H, Nadal J, Wilhelm K, Kuhl C, Schild H, Meyer C. Frühe Stase bei erster Radioembolisation mit Harzmikrosphären. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wilhelm K. PRT und Facettengelenksdenervierung. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Groetz S, Wilhelm K, Willinek W, Pieper C, Schild H, Thomas D. A new robotic assistance system for percutaneous CT-guided punctures: Initial experience. MINIM INVASIV THER 2015; 25:79-85. [DOI: 10.3109/13645706.2015.1110825] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Wilhelm K, Fritsche HM, Netsch C. [Percutaneous Stone Treatment Today: Standard-, Mini-, Micro-, Ultramini-PCNL]. Aktuelle Urol 2015; 46:297-302. [PMID: 26227130 DOI: 10.1055/s-0035-1555863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Percutaneous nephrolithotripsy (PCNL) is one of the main interventional treatment modalities for large kidney stones (> 2 cm diameter). With the implementation of miniaturised techniques the indications for PCNL have been broadened to smaller stones. Especially for urologists without emphasis on endourology it is difficult to have an overview of the growing multitude of available systems and techniques. This article describes the currently available systems for percutaneous stone treatment with their peculiarities and indications. MATERIALS AND METHODS A PubMed-based literature search has been conducted. Relevant articles and additional manufacturers' literature have been compiled to create a summary of the different available PCNL systems. Furthermore, a brief literature review is given regarding indications, stone-free rates and complication rates of each system category. RESULTS Several manufacturers have developed different PCNL systems with varying diameters and special features. The indications for the different systems are overlapping. Retrospective studies showed reduced complication rates (especially less bleeding and need for transfusions) but prospective randomised controlled trials on this topic are still lacking. Assessed with the criteria of evidence-based medicine, the currently available evidence does not clearly answer the question whether a miniaturisation of PCNL systems is advantageous for the patient. CONCLUSION Invasiveness of PCNL can be reduced with the nowadays available miniaturised systems. The indication for PCNL has been broadened to small kidney stones > 1 cm diameter.
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Affiliation(s)
- K. Wilhelm
- Klinik für Urologie, Department für Chirurgie, Universitätsklinikum Freiburg, Freiburg
| | - H.-M. Fritsche
- Klinik für Urologie, Caritas-Krankenhaus St. Josef, Universität Regensburg, Regensburg
| | - C. Netsch
- Abteilung für Urologie, Asklepios Klinik Barmbek, Hamburg
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Wilhelm K. Radikuläre Schmerztherapie und Facettenblockade. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pieper C, Fischer S, Strunk H, Meyer C, Thomas D, Willinek W, Hauser S, Nadal J, Schild H, Wilhelm K. Perkutane CT-gesteuerte Radiofrequenz-Ablation von solitären Nierentumoren: Retrospektive Single Center Erfahrungen über 10 Jahre. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pieper C, Fischer S, Strunk H, Meyer C, Thomas D, Willinek W, Hauser S, Nadal J, Schild H, Wilhelm K. Percutaneous CT-Guided Radiofrequency Ablation of Solitary Small Renal Masses: A Single Center Experience. ROFO-FORTSCHR RONTG 2015; 187:577-83. [DOI: 10.1055/s-0034-1399340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Pieper
- Department of Radiology, University of Bonn, Germany
| | - S. Fischer
- Department of Radiology, University of Bonn, Germany
| | - H. Strunk
- Department of Radiology, University of Bonn, Germany
| | - C. Meyer
- Department of Radiology, University of Bonn, Germany
| | - D. Thomas
- Department of Radiology, University of Bonn, Germany
| | - W. Willinek
- Department of Radiology, University of Bonn, Germany
| | - S. Hauser
