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Tiedt S, Herzberg M, Küpper C, Feil K, Kellert L, Dorn F, Liebig T, Alegiani A, Dichgans M, Wollenweber FA, Alber B, Bangard C, Berrouschot J, Bode F, Boeckh-Behrens T, Bohner G, Bormann A, Braun M, Eckert B, Fiehler J, Flottmann F, Gerloff C, Hamann G, Henn K, Kastrup A, Kraemer C, Krause L, Lehm M, Liman J, Lowens S, Mpotsaris A, Nolte C, Papanagiotou P, Petersen M, Petzold G, Pfeilschifter W, Psychogios M, Reich A, von Rennenberg R, Röther J, Schäfer J, Siebert E, Siedow A, Solymosi L, Thomalla G, Thonke S, Wagner M, Wunderlich S, Zweynert S. Stroke Etiology Modifies the Effect of Endovascular Treatment in Acute Stroke. Stroke 2020; 51:1014-1016. [DOI: 10.1161/strokeaha.119.028383] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Stroke etiology drives thrombus composition. We thus hypothesized that endovascular treatment shows different efficacy in cardioembolic versus noncardioembolic large-vessel occlusions (LVOs).
Methods—
Procedural characteristics, grade of reperfusion, and functional outcome at discharge and 90 days were compared between patients with cardioembolic versus noncardioembolic LVO from the GSR-ET (German Stroke Registry–Endovascular Treatment; n=2589). To determine associations with functional outcome, adjusted odds ratios and 95% CIs were calculated using ordinal multivariable logistic regression models adjusting for potential baseline confounder variables.
Results—
Endovascular treatment of cardioembolic LVO had a higher rate of successful reperfusion (85.6% versus 81.0%;
P
=0.002) and a higher rate of complete reperfusion after a single thrombectomy pass (45.7% versus 38.1%;
P
<0.001) compared with noncardioembolic LVO. Cardioembolic LVO was associated with better functional outcome at discharge (adjusted odds ratio, 1.61 [95% CI, 1.37–1.88]) and 90 days (adjusted odds ratio, 1.29 [95% CI, 1.09–1.53]). In mediation analysis, reperfusion explained 47% of the effect of etiology on functional outcome at discharge.
Conclusions—
These results provide evidence for higher efficacy of endovascular treatment in cardioembolic LVO compared with noncardioembolic LVO.
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Affiliation(s)
- Steffen Tiedt
- From the Institute for Stroke and Dementia Research (S.T., M.D., F.A.W.), University Hospital, LMU Munich, Germany
| | - Moriz Herzberg
- From the Institute for Stroke and Dementia Research (S.T., M.D., F.A.W.), University Hospital, LMU Munich, Germany
- Institute of Neuroradiology (M.H., F.D., T.L.), University Hospital, LMU Munich, Germany
| | - Clemens Küpper
- Department of Neurology (C.K., K.F., L.K., F.A.W.), University Hospital, LMU Munich, Germany
| | - Katharina Feil
- Department of Neurology (C.K., K.F., L.K., F.A.W.), University Hospital, LMU Munich, Germany
| | - Lars Kellert
- Department of Neurology (C.K., K.F., L.K., F.A.W.), University Hospital, LMU Munich, Germany
| | - Franziska Dorn
- Institute of Neuroradiology (M.H., F.D., T.L.), University Hospital, LMU Munich, Germany
| | - Thomas Liebig
- Institute of Neuroradiology (M.H., F.D., T.L.), University Hospital, LMU Munich, Germany
| | - Anna Alegiani
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Germany (A.A.)
