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Bünemann EK, Reimer M, Smolders E, Smith SR, Bigalke M, Palmqvist A, Brandt KK, Möller K, Harder R, Hermann L, Speiser B, Oudshoorn F, Løes AK, Magid J. Do contaminants compromise the use of recycled nutrients in organic agriculture? A review and synthesis of current knowledge on contaminant concentrations, fate in the environment and risk assessment. Sci Total Environ 2024; 912:168901. [PMID: 38042198 DOI: 10.1016/j.scitotenv.2023.168901] [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] [Received: 07/05/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Abstract
Use of nutrients recycled from societal waste streams in agriculture is part of the circular economy, and in line with organic farming principles. Nevertheless, diverse contaminants in waste streams create doubts among organic farmers about potential risks for soil health. Here, we gather the current knowledge on contaminant levels in waste streams and recycled nutrient sources, and discuss associated risks. For potentially toxic elements (PTEs), the input of zinc (Zn) and copper (Cu) from mineral feed supplements remains of concern, while concentrations of PTEs in many waste streams have decreased substantially in Europe. The same applies to organic contaminants, although new chemical groups such as flame retardants are of emerging concern and globally contamination levels differ strongly. Compared to inorganic fertilizers, application of organic fertilizers derived from human or animal feces is associated with an increased risk for environmental dissemination of antibiotic resistance. The risk depends on the quality of the organic fertilizers, which varies between geographical regions, but farmland application of sewage sludge appears to be a safe practice as shown by some studies (e.g. from Sweden). Microplastic concentrations in agricultural soils show a wide spread and our understanding of its toxicity is limited, hampering a sound risk assessment. Methods for assessing public health risks for organic contaminants must include emerging contaminants and potential interactions of multiple compounds. Evidence from long-term field experiments suggests that soils may be more resilient and capable to degrade or stabilize pollutants than often assumed. In view of the need to source nutrients for expanding areas under organic farming, we discuss inputs originating from conventional farms vs. non-agricultural (i.e. societal) inputs. Closing nutrient cycles between agriculture and society is feasible in many cases, without being compromised by contaminants, and should be enhanced, aided by improved source control, waste treatment and sound risk assessments.
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Affiliation(s)
- E K Bünemann
- Research Institute of Organic Agriculture (FiBL), Ackerstrasse 113, 5070 Frick, Switzerland.
| | - M Reimer
- University of Hohenheim, Department of Fertilization and Soil Matter Dynamics, Fruwirthstr. 20, 70599 Stuttgart, Germany; Aarhus University, Department of Agroecology, Blichers Allé 20, 8830 Tjele, Denmark
| | - E Smolders
- Division Soil and Water Management, KU Leuven, Kasteelpark Arenberg 20, 3001 Leuven, Belgium
| | - S R Smith
- Department of Civil and Environmental Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - M Bigalke
- Department of Soil Mineralogy and Soil Chemistry, Institute for Applied Geosciences, Technical University of Darmstadt, Schnittspahnstraße 9, 64287 Darmstadt, Germany
| | - A Palmqvist
- Department of Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark
| | - K K Brandt
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg, Denmark
| | - K Möller
- University of Hohenheim, Department of Fertilization and Soil Matter Dynamics, Fruwirthstr. 20, 70599 Stuttgart, Germany
| | - R Harder
- Environmental Engineering Group, Department of Energy and Technology, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden
| | - L Hermann
- Proman Management GmbH, Weingartenstrasse 92, 2214 Auersthal, Austria
| | - B Speiser
- Research Institute of Organic Agriculture (FiBL), Ackerstrasse 113, 5070 Frick, Switzerland
| | - F Oudshoorn
- Innovation Centre for Organic Farming (ICOEL), Agro Food Park 26, 8200 Aarhus, Denmark
| | - A K Løes
- Norwegian Centre for Organic Agriculture (NORSØK), Gunnars veg 6, N-6630 Tingvoll, Norway
| | - J Magid
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg, Denmark
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Howe SL, März M, Pinter J, Krüger-Ziolek S, Pretty C, Shaw GM, Desaive T, Möller K, Chase JG. Cheek support affects lung mechanics measurements of tidal-based spontaneous breathing. Comput Methods Programs Biomed 2020; 193:105526. [PMID: 32402845 DOI: 10.1016/j.cmpb.2020.105526] [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] [Received: 02/04/2020] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Patients are required to support their cheeks during breath-occluding lung function tests. This prevents cheek expansion which would alter pressure measured at the mouth, and, consequently, lung mechanics measurements. To date, the effect of cheek support on airway resistance measurements has been assessed. However other lung mechanics have not been studied as thoroughly, and no algorithm to account for the effect of missing cheek support on lung mechanics measurements has been developed. METHODS Lung mechanics were assessed with a breath occlusion test during light panting in healthy subjects with and without cheek support in a body plethysmograph. Average model-based airway resistance, lung elastance, and a parameter representing the viscoelastic were measured. Results were compared to quantify the effect of cheek support on these three parameters. RESULTS In the nine healthy subjects (5 Female, 4 Male) recruited for this study, all mechanics tended to be underestimated when cheeks were unsupported. Changes in elastance, resistance, and viscoelastic parameter ranged between 1.6-66.8 %, -4.5-21.8 %, and -4.7-68.2 %, respectively, when cheek support was added. The underestimation was due to reduced mouth pressure during cheek expansion when the breath was occluded. The variance of lung mechanics parameters did not change with cheek support in all subjects. CONCLUSIONS The error in lung mechanics measurement caused by unsupported cheeks was subject dependent. Hence, no rule-of-thumb could be identified to reconstruct missing cheek support. For correct lung mechanics measurements during breath-occluding lung tests, patients must have adequate cheek support. ABBREVIATIONS ROCC: Occlusion resistance; COPD: Chronic Obstructive Pulmonary Disorder; SB: spontaneous breathing.
