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| 1 | Long-term outcome and prognostic factors of patients with hilar cholangiocarcinoma显示文摘AIM: To evaluate the long-term outcome and prognostic factors of patients with hilar cholangiocarinoma. METHODS: Ninety-six consecutive patients underwent treatment for malignant hilar bile duct tumors during 1995–2005. Of the 96 patients, 20 were initially treated with surgery (n = 2 R0 / n = 18 R1). In non-operated patients, data analysis was performed retrospectively. RESULTS: Among the 96 patients, 76 were treated with endoscopic transpapillary (ERC, n = 45) and/or percutaneous transhepatic biliary drainage (PTBD, n = 31). The mean survival time of these 76 patients undergoing palliative endoscopic and/or percutaneous drainage was 359 ± 296 d. The mean survival time of patients with initial bilirubin levels > 10 mg/dL was significantly lower (P < 0.001) than patients with bilirubin levels < 10 mg/dL. The mean survival time of patients with Bismuth stage Ⅱ (n = 8), Ⅲ (n = 28) and Ⅳ (n = 40) was 496 ± 300 d, 441 ± 385 d and 274 ± 218 d, respectively. Thus, patients with advanced Bismuth stage showed a reduced mean survival time, but the difference was not significant. The type of biliary drainage had no significant beneficial effect on the mean survival time (ERC vs PTBD, P = 0.806). CONCLUSION: Initial bilirubin level is a significant prognostic factor for survival of patients. In contrast, age, tumor stage according to the Bismuth-Corlette classification, and types of intervention are not significant prognostic parameters for survival. Palliative treatment with endoscopic or percutaneous biliary drainage is still suboptimal, new diagnostic and therapeutic tools need to be evaluated. | Andreas Weber Sonja Landrock Jochen Schneider Manfred Stangl Bruno Neu Peter Born Meinhard Classen Thomas Rsch Roland M Schmid Christian Prinz | 2007 | World Journal of Gastroenterology2007，13，9： | 23 |
| 2 | Diagnostic approaches for cholangiocarcinoma显示文摘Cholangiocarcinomas arise from the epithelial cells of the bile ducts and are associated with poor prognosis. Despite new diagnostic approaches, the definite diagnosis of this malignancy continues to be challenging. Cholangiocarcinomas often grow longitudinally along the bile duct rather than in a radial direction. Thus, large tumor masses are frequently absent and imaging techniques, including ultrasound, CT, and MRI have only limited sensitivity. Tissue collection during endoscopic (ERCP) and/or percutaneous transhepatic (PTC) procedures are usually used to confirm a definitive diagnosis of cholangiocarcinoma. However, forceps biopsy and brush cytology provide positive results for malignancy in about only 50% of patients. Percutaneous and peroral cholangioscopy using fiber-optic techniques were therefore developed for direct visualization of the biliary tree, yielding additional information about endoscopic appearance and tumor extension, as well as a guided biopsy acquistion. Finally, endoscopic ultrasonography (EUS) complements endoscopic and percutaneous approaches and may provide a tissue diagnosis of tumors in the biliary region through fine-needle aspiration. In the future, new techniques allowing for early detection, including molecular markers, should be developed to improve the diagnostic sensitivity in this increasing tumor entity. | Andreas Weber Roland M Schmid Christian Prinz | 2008 | World Journal of Gastroenterology2008，14，26： | 21 |
| 3 | In vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens of acute cholangitis显示文摘AIM: To analyze the in vitro activity of moxifloxacin and piperacillin/sulbactam against pathogens isolated from patients with acute cholangitis. METHODS: In this prospective study a total of 65 patients with acute cholangitis due to biliary stone obstruction (n = 7), benign biliary stricture (n = 16), and malignant biliary stricture (n = 42) were investigated with regard to spectrum of bacterial infection and antibiotic resistance. Pathogens were isolated from bile cultures in all study patients. In 22 febrile patients, blood cultures were also obtained. In vitro activity of moxifloxacin and piperacillin/ sulbactam was determined