| | | | - Frank A. Wollenweber
- From the Institute for Stroke and Dementia Research (S.T., M.D., F.A.W.), University Hospital, LMU Munich, Germany
- Department of Neurology (C.K., K.F., L.K., F.A.W.), University Hospital, LMU Munich, Germany
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Slebocki K, Kraus B, Chang D, Maintz D, Bangard C. Zufallsbefunde im Rahmen der Dual Source CT des Abdomens: Korrelation zwischen echt-nativen und virtuell-nativen Bildern zur Beurteilung von Nebennierenraumforderungen, Nieren- und Leberzysten. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550899] [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: 10/23/2022]
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3
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Liss B, Vehreschild JJ, Bangard C, Maintz D, Frank K, Grönke S, Michels G, Hamprecht A, Wisplinghoff H, Markiefka B, Hekmat K, Vehreschild MJGT, Cornely OA. Our 2015 approach to invasive pulmonary aspergillosis. Mycoses 2015; 58:375-82. [DOI: 10.1111/myc.12319] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 12/13/2022]
Affiliation(s)
- B. Liss
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- Center for Integrated Oncology CIO KölnBonn; University of Cologne; Cologne Germany
| | - J. J. Vehreschild
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- Center for Integrated Oncology CIO KölnBonn; University of Cologne; Cologne Germany
- German Centre for Infection Research (DZIF); partner site Bonn-Cologne; Cologne Germany
| | - C. Bangard
- Department of Radiology; University Hospital of Cologne; Cologne Germany
| | - D. Maintz
- Department of Radiology; University Hospital of Cologne; Cologne Germany
| | - K. Frank
- Department III of Internal Medicine; Heart Centre of the University of Cologne; Cologne Germany
| | - S. Grönke
- Department III of Internal Medicine; Heart Centre of the University of Cologne; Cologne Germany
| | - G. Michels
- Department III of Internal Medicine; Heart Centre of the University of Cologne; Cologne Germany
| | - A. Hamprecht
- Institute for Medical Microbiology; Immunology and Hygiene; University Hospital of Cologne; Cologne Germany
| | - H. Wisplinghoff
- Institute for Medical Microbiology; Immunology and Hygiene; University Hospital of Cologne; Cologne Germany
| | - B. Markiefka
- Institute of Pathology; University Hospital of Cologne; Cologne Germany
| | - K. Hekmat
- Department of Cardiothoracic Surgery; University Hospital of Cologne; Cologne Germany
| | - M. J. G. T. Vehreschild
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- Center for Integrated Oncology CIO KölnBonn; University of Cologne; Cologne Germany
- German Centre for Infection Research (DZIF); partner site Bonn-Cologne; Cologne Germany
| | - O. A. Cornely
- Department I of Internal Medicine; University Hospital of Cologne; Cologne Germany
- Center for Integrated Oncology CIO KölnBonn; University of Cologne; Cologne Germany
- German Centre for Infection Research (DZIF); partner site Bonn-Cologne; Cologne Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD); University of Cologne; Cologne Germany
- Clinical Trials Centre Cologne; ZKS Köln; University of Cologne; Cologne Germany
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4
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Affiliation(s)
- K. Schweer
- Medizinische Klinik I, Universitätsklinikum Köln
| | | | - C. Bangard
- Institut und Poliklinik für Radiologische Diagnostik, Universitätsklinikum Köln
| | - K. Frank
- Herzzentrum, Sektion Pneumologie, Universitätsklinikum Köln
| | - O. Cornely
- Klinik I für Innere Medizin und Center for Integrated Oncology (CIO) Köln-Bonn, Uniklinik Köln; ZKS Köln, BMBF 01KN1106 und Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Universität zu Köln
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Franke M, Winand S, Chang DH, Wille S, Maintz D, Bangard C. Reversible perkutane Harnleiterokklusion mittels ablösbarer neuroradiologischer Ballons – eine neue Technik. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373053] [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: 10/25/2022]
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Bangard C, Probst N, Franke M, Chang DH, Matoussevitch V, Maintz D. Retrospektive Evaluation der Anzahl notwendiger Interventionen nativer Oberarmdialyseshunts in Abhängigkeit von der Verwendung Paclitaxel-beschichteter oder einfacher Ballons. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373098] [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: 10/25/2022]
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Franke M, Persigehl T, Chang DH, Semrau R, Kocher M, Maintz D, Bangard C. Sicherheit, Effektivität und Erfolg der perkutanen, CT-gesteuerten fiducial marker-Implantation/Goldmarkerimplantation in der Vorbereitung zur streotaktischen Cyberknife- Radiotherapie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373049] [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: 10/25/2022]
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Schweer KE, Bangard C, Hekmat K, Cornely OA. Chronic pulmonary aspergillosis. Mycoses 2013; 57:257-70. [PMID: 24299422 DOI: 10.1111/myc.12152] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 09/28/2013] [Accepted: 10/10/2013] [Indexed: 01/15/2023]
Abstract
Chronic pulmonary aspergillosis (CPA) is a group of consuming diseases usually presenting with prolonged and relapsing cough, dyspnoea and weight loss. Acute symptoms such as haemoptysis and bronchial or pulmonary haemorrhage may occasionally occur. CPA affects patients with underlying pulmonary conditions, for example, chronic obstructive pulmonary disease or mycobacteriosis or common immunosuppressive conditions such as diabetes. Precise epidemiology is unknown, and while prevalence is considered low the chronic and relapsing nature of the disease challenges the treating physician. Diagnostics largely rely on serologic Aspergillus precipitins and findings on thoracic computed tomography. The latter are manifold comprising cavity formation, pleural involvement and sometimes aspergilloma. Other markers for aspergillosis are less helpful, in part due to the non- or semi-invasive nature of these forms of Aspergillus infection. Various antifungals were shown to be effective in CPA treatment. Azoles are the most frequently applied antifungals in the outpatient setting, but are now compromised by findings of Aspergillus resistance. Long-term prognosis is not fully elucidated and may be driven by the underlying morbidities. Prospective registry-type studies may be suitable to systematically broaden our CPA knowledge base. This article gives an overview of the available literature and proposes a clinical working algorithm for CPA management.
