15 results on '"Kantowski, Marcus"'
Search Results
2. Management of intra-thoracic anastomotic leakages after esophagectomy: updated systematic review and meta-analysis of endoscopic vacuum therapy versus stenting
- Author
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Scognamiglio, Pasquale, Reeh, Matthias, Melling, Nathaniel, Kantowski, Marcus, Eichelmann, Ann-Kathrin, Chon, Seung-Hun, El-Sourani, Nader, Schön, Gerhard, Höller, Alexandra, Izbicki, Jakob R., and Tachezy, Michael
- Published
- 2022
- Full Text
- View/download PDF
3. Endoscopic vacuum therapy versus stent treatment of esophageal anastomotic leaks (ESOLEAK): study protocol for a prospective randomized phase 2 trial
- Author
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Tachezy, Michael, Chon, Seung-Hun, Rieck, Isabel, Kantowski, Marcus, Christ, Hildegard, Karstens, Karl, Gebauer, Florian, Goeser, Tobias, Rösch, Thomas, Izbicki, Jakob R., and Bruns, Christiane J.
- Published
- 2021
- Full Text
- View/download PDF
4. Additional file 2 of Endoscopic vacuum therapy versus stent treatment of esophageal anastomotic leaks (ESOLEAK): study protocol for a prospective randomized phase 2 trial
- Author
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Tachezy, Michael, Chon, Seung-Hun, Rieck, Isabel, Kantowski, Marcus, Christ, Hildegard, Karstens, Karl, Gebauer, Florian, Goeser, Tobias, Rösch, Thomas, Izbicki, Jakob R., and Bruns, Christiane J.
- Abstract
Additional file 2. German Study Register
- Published
- 2021
- Full Text
- View/download PDF
5. Additional file 1 of Endoscopic vacuum therapy versus stent treatment of esophageal anastomotic leaks (ESOLEAK): study protocol for a prospective randomized phase 2 trial
- Author
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Tachezy, Michael, Chon, Seung-Hun, Rieck, Isabel, Kantowski, Marcus, Christ, Hildegard, Karstens, Karl, Gebauer, Florian, Goeser, Tobias, Rösch, Thomas, Izbicki, Jakob R., and Bruns, Christiane J.
- Abstract
Additional file 1. WHO Trial Items
- Published
- 2021
- Full Text
- View/download PDF
6. Endoscopic vacuum therapy versus stenting for postoperative esophago-enteric anastomotic leakage: systematic review and meta-analysis
- Author
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Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., Tachezy, Michael, Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., and Tachezy, Michael
- Abstract
Background Esophageal anastomotic leakage still represents a challenging complication after esophageal surgery. Endoscopically placed self-expandable metal stents (SEMS) are the treatment of choice, but since the introduction of endoscopic vacuum therapy (EVT) for esophageal leakage 10 years ago, increasing evidence has demonstrated that EVT might be a superior alternative. Therefore, we performed a systematic review and meta-analysis to compare the effectiveness and related morbidity of SEMS and EVT in the treatment of esophageal leak. Methods We systematically searched for studies comparing SEMS and EVT to treat anastomotic leakage after esophageal surgery. Predefined end points including outcome, treatment success, endoscopy, treatment duration, hospitalization time, morbidity, and mortality were assessed and included in the meta-analysis. Results Five retrospective studies including 274 patients matched the inclusion criteria. Compared with stenting, EVT was significantly associated with a higher rate of leak closure (odds ratio [OR] 3.14, 95% confidence interval [CI] 1.23 to 7.98), more endoscopic device changes (pooled median difference of 3.09; 95 % CI 1.54 to 4.64]), a shorter duration of treatment (pooled median difference - 11.90 days; 95% CI - 18.59 to -5.21 days), and a lower mortality rate (OR 0.39, 95 % CI 0.18 to 0.83). There were no significant differences in short-term and major complications. Conclusions Owing to the retrospective quality of the studies with potential biases, the results of the meta-analysis must be interpreted with caution. However, the analysis indicates the potential benefit of EVT, which should be further investigated with standardized and prospectively collected data.