by agar diffusion. RESULTS: Thirty-one out of 65 patients had positive bile and/or blood cultures. In 31 patients, 63 isolates with 17 different species were identified. The predominant strains were Enterococcus species (26/63), E.coli (13/63) and Klebsiella species (8/63). A comparable in vitro activity of moxifloxacin and piperacillin/sulbactam was observed for E.coli and Klebsiella species. In contrast, Enterococcus species had higher resistances towards moxifloxacin. Overall bacteria showed antibiotic resistances in vitro of 34.9% for piperacillin/sulbactam and 36.5% for moxifloxacin.CONCLUSION: Enterococcus species , E.coli and Klebsiella species were the most common bacteria isolated from bile and/or blood from patients with acute cholangitis. Overall, a mixed infection with several species was observed, and bacteria showed a comparable in vitro activity for piperacillin/sulbactam and moxifloxacin. | Andreas Weber Wolfgang Huber Klaus Kamereck Philipp Winkle Petra Voland Hans Weidenbach Roland M Schmid Christian Prinz | 2008 | World Journal of Gastroenterology2008，14，20： | 18 |
| 4 | Endoscopic transpapillary brush cytology and forceps biopsy in patients with hilar cholangiocarcinoma显示文摘AIM: To evaluate the sensitivity of brush cytology and forceps biopsy in a homogeneous patient group with hilar cholangiocarcinoma.METHODS: Brush cytology and forceps biopsy were routinely performed in patients with suspected malignant biliary strictures. Fifty-eight consecutive patients undergoing endoscopic retrograde cholangio-pancreatography (ERCP) including forceps biopsy and brush cytology in patients with hilar cholangiocarcinoma between 1995-2005.RESULTS: Positive results for malignancy were obtained in 24/58 patients (41.4%) by brush cytology and in 31/58 patients (53.4%) by forceps biopsy. The combination of both techniques brush cytology and forceps biopsy resulted only in a minor increase in diagnostic sensitivity to 60.3% (35/58 patients). In 20/58 patients (34.5%), diagnosis were obtained by both positive cytology and positive histology, in 11/58 (19%) by positive histology (negative cytology) and only 4/58 patients (6.9%) were confirmed by positive cytology (negative histology).CONCLUSION: Brush cytology and forceps biopsy have only limited sensitivity for the diagnosis of malignant hilar tumors. In our eyes, additional diagnostic techniques should be evaluated and should become routine in patients with negative cytological and histological findings. | Andreas Weber Claus von Weyhern Falko Fend Jochen Schneider Bruno Neu Alexander Meining Hans Weidenbach Roland M Schmid Christian Prinz | 2008 | World Journal of Gastroenterology2008，14，7： | 17 |
| 5 | Clinically detected gastroenteropancreatic neuroendocrine tumors are on the rise: Epidemiological changes in Germany显示文摘AIM:To study the epidemiologic changes of gastroenteropancreatic neuroendocrine tumors(GEP-NET)in Germany,we analyzed two time periods 1976-1988 and1998-2006.METHODS:We evaluated epidemiological data of GEP-NET from the former East German National Cancer Registry(DDR Krebsregister,1976-1988)and its successor,the Joint Cancer Registry(GKR,1998-2006),which was founded after German reunification.Due to a particularly substantial database the epidemiological data from the federal states of Mecklenburg-Western Pomerania,Saxony,Brandenburg and Thuringia,covering a population of more than 10.8 million people,were analyzed.Survival probabilities were calculated using life table analysis.In addition,GEP-NET patients were evaluated for one or more second(non-GEP-NET)primary malignancies.RESULTS:A total of 2821 GEP neuroendocrine neoplasms were identified in the two registries.The overall incidence increased significantly between 1976 and2006 from 0.31(per 100.000 inhabitants per year)to2.27 for men and from 0.57 to 2.38 for women.In the later period studied(2004-2006),the small intestine was the most common site.Neuroendocrine(NE)neoplasms of the small intestine showed the largest absolute increase in incidence,while rectal NE neoplasms exhibited the greatest relative increase.Only the incidence of appendiceal NET in women showed little change between 1976 and 2006.Overall survival