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Affiliation(s)
- K E Schweer
- 1st Department of Internal Medicine, Center for Clinical Studies II in Infectious Diseases, University Hospital Cologne, Cologne, Germany
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Chang DH, Kabbasch C, Bovenschulte H, Libicher M, Maintz D, Bangard C. [Experiences with power-injectable port systems: complications, patient satisfaction and clinical benefit]. ROFO-FORTSCHR RONTG 2013; 185:454-60. [PMID: 23616022 DOI: 10.1055/s-0032-1330713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Evaluation of complications, patient satisfaction and clinical benefit of port systems with authorization for high pressure injection of contrast agent during CT/MR examinations. MATERIALS AND METHODS Ultrasound-guided insertions of central venous port catheters were performed through the lateral subclavian vein at a university teaching hospital. The radiological information system (HIS/RIS) was used to evaluate technical success and complication rates. Assessment of patient satisfaction and clinical benefit was carried out by a questionnaire during a telephone call 6 months after implantation of the port system. RESULTS A total of 195 port systems in 193 patients were implanted. The catheter remained in place for a mean duration of 169 days (overall 29,210 catheter days). The technical success rate was 99.5 % and the overall complication rate was 17.4 % (24/138; 0.82 per 1000 catheter days). Follow-up revealed 13 early port explantations (9 %). Most of the patients reported high satisfaction in general (satisfied/very satisfied: 94 %). 34/209 contrast-enhanced CT/MRT scans (16 %) were performed using the port for contrast media injection. There were no complications during or after administration of contrast agent via the port system. CONCLUSION The Powerport system is a safe alternative for peripheral i. v. contrast media injection during CT/MR scans, but has been infrequently used. Most patients reported high overall satisfaction with the port system.
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Affiliation(s)
- D-H Chang
- Institut für Radiologische Diagnostik, Uniklinik Köln, Cologne, Germany.
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Chang DH, Müller D, Maintz D, Bangard C. Popliteales arterielles Entrapmentsyndrom - seltene Ursache einer thrombembolischen Unterschenkelischämie einer 14-jährigen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346651] [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: 10/26/2022]
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Bangard C, Chang DH, Libicher M, Bovenschulte H, Kochanek M, Reuter H, Maintz D. Fehllage zentraler Venenkatheter in der Arteria subclavia: zuverlässige Entfernung mit einem perkutanen Verschlusssystem (AngioSeal). ROFO-FORTSCHR RONTG 2013; 185:546-9. [DOI: 10.1055/s-0032-1330738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - D-H. Chang
- Institut und Poliklinik für Radiologische Diagnostik, Uniklinik Köln
| | - M. Libicher
- Institut für diagnostische und interventionelle Radiologie, Diakonie-Klinikum Schwäbisch Hall
| | - H. Bovenschulte
- Institut und Poliklinik für Radiologische Diagnostik, Uniklinik Köln
| | - M. Kochanek
- Medizinische Klinik I für Innere Medizin, Uniklinik Köln
| | - H. Reuter
- Medizinische Klinik III für Innere Medizin, Uniklinik Köln
| | - D. Maintz
- Institut und Poliklinik für Radiologische Diagnostik, Uniklinik Köln
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12
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Lethaus B, Weigl S, Kloss-Brandstätter A, Kloss F, Kessler P, Hölzle F, Bangard C. Looking for landmarks in medial orbital trauma surgery. Int J Oral Maxillofac Surg 2013; 42:209-13. [DOI: 10.1016/j.ijom.2012.10.037] [Citation(s) in RCA: 8] [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] [Received: 03/16/2011] [Revised: 08/06/2012] [Accepted: 10/05/2012] [Indexed: 10/27/2022]
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13
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Chang DH, Mueller D, Bangard C. Popliteales arterielles Entrapmentsyndrom - seltene Ursache einer thrombembolischen Unterschenkelischämie einer 14-Jährigen. ROFO-FORTSCHR RONTG 2013; 185:490-1. [DOI: 10.1055/s-0032-1330518] [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: 10/27/2022]
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Affiliation(s)
- H-M Curth
- Department of Gastroenterology and Hepatology, University of Cologne, Germany.