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Affiliation(s)
- S L Howe
- University of Canterbury, 8041, Christchurch, New Zealand.
| | - M März
- Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany
| | - J Pinter
- Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany
| | - S Krüger-Ziolek
- Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany
| | - C Pretty
- University of Canterbury, 8041, Christchurch, New Zealand
| | - G M Shaw
- Christchurch Hospital, 8011, Christchurch, New Zealand
| | | | - K Möller
- Institute of Technical Medicine (ITeM), Furtwangen University, Villingen-Schwenningen, Germany
| | - J G Chase
- University of Canterbury, 8041, Christchurch, New Zealand
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Poller WC, Pieber M, Boehm-Sturm P, Ramberger E, Karampelas V, Möller K, Schleicher M, Wiekhorst F, Löwa N, Wagner S, Schnorr J, Taupitz M, Stangl K, Stangl V, Ludwig A. Very small superparamagnetic iron oxide nanoparticles: Long-term fate and metabolic processing in atherosclerotic mice. Nanomedicine 2018; 14:2575-2586. [PMID: 30179669 DOI: 10.1016/j.nano.2018.07.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/03/2018] [Accepted: 07/28/2018] [Indexed: 12/21/2022]
Abstract
We investigated the biotransformation of very small superparamagnetic iron oxide nanoparticles (VSOP) in atherosclerotic LDLR-/- mice. Transmission electron microscopy revealed an uptake of VSOP not only by macrophages but also by endothelial cells in liver, spleen, and atherosclerotic lesions and their accumulation in the lysosomal compartment. Using magnetic particle spectroscopy (MPS), we show that the majority of VSOP's superparamagnetic iron was degraded within 28 days. MPS spectrum shape indicated changes in the magnetic properties of VSOP during the biodegradation process. Experiments with primary murine bone marrow derived macrophages, primary murine liver sinusoidal endothelial cells, and primary human aortic endothelial cells demonstrated that loading with VSOP induced a differential response of cellular iron homeostasis mechanisms with increased levels of ferritin and iron transport proteins in macrophages and increased levels of ferritin in endothelial cells.
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Affiliation(s)
- Wolfram C Poller
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany; Berlin Institute of Health (BIH), Berlin, Germany.
| | - Melanie Pieber
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany
| | - Philipp Boehm-Sturm
- Charité-Universitätsmedizin Berlin, Department of Experimental Neurology and Center for Stroke Research Berlin, Berlin, Germany; Charité-Universitätsmedizin Berlin, NeuroCure Cluster of Excellence and Charité Core Facility 7T Experimental MRIs, Berlin, Germany
| | - Evelyn Ramberger
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany
| | - Vasileios Karampelas
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany
| | - Konstantin Möller
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany
| | - Moritz Schleicher
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany
| | | | - Norbert Löwa
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | - Susanne Wagner
- Charité-Universitätsmedizin Berlin, Klinik für Radiologie, Berlin, Germany
| | - Jörg Schnorr
- Charité-Universitätsmedizin Berlin, Klinik für Radiologie, Berlin, Germany
| | - Matthias Taupitz
- Charité-Universitätsmedizin Berlin, Klinik für Radiologie, Berlin, Germany
| | - Karl Stangl
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany
| | - Verena Stangl
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany.
| | - Antje Ludwig
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Berlin, Germany
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Zhao Z, Peng SY, Chang MY, Hsu YL, Frerichs I, Chang HT, Möller K. Spontaneous breathing trials after prolonged mechanical ventilation monitored by electrical impedance tomography: an observational study. Acta Anaesthesiol Scand 2017; 61:1166-1175. [PMID: 28832898 DOI: 10.1111/aas.12959] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The study objective was to examine the correlation between regional ventilation distribution measured with electrical impedance tomography (EIT) and weaning outcomes during spontaneous breathing trial (SBT). METHODS Fifteen patients received 100% automatic tube compensation (ATC) during the first and 70% during the second hour. Another 15 patients received external continuous positive airway pressure (CPAP) of 5 and 7.5 cmH2 O during the first and second hours, respectively. Regional ventilation distributions were monitored with EIT. RESULTS Tidal volume and tidal variation of impedance correlated significantly during assist-control ventilation and ATC in all patients (r2 = 0.80 ± 0.18, P < 0.001). Higher support levels resulted in similar ventilation distribution and tidal volume, but higher end-expiratory lung impedance (EELI) (P < 0.05). Analysis of regional intratidal gas distribution revealed a redistribution of ventilation towards dorsal regions with lower support level in 13 of 30 patients. These patients had a higher weaning success rate (only 1 of 13 patients failed). Eight of 17 other patient failed (P < 0.05). The number of SBT days needed for weaning was significantly lower in the former group of 13 patients (13.1 ± 4.0 vs. 20.9 ± 11.2 days, P < 0.05). CONCLUSIONS Regional ventilation distribution patterns during inspiration were associated with weaning outcomes, and they may be used to predict the success of extubation.