- Department of Urology, University of Bonn, Germany
| | - J. Nadal
- Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Germany
| | - H. Schild
- Department of Radiology, University of Bonn, Germany
| | - K. Wilhelm
- Department of Radiology, Johanniter GmbH, Johanniter Hospital Bonn, Germany
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Jha S, Hannu M, Newton P, Wilhelm K, Hayward C, Jabbour A, Kotlyar E, Keogh A, Dhital K, Granger E, Jansz P, Spratt P, Montgomery E, Harkess M, Tunnicliff P, Shaw S, MacDonald P. Inclusion of Cognitive and Mood Domains in the Assessment of Frailty Enhances Outcome Prediction in Heart Transplant-Eligible Patients With Advanced Heart Failure. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jha S, Hannu M, Newton P, Wilhelm K, Hayward C, Jabbour A, Kotlyar E, Keogh A, Dhital K, Granger E, Jansz P, Spratt P, Montgomery E, Tunnicilff P, Shaw S, MacDonald P. Frailty as a Predictor of Outcomes in Heart Transplant-Eligible Patients With Advanced Heart Failure. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Hannu M, Jha S, Wilhelm K, Montgomery E, Tunnicliff P, Shaw S, Hayward C, Harkess M, Kotlyar E, Jabbour A, Keogh A, Granger E, Dhital K, Jansz P, Newton P, Robson D, MacDonald P, Spratt P. Inclusion of Cognitive and Mood Domains in the Assessment of Frailty Enhances Outcome Prediction in Patients Undergoing Ventricular Assist Device Implantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Wilhelm K, Wilhelm J, Fürll M. Use of thermography to monitor sole haemorrhages and temperature distribution over the claws of dairy cattle. Vet Rec 2015; 176:146. [DOI: 10.1136/vr.101547] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- K. Wilhelm
- Veterinary Practice of Dr. Wilhelm; Plauen Germany
| | - J. Wilhelm
- Veterinary Practice of Dr. Wilhelm; Plauen Germany
| | - M. Fürll
- Faculty of Veterinary Medicine; Large Animal Clinic for Internal Medicine, University of Leipzig; Leipzig Germany
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Kowar M, Frackowiak M, Friedrich C, Wilhelm K, Walger P, Jacobs A. Sensorische Aphasie unter Therapie mit Metronidazol – eine wichtige Differenzialdiagnose der akuten zerebralen Ischämie. Dtsch Med Wochenschr 2014; 139:2341-3. [DOI: 10.1055/s-0034-1387341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. Kowar
- Klinik für Geriatrie mit Neurologie und Tagesklinik
| | | | - C. Friedrich
- Klinik für Geriatrie mit Neurologie und Tagesklinik
| | | | - P. Walger
- Abteilung Innere Medizin, Intensivmedizin und Hygiene, Evangelische Kliniken, Johanniter Krankenhaus, Bonn
| | - A. Jacobs
- Klinik für Geriatrie mit Neurologie und Tagesklinik
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Luetkens JA, Wilhelm K, Düsing R, Woitas RP, Thomas D, Hundt F, Doerner J, Schild HH, Nähle CP. Renal denervation: results of a single-center cohort study. ROFO-FORTSCHR RONTG 2014; 187:36-41. [PMID: 25188311 DOI: 10.1055/s-0034-1385125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension. MATERIALS AND METHODS Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation. RESULTS Mean follow-up time between renal denervation and blood pressure re-assessment was 9.5 ± 3.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.3 ± 20.3/103.8 ± 20.4 mmHg and 155.2 ± 20.5/93.7 ± 14.5 mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.7 ± 14.9/89.5 ± 12.1 (p < 0.05). ABPM values remained unchanged (147.9 ± 20.3/90.3 ± 15.6, p > 0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.7 ± 2.0 vs. 4.2 ± 1.2, p = 0.18). No renovascular complications were detected in follow-up MRI. CONCLUSION After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension. KEY POINTS • Renal denervation showed no significant effects on 24-h ambulatory blood pressure measurements. • A significant decrease in office blood pressure measurements may be explained by a potential detection bias. • Renal artery alterations were not observed on follow-up MRI scans.