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Abken H, Schmidt P, Schlaak M, Hombach A, Bangard C, Kurschat P, Zigrino P. 62 Proffered Paper: Regression of Metastatic Melanoma by Targeting Melanoma Stem Cells. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70766-9] [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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Kriz J, Bangard C, Haverkamp U, Bongartz R, Baues C, Engert A, Mueller RP, Eich HT. Quality control of involved-field radiotherapy for patients with early stage Hodgkin's lymphoma based on a central prospective review. Comparison of the results between two study generations of the German Hodgkin Study Group. Strahlenther Onkol 2012; 188:660-5. [PMID: 22692351 DOI: 10.1007/s00066-012-0103-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 03/07/2012] [Accepted: 03/08/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Based on experience in trials HD10 and HD11 (1998-2003), the radiotherapy reference center of the German Hodgkin Study Group (GHSG) continued their central prospective radiation oncological review in trials HD13 and HD14. The purpose of this analysis was to identify the impact of this procedure on radiotherapeutic management and to compare findings with former trials. METHODS Between 2003 and 2009, 1,710 patients were enrolled in the HD13 trial (early favorable stages) and 2,039 patients in the HD14 trial (early unfavorable stages). All patients received a total of 30 Gy involved-field (IF) radiotherapy within a combined modality approach. RESULTS For patients in HD13, there was a correction of disease involvement in 847/1,518 patients (56%), and for patients in HD14 in 1,370/1,905 patients (72%). Most discrepancies were observed in the lower mediastinum (19.2%), infraclavicular (31.7%), upper cervical (12.7%), and supraclavicular (10.8%) lymph nodes. This resulted in a change of disease stage in 241 (7%) patients and a shift into another study protocol in 66 (2%) patients. Due to the incorrect lymph node documentation of the participating study centers, the IF radiotherapy volume had to be enlarged in 1,063/3,423 patients (31%) and reduced in 244/3,423 patients (7.1%). These findings are comparable to the results of the quality control in the trials HD10 and HD11 (2,611 patients reviewed). CONCLUSION Central review of the diagnostic imaging and clinical findings of Hodgkin's lymphoma patients shows a considerable number of discrepancies compared with the local evaluation. Thus, meticulous evaluation of all imaging information in close collaboration between the radiation oncologist and diagnostic radiologist is mandatory.
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Affiliation(s)
- J Kriz
- Department of Radiation Oncology, University of Muenster, Albert-Schweitzer Campus 1, Gebäude 1A, 48419, Muenster, Germany
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Chang DH, Kabbasch C, Bovenschulte H, Bangard C. Komplikationsrate, Patientenzufriedenheit und klinischer Einsatz nach Implantation eines PowerPorts - eine prospektive Analyse. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311261] [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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Bangard C. Bildgesteuerte Drainagen: Aktuelles Material, klinischer Einsatz und Ergebnisse. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1310875] [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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Bovenschulte H, Chang D, Michels G, Kochanek M, Liebig T, Bangard C. Technische Mitteilung: Fehlplatzierter 13F-Shaldonkatheter in der A. subclavia – kontrollierte Entfernung mit einem unterdimensionierten 8F-Kollagen-Verschlusssystem (AngioSeal®) und endovaskulärer Ballonfixation. ROFO-FORTSCHR RONTG 2011; 183:758-60. [DOI: 10.1055/s-0031-1273448] [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: 10/18/2022]
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Abstract
The impact of radiofrequency ablation (RFA) as a local ablative tumor therapy is increasing. Randomized trials justify RFA for small hepatocellular carcinoma (HCC) (single tumor ≤ 5 cm or three or less tumors ≤ 3 cm). Surgical resection still remains the gold standard for resectable colorectal liver metastases (CRLM). Several single center trials demonstrate improved patient survival by RFA and justify RFA for non-resectable CRLM. Local recurrence increases significantly with tumor diameters > 3 cm. There is insufficient evidence at this time to resolve the issue of optimal approach for treatment of CRLM. Technical development of the electrode design, improved ablation algorithms, and simplification of the exact electrode placement by new real-time fusion techniques of pre-interventional CT or MRT images with intra-interventional ultrasound have the potential to reduce the variable and sometimes high rate of local tumor recurrence. The clinical impact of immunological aspects following RFA with regard to patient survival and local tumor recurrence remains unclear.