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Affiliation(s)
- Z. Zhao
- Institute of Technical Medicine; Furtwangen University; Villingen-Schwenningen Germany
- Department of Biomedical Engineering; Fourth Military Medical University; Xi'an China
| | - S.-Y. Peng
- Division of Pulmonary Medicine; Department of Internal Medicine; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - M.-Y. Chang
- Division of Pulmonary Medicine; Department of Internal Medicine; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - Y.-L. Hsu
- Division of Pulmonary Medicine; Department of Internal Medicine; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - I. Frerichs
- Department of Anesthesiology and Intensive Care Medicine; University Medical Center of Schleswig-Holstein Campus Kiel; Kiel Germany
| | - H.-T. Chang
- Medical Intensive Care Unit; Department of Critical Care Medicine; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - K. Möller
- Institute of Technical Medicine; Furtwangen University; Villingen-Schwenningen Germany
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Kretschmer J, Bibiano C, Laufer B, Docherty PD, Chiew YS, Redmond D, Chase JG, Möller K. Differences in respiratory mechanics estimation with respect to manoeuvres and mathematical models. Biomed Phys Eng Express 2017. [DOI: 10.1088/2057-1976/aa5a31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Möller K, Kohles N, Eßer D. [Surgery in Salivary Gland Diseases]. Laryngorhinootologie 2016; 95:709-732. [PMID: 27764856 DOI: 10.1055/s-0042-114367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Salivary gland surgery is a common procedure in otorhinolaryngology. Parotidectomy and submandibulectomy represent the treatment of choice in benign and malignant tumors of the salivary glands. However, as to this point there are no guidelines are concerning diagnostic and therapeutic approaches of benign and malignant tumors of the salivary gland. Since the introduction of sialendoscopy there are new diagnostic and therapeutic procedures available in treating obstructive sialadenitis. The present article provides an overview of anatomical principles, diagnostic approaches and the most important salivary gland surgeries for future otorhinolaryngologists under specialist training.
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Möller K, Sollerman C, Geijer M, Kopylov P, Tägil M. Avanta Versus Swanson Silicone Implants in the MCP Joint—A Prospective, Randomized Comparison of 30 Patients Followed for 2 Years. ACTA ACUST UNITED AC 2016; 30:8-13. [PMID: 15620485 DOI: 10.1016/j.jhsb.2004.09.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2004] [Accepted: 09/16/2004] [Indexed: 11/26/2022]
Abstract
The results of Swanson and Avanta metacarpophalangeal joint arthroplasties in rheumatoid patients were compared in a prospective, randomized study of 30 patients (120 implants). At 2-year follow-up, grip strength was measured, hand function was assessed with the Sollerman test and the subjective outcome was determined with visual analogue scores. With both implants ulnar deviation and flexion deformities decreased, and there was no difference between the groups. The increase in range of motion was 7° greater with Avanta implants than with Swanson implants. Grip strength and hand function were unaltered but the visual analogue scales showed decreased pain levels and subjective improvements in hand function, grip strength and cosmesis. Twenty-four of 30 patients were satisfied. Fracture of the silicone spacer occurred with 12 Avanta (20%) and eight Swanson implants (13%), with a higher fracture frequency in men.
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Affiliation(s)
- K Möller
- Department of Hand Surgery, Sahlgrenska University Hospital/Sahlgrenska, Göteborg, Sweden.
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Poller WC, Löwa N, Wiekhorst F, Taupitz M, Wagner S, Möller K, Baumann G, Stangl V, Trahms L, Ludwig A. Magnetic Particle Spectroscopy Reveals Dynamic Changes in the Magnetic Behavior of Very Small Superparamagnetic Iron Oxide Nanoparticles During Cellular Uptake and Enables Determination of Cell-Labeling Efficacy. J Biomed Nanotechnol 2016; 12:337-46. [PMID: 27305767 DOI: 10.1166/jbn.2016.2204] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In vivo tracking of nanoparticle-labeled cells by magnetic resonance imaging (MRI) crucially depends on accurate determination of cell-labeling efficacy prior to transplantation. Here, we analyzed the feasibility and accuracy of magnetic particle spectroscopy (MPS) for estimation of cell-labeling efficacy in living THP-1 cells incubated with very small superparamagnetic iron oxide nanoparticles (VSOP). Cell viability and proliferation capacity were not affected by the MPS measurement procedure. In VSOP samples without cell contact, MPS enabled highly accurate quantification. In contrast, MPS constantly overestimated the amount of cell associated and internalized VSOP. Analyses of the MPS spectrum shape expressed as harmonic ratio A₅/A₃ revealed distinct changes in the magnetic behavior of VSOP in response to cellular uptake. These changes were proportional to the deviation between MPS and actual iron amount, therefore allowing for adjusted iron quantification. Transmission electron microscopy provided visual evidence that changes in the magnetic properties correlated with cell surface interaction of VSOP as well as with alterations of particle structure and arrangement during the phagocytic process. Altogether, A₅/A₃-adjusted MPS enables highly accurate, cell-preserving VSOP quantification and furthermore provides information on the magnetic characteristics of internalized VSOP.