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Affiliation(s)
- J A Luetkens
- Department of Radiology, University of Bonn, Bonn
| | - K Wilhelm
- Department of Radiology, Johanniter Hospital, Bonn
| | | | - R P Woitas
- Department of Internal Medicine I, University of Bonn, Bonn
| | - D Thomas
- Department of Radiology, University of Bonn, Bonn
| | - F Hundt
- Department of Internal Medicine I, University of Bonn, Bonn
| | - J Doerner
- Department of Radiology, University of Bonn, Bonn
| | - H H Schild
- Department of Radiology, University of Bonn, Bonn
| | - C P Nähle
- Department of Radiology, University of Bonn, Bonn
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Carter D, Hannu M, Montgomery E, Harkess M, Shaw S, De Tullio N, Cooper K, Wilhelm K, Havryk A, Macdonald P. The Prevalence of the Frailty Syndrome in Advanced Heart and Lung Failure. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Boschewitz JM, Hadizadeh DR, Kukuk GM, Meyer C, Wilhelm K, Koscielny A, Verrel F, Gieseke J, Schild HH, Willinek WA. 0.125 mm(3) spatial resolution steady-state MR angiography of the thighs with a blood pool contrast agent using the quadrature body coil only at 1.5 Tesla. J Magn Reson Imaging 2014; 40:996-1001. [PMID: 24845363 DOI: 10.1002/jmri.24455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/10/2013] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To implement and evaluate high spatial resolution three-dimensional MR contrast-enhanced angiography (3D-CEMRA) of the thighs using a blood pool contrast agent (BPCA) using the quadrature body coil only in patients with peripheral arterial occlusive disease (PAOD) in cases receiver coils cannot be used at 1.5 Tesla (T). MATERIALS AND METHODS Nineteen patients (mean age: 68.7 ± 11.2 years; range, 38-83 years) with known PAOD (Fontaine stages; III: 16, IV: 3) prospectively underwent 3D-CEMRA at 1.5T with a noninterpolated voxel size of 0.49 × 0.49 × 0.48 mm(3) . Digital subtraction angiography (DSA) was available for comparison in all patients. Two readers independently evaluated movement artifacts, overall image quality of 3D-CEMRA, and grade of stenosis as compared to DSA. SNR and CNR levels were quantified. RESULTS The 3D-CEMRA was successfully completed in all patients. Patient movement artifacts that affected stenosis grading occurred in 3/38 thighs. Overall image quality was rated excellent in 15/38, good in 12/38, and diagnostic in 8/38 thighs. Stenosis grading matched with that in DSA in 35/38 thighs. High SNR and CNR were measured in all vessels. CONCLUSION The 0.125 mm(3) spatial resolution 3D-CEMRA of the thighs with a BPCA is feasible using a quadrature body coil exclusively with excellent image quality despite long acquisition times. J. Magn. Reson. Imaging 2014;40:996-1001. © 2014 Wiley Periodicals, Inc.
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Ezziddin S, Wilhelm K, Fimmers R, Spengler U, Palmedo H, Strunk H, Schild HH, Biersack HJ, Risse J, Ahmadzadehfar H, Habibi E. Survival after 131I-labeled lipiodol therapy for hepatocellular carcinoma. Nuklearmedizin 2014; 53:46-53. [DOI: 10.3413/nukmed-0610-13-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
SummaryThis study investigated the efficacy of 131iod- ine-labeled lipiodol (1311-lipiodol) as a palliative therapy, evaluated overall survival (OS) across Barcelona Clinic Liver Cancer (BCLC) stages, and determined the main prognostic factors influencing OS in patients with hepatocellular carcinoma (HCC). Patients, methods: We retrospectively analyzed 57 (44 men; mean age, 65.7 years; mean activity per session, 1.6 GBq; mean cumulative activity in patients with >1 sessions, 3.9 GBq) HCC patients who underwent 1311-lipiodol therapy. A majority of patients exhibited Child-Pugh class B (53.6%) disease and a good Eastern Cooperative Oncology Group performance status (0-1; 72%). Multinodular disease was observed in 87.7% patients, bilobar disease in 73%, and portal vein occlusion (PVO) in 54%. Furthermore, 21.1% patients were staged as BCLC B and 59.6 % as BCLC C. All patients were followed until death. Results: The median OS was 6.4 months, which varied significantly with disease stage (median OS for BCLC A, B, C, and D was 29.4, 12.0, 4.6, and 2.7 months, respectively; p = 0.009); Child-Pugh score and class; presence of ascites, PVO, or extrahepatic disease; largest lesion size; favourable treatment response; international normalized ratio, baseline albumin and alpha-fetopro- tein levels. Patients with a Child-Pugh A liver disease had a longer OS. Conclusion: Currently, different treatment modalities for HCC include radioembolization, transarterial chemoemboliz- ation, and systemic therapy with sorafenib; however, 1311-lipiodol therapy remains a feasible alternative for patients without a favourable response to other therapies, particularly for patients with Child-Pugh A liver cirrhosis.