- Published
- 2020
7. Decreased Frequency of Intestinal CD39+ γδ+ T Cells With Tissue-Resident Memory Phenotype in Inflammatory Bowel Disease
- Author
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Libera, Jana, primary, Wittner, Melanie, additional, Kantowski, Marcus, additional, Woost, Robin, additional, Eberhard, Johanna M., additional, de Heer, Jocelyn, additional, Reher, Dominik, additional, Huber, Samuel, additional, Haag, Friedrich, additional, and Schulze zur Wiesch, Julian, additional
- Published
- 2020
- Full Text
- View/download PDF
8. Comparison of the integrin α4β7 expression pattern of memory T cell subsets in HIV infection and ulcerative colitis
- Author
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Wittner, Melanie, primary, Schlicker, Veronika, additional, Libera, Jana, additional, Bockmann, Jan-Hendrik, additional, Horvatits, Thomas, additional, Seiz, Oliver, additional, Kummer, Silke, additional, Manthey, Carolin F., additional, Hüfner, Anja, additional, Kantowski, Marcus, additional, Rösch, Thomas, additional, Degen, Olaf, additional, Huber, Samuel, additional, Eberhard, Johanna M., additional, and Schulze zur Wiesch, Julian, additional
- Published
- 2019
- Full Text
- View/download PDF
9. Decreased Frequency of Intestinal CD39+ γδ+ T Cells With Tissue-Resident Memory Phenotype in Inflammatory Bowel Disease.
- Author
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Libera, Jana, Wittner, Melanie, Kantowski, Marcus, Woost, Robin, Eberhard, Johanna M., de Heer, Jocelyn, Reher, Dominik, Huber, Samuel, Haag, Friedrich, and Schulze zur Wiesch, Julian
- Subjects
INFLAMMATORY bowel diseases ,T cells ,BLOOD cells ,LARGE intestine ,ADENOSINE triphosphate - Abstract
The ectoenzymes CD39 and CD73 play a major role in controlling tissue inflammation by regulating the balance between adenosine triphosphate (ATP) and adenosine. Still, little is known about the role of these two enzymes and ATP and its metabolites in the pathophysiology of inflammatory bowel disease (IBD). We isolated mononuclear cells from peripheral blood and lamina propria of the large intestine of patients diagnosed with IBD and of healthy volunteers. We then comprehensively analyzed the CD39 and CD73 expression patterns together with markers of activation (HLA-DR, CD38), differentiation (CCR7, CD45RA) and tissue-residency (CD69, CD103, CD49a) on CD4
+ , CD8+ , γδ+ T cells and mucosa-associated invariant T cells using flow cytometry. CD39 expression levels of γδ+ and CD8+ T cells in lamina propria lymphocytes (LPL) were much higher compared to peripheral blood mononuclear cells. Moreover, the frequency of CD39+ CD4+ and CD8+ , but not γδ+ LPL positively correlated with T-cell activation. The frequency of CD39+ cells among tissue-resident memory LPL (Trm) was higher compared to non-Trm for all subsets, confirming that CD39 is a marker for the tissue-resident memory phenotype. γδ+ Trm also showed a distinct cytokine profile upon stimulation – the frequency of IFN-γ+ and IL-17A+ cells was significantly lower in γδ+ Trm compared to non-Trm. Interestingly, we observed a decreased frequency of CD39+ γδ+ T cells in IBD patients compared to healthy controls (p = 0.0049). Prospective studies need to elucidate the exact role of this novel CD39+ γδ+ T-cell population with tissue-resident memory phenotype and its possible contribution to the pathogenesis of IBD and other inflammatory disorders. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