of patients varied for sex,tumor site and the two periods studied but improved significantly over time.Interestingly,about 20%of the GEP-NET patients developed one or more second malignancies.Their most common location was the gastrointestinal tract.GEP-NET patients without second malignancies fared better than those with one or more of them.CONCLUSION:The number of detected GEP-NET increased about 5-fold in Germany between 1976 and2006.At the same time,their anatomic distribution changed,and the survival of GEP-NET patients improved significantly.Second malignancies are common and influence the overall survival of GEP-NET patients.Thus,GEP-NET warrant our attention as well as intensive research on their tumorigenesis. | Hans Scherübl Brigitte Streller Roland Stabenow Hermann Herbst Michael Hopfner Christoph Schwertner Joachim Steinberg Jan Eick Wanda Ring Krishna Tiwari Soren M Zappe | 2013 | World Journal of Gastroenterology2013，19，47： | 16 |
| 6 | New aspects in the pathomechanism and diagnosis of the laryngopharyngeal reflux-clinical impact of laryngeal proton pumps and pharyngeal p H metry in extraesophageal gastroesophageal reflux disease显示文摘AIM:To determine the laryngeal H+K+-ATPase and pharyngeal p H in patients with laryngopharyngeal reflux(LPR)-symptoms as well as to assess the symptom scores during PPI therapy.METHODS:Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area(immunohistochemistry and PCR analysis).Immunohistochemical staining was performed with monoclonal mouse antibodies against human H+K+-ATPase.Quantitative real-time RT-PCR for each of the H+K+-ATPase subunits was performed.The p H values were assessed in the aerosolized environment of the oropharynx(Dxp H Catheter) and compared to a subsequently applied combined p H/MII measurement.RESULTS:Twenty patients with LPR symptoms were included.In only one patient,the laryngeal H+K+-ATPase was verified by immunohistochemical staining.In another patient,real-time RT-PCR for each H+K+-ATPase subunit was positive.Fourteen out of twenty patients had pathological results in Dxp H,and 6/20 patients had pathological results in p H/MII.Four patients had pathological results in both functional tests.Nine out of twenty patients responded to PPIs.CONCLUSION:The laryngeal H+K+-ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms.Alternative hypotheses for the pathomechanism are needed.The role of pharyngeal p H-metry remains unclearand its use can only be recommended for patients in a research study setting. | Valentin Becker Romina Drabner Simone Graf Christoph Schlag Simon Nennstiel Anna Maria Buchberger Roland M Schmid Dieter Saur Monther Bajbouj | 2015 | World Journal of Gastroenterology2015，21，3： | 14 |
| 7 | Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis显示文摘BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the disease.AIM To quantify the association between subgroups of BMI and the severity and mortality of AP.METHODS A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number CRD42017077890.RESULTS A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI < 18.5 had no significant effect on severity;however, BMI > 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality is almost equal in the normal BMI and BMI 25-30 subgroups. A BMI >30 results in a three times higher risk of mortality in comparison to a BMI < 30(OR = 2.89, 95%CI: 1.10-7.36, P = 0.026).CONCLUSION Our findings confirm that a BMI above 25 increases the risk of severe AP, while a BMI > 30 raises the risk of mortality. A BMI < 18.5 carries an almost two times higher risk of mortality in AP. | Dalma Dobszai Péter Mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross Alexandra Mikó Lajos Szakó Agnes Meczker Roland Hágendorn Katalin Márta Andrea Szentesi Péter Hegyi on behalf of the Hungarian Pancreatic Study Group | 2019 | World Journal of Gastroenterology2019，25，6： | 11 |
| 8 | Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis显示文摘AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal strictures.METHODS A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment tools.RESULTS Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid injection.CONCLUSION Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research. | László Szapáry Benedek Tinusz Nelli Farkas Katalin Márta Lajos Szakó Agnes Meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi Alexandra Mikó Dezso Csupor Péter Hegyi Balint Eross | 2018 | World Journal of Gastroenterology2018，24，21： | 7 |
