AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colore...AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS： Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment （CEUS date 1） and before the second （CEUS date 2） and fourth （CEU5 date 3） cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak （l-I-P） and RISE RATE]were correlated with radiological response.RESULTS： For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant （P 〈 0.001） correlation in TTP between metastases of responders （9.08 s） and non-responders （14.76 s） ar- chived on CEUS date 1. By calculating a standardized quotient （metastases divided by normal liver tissue） we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly （P 〈 0.01） dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION： CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.展开更多
AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome X (CSX) as a subform of non-cardiac chest pain ...AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome X (CSX) as a subform of non-cardiac chest pain (NCCP). METHODS: We investigated 114 patients with CSX using symptom questionnaires. A subgroup of these patients were investigated regarding upper gastrointestinal disorders (GIs) and treated with PPI. Patients not willing to participate in investigation and treatment served as control group. RESULTS: Thirty-six patients denied any residual symptoms and were not further evaluated. After informed consent in 27 of the remaining 78 patients, we determined the prevalence of disorders of the upper GI tract and quantifi ed the effect of treatment with pantoprazole. We found a high prevalence of gastroenterological pathologies (26/27 patients, 97%)with gastritis, gastroesophageal reflux disease (GERD) and acid reflux as the most common associated disorders. If treated according to the study protocol, these patients showed a significant improvement in the symptom score. Patients treated by primary care physicians, not according to the study protocol had a minor response to treatment (n = 19, -43%), while patients not treated at all (n = 26) had no improvement of symptoms (-0%). CONCLUSION: Disorders of the upper GI tract are a frequent origin of CSX in a German population and can be treated with pantoprazole if given for a longer period.展开更多
AIM: To study the relationship between the patterns of postprandial peristalsis and transduodenal bolus transport in healthy subjects. METHODS: Synchronous recording of chyme transport and peristaltic activity was per...AIM: To study the relationship between the patterns of postprandial peristalsis and transduodenal bolus transport in healthy subjects. METHODS: Synchronous recording of chyme transport and peristaltic activity was performed during the fasting state and after administration of a test meal using a special catheter device with cascade configuration of impedance electrodes and solid-state pressure transducers. The catheter was placed into the duodenum, where the f irst channel was located in the f irst part of the duodenum and the last channel at the duodenojejunal junction. After identif ication of previously def ined chyme transport patterns the associated peristaltic patterns were analyzed. RESULTS: The interdigestive phase 3 complex was reliably recorded with both techniques. Of 497 analyzed impedance bolus transport events, 110 (22%) were short-spanned propulsive, 307 (62%) long-spanned propulsive, 70 (14%) complex propulsive, and 10 (2%) retrograde transport. Short-spanned chyme transports were predominantly associated with stationary or propagated contractions propagated over short distance. Long-spanned and complex chyme transports were predominantly associated with propulsive peristaltic patterns, which were frequently complex and comprised multiple contractions. Propagated double wave contraction, propagated contraction with a clustered contraction, and propagated cluster of contractions have been identif ied to be an integralted part of a peristaltic sequence in human duodenum. CONCLUSION: Combined impedancometry and manometry improves the analysis of the peristaltic patterns that are associated with postprandial transduodenal chymetransport. Postprandial transduodenal bolus transport is regulated by propulsive peristaltic patterns, which are frequently complex but well organized. This f inding should be taken into consideration in the analysis of intestinal motility studies.展开更多
文摘AIM： To evaluate whether contrast enhanced ultra- sound （CEUS） might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS： Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment （CEUS date 1） and before the second （CEUS date 2） and fourth （CEU5 date 3） cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak （l-I-P） and RISE RATE]were correlated with radiological response.RESULTS： For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant （P 〈 0.001） correlation in TTP between metastases of responders （9.08 s） and non-responders （14.76 s） ar- chived on CEUS date 1. By calculating a standardized quotient （metastases divided by normal liver tissue） we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly （P 〈 0.01） dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION： CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.
文摘AIM: To investigate the frequency of gastroen-terological diseases in the etiology and the efficacy of proton pump inhibitors (PPIs) in the treatment of cardiac syndrome X (CSX) as a subform of non-cardiac chest pain (NCCP). METHODS: We investigated 114 patients with CSX using symptom questionnaires. A subgroup of these patients were investigated regarding upper gastrointestinal disorders (GIs) and treated with PPI. Patients not willing to participate in investigation and treatment served as control group. RESULTS: Thirty-six patients denied any residual symptoms and were not further evaluated. After informed consent in 27 of the remaining 78 patients, we determined the prevalence of disorders of the upper GI tract and quantifi ed the effect of treatment with pantoprazole. We found a high prevalence of gastroenterological pathologies (26/27 patients, 97%)with gastritis, gastroesophageal reflux disease (GERD) and acid reflux as the most common associated disorders. If treated according to the study protocol, these patients showed a significant improvement in the symptom score. Patients treated by primary care physicians, not according to the study protocol had a minor response to treatment (n = 19, -43%), while patients not treated at all (n = 26) had no improvement of symptoms (-0%). CONCLUSION: Disorders of the upper GI tract are a frequent origin of CSX in a German population and can be treated with pantoprazole if given for a longer period.
基金Supported by a grant of the University of Aachen "START-Project"
文摘AIM: To study the relationship between the patterns of postprandial peristalsis and transduodenal bolus transport in healthy subjects. METHODS: Synchronous recording of chyme transport and peristaltic activity was performed during the fasting state and after administration of a test meal using a special catheter device with cascade configuration of impedance electrodes and solid-state pressure transducers. The catheter was placed into the duodenum, where the f irst channel was located in the f irst part of the duodenum and the last channel at the duodenojejunal junction. After identif ication of previously def ined chyme transport patterns the associated peristaltic patterns were analyzed. RESULTS: The interdigestive phase 3 complex was reliably recorded with both techniques. Of 497 analyzed impedance bolus transport events, 110 (22%) were short-spanned propulsive, 307 (62%) long-spanned propulsive, 70 (14%) complex propulsive, and 10 (2%) retrograde transport. Short-spanned chyme transports were predominantly associated with stationary or propagated contractions propagated over short distance. Long-spanned and complex chyme transports were predominantly associated with propulsive peristaltic patterns, which were frequently complex and comprised multiple contractions. Propagated double wave contraction, propagated contraction with a clustered contraction, and propagated cluster of contractions have been identif ied to be an integralted part of a peristaltic sequence in human duodenum. CONCLUSION: Combined impedancometry and manometry improves the analysis of the peristaltic patterns that are associated with postprandial transduodenal chymetransport. Postprandial transduodenal bolus transport is regulated by propulsive peristaltic patterns, which are frequently complex but well organized. This f inding should be taken into consideration in the analysis of intestinal motility studies.