- View/download PDF
10. EUS Needle Identification Comparison and Evaluation study (with videos).
- Author
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UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Tang, Shou-Jiang, Vilmann, Andreas S, Saftoiu, Adrian, Wang, Wanmei, Streba, Costin Teodor, Fink, Peter P, Griswold, Michael, Wu, Ruonan, Dietrich, Christoph F, Jenssen, Christian, Hocke, Michael, Kantowski, Marcus, Pohl, Jürgen, Fockens, Paul, Annema, Jouke T, van der Heijden, Erik H F M, Havre, Roald Flesland, Pham, Khanh Do-Cong, Kunda, Rastislav, Deprez, Pierre Henri, Mariana, Jinga, Vazquez-Sequeiros, Enrique, Larghi, Alberto, Buscarini, Elisabetta, Fusaroli, Pietro, Lahav, Maor, Puri, Rajesh, Garg, Pramod Kumar, Sharma, Malay, Maluf-Filho, Fauze, Sahai, Anand, Brugge, William R, Lee, Linda S, Aslanian, Harry R, Wang, Andrew Y, Shami, Vanessa M, Markowitz, Arnold, Siddiqui, Ali A, Mishra, Girish, Scheiman, James M, Isenberg, Gerard, Siddiqui, Uzma D, Shah, Raj J, Buxbaum, James, Watson, Rabindra R, Willingham, Field F, Bhutani, Manoop S, Levy, Michael J, Harris, Cynthia, Wallace, Michael B, Nolsøe, Christian Pállson, Lorentzen, Torben, Bang, Niels, Sørensen, Sten Mellerup, Gilja, Odd Helge, D'Onofrio, Mirko, Piscaglia, Fabio, Gritzmann, Norbert, Radzina, Maija, Sparchez, Zeno Adrian, Sidhu, Paul S, Freeman, Simon, McCowan, Timothy C, de Araujo, Cyrillo Rodrigues, Patel, Akash, Ali, Mohammad Adel, Campbell, Garth, Chen, Edward, Vilmann, Peter, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Tang, Shou-Jiang, Vilmann, Andreas S, Saftoiu, Adrian, Wang, Wanmei, Streba, Costin Teodor, Fink, Peter P, Griswold, Michael, Wu, Ruonan, Dietrich, Christoph F, Jenssen, Christian, Hocke, Michael, Kantowski, Marcus, Pohl, Jürgen, Fockens, Paul, Annema, Jouke T, van der Heijden, Erik H F M, Havre, Roald Flesland, Pham, Khanh Do-Cong, Kunda, Rastislav, Deprez, Pierre Henri, Mariana, Jinga, Vazquez-Sequeiros, Enrique, Larghi, Alberto, Buscarini, Elisabetta, Fusaroli, Pietro, Lahav, Maor, Puri, Rajesh, Garg, Pramod Kumar, Sharma, Malay, Maluf-Filho, Fauze, Sahai, Anand, Brugge, William R, Lee, Linda S, Aslanian, Harry R, Wang, Andrew Y, Shami, Vanessa M, Markowitz, Arnold, Siddiqui, Ali A, Mishra, Girish, Scheiman, James M, Isenberg, Gerard, Siddiqui, Uzma D, Shah, Raj J, Buxbaum, James, Watson, Rabindra R, Willingham, Field F, Bhutani, Manoop S, Levy, Michael J, Harris, Cynthia, Wallace, Michael B, Nolsøe, Christian Pállson, Lorentzen, Torben, Bang, Niels, Sørensen, Sten Mellerup, Gilja, Odd Helge, D'Onofrio, Mirko, Piscaglia, Fabio, Gritzmann, Norbert, Radzina, Maija, Sparchez, Zeno Adrian, Sidhu, Paul S, Freeman, Simon, McCowan, Timothy C, de Araujo, Cyrillo Rodrigues, Patel, Akash, Ali, Mohammad Adel, Campbell, Garth, Chen, Edward, and Vilmann, Peter
- Abstract
BACKGROUND AND AIMS: EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. METHODS: Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. RESULTS: There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). CONCLUSIONS: All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity.
