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703 results on '"Kiesslich R"'

109. Diagnostische Lücke im Staging von Rektumadenomen und frühen -karzinomen: Stellt die konfokale Chromolaser-Endomikroskopie ein ergänzendes diagnostisches Mittel dar?

Author

Borschitz, Th and Kiesslich, R

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Durch die Weiterentwicklung der Diagnostik konnte das präoperative Staging von Rektumtumoren signifikant verbessert werden. Allerdings lassen sich bei Neoplasien, die als Adenome oder frühe Karzinome eingestuft werden, z.T. diskrepante Befunde zwischen präoperativer (Biopsie/Endosonographie[ERUS])[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie

Published
2009
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113. Hemospray application in nonvariceal upper gastrointestinal bleeding: results of the Survey to Evaluate the Application of Hemospray in the Luminal Tract

Author

Smith, L.A., Stanley, A.J., Bergman, J.J., Kiesslich, R., Hoffman, A., Tjwa, E.T., Kuipers, E.J., Holstein, C.S. von, Oberg, S., Brullet, E., Schmidt, P.N., Iqbal, T., Mangiavillano, B., Masci, E., Prat, F., Morris, A.J., Smith, L.A., Stanley, A.J., Bergman, J.J., Kiesslich, R., Hoffman, A., Tjwa, E.T., Kuipers, E.J., Holstein, C.S. von, Oberg, S., Brullet, E., Schmidt, P.N., Iqbal, T., Mangiavillano, B., Masci, E., Prat, F., and Morris, A.J.

Abstract

Item does not contain fulltext, BACKGROUND: Hemospray TM (TC-325) is a novel hemostatic agent licensed for use in nonvariceal upper gastrointestinal bleeding (NVUGIB) in Europe. GOALS: We present the operating characteristics and performance of TC-325 in the largest registry to date of patients presenting with NVUGIB in everyday clinical practice. METHODS: Prospective anonymized data of device performance and clinical outcomes were collected from 10 European centers using the multicentre SEAL survey (Survey to Evaluate the Application of Hemospray in the Luminal tract). TC-325 was used as a monotherapy or as second-line therapy in combination with other hemostatic modalities at the endoscopists' discretion. RESULTS: Sixty-three patients (44 men, 19 women), median age 69 (range, 21 to 98) years with NVUGIB requiring endoscopic hemostasis were treated with TC-325. There were 30 patients with bleeding ulcers and 33 with other NVUGIB pathology. Fifty-five (87%) were treated with TC-325 as monotherapy; 47 [85%; 95% confidence interval (CI), 76%-94%] of them achieved primary hemostasis, and rebleeding rate at 7 days was 15% (95% CI, 5%-25%). Primary hemostasis rate for TC-325 in patients with ulcer bleeds was 76% (95% CI, 59%-93%). Eight patients, who otherwise may have required either surgery or interventional radiology, were treated with TC-325 as second-line therapy after failure of other endoscopic treatments, all of whom achieved hemostasis following the adjunct of TC-325. CONCLUSIONS: This multicentre registry identifies potentially useful characteristics of Hemospray (TC-325) when used either as monotherapy or as a rescue therapy in a wide variety of ulcer and nonulcer NVUGIB.

Published
2014

127. A new sonomorphologic scoring system (Mainz Score) for the assessment of ovarian tumors using transvaginal ultrasonography. Part I: A comparison between the scoring-system and the assessment by an experienced sonographer

Author

Franz Bahlmann, Weber G, Eberhard Merz, and Kiesslich R

Subjects
Adult, medicine.medical_specialty, Scoring system, Adolescent, Sensitivity and Specificity, Endosonography, Tumor Status, Ovarian tumor, Text mining, Ascites, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective cohort study, Ovarian Neoplasms, business.industry, Ovary, Echogenicity, Middle Aged, Surgery, Ovarian Cysts, Sonographer, Female, Radiology, medicine.symptom, business
Abstract