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Jenssen C, Tuma J, Möller K, Cui XW, Kinkel H, Uebel S, Dietrich CF. [Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - part 2: color and spectral Doppler artifacts]. Z Gastroenterol 2016; 54:569-78. [PMID: 27284933 DOI: 10.1055/s-0042-103248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues of the body and with foreign materials. On the one hand, they may be diagnostically helpful. On the other hand, they may be distracting and may lead to misdiagnosis. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review commented on the physics of artifacts and described the most important B-mode artifacts. Part 2 focuses on the clinically relevant artifacts in Doppler and color-coded duplex sonography. Problems and pitfalls of interpretation arising from artifacts, as well as the diagnostic use of Doppler and colour-coded duplex sonography, are discussed.
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Affiliation(s)
- C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Strausberg, Deutschland
| | - J Tuma
- Sonografie Institut, Uster, Switzerland
| | - K Möller
- SANA-Klinikum Lichtenberg, Berlin, Deutschland
| | - X W Cui
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
| | - H Kinkel
- Krankenhaus Düren GmbH, Düren, Deutschland
| | - S Uebel
- Hitachi Medical Systems GmbH, Wiesbaden, Deutschland
| | - C F Dietrich
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Deutschland
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Durisala N, Manchaiah V, Granberg S, Möller K. Determination and classification of the problems experienced by adults with single-sided deafness using ICF classification: an exploratory study using 26 participants. Clin Otolaryngol 2016; 42:748-752. [PMID: 27184914 DOI: 10.1111/coa.12671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- N Durisala
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
| | - V Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Department of Behavioral Sciences and Learning, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.,Audiology India, Mysore, India
| | - S Granberg
- The Swedish Institute for Disability Research (SIDR), School of Health Sciences, Örebro University, Örebro, Sweden.,Audiological Research Center, Örebro University Hospital, Örebro, Sweden
| | - K Möller
- The Swedish Institute for Disability Research (SIDR), School of Health Sciences, Örebro University, Örebro, Sweden.,Audiological Research Center, Örebro University Hospital, Örebro, Sweden
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Tuma J, Jenssen C, Möller K, Cui XW, Kinkel H, Uebel S, Dietrich CF. [Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - Part 1: B-mode artifacts]. Z Gastroenterol 2016; 54:433-50. [PMID: 27171335 DOI: 10.1055/s-0042-103247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.
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Affiliation(s)
- J Tuma
- Sonografie-Institut, Uster, Switzerland
| | - C Jenssen
- Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany
| | - K Möller
- SANA-Klinikum Lichtenberg, Berlin, Germany
| | - X W Cui
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
| | - H Kinkel
- Krankenhaus Düren GmbH, Düren, Germany
| | - S Uebel
- Hitachi Medical Systems GmbH, Wiesbaden, Germany
| | - C F Dietrich
- Caritas-Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
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Weigand T, Peters V, Kebbewar M, Janssen B, Hoffmann GF, Möller K, Wygoda S, Charbit M, Fernandes-Teixeira A, Jeck N, Zschocke JZ, Schmitt CP, Schaefer F, Wühl E. Der Carnosinase-Genotyp beeinflusst die Progression der chronischen Niereninsuffizenz bei Kindern mit Glomerulopathien. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580824] [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: 10/21/2022]
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Stehle P, Lehmann T, Redmond D, Möller K, Kretschmer J. A java based simulator with user interface to simulate ventilated patients. Current Directions in Biomedical Engineering 2015. [DOI: 10.1515/cdbme-2015-0102] [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: 11/15/2022] Open
Abstract
Abstract
Mechanical ventilation is a life-saving intervention, which despite its use on a routine basis, poses the risk of inflicting further damage to the lung tissue if ventilator settings are chosen inappropriately. Medical decision support systems may help to prevent such injuries while providing the optimal settings to reach a defined clinical goal. In order to develop and verify decision support algorithms, a test bench simulating a patient’s behaviour is needed. We propose a Java based system that allows simulation of respiratory mechanics, gas exchange and cardiovascular dynamics of a mechanically ventilated patient. The implemented models are allowed to interact and are interchangeable enabling the simulation of various clinical scenarios. Model simulations are running in real-time and show physiologically plausible results.