| 9 | Patient comfort and quality in colonoscopy显示文摘AIM: To explore the relationship of patient comfort and experience to commonly used performance indicators for colonoscopy. METHODS: All colonoscopies performed in our four endoscopy centres are recorded in two reporting systems that log key performance indicators. From 2008 to 2011, all procedures performed by qualified endoscopists were evaluated; procedures performed by trainees were excluded. The following variables were measured: Caecal intubation rate (CIR), nurse-reported comfort levels (NRCL) on a scale from 1 to 5, polyp detection rate (PDR), patient experience of the procedure (worse than expected, as expected, better than expected), and use of sedation and analgesia. Pearson' s correlation coefficient was used to identify relationships between performance indicators.RESULTS: A total of 17027 colonoscopies were performed by 23 independent endoscopists between 2008 and 2011. Caecal intubation rate varied from 79.0% to 97.8%, with 18 out of 23 endoscopists achieving a CIR of > 90%. The percentage of patients experiencing significant discomfort during their procedure (defined as NRCL of 4 or 5) ranged from 3.9% to 19.2% with an average of 7.7%. CIR was negatively correlated with NRCL-45 (r=-0.61, P < 0.005), and with poor patient experience (r=-0.54, P < 0.01). The average dose of midazolam (mean 1.9 mg, with a range of 1.1 to 3.5 mg) given by the endoscopist was negatively correlated with CIR (r=-0.59, P < 0.01). CIR was positively correlated with PDR (r=0.44, P < 0.05), and with the numbers of procedures performed by the endoscopists (r=0.64, P < 0.01). CONCLUSION: The best colonoscopists have a higher CIR, use less sedation, cause less discomfort and find more polyps. Measuring patient comfort is valuable in monitoring performance. | Vivian E Ekkelenkamp Kevin Dowler Roland M Valori Paul Dunckley | 2013 | World Journal of Gastroenterology2013，19，15： | 5 |
| 10 | Changes in myocardial collagen content before and after left ventricular assist device application in dilated cardiomyopathy显示文摘Background The purposes of this study were to confirm the changes in myocardial collagen level after left ventricular assist device (LVAD) support in dilated cardiomyopathy (DCM), find the relation between these changes and prognosis, an d test a practical method to assess the level of myocardial collagen.Methods Left ventricular samples were collected from DCM patients with different prognosis (transplanted group n=8, weaning group n=10) at the time when the LV ADs were implanted and again during cardiac transplantation (n=8). The level of neutral salt soluble collagen (NSC) and acid soluble collagen (ASC) was measured by Sircol collagen assay, and that of total collagen and insoluble collagen (ISC) by quantification of hydroxyproline (Hyp). Serum samples were collected from a portion of these patients (transplanted group, n=6; weaning group n=7) at the time the LVADs were implanted, 1 month after implantation and on explantation. Circulating concentration of carboxy-terminal propeptide of type Ⅰ procollagen (PⅠCP), amino-terminal propeptide of type Ⅰ procollagen (PⅠNP), amino-terminal propeptide of type Ⅲ procollagen (PⅢNP) and type Ⅰ collagen telopeptide (ⅠCTP) were measured by the equilibrium type radioimmunoassay. Results Before LVAD implantation the level of NSC and ISC in th e weaning group was higher but ASC in the transplanted group was lower than in the control s (P<0.05). After LVAD support, the level of total collagen was higher, but ASC was also lower in the transplanted group than in the controls (P<0.05). In comparison of the pre- and po st-LVAD subgroups of the transplanted and weaning groups, all collagen fraction levels before LVAD implantation were lower in the transplanted group than in the weaning group (P<0.05); but this difference disappeared after LVAD support. Comparison of the pre- and post-LVAD subgroups