OBJECTIVE The problem of an accurate sonographic assessment of ovarian tumor status has not yet been solved. To what extent can the preoperative assessment of adnexal tumors be improved on the basis of a maximum number of sonographic tumor parameters included in the newly developed sonomorphologic Mainz Score? MATERIALS AND METHODS In a prospective study 314 premenopausal patients with adnexal tumor underwent a transvaginal sonographic examination performed by an experienced sonographer. In parallel to the sonographic examination a new score including 10 different sonographic parameters was used to predict adnexal tumor status: 1. Total tumor structure, 2. tumor border, 3. wall thickness, 4. inner echos in cystic component, 5. septa, 6. shape of echo complex or of the completely solid tumor, 7. echogenicity of the echo complex or of the completely solid tumor, 8. acuostic phenomena behind tumor, 9. ascites, 10. detection of liver metastases/peritoneal carcinosis Depending on the respective degree of expression, the individual characteristics were rated on a scale from 0 to 2. The total score obtained following addition of the points recorded for each parameters served to confirm the validity of the sonographic tumor status assessment. The first sonographer assessed the tumor status based on his experience and in the knowledge of all clinical parameters. The second sonographer evaluated the tumor status based on the score. All preoperative ultrasonographic findings were compared with the postoperative histologic analysis. RESULTS A maximum number of 20 points may be obtained using the Mainz Score. Tumors with a total score of below 9 were rated as benign and those with a score of above 9 as malignant. This resulted in a sensitivity of 96.4%, a specificity of 80.7%, a positive predictive value of 47.4%, and a negative predictive value of 99.6%. The predictive value of the scoring-system was diminished by the presence of 30 false-positive cases, which were identified as inflammatory conglomerate tumors, teratomas, endometrial cysts, cystadenomas and hemorrhagic cysts. The experienced sonographer assessed 233 cases as benign and 24 cases as malignant. The findings were confirmed by the histological examination in 252 of 257 cases. No conclusive prediction of tumor status could be made in 57 tumors. However, the application of the Mainz Score enabled an accurate prediction of the tumor status in 44 of the 57 cases. With the exception of septal thickness all assessment criteria of the score showed a statistically significant correlation between the assigned score and the histologic findings, (p < 0.05). CONCLUSIONS The use of the Mainz Score enables even less experienced sonographers to assess the status of premenopausal adnexal tumors with a high degree of accuracy. The score provides the experienced sonographer with a refined and improved method for the prediction of tumor status, especially in the presence of not readily assessable findings.

Published
1998

133. P209 In vivo molecular imaging using fluorescent anti-TNF antibodies and confocal laser endomicroscopy predicts response to anti-TNF therapy in Crohn's disease patients

Author

Atreya, R., primary, Neumann, H., additional, Neufert, C., additional, Waldner, M.J., additional, Zopf, Y., additional, Willma, M., additional, App, C., additional, Müunster, T., additional, Kessler, H., additional, Maas, S., additional, Gebhardt, B., additional, Heimke-Brinck, R., additional, Reuter, E., additional, Dörje, F., additional, Rau, T.T., additional, Wang, T.D., additional, Kiesslich, R., additional, Vieth, M., additional, Hannappel, E., additional, and Neurath, M.F., additional

Published
2013
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134. Methylation status of p14ARF and p16INK4a as detected in pancreatic secretions.

Author

Klump, B, Hsieh, C J, Nehls, O, Dette, S, Holzmann, K, Kießlich, R, Jung, M, Sinn, U, Ortner, M, Porschen, R, Gregor, M, and Kiesslich, R

Subjects
PANCREATIC diseases, PANCREATITIS, METHYLATION, CANCER
Abstract

The clinical management of pancreatic disease is often hampered by a lack of tissue diagnosis. Endoscopic pancreatography offers the opportunity to investigate exfoliated cells. However, the significance of mere cytological investigation is compromised by an insufficient sensitivity. The evaluation of the molecular background of carcinogenesis hopefully is capable of providing more sensitive diagnostic markers. The p16INK4a-/retinoblastoma tumour-suppressive pathway has been shown to be involved in the development of near to all pancreatic neoplasms. p14ARF is another tumour suppressor located in the immediate neighbourhood of p16INK4a. Promoter methylation has been demonstrated to be a major inactivating mechanism of both genes. We sought to further evaluate the role of the gene locus INK4a methylation status in the endoscopic differentiation of chronic inflammatory and neoplastic pancreatic disease. Pancreatic fluid specimens of 61 patients with either pancreatic carcinoma (PCA: 39), chronic pancreatitis (CP: 16) or a normal pancreatogram (NAD: 6) were retrieved. In order to detect methylation of either the p14ARF or the p16INK4a promoter a methylation-specific PCR protocol was applied. While 19 out of 39 patients with PCA showed p16 promoter methylation (49%), none of the 16 patients with CP revealed p16 promoter methylation. p14ARF methylation was found in a lower percentage of PCA specimens and in none of the samples of patients with CP. These results suggest a specific significance of INK4a for the development of malignant pancreatic disease. Our data further indicate a potential role for INK4a methylation as a diagnostic marker in the endoscopic differentiation of benign and malignant pancreatic disease. [ABSTRACT FROM AUTHOR]

Published
2003
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135. High-definition endoscopy with i Scan and Lugol's solution for the detection of inflammation in patients with nonerosive reflux disease: histologic evaluation in comparison with a control group.