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Affiliation(s)
- C Bangard
- Institut und Poliklinik für Radiologische Diagnostik, Uniklinik Köln.
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Chang DH, Liebig T, Bangard C. [Closure of an iatrogenic arteriovenous fistula and an pseudoaneurysm of the lower leg with the Amplatzer vascular plug]. ROFO-FORTSCHR RONTG 2011; 183:394-6. [PMID: 21246478 DOI: 10.1055/s-0029-1245968] [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: 10/18/2022]
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22
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Kriz J, Mueller R, Bangard C, Bongartz R, Engert A, Eich H. Quality Control of Involved Field (IF)-radiotherapy for Patients with Early-stage Hodgkin Lymphoma Based on a Central Prospective Review: Comparison of the Results between Two Study Generations of the German Hodgkin Study Group (GHSG). Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1269] [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: 12/01/2022]
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23
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Vehreschild JJ, Rüping MJGT, Wisplinghoff H, Farowski F, Steinbach A, Sims R, Stollorz A, Kreuzer KA, Hallek M, Bangard C, Cornely OA. Clinical effectiveness of posaconazole prophylaxis in patients with acute myelogenous leukaemia (AML): a 6 year experience of the Cologne AML cohort. J Antimicrob Chemother 2010; 65:1466-71. [PMID: 20410061 DOI: 10.1093/jac/dkq121] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Large randomized controlled trials have shown significant decreases in morbidity and mortality in leukaemia patients with posaconazole prophylaxis. However, the value of prophylaxis has been questioned in centres with a low incidence of invasive fungal diseases (IFDs) and pre-emptive treatment strategies. METHODS We prospectively evaluated the epidemiology of IFDs in acute myelogenous leukaemia (AML) patients undergoing first remission-induction chemotherapy before and after posaconazole prophylaxis had been introduced as a standard of care. Patients admitted from January 2003 to December 2005 received topical polyenes as antifungal prophylaxis (first group), while those admitted between January 2006 and December 2008 received 200 mg of oral posaconazole three times daily (second group). Other diagnostic and therapeutic standard operating procedures remained unchanged. RESULTS A total of 82 patients in the polyene prophylaxis group and 77 in the posaconazole prophylaxis group were included in the final analysis. Baseline characteristics were well matched between groups. Patients receiving topical polyene prophylaxis were more likely to experience breakthrough IFDs (19.5% and 3.9%; P = 0.003) or breakthrough aspergillosis (13.4% and 2.6%; P = 0.018) than patients receiving systemic posaconazole prophylaxis. They also had more febrile days (mean 10.7 +/- 9.66 and 7.3 +/- 5.73; P = 0.007), longer need for inpatient treatment (mean 53.0 +/- 24.16 and 46.0 +/- 14.39; P = 0.026) and a shorter fungal-free survival (78.7 and 90.4 days; P = 0.024). No significant differences were observed for persistent fever, pneumonia, lung infiltrates indicative of invasive pulmonary aspergillosis, or attributable and overall mortality. CONCLUSIONS After introduction of posaconazole prophylaxis for patients with AML, the number of febrile days, the incidence rate of IFDs and aspergillosis and the duration of hospitalization decreased significantly.
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Affiliation(s)
- J J Vehreschild
- Klinik I für Innere Medizin, Klinikum der Universität zu Köln, Köln, Germany.
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Kochanek M, Shimabukuro-Vornhagen A, Bangard C, Skouras E, von Bergwelt-Baildon M. Gas-producing Escherichia coli fasciitis leading to air-embolism of the lower vena cava. Infection 2010; 38:154-5. [PMID: 20306280 DOI: 10.1007/s15010-009-9369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Kochanek
- Klinik I für Innere Medizin, Klinikum der Universität zu Köln, Köln, Germany.