- Published
- 2016
11. EUS Needle Identification Comparison and Evaluation study (with videos)
- Author
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Tang, Shou-Jiang, Vilmann, Andreas Slot, Saftoiu, Adrian, Wang, Wanmei, Streba, Costin Teodor, Fink, Peter P, Griswold, Michael, Wu, Ruonan, Dietrich, Christoph F, Jenssen, Christian, Hocke, Michael, Kantowski, Marcus, Pohl, Jürgen, Fockens, Paul, Annema, Jouke T, van der Heijden, Erik H F M, Havre, Roald Flesland, Pham, Khanh Do-Cong, Kunda, Rastislav, Deprez, Pierre H, Mariana, Jinga, Vazquez-Sequeiros, Enrique, Larghi, Alberto, Buscarini, Elisabetta, Fusaroli, Pietro, Lahav, Maor, Puri, Rajesh, Garg, Pramod Kumar, Sharma, Malay, Maluf-Filho, Fauze, Sahai, Anand, Brugge, William R, Lee, Linda S, Aslanian, Harry R, Wang, Andrew Y, Shami, Vanessa M, Markowitz, Arnold, Siddiqui, Ali A, Mishra, Girish, Scheiman, James M, Isenberg, Gerard, Siddiqui, Uzma D, Shah, Raj J, Buxbaum, James, Watson, Rabindra R, Willingham, Field F, Bhutani, Manoop S, Levy, Michael J, Harris, Cynthia, Wallace, Michael B, Nolsøe, Christian Pállson, Lorentzen, Torben, Bang Sørensen, Niels, Sørensen, Sten Mellerup, Gilja, Odd Helge, D'Onofrio, Mirko, Piscaglia, Fabio, Gritzmann, Norbert, Radzina, Maija, Sparchez, Zeno Adrian, Sidhu, Paul S, Freeman, Simon, McCowan, Timothy C, de Araujo, Cyrillo Rodrigues, Patel, Akash, Ali, Mohammad Adel, Campbell, Garth, Chen, Edward, Vilmann, Peter, Tang, Shou-Jiang, Vilmann, Andreas Slot, Saftoiu, Adrian, Wang, Wanmei, Streba, Costin Teodor, Fink, Peter P, Griswold, Michael, Wu, Ruonan, Dietrich, Christoph F, Jenssen, Christian, Hocke, Michael, Kantowski, Marcus, Pohl, Jürgen, Fockens, Paul, Annema, Jouke T, van der Heijden, Erik H F M, Havre, Roald Flesland, Pham, Khanh Do-Cong, Kunda, Rastislav, Deprez, Pierre H, Mariana, Jinga, Vazquez-Sequeiros, Enrique, Larghi, Alberto, Buscarini, Elisabetta, Fusaroli, Pietro, Lahav, Maor, Puri, Rajesh, Garg, Pramod Kumar, Sharma, Malay, Maluf-Filho, Fauze, Sahai, Anand, Brugge, William R, Lee, Linda S, Aslanian, Harry R, Wang, Andrew Y, Shami, Vanessa M, Markowitz, Arnold, Siddiqui, Ali A, Mishra, Girish, Scheiman, James M, Isenberg, Gerard, Siddiqui, Uzma D, Shah, Raj J, Buxbaum, James, Watson, Rabindra R, Willingham, Field F, Bhutani, Manoop S, Levy, Michael J, Harris, Cynthia, Wallace, Michael B, Nolsøe, Christian Pállson, Lorentzen, Torben, Bang Sørensen, Niels, Sørensen, Sten Mellerup, Gilja, Odd Helge, D'Onofrio, Mirko, Piscaglia, Fabio, Gritzmann, Norbert, Radzina, Maija, Sparchez, Zeno Adrian, Sidhu, Paul S, Freeman, Simon, McCowan, Timothy C, de Araujo, Cyrillo Rodrigues, Patel, Akash, Ali, Mohammad Adel, Campbell, Garth, Chen, Edward, and Vilmann, Peter
- Abstract
Background and Aims EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development. Methods Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices. Results There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001). Conclusions All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity., BACKGROUND AND AIMS: EUS-guided FNA or biopsy sampling is widely practiced. Optimal sonographic visualization of the needle is critical for image-guided interventions. Of the several commercially available needles, bench-top testing and direct comparison of these needles have not been done to reveal their inherent echogenicity. The aims are to provide bench-top data that can be used to guide clinical applications and to promote future device research and development.METHODS: Descriptive bench-top testing and comparison of 8 commonly used EUS-FNA needles (all size 22 gauge): SonoTip Pro Control (Medi-Globe); Expect Slimline (Boston Scientific); EchoTip, EchoTip Ultra, EchoTip ProCore High Definition (Cook Medical); ClearView (Conmed); EZ Shot 2 (Olympus); and BNX (Beacon Endoscopic), and 2 new prototype needles, SonoCoat (Medi-Globe), coated by echogenic polymers made by Encapson. Blinded evaluation of standardized and unedited videos by 43 EUS endoscopists and 17 radiologists specialized in GI US examination who were unfamiliar with EUS needle devices.RESULTS: There was no significant difference in the ratings and rankings of these needles between endosonographers and radiologists. Overall, 1 prototype needle was rated as the best, ranking 10% to 40% higher than all other needles (P < .01). Among the commercially available needles, the EchoTip Ultra needle and the ClearView needle were top choices. The EZ Shot 2 needle was ranked statistically lower than other needles (30%-75% worse, P < .001).CONCLUSIONS: All FNA needles have their inherent and different echogenicities, and these differences are similarly recognized by EUS endoscopists and radiologists. Needles with polymeric coating from the entire shaft to the needle tip may offer better echogenicity.