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Boschewitz JM, Andersson M, Naehle CP, Schild HH, Wilhelm K, Meyer C. Retrospective evaluation of safety and effectiveness of the EXOSEAL vascular closure device for single vascular closure and closure after repeat puncture in diagnostic and interventional radiology: single-center experience. J Vasc Interv Radiol 2013; 24:698-702. [PMID: 23622041 DOI: 10.1016/j.jvir.2013.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/12/2013] [Accepted: 02/12/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To retrospectively evaluate the safety and effectiveness of the EXOSEAL vascular closure device (VCD) for first or repeated closure after retrograde percutaneous femoral arterial access. MATERIALS AND METHODS A retrospective analysis of 417 patients (271 men; mean age, 64.1 y±12.8; age range, 22-94 y) who had undergone arterial closure with the EXOSEAL VCD was performed. Procedures with retrograde femoral access and closure with the 5-F, 6-F, or 7-F EXOSEAL VCD according to the manufacturer's instructions were included. The clinical indications included the full procedural portfolio of a radiologic department with a focus on transarterial hepatic procedures. After EXOSEAL VCD closure, patients were restricted to bed rest for 4 hours. RESULTS From August 2010 to March 2012, a total of 682 EXOSEAL VCDs (5-F, n = 276; 6-F, n = 394; 7-F, n = 12) were used in 659 procedures with a total of 404 repeated closures. The EXOSEAL VCD was used successfully in 676 of 682 procedures (99.1%). Hemostasis was achieved in 651 of 682 procedures (95.5%). No major complications were encountered. There were eight cases (1.17%) of minor complications despite a successful vascular closure procedure, none requiring further therapy. There were no complications in any of the 404 cases of repeated vascular closure. CONCLUSIONS The results of this study suggest that the EXOSEAL VCD is safe and effective in single and repeated closure of retrograde percutaneous femoral arterial access in interventional radiology cases.
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Affiliation(s)
- Jack M Boschewitz
- Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, D-53105 Bonn, Germany
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Henrich D, Seebach C, Nau C, Basan S, Relja B, Wilhelm K, Schaible A, Frank J, Barker J, Marzi I. Establishment and characterization of the Masquelet induced membrane technique in a rat femur critical-sized defect model. J Tissue Eng Regen Med 2013; 10:E382-E396. [PMID: 24668794 DOI: 10.1002/term.1826] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 06/05/2013] [Accepted: 08/30/2013] [Indexed: 12/20/2022]
Abstract
The Masquelet induced membrane technique for reconstructing large diaphyseal defects has been shown to be a promising clinical treatment, yet relatively little is known about the cellular, histological and biochemical make-up of these membranes and how they produce this positive clinical outcome. We compared cellular make-up, histological changes and growth factor expression in membranes induced around femur bone defects and in subcutaneous pockets at 2, 4 and 6 weeks after induction, and to the periosteum. We found that membranes formed around bone defects were similar to those formed in subcutaneous pockets; however, both were significantly different from periosteum with regard to structural characteristics, location of blood vessels and overall thickness. Membranes induced at the femur defect (at 2 weeks) and in periosteum contain mesenchymal stem cells (MSCs; STRO-1+ ) which were not found in membranes induced subcutaneously. BMP-2, TGFβ and VEGF were significantly elevated in membranes induced around femur defects in comparison to subcutaneously induced membranes, whereas SDF-1 was not detectable in membranes induced at either site. We found that osteogenic and neovascular activity had mostly subsided by 6 weeks in membranes formed at both sites. It was conclude that cellular composition and growth factor content in induced membranes depends on the location where the membrane is induced and differs from periosteum. Osteogenic and neovascular activity in the membranes is maximal between 2 and 4 weeks and subsides after 6. Based on this, better and quicker bone healing might be achieved if the PMMA cement were replaced with a bone graft earlier in the Masquelet technique. Copyright © 2013 John Wiley & Sons, Ltd.