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Bangard C, Rösgen S, Wahba R, Hellmich M, Wiemker R, Fischer JH, Stippel DL, Lackner KJ. Perkutane intrahepatische RF Ablation im Schweinemodell: erste Ergebnisse mit der Rita XLi Sonde. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252775] [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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Bangard C, Rösgen S, Wahba R, Hellmich M, Wiemker R, Fischer JH, Stippel DL, Lackner KJ. Monopolare RFA in Schweinelebern: Methode zur in vivo Bestimmung der Asymmetrie von Nekrosezonen im Verhältnis zur Applikatorschaftachse. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252797] [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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Bovenschulte H, Bangard C, Lackner KJ. [Superior vena cava stent implantation: preserving an indwelling port catheter by temporary shift of the brachiocephalic vein]. ROFO-FORTSCHR RONTG 2010; 182:274-5. [PMID: 20112175 DOI: 10.1055/s-0028-1109993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wahba R, Bangard C, Kleinert R, Rösgen S, Fischer JH, Lackner KJ, Hölscher AH, Stippel DL. Electro-physiological parameters of hepatic radiofrequency ablation—a comparison of an in vitro versus an in vivo porcine liver model. Langenbecks Arch Surg 2009; 394:503-9. [DOI: 10.1007/s00423-009-0475-y] [Citation(s) in RCA: 5] [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] [Received: 01/31/2009] [Accepted: 02/20/2009] [Indexed: 10/21/2022]
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Bangard C, Gawenda M, Lackner K. [Transarterial occlusion of type 1 endoleak of the aortic arch by coil embolization and thrombin injection after endovascular therapy of retrograde Stanford A dissection]. ROFO-FORTSCHR RONTG 2009; 180:926-8. [PMID: 19238645 DOI: 10.1055/s-2008-1027650] [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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Schlegel M, Sack A, Nowak D, Dafotakis M, Bangard C, Shamay-Tsoory S, Onur Ö, Kessler J, Kalbe E. Relevanz des rechten präfrontalen Cortex für kognitive und affektive Theory of Mind-Leistungen: eine TMS-Studie. Akt Neurol 2008. [DOI: 10.1055/s-0028-1086533] [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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Berg F, Gossmann A, Bangard C, Bovenschulte H, Hellmich M, Lackner K. Pelvic and lower leg arteries: Diagnostic Accuracy of Contrast-Enhanced MR-Angiography at 3.0 Tesla in hybrid technique. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1052584] [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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Bangard C, Prenzel K, Yavuzyasar S, Fischer JH, Lackner KJ, Hölscher AH, Stippel DL. Welche Parameter sind zur Positionierung einer Radiofrequenzablationssonde notwendig – Evaluation eines einfachen Algorithmus. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073706] [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: 10/21/2022]
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Berg F, Gossmann A, Bangard C, Bovenschulte H, Nijenhuis M, Hellmich M, Lackner K. Kontrastverstärkte MR-Angiographie der Becken- und Beinarterien in Hybrid-Technik am 3 Tesla MR Tomographen: Erste klinische Ergebnisse. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977038] [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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Gossmann A, Bangard C, Warm M, Schmutzler RK, Mallmann P, Lackner K. MRT gesteuerte Drahtmarkierung an einem offenen 1,0 Tesla MR Scanner mittels Echtzeitdarstellung der Nadelplatzierung bei suspekten Mammabefunden. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976927] [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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Bangard C, Paszek J, Berg F, Eyl G, Kessler J, Lackner K, Gossmann A. MR Untersuchung claustrophobischer Patienten in einem offenen 1.0 Tesla MR System: Bewegungsartefakte und Untersuchungsakzeptanz verglichen mit geschlossenen MR Systemen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977143] [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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Stippel DL, Bangard C, Schleimer K, Koerber F, Beckurts KTE, Hoppe B. Successful Renal Transplantation in a Child With Thrombosis of the Inferior Vena Cava and Both Iliac Veins. Transplant Proc 2006; 38:688-90. [PMID: 16647445 DOI: 10.1016/j.transproceed.2006.01.068] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An 8-year-old girl who was born premature in the 24th gestational week suffered a septic venous thrombosis due to an indwelling central line during the early perinatal period. As a result the inferior vena cava including the intrahepatic segment and both iliac veins was obliterated. The right kidney was primarily dysplastic, and the left kidney developed a partial infarction. Renal function was compensated until the age of 6 years. Magnetic resonance angiography at that time showed a collateral system via the azygos vein. The venous pressure and its variation with breathing as measured invasively showed normal values. During pretransplant initiation of immunosuppressive therapy, the child developed cerebral convulsions after the third dose of cyclosporine. Therefore we utilized a regimen of rapamycin, mycophenolate mofetil, and steroids. The transplantation was performed using a living donor graft from the child's mother. The relatively long vein from the left kidney was used for anastomosis with a large presacral collateral vein. Twelve months after transplantation the kidney function is stable with a serum creatinine of 0.5 mg/dL. The recipient thrombosis of the caval and iliac veins is not a principal contraindication for successful renal transplantation. MR angiography and invasive pressure measurements facilitated evaluation of the collateral venous system. The living donation setting allowed the initiation of an immunosuppressive regimen that was tailored to the concomitant diseases of the child.