of the transplanted group showed increased le vel of NSC and total collagen after LVAD support. The changes of serum p eptide concentration showed that PⅢNP increased constantly in the transplanted group, but PⅠCP and PⅠNP increased in the weaning group after LVAD implantation. Conclusions The changes in myocardial collagen level as a sign of myocardial interstitial remodeling in DCM are not involved with total collagen b ut invalved with collagen fractions, and they are related to prognosis. The changes of myocardial c ollagen content and serum procollagen peptide after LVAD support can be regarded as an expression of the reverse of maladaptive myocardial interstitial remodeling. | 梁红 Johannes Müller 翁渝国 Gerd Wallukat 付平 林汉生 Sabina Bartel Christoph Knosalla Reinhard Pregla Roland Hetzer | 2004 | Chinese Medical Journal2004，，3： | 3 |
| 11 | Pulse pressure and aortic pulse wave are markers of cardiovascular risk in hypertensive populations显示文摘 | Roland Asmar Annie Rudnichi Jacques Blacher Gérard M London Michel E Safar | 2001 | American Journal of Hypertension2001，，2： | 3 |
| 12 | Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study显示文摘AIM To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.METHODS We used data from PsyC oL aus, a large Swiss Population Cohort Study(n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety(early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects. RESULTS Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders(men), and measles/mumps/rubella-infections with early and late anxiety disorders(women). Gastric inflammatory diseases took effect in mood disorders(both sexes) and in early disorders(men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne(associations with mood disorders in men) and psoriasis(associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders(men), and neurodevelopmental and early anxiety disorders(women).CONCLUSION Infectious, atopic and inflammatory diseases areimportant risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced. | Vladeta Ajdacic-Gross Aleksandra Aleksandrowicz Stephanie Rodgers Margot Mutsch Anja Tesic Mario Müller Wolfram Kawohl Wulf R?ssler Erich Seifritz Enrique Castelao Marie-Pierre F Strippoli Caroline Vandeleur Roland von K?nel Rosa Paolicelli Markus A Landolt Cornelia Witthauer Roselind Lieb Martin Preisig | 2016 | World Journal of Psychiatry2016，6，4： | 2 |
| 13 | 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)显示文摘 | Giuseppe Mancia Guy De Backer Anna Dominiczak Renata Cifkova Robert Fagard Giuseppe Germano Guido Grassi Anthony M Heagerty Sverre E Kjeldsen Stephane Laurent Krzysztof Narkiewicz Luis Ruilope Andrzej Rynkiewicz Roland E Schmieder Harry AJ Struijker Boudi | 2007 | Journal of Hypertension2007，，6： | 2 |
| 14 | Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial显示文摘 | Mirjam Christ-Crain Daiana Jaccard-Stolz Roland Bingisser Mikael M Gencay Peter R Huber Michael Tamm Beat Müller | 2004 | 2004 (9409)2004，，9409： | 2 |
| 15 | 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)显示文摘 | Giuseppe Mancia Guy De Backer Anna Dominiczak Renata Cifkova Robert Fagard Giuseppe Germano Guido Grassi Anthony M Heagerty Sverre E Kjeldsen Stephane Laurent Krzysztof Narkiewicz Luis Ruilope Andrzej Rynkiewicz Roland E Schmieder Harry AJ Struijker Boudi | 2007 | Journal of Hypertension2007，，6： | 2 |
| 16 | Cytokerat in 20 in human carcinoma显示文摘 | Roland M Adrea L Jurgen L | 1992 | Am J Path1992，140，： | 1 |
| 17 | ICAM-1 expression deter- mines malignant potential of cancer 显示文摘 | Roland C L Harken A H Sarr M G | 2007 | Surgery2007，141，6： | 1 |
| 18 | Prenatal androgenization of fe- male mice programs an increase in firing activity of gona- dotropin-rclcasing hormone (GnRH) neurons that is re- versed by metformin treatment in adulthood 显示文摘 | Roland A V Moenter S M | 2011 | Endocri- nology2011，152，2： | 1 |
| 19 | The RolandMorris Disability Questionnaire and the Oswestry Disablity Questionnaire显示文摘 | Fairbank J | 2000 | Spine2000，25，24： | 1 |
| 20 | Evaluation of raw coals as fuels for direct carbon fuel cells 显示文摘 | LI X ZHU Z H ROLAND D M | 2010 | Joumal of Power Sources2010，195，13： | 1 |
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