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Affiliation(s)
- P. Stehle
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - T. Lehmann
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - D. Redmond
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - K. Möller
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - J. Kretschmer
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
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Lebok P, Mittenzwei A, Kluth M, Özden C, Taskin B, Hussein K, Möller K, Hartmann A, Lebeau A, Witzel I, Mahner S, Wölber L, Jänicke F, Geist S, Paluchowski P, Wilke C, Heilenkötter U, Simon R, Sauter G, Terracciano L, Krech R, von der Assen A, Müller V, Burandt E. 8p deletion is strongly linked to poor prognosis in breast cancer. Cancer Biol Ther 2015; 16:1080-7. [PMID: 25961141 DOI: 10.1080/15384047.2015.1046025] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 10/23/2022] Open
Abstract
Deletions of chromosome 8p occur frequently in breast cancers, but analyses of its clinical relevance have been limited to small patient cohorts and provided controversial results. A tissue microarray with 2,197 breast cancers was thus analyzed by fluorescence in-situ hybridization using an 8p21 probe in combination with a centromere 8 reference probe. 8p deletions were found in 50% of carcinomas with no special type, 67% of papillary, 28% of tubular, 37% of lobular cancers and 56% of cancers with medullary features. Deletions were always heterozygous. 8p deletion was significantly linked to advanced tumor stage (P < 0.0001), high-grade (P < 0.0001), high tumor cell proliferation (Ki67 Labeling Index; P < 0.0001), and shortened overall survival (P < 0.0001). For example, 8p deletion was seen in 32% of 290 grade 1, 43% of 438 grade 2, and 65% of 427 grade 3 cancers. In addition, 8p deletions were strongly linked to amplification of MYC (P < 0.0001), HER2 (P < 0.0001), and CCND1 (p = 0.001), but inversely associated with ER receptor expression (p = 0.0001). Remarkably, 46.5% of 8p-deleted cancers harbored amplification of at least one of the analyzed genes as compared to 27.5% amplifications in 8p-non-deleted cancers (P < 0.0001). In conclusion, 8p deletion characterizes a subset of particularly aggressive breast cancers. As 8p deletions are easy to analyze, this feature appears to be highly suited for future DNA based prognostic breast cancer panels. The strong link of 8p deletion with various gene amplifications raises the possibility of a role for regulating genomic stability.
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Key Words
- 8p
- ER, estrogen receptor
- FISH
- FISH, fluorescence in situ hybridization
- HER2, human epidermal growth factor receptor 2
- Ki67LI, Ki67 Labeling index
- LOH, loss of heterozygosity
- NGS, next generation sequencing
- NST, no special type
- PR, progesterone receptor
- TMA, tissue microarray
- breast cancer
- deletion
- pN, nodal stage
- pT, pathological tumor stage
- prognosis
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Affiliation(s)
- P Lebok
- a Institute of Pathology; University Medical Center Hamburg-Eppendorf ; Hamburg , Germany
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Schranz C, Becher T, Schädler D, Weiler N, Möller K. Model-based setting of inspiratory pressure and respiratory rate in pressure-controlled ventilation. Physiol Meas 2014; 35:383-97. [PMID: 24499739 DOI: 10.1088/0967-3334/35/3/383] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Mechanical ventilation carries the risk of ventilator-induced-lung-injury (VILI). To minimize the risk of VILI, ventilator settings should be adapted to the individual patient properties. Mathematical models of respiratory mechanics are able to capture the individual physiological condition and can be used to derive personalized ventilator settings. This paper presents model-based calculations of inspiration pressure (pI), inspiration and expiration time (tI, tE) in pressure-controlled ventilation (PCV) and a retrospective evaluation of its results in a group of mechanically ventilated patients. Incorporating the identified first order model of respiratory mechanics in the basic equation of alveolar ventilation yielded a nonlinear relation between ventilation parameters during PCV. Given this patient-specific relation, optimized settings in terms of minimal pI and adequate tE can be obtained. We then retrospectively analyzed data from 16 ICU patients with mixed pathologies, whose ventilation had been previously optimized by ICU physicians with the goal of minimization of inspiration pressure, and compared the algorithm's 'optimized' settings to the settings that had been chosen by the physicians. The presented algorithm visualizes the patient-specific relations between inspiration pressure and inspiration time. The algorithm's calculated results highly correlate to the physician's ventilation settings with r = 0.975 for the inspiration pressure, and r = 0.902 for the inspiration time. The nonlinear patient-specific relations of ventilation parameters become transparent and support the determination of individualized ventilator settings according to therapeutic goals. Thus, the algorithm is feasible for a variety of ventilated ICU patients and has the potential of improving lung-protective ventilation by minimizing inspiratory pressures and by helping to avoid the build-up of clinically significant intrinsic positive end-expiratory pressure.
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Affiliation(s)
- C Schranz
- Institute of Technical Medicine, Furtwangen University, Jakob-Kienzle-Str. 17, 78054 Villingen-Schwenningen, Germany
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Schranz C, Riedlinger A, Huhle R, Braune A, Gama de Abreu M, Koch E, Möller K. Selection Criteria for Competing Models of Respiratory Mechanics. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-N/bmt-2013-4326/bmt-2013-4326.xml. [PMID: 24043038 DOI: 10.1515/bmt-2013-4326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schranz C, Becher T, Schädler D, Weiler N, Möller K. Model-Based Ventilator Settings in Pressure Controlled Ventilation. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-S/bmt-2013-4425/bmt-2013-4425.xml. [PMID: 24043203 DOI: 10.1515/bmt-2013-4425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kretschmer J, Schranz C, Knöbel C, Wingender J, Koch E, Möller K. Efficient computation of interacting model systems. J Biomed Inform 2013; 46:401-9. [PMID: 23395682 DOI: 10.1016/j.jbi.2013.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 01/11/2013] [Accepted: 01/17/2013] [Indexed: 11/15/2022]
Abstract
Physiological processes in the human body can be predicted by mathematical models. Medical Decision Support Systems (MDSS) might exploit these predictions when optimizing therapy settings. In critically ill patients depending on mechanical ventilation, these predictions should also consider other organ systems of the human body. In a previously presented framework we combine elements of three model families: respiratory mechanics, cardiovascular dynamics and gas exchange. Computing combinations of moderately complex submodels showed to be computationally costly thus limiting the applicability of those model combinations in an MDSS. A decoupled computing approach was therefore developed, which enables individual evaluation of every submodel. Direct model interaction is not possible in separate calculations. Therefore, interface signals need to be substituted by estimates. These estimates are iteratively improved by increasing model detail in every iteration exploiting the hierarchical structure of the implemented model families. Simulation error converged to a minimum after three iterations. Maximum simulation error showed to be 1.44% compared to the original common coupled computing approach. Simulation error was found to be below measurement noise generally found in clinical data. Simulation time was reduced by factor 34 using one iteration and factor 13 using three iterations. Following the proposed calculation scheme moderately complex model combinations seem to be applicable for model based decision support.