- Published
- 2016
12. Pre-Study protocol MagPEP: a multicentre randomized controlled trial of magnesium sulphate in the prevention of post-ERCP pancreatitis
- Author
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Fluhr, Gabriele, primary, Mayerle, Julia, additional, Weber, Eckhard, additional, Aghdassi, Ali, additional, Simon, Peter, additional, Gress, Thomas, additional, Seufferlein, Thomas, additional, Mössner, Joachim, additional, Stallmach, Andreas, additional, Rösch, Thomas, additional, Müller, Martina, additional, Siegmund, Britta, additional, Büchner-Steudel, Petra, additional, Zuber-Jerger, Ina, additional, Kantowski, Marcus, additional, Hoffmeister, Albrecht, additional, Rosendahl, Jonas, additional, Linhart, Thomas, additional, Maul, Jochen, additional, Czakó, László, additional, Hegyi, Péter, additional, Kraft, Matthias, additional, Engel, Georg, additional, Kohlmann, Thomas, additional, Glitsch, Anne, additional, Pickartz, Tilman, additional, Budde, Christoph, additional, Nitsche, Claudia, additional, Storck, Kirsten, additional, and Lerch, Markus M, additional
- Published
- 2013
- Full Text
- View/download PDF
13. Endoscopic vacuum therapy versus stenting for postoperative esophago-enteric anastomotic leakage: systematic review and meta-analysis
- Author
-
Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., Tachezy, Michael, Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., and Tachezy, Michael
- Abstract
Background Esophageal anastomotic leakage still represents a challenging complication after esophageal surgery. Endoscopically placed self-expandable metal stents (SEMS) are the treatment of choice, but since the introduction of endoscopic vacuum therapy (EVT) for esophageal leakage 10 years ago, increasing evidence has demonstrated that EVT might be a superior alternative. Therefore, we performed a systematic review and meta-analysis to compare the effectiveness and related morbidity of SEMS and EVT in the treatment of esophageal leak. Methods We systematically searched for studies comparing SEMS and EVT to treat anastomotic leakage after esophageal surgery. Predefined end points including outcome, treatment success, endoscopy, treatment duration, hospitalization time, morbidity, and mortality were assessed and included in the meta-analysis. Results Five retrospective studies including 274 patients matched the inclusion criteria. Compared with stenting, EVT was significantly associated with a higher rate of leak closure (odds ratio [OR] 3.14, 95% confidence interval [CI] 1.23 to 7.98), more endoscopic device changes (pooled median difference of 3.09; 95%CI 1.54 to 4.64]), a shorter duration of treatment (pooled median difference -11.90 days; 95%CI -18.59 to -5.21 days), and a lower mortality rate (OR 0.39, 95%CI 0.18 to 0.83). There were no significant differences in short-term and major complications. Conclusions Owing to the retrospective quality of the studies with potential biases, the results of the meta-analysis must be interpreted with caution. However, the analysis indicates the potential benefit of EVT, which should be further investigated with standardized and prospectively collected data.