Author

Rey, J. W., Deris, N., Marquardt, J. U., Thomaidis, T., Moehler, M., Kittner, J. M., Nguyen-Tat, M., Dümcke, S., Tresch, A., Biesterfeld, S., Goetz, M., Mudter, J., Neurath, M. F., Galle, P. R., Kiesslich, R., and Hoffman, A.

Subjects
ENDOSCOPY, INFLAMMATION, GASTROESOPHAGEAL reflux, BARRETT'S esophagus, CONTROL groups
Abstract

Nonerosive reflux disease ( NERD) is commonly diagnosed in patients with symptoms of reflux. The aim of the present study was to determine whether high-definition endoscopy ( HD) plus equipped with the i Scan function or chromoendoscopy with Lugol's solution might permit the differentiation of NERD patients from those without reflux symptoms, proven by targeted biopsies of endoscopic lesions. A total of 100 patients without regular intake of proton pump inhibitors and with a normal conventional upper endoscopy were prospectively divided into NERD patients and controls. A second upper endoscopy was performed using HD+ with additional i Scan function and then Lugol's solution was applied. Biopsy specimens were taken from the gastroesophageal junction in all patients. A total of 65 patients with reflux symptoms and 27 controls were included. HD+ endoscopy with i Scan revealed subtle mucosal breaks in 52 patients; the subsequent biopsies confirmed esophagitis in all cases. After Lugol's solution, 58 patients showed mucosal breaks. Sensitivity for the i Scan procedure was 82.5%, whereas that for Lugol's solution was 92.06%. Excellent positive predictive values of 100% and 98.3%, respectively, were noted. The present study suggests that the majority of patients with NERD and typical symptoms of reflux disease can be identified by i Scan or Lugol's chromoendoscopy as minimal erosive reflux disease ( ERD) patients. [ABSTRACT FROM AUTHOR]

Published
2016
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138. Die endomikroskopische molekulare Bildgebung bei M. Crohn Patienten in vivo ermöglicht die Vorhersage des Therapieansprechens auf eine anti-TNF Antikörper Therapie im Rahmen einer prospektiven klinischen Phase 1 Studie

Author

Atreya, R, primary, Neumann, H, additional, Neufert, C, additional, Zopf, Y, additional, Waldner, MJ, additional, Försch, S, additional, Kiesslich, R, additional, Münster, T, additional, Kessler, H, additional, Maas, S, additional, Gebhardt, B, additional, Heimke-Brinck, R, additional, Reuter, E, additional, Dörje, F, additional, Rau, TT, additional, Vieth, M, additional, Hannappel, E, additional, and Neurath, MF, additional

Published
2012
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139. Ergebnisse einer prospektiven klinischen Phase 1 Studie: Die molekulare endoskopische Bildgebung bei M. Crohn Patienten in vivo ermöglicht die Vorhersage des Therapieansprechens auf die anti-TNF Antikörper Therapie

Author

Atreya, R, primary, Neumann, H, additional, Neufert, C, additional, Zopf, Y, additional, Waldner, MJ, additional, Försch, S, additional, Kiesslich, R, additional, Münster, T, additional, Kessler, HP, additional, Maas, S, additional, Gebhardt, B, additional, Reuter, E, additional, Heimke-Brinck, R, additional, Dörje, F, additional, Rau, TT, additional, Vieth, M, additional, Hannappel, E, additional, and Neurath, MF, additional

Published
2012
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148. Anti-TNF Antikörper führen zur Aufhebung der TNFR2 und CD14+ Makrophagen vermittelten Apoptoseresistenz in lamina propria T-Zellen bei chronisch entzündlichen Darmerkrankungen

Author

Atreya, R, primary, Zimmer, M, additional, Bartsch, B, additional, Waldner, M, additional, Atreya, I, additional, Hildner, K, additional, Neumann, H, additional, Hoffman, A, additional, Kiesslich, R, additional, Rink, AD, additional, Rose-John, S, additional, Rau, T, additional, Kessler, HP, additional, Schmid, J, additional, and Neurath, MF, additional

Published
2011
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