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Affiliation(s)
- J Kretschmer
- Furtwangen University, Institute of Technical Medicine, Jakob-Kienzle-Straße 17, 78054 Villingen-Schwenningen, Germany.
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Kretschmer J, Riedlinger A, Becher T, Schädler D, Weiler N, Möller K. A Family of Physiological Models to Simulate Human Gas Exchange. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-N/bmt-2013-4353/bmt-2013-4353.xml. [DOI: 10.1515/bmt-2013-4353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zhao Z, Vogt B, Falkenberg C, Weiler N, Möller K, Frerichs I. Customized electrical impedance tomography based analysis of regional lung function: a feasibility study. ACTA ACUST UNITED AC 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-E/bmt-2013-4131/bmt-2013-4131.xml. [DOI: 10.1515/bmt-2013-4131] [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: 11/15/2022]
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Riedlinger A, Schranz C, Möller K. Robustness Analysis of a Mathematical Gas Exchange Model. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-N/bmt-2013-4354/bmt-2013-4354.xml. [DOI: 10.1515/bmt-2013-4354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kretschmer J, Riedlinger A, Möller K. Predicting etCO2 Response in a Model of Ventilation-Perfusion Mismatch. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-N/bmt-2013-4324/bmt-2013-4324.xml. [DOI: 10.1515/bmt-2013-4324] [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: 11/15/2022]
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Reyes Adame M, Krueger-Ziolek S, Möller K, Seemann E. Combining Real World Problems with Student Competitions in Engineering Education. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-R/bmt-2013-4417/bmt-2013-4417.xml. [DOI: 10.1515/bmt-2013-4417] [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: 11/15/2022]
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Scherer J, Schranz C, Knörzer A, Möller K. Model-based Optimization of Ventilator Settings for Bedside Application. BIOMED ENG-BIOMED TE 2013; 58 Suppl 1:/j/bmte.2013.58.issue-s1-I/bmt-2013-4212/bmt-2013-4212.xml. [DOI: 10.1515/bmt-2013-4212] [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: 11/15/2022]
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Mueller-Lisse UG, Zhao Z, Fischer R, Huber RM, Reiser MF, Möller K. Erste Erfahrungen mit der Elektro-Impedanz-Tomographie (EIT) zur Messung der regionalen Obstruktion bei Erwachsenen mit zystischer Fibrose (CF). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311013] [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: 10/28/2022]
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29
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Adame MR, Al-Jawad A, Romanovas M, Hobert MA, Maetzler W, Möller K, Manoli Y. TUG Test Instrumentation for Parkinson’s disease patients using Inertial Sensors and Dynamic Time Warping. ACTA ACUST UNITED AC 2012. [DOI: 10.1515/bmt-2012-4426] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bertzbach F, Franz T, Möller K. How to achieve and prove performance improvement - 15 years of experience in German wastewater benchmarking. Water Sci Technol 2012; 65:661-668. [PMID: 22277224 DOI: 10.2166/wst.2012.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper shows the results of performance improvement, which have been achieved in benchmarking projects in the wastewater industry in Germany over the last 15 years. A huge number of changes in operational practice and also in achieved annual savings can be shown, induced in particular by benchmarking at process level. Investigation of this question produces some general findings for the inclusion of performance improvement in a benchmarking project and for the communication of its results. Thus, we elaborate on the concept of benchmarking at both utility and process level, which is still a necessary distinction for the integration of performance improvement into our benchmarking approach. To achieve performance improvement via benchmarking it should be made quite clear that this outcome depends, on one hand, on a well conducted benchmarking programme and, on the other, on the individual situation within each participating utility.
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Affiliation(s)
- F Bertzbach
- Aquabench GmbH, Ferdinandstraße 6, D-20095 Hamburg, Germany.