14. Endoscopic vacuum therapy versus stenting for postoperative esophago-enteric anastomotic leakage: systematic review and meta-analysis
- Author
-
Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., Tachezy, Michael, Scognamiglio, Pasquale, Reeh, Matthias, Karstens, Karl, Bellon, Eugen, Kantowski, Marcus, Schoen, Gerhard, Zapf, Antonia, Chon, Seung-Hun, Izbicki, Jakob R., and Tachezy, Michael
- Abstract
Background Esophageal anastomotic leakage still represents a challenging complication after esophageal surgery. Endoscopically placed self-expandable metal stents (SEMS) are the treatment of choice, but since the introduction of endoscopic vacuum therapy (EVT) for esophageal leakage 10 years ago, increasing evidence has demonstrated that EVT might be a superior alternative. Therefore, we performed a systematic review and meta-analysis to compare the effectiveness and related morbidity of SEMS and EVT in the treatment of esophageal leak. Methods We systematically searched for studies comparing SEMS and EVT to treat anastomotic leakage after esophageal surgery. Predefined end points including outcome, treatment success, endoscopy, treatment duration, hospitalization time, morbidity, and mortality were assessed and included in the meta-analysis. Results Five retrospective studies including 274 patients matched the inclusion criteria. Compared with stenting, EVT was significantly associated with a higher rate of leak closure (odds ratio [OR] 3.14, 95% confidence interval [CI] 1.23 to 7.98), more endoscopic device changes (pooled median difference of 3.09; 95%CI 1.54 to 4.64]), a shorter duration of treatment (pooled median difference -11.90 days; 95%CI -18.59 to -5.21 days), and a lower mortality rate (OR 0.39, 95%CI 0.18 to 0.83). There were no significant differences in short-term and major complications. Conclusions Owing to the retrospective quality of the studies with potential biases, the results of the meta-analysis must be interpreted with caution. However, the analysis indicates the potential benefit of EVT, which should be further investigated with standardized and prospectively collected data.
15. Decreased Frequency of Intestinal CD39 + γδ + T Cells With Tissue-Resident Memory Phenotype in Inflammatory Bowel Disease.
- Author
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Libera J, Wittner M, Kantowski M, Woost R, Eberhard JM, de Heer J, Reher D, Huber S, Haag F, and Schulze Zur Wiesch J
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Female, Gene Expression, Humans, Immunologic Memory, Immunophenotyping, Inflammatory Bowel Diseases diagnosis, Intestinal Mucosa immunology, Intestinal Mucosa metabolism, Intestinal Mucosa pathology, Lymphocyte Activation, Male, Middle Aged, Apyrase metabolism, Inflammatory Bowel Diseases immunology, Inflammatory Bowel Diseases metabolism, Lymphocyte Count, Receptors, Antigen, T-Cell, gamma-delta metabolism, T-Lymphocyte Subsets immunology, T-Lymphocyte Subsets metabolism
- Abstract
The ectoenzymes CD39 and CD73 play a major role in controlling tissue inflammation by regulating the balance between adenosine triphosphate (ATP) and adenosine. Still, little is known about the role of these two enzymes and ATP and its metabolites in the pathophysiology of inflammatory bowel disease (IBD). We isolated mononuclear cells from peripheral blood and lamina propria of the large intestine of patients diagnosed with IBD and of healthy volunteers. We then comprehensively analyzed the CD39 and CD73 expression patterns together with markers of activation (HLA-DR, CD38), differentiation (CCR7, CD45RA) and tissue-residency (CD69, CD103, CD49a) on CD4
+ , CD8+ , γδ+ T cells and mucosa-associated invariant T cells using flow cytometry. CD39 expression levels of γδ+ and CD8+ T cells in lamina propria lymphocytes (LPL) were much higher compared to peripheral blood mononuclear cells. Moreover, the frequency of CD39+ CD4+ and CD8+ , but not γδ+ LPL positively correlated with T-cell activation. The frequency of CD39+ cells among tissue-resident memory LPL (Trm) was higher compared to non-Trm for all subsets, confirming that CD39 is a marker for the tissue-resident memory phenotype. γδ+ Trm also showed a distinct cytokine profile upon stimulation - the frequency of IFN-γ+ and IL-17A+ cells was significantly lower in γδ+ Trm compared to non-Trm. Interestingly, we observed a decreased frequency of CD39+ γδ+ T cells in IBD patients compared to healthy controls ( p = 0.0049). Prospective studies need to elucidate the exact role of this novel CD39+ γδ+ T-cell population with tissue-resident memory phenotype and its possible contribution to the pathogenesis of IBD and other inflammatory disorders., (Copyright © 2020 Libera, Wittner, Kantowski, Woost, Eberhard, de Heer, Reher, Huber, Haag and Schulze zur Wiesch.)- Published
- 2020
- Full Text
- View/download PDF
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