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Affiliation(s)
- D L Stippel
- Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
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Bangard C, Gossmann A, Bloemers K, Bos C, Siakavara E, Lackner K. Kinematische Knieuntersuchungen in einem offenen 1.0 Tesla MR System. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940621] [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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Gossmann A, Bangard C, Bloemers K, Bos C, Siakavara E, Lackner K. Funktionsuntersuchungen der LWS mittels einem offenen Hochfeld-MRT. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940620] [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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Zähringer M, Hilgers J, Krüger K, Strohe D, Bangard C, Neumann L, Warm M, Reiser M, Töx U, Lackner K. Die sonographisch gezielte Implantation von Portkathetersystemen über die laterale Vena subclavia. ROFO-FORTSCHR RONTG 2006; 178:324-9. [PMID: 16508841 DOI: 10.1055/s-2006-926472] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. MATERIALS AND METHODS Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n = 239), total parenteral nutrition (n = 2) and intravenous medication (n = 30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. RESULTS A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter ex-plantation due to dysfunction or infection was 0.07 per 1000 catheter days. CONCLUSION Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary.
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Affiliation(s)
- M Zähringer
- Institut für Radiologische Diagnostik, Universität zu Köln.
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Stippel DL, Kasper HU, Schleimer K, Töx U, Bangard C, Hölscher AH, Beckurts KTE. Successful use of sirolimus in a patient with bulky ovarian metastasis of hepatocellular carcinoma after liver transplantation. Transplant Proc 2005; 37:2185-7. [PMID: 15964374 DOI: 10.1016/j.transproceed.2005.03.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [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: 07/12/2004] [Indexed: 12/23/2022]
Abstract
This 44-year-old woman developed multifocal hepatocellular carcinoma (HCC) within hepatitis B-induced liver cirrhosis. At the time of listing for transplantation the HCC had progressed beyond the Milan criteria. Due to her young age, high grade of histological differentiation according to biopsy, and lack of therapeutic alternatives, she was listed for transplantation. She received an organ from the Eurotransplant marginal liver list. Immunosuppression was reduced to tacrolimus monotherapy within 4 months. Five months after transplantation bilateral bulky ovarian metastases were seen on computed tomography (CT) scan. A bilateral salphingo-oophorectomy was performed and immunosuppression switched to sirolimus monotherapy. Fourteen months after this procedure and 19 months after transplantation, the patient is asymptomatic with stable liver function. She is free of recurrence as judged by CT scan, bone scan, and alpha-fetoprotein. In conclusion, radical surgical treatment and immunosuppression using sirolimus may achieve tumor-free survival in selected patients with advanced or recurrent HCC.
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Affiliation(s)
- D L Stippel
- Department of Visceral and Vascular Surgery, University of Cologne, Joseph Stelzmann Strasse 9, 50931 Köln, Germany.
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Stippel DL, Bangard C, Kasper HU, Fischer JH, Hölscher AH, Gossmann A. Experimental bile duct protection by intraductal cooling during radiofrequency ablation. Br J Surg 2005; 92:849-55. [PMID: 15892161 DOI: 10.1002/bjs.5002] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The use of radiofrequency ablation (RFA) for liver tumours is limited by the proximity of large bile ducts to the targeted lesion. The aim of this randomized study was to evaluate intraductal cooling as a mean of protecting the bile ducts during RFA. METHODS Twelve pigs underwent RFA adjacent to the right bile duct. After placement of an intraductal cooling catheter and a RFA probe, pigs were randomized to cooling or no cooling. Intraductal temperature was measured in all animals. The bile ducts were assessed by magnetic resonance imaging (MRI) and cholangiography 1 and 28 days after the procedure. RESULTS Intraductal cooling abolished the increase of intraductal temperature seen in the absence of cooling. Concurrent cholangiography and MRI showed a biliary lesion in one of six pigs subjected to intraductal cooling and in five of six without cooling (P = 0.040). The biliary injuries were barely visible by MRI on day 1 but were clearly visible on day 28. CONCLUSION Intraductal cooling can prevent biliary injury induced by RFA. The exact parameters for intraductal cooling require further investigation to establish the best compromise between bile duct protection and complete ablation of surrounding tissue.