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Docherty P, Schranz C, Chase J, Chiew Y, Möller K. Traversing the Fuzzy Valley: Problems Caused by Reliance on Default Simulation and Parameter Identification Programs for Discontinuous Models. ACTA ACUST UNITED AC 2012. [DOI: 10.3182/20120829-3-hu-2029.00033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Schranz C, Knöbel C, Kretschmer J, Zhao Z, Möller K. Hierarchical Parameter Identification in Models of Respiratory Mechanics. IEEE Trans Biomed Eng 2011; 58:3234-41. [DOI: 10.1109/tbme.2011.2166398] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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33
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Möller K, Klingel K, Kaiser U, Thum M, Bönig A, Kandolf R, Hasenfuss G, Scholz KH. [Immunsuppressive therapy in virus-negative eosinophilic inflammatory cardiomyopathy]. Dtsch Med Wochenschr 2011; 136:816-9. [PMID: 21487971 DOI: 10.1055/s-0031-1275810] [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 ADMISSION FINDINGS A 52 year-old women presented with long-standing dyspnoea at exercise as a symptom of heart failure. A coronary heart disease had been excluded by coronary angiography a year before. The symptoms had persisted despite application of guideline-based anticongestive medication. INVESTIGATIONS Electrocardiography showed sinus rhythm with decreased anterior wall amplitudes without acute ischemic signs. The white blood count revealed elevated leucocytes with high numbers of eosinophilic granulocytes. Echocardiography demonstrated severe left ventricular dysfunction with an ejection fraction of 30 % and a left ventricular end-diastolic diameter of 75 mm. Magnetic resonance imaging showed a pathologic late enhancement in the left ventricular wall. Six myocardial biopsies were obtained and revealed virus-negative eosinophilic inflammatory cardiomyopathy with focal fibrotic scarring. DIAGNOSIS, TREATMENT AND COURSE The patient was treated according to a previously published study on virus-negative inflammatory heart disease with prednisone 1 mg/kg daily for 4 weeks followed by 0.33 mg/kg daily for 5 month and azathioprine 2 mg/kg daily for 6 month. The echocardiography of the left ventricular function showed an increase from 30 to 45 % and the clinical symptoms of the heart failure resolved to NYHA II. CONCLUSION In patients with virus-negative eosinophilic inflammatory cardiomyopathy standardized therapy with prednisone and azathioprine can improve LV function and clinical symptoms.
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Affiliation(s)
- K Möller
- Medizinische Klinik 1, St. Bernward Krankenhaus Hildesheim
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Lozano-Zahonero S, Gottlieb D, Haberthür C, Guttmann J, Möller K. Automated mechanical ventilation: adapting decision making to different disease states. Med Biol Eng Comput 2010; 49:349-58. [PMID: 21069471 DOI: 10.1007/s11517-010-0712-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 10/27/2010] [Indexed: 10/18/2022]
Abstract
The purpose of the present study is to introduce a novel methodology for adapting and upgrading decision-making strategies concerning mechanical ventilation with respect to different disease states into our fuzzy-based expert system, AUTOPILOT-BT. The special features are: (1) Extraction of clinical knowledge in analogy to the daily routine. (2) An automated process to obtain the required information and to create fuzzy sets. (3) The controller employs the derived fuzzy rules to achieve the desired ventilation status. For demonstration this study focuses exclusively on the control of arterial CO(2) partial pressure (p(a)CO(2)). Clinical knowledge from 61 anesthesiologists was acquired using a questionnaire from which different disease-specific fuzzy sets were generated to control p(a)CO(2). For both, patients with healthy lung and with acute respiratory distress syndrome (ARDS) the fuzzy sets show different shapes. The fuzzy set "normal", i.e., "target p(a)CO(2) area", ranges from 35 to 39 mmHg for healthy lungs and from 39 to 43 mmHg for ARDS lungs. With the new fuzzy sets our AUTOPILOT-BT reaches the target p(a)CO(2) within maximal three consecutive changes of ventilator settings. Thus, clinical knowledge can be extended, updated, and the resulting mechanical ventilation therapies can be individually adapted, analyzed, and evaluated.
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Affiliation(s)
- S Lozano-Zahonero
- Department of Biomedical Engineering, Furtwangen University, Villingen-Schwenningen Campus, Jakob Kienzle Straße 17, Villingen-Schwenningen, 78054, Germany.
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Möller K, Piella E, Algenstaedt P, Müller-Wiefel D. P49 AN ERYTHROPOIETIN RECEPTOR (EPOR) IN HUMAN ADIPOSE TISSUE (AT). ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70116-1] [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: 10/19/2022]
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36
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Jaeger NI, Möller K, Plath PJ. The Development of a Model for the Cooperative Behavior of Palladium Crystallites During the Catalytic Oxidation of CO. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bbpc.19850890613] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Lozano-Zahonero S, Gottlieb D, Guttmann J, Möller K. Towards partially automated ventilation: adapting decision-making according to medical preferences. Crit Care 2010. [PMCID: PMC2934064 DOI: 10.1186/cc8441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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38
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Schwenninger D, Runck H, Schumann S, Möller K. Lung tissue properties obtained by optical alveolar elastometry. Crit Care 2010. [PMCID: PMC2934006 DOI: 10.1186/cc8403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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39
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Zhao Z, Guttmann J, Möller K. Mechanical ventilation with different alveolar pressures improves alveolar recruitment: a model study. Crit Care 2010. [PMCID: PMC2934150 DOI: 10.1186/cc8419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Piella EC, Möller K, Ramuschkat M, Müller-Wiefel DE, Algenstaedt P. Signalling des Erythropoetin-Rezeptors (EPOR) in humanem Fettgewebe nach Stimulation mit Erythropoetin. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221949] [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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Piella EC, Möller K, Ramuschkat M, Müller-Wiefel DE, Algenstaedt P. Nachweis eines gewebsspezifischen Erythropoetin-Rezeptors (EPOR) in humanem Fettgewebe. DIABETOL STOFFWECHS 2009. [DOI: 10.1055/s-0029-1221950] [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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Kretschmer J, Wahl A, Guttmann J, Möller K. Dynamic generation of physiological model systems. Crit Care 2009. [PMCID: PMC4084037 DOI: 10.1186/cc7315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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45