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Affiliation(s)
- D Henrich
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany.
| | - C Seebach
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - C Nau
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - S Basan
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - B Relja
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - K Wilhelm
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - A Schaible
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - J Frank
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - J Barker
- Frankfurt Initiative for Regenerative Medicine, Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
| | - I Marzi
- Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe University, Frankfurt am, Main, Germany
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Nähle CP, Schild H, Wilhelm K. [Renal denervation: ready for prime time?]. Dtsch Med Wochenschr 2013; 138:2212-8. [PMID: 24132535 DOI: 10.1055/s-0033-1349568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- C P Nähle
- Radiologische Klinik, Universitätsklinikum Bonn
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Golfieri R, Bilbao JI, Carpanese L, Cianni R, Gasparini D, Ezziddin S, Paprottka PM, Fiore F, Cappelli A, Rodriguez M, Ettorre GM, Saltarelli A, Geatti O, Ahmadzadehfar H, Haug AR, Izzo F, Giampalma E, Sangro B, Pizzi G, Notarianni E, Vit A, Wilhelm K, Jakobs TF, Lastoria S. Comparison of the survival and tolerability of radioembolization in elderly vs. younger patients with unresectable hepatocellular carcinoma. J Hepatol 2013; 59:753-61. [PMID: 23707371 DOI: 10.1016/j.jhep.2013.05.025] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/19/2013] [Accepted: 05/10/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS The European Network on Radioembolization with Yttrium-90 resin microspheres study group (ENRY) conducted a retrospective study to evaluate the outcomes among elderly (≥ 70 years) and younger patients (<70 years) with unresectable hepatocellular carcinoma (HCC) who received radioembolization at 8 European centers. METHODS Patients with confirmed diagnosis of unresectable HCC who either progressed following resection or locoregional treatment and/or who were considered poor candidates for chemoembolization were evaluated by a multidisciplinary team for radioembolization with (90)Y-resin microspheres (SIR-Spheres; Sirtex Medical). The survival outcome and all adverse events were compared between the two age groups. RESULTS Between 2003 and 2009, 128 elderly and 197 younger patients received radioembolization. Patients in both groups had similar demographic characteristics. Many elderly and younger patients alike had multinodular, BCLC stage C disease, invading both lobes (p = 0.648). Elderly patients had a lower tumor burden, a smaller median target liver volume (p = 0.016) and appeared more likely to receive segmental treatment (p = 0.054). Radioembolization was equally well tolerated in both cohorts and common procedure-related adverse events were predominantly grade 1-2 and of short duration. No significant differences in survival between the groups were found (p = 0.942) with similar median survival in patients with early, intermediate or advanced BCLC stage disease. CONCLUSIONS Radioembolization appears to be as well-tolerated and effective for the elderly as it is for younger patients with unresectable HCC. Age alone should not be a discriminating factor for the management of HCC patients.
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Affiliation(s)
- Rita Golfieri
- Azienda Ospedaliero-Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy.
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