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Affiliation(s)
- D L Stippel
- Department of Visceral and Vascular Surgery, University of Cologne, Germany.
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Zähringer M, Hilgers J, Krüger K, Strohe D, Neumann L, Bangard C, Goßmann A, Lackner K. Ultraschallgesteuerte Implantation von Subclavia Portsystemen. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867554] [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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Goßmann A, Bangard C, Mühler A, Krüger K, Zähringer M, Warm M, Schmutzler R, Lackner K. Erste Erfahrungen in der Interpretation von MR-Mammographien mittels der „3-time-point Methode (3TP)“. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868211] [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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Krüger K, Zähringer M, Strohe D, Bangard C, Böcker J, Stützer H, Lackner K. Perkutaner, ultraschallgesteuerter Verschluss des iatrogenen Aneurysma spurium mit Thrombin: Ergebnisse einer prospektiven Studie an 240 Patienten. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867551] [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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Krüger K, Zähringer M, Bendel M, Strohe D, Bangard C, Weise C, Lackner K. Längenadaptierte, zentrierte endovaskuläre Gamma-Bestrahlung nach perkutaner Ballon-Angioplastie (PTA) femoropoplitealer De-novo-Stenosen: 1-Jahr-Follow-up einer prospektiven Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867854] [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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Bangard C, Goßmann A, Stippel D, Kasper HU, Bosse M, Hölscher A, Lackner K. Abgrenzbarkeit von Radiofrequenzläsionen im Schweinemodell: Vergleich eines extrazellulären mit einem SPIO Kontrastmittel. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867634] [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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Bangard C, Lotz J, Rosenthal H, Galanski M. Erdheim-Chester disease versus multifocal fibrosis and Ormond's disease: a diagnostic dilemma. Clin Radiol 2005; 59:1136-41. [PMID: 15556598 DOI: 10.1016/j.crad.2003.09.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 03/26/2003] [Revised: 09/12/2003] [Accepted: 09/30/2003] [Indexed: 11/23/2022]
Abstract
AIM The aim of the study was to evaluate the effectiveness of different imaging techniques with respect to diagnosis and differential diagnosis between Erdheim-Chester disease (ECD) and multifocal fibrosis (MF)/Ormond's disease (OD). METHOD Three cases of ECD were included, two of which were misdiagnosed as MF/OD. Findings in different imaging techniques [plain radiography, skeletal scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI)] of the lower extremities, chest MRI, craniofacial MRI, abdominal CT and MRI) were compared and ranked with regard to diagnostic efficacy. RESULTS Differentiation between ECD and MF/OD is only possible by imaging the long bones. Bone roentgenograms and skeletal scintigraphy, followed by MRI and CT of the lower extremities are the most effective imaging techniques. CONCLUSION A low threshold for carrying out plain radiography of the lower limbs in case of RF/MF will increase the number of ECD-cases.
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Affiliation(s)
- C Bangard
- Department of Radiology, University of Cologne, Cologne, Germany.
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Abstract
A seventy-year-old woman presented with persistent edema of the left lower eyelid and induration in the inner angle of her left eye. Histological examination revealed granulomatous blepharitis of the lower eyelid as well as a solid basal cell carcinoma with partial calcification in the inner angle of the eye. The edema of the lower eyelid resolved upon complete surgical removal of the tumor.
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Affiliation(s)
- S M Erdmann
- Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Aachen
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Bangard C, Goßmann A, Stippel D, Kasper HU, Bosse M, Hölscher A, Lackner K. Dynamische MR Tomographie von Radiofrequenzläsionen mittels leberspezifischem Kontrastmittel: Zusammenhang zwischen Größe und Lokalisation der Ablationsareale. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-828012] [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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Abstract
Allergy to human seminal fluid is a rare but potentially life-threatening disorder. Acute symptoms range from local reactions to generalized symptoms. A 30-year-old woman experienced vulvovaginal itching, erythema and swelling as well as generalized urticaria and angioedema of the neck and face after unprotected sexual intercourse. A scratch test with undiluted seminal fluid and the detection of specific IgE antibodies revealed a type I allergy to seminal fluid. Risk factors and therapeutic options are discussed.
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Affiliation(s)
- C Bangard
- Klinik für Dermatologie und Allergologie, Universitätsklinikum der RWTH Aachen, Aachen
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