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Zhao Z, Möller K, Steinmann D, Guttmann J. Global and local inhomogeneity indices of lung ventilation based on electrical impedance tomography. IFMBE Proceedings 2009. [DOI: 10.1007/978-3-540-89208-3_63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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46
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47
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Lozano-Zahonero S, Wahl A, Gottlieb D, Arntz J, Schumann S, Guttmann J, Möller K. Control system for automated titration of positive end-expiratory pressure and tidal volume using dynamic nonlinear compliance as the setpoint. Crit Care 2009. [PMCID: PMC4083929 DOI: 10.1186/cc7207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Jenssen C, Möller K, Wagner S, Sarbia M. [Endoscopic ultrasound-guided biopsy: diagnostic yield, pitfalls, quality management]. Z Gastroenterol 2008; 46:897-908. [PMID: 18810676 DOI: 10.1055/s-2008-1027419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The differential diagnosis of tumorous lesions in the pancreas, liver, adrenal gland or lymph nodes is ambiguous. Specific tissue diagnoses are essential for treatment decisions. Endoscopic ultrasound-guided biopsy has proven to be a reliable and effective modality in obtaining samples for cytological or histological examinations either primarily or in cases in which other biopsy techniques have failed. The reproducibility of cytopathological diagnoses among pathologists with special experience in assessing material obtained by endoscopic ultrasound-guided biopsies is very high. False positive diagnoses of malignancy in endoscopic ultrasound-guided biopsy are rare; false negative diagnoses appear in a variable frequency depending on target tissue, technical factors, and expertise of the endosonographer and cytopathologist. There are numerous challenges and pitfalls in the differential diagnostic classification of benign and malignant lesions. These problems are related to the characteristics of samples obtained by endoscopic ultrasound-guided biopsy, as well as to the multiple diagnoses with similar or overlapping cytological or histological characteristics. This review discusses the performance of endoscopic ultrasound-guided biopsy in establishing specific tissue diagnoses, possible pitfalls as well as opportunities to minimise differential diagnostic errors.
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Affiliation(s)
- C Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland GmbH, Prçtzeler Chaussee 5, 15344 Strausberg.
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Jenssen C, Möller K, Wagner S, Sarbia M. [Endoscopic ultrasound-guided biopsy: diagnostic yield, pitfalls, quality management part 1: optimizing specimen collection and diagnostic efficiency]. Z Gastroenterol 2008; 46:590-600. [PMID: 18537087 DOI: 10.1055/s-2008-1027413] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Endoscopic ultrasound-guided biopsies have proven to be of significant value in the diagnostic evaluation of benign and malignant diseases, as well as in the staging of malignant tumours of the gastrointestinal tract and adjacent organs. The high prognostic and therapeutic relevance of the resulting cytopathological diagnoses necessitates a shared responsibility of endosonographer and cytopathologist. Quality control programs are required. The diagnostic yield of endoscopic ultrasound-guided biopsies depends on the location, size and characteristics of target tissues, and technical factors (i. e., type of needle used, biopsy technique, and material processing). Other weighing factors include training, expertise and interaction of the endosonographer with cytopathologists. On-site cytological evaluation, which has proven to be successful in optimising the diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration biopsy, is notably practiced in Northern American and French academic institutions. It seems to be a sensible alternative to collect specimens for histological and immunohistochemical investigations in addition to the cytological smears in consideration of the economic and structural terms in the German health-care system. Endoscopic ultrasound-guided fine-needle aspiration succeeds in harvesting core biopsies in 3 out of 4 cases with 22-gauge needles. Therefore the use of 19-gauge needles for endoscopic ultrasound-guided aspiration or trucut biopsy may be necessary only in selected cases.
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Affiliation(s)
- C Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland.
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50
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Lozano S, Möller K, Brendle A, Gottlieb D, Schumann S, Stahl C, Guttmann J. AUTOPILOT-BT: A system for knowledge and model based mechanical ventilation. Technol Health Care 2008. [DOI: 10.3233/thc-2008-16101] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- S. Lozano
- Department of Biomedical Engineering, Furtwangen University, Villingen-Schwenningen Campus, Germany
| | - K. Möller
- Department of Biomedical Engineering, Furtwangen University, Villingen-Schwenningen Campus, Germany
| | - A. Brendle
- Section of Experimental Anesthesiology, Department of Anesthesiology and Critical Care Medicine, University Hospital Freiburg, Germany
| | - D. Gottlieb
- Section of Experimental Anesthesiology, Department of Anesthesiology and Critical Care Medicine, University Hospital Freiburg, Germany
| | - S. Schumann
- Section of Experimental Anesthesiology, Department of Anesthesiology and Critical Care Medicine, University Hospital Freiburg, Germany
| | - C.A. Stahl
- Section of Experimental Anesthesiology, Department of Anesthesiology and Critical Care Medicine, University Hospital Freiburg, Germany
| | - J. Guttmann
- Section of Experimental Anesthesiology, Department of Anesthesiology and Critical Care Medicine, University Hospital Freiburg, Germany
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