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Proß V, Sattler A, Lukassen S, Tóth L, Thole LML, Siegle J, Stahl C, He A, Damm G, Seehofer D, Götz C, Bayerl C, Jäger P, Macke A, Eggeling S, Kirzinger B, Mayr T, Herbst H, Beyer K, Laue D, Krönke J, Braune J, Rosseck F, Kittner B, Friedersdorff F, Hubatsch M, Weinberger S, Lachmann N, Hofmann VM, Schrezenmeier E, Ludwig C, Schrezenmeier H, Jechow K, Conrad C, Kotsch K. SARS-CoV-2 mRNA vaccination-induced immunological memory in human nonlymphoid and lymphoid tissues. J Clin Invest 2023; 133:e171797. [PMID: 37815874 PMCID: PMC10721158 DOI: 10.1172/jci171797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
Tissue-resident lymphocytes provide organ-adapted protection against invading pathogens. Whereas their biology has been examined in great detail in various infection models, their generation and functionality in response to vaccination have not been comprehensively analyzed in humans. We therefore studied SARS-CoV-2 mRNA vaccine-specific T cells in surgery specimens of kidney, liver, lung, bone marrow, and spleen compared with paired blood samples from largely virus-naive individuals. As opposed to lymphoid tissues, nonlymphoid organs harbored significantly elevated frequencies of spike-specific CD4+ T cells compared with blood showing hallmarks of tissue residency and an expanded memory pool. Organ-derived CD4+ T cells further exhibited increased polyfunctionality over those detected in blood. Single-cell RNA-Seq together with T cell receptor repertoire analysis indicated that the clonotype rather than organ origin is a major determinant of transcriptomic state in vaccine-specific CD4+ T cells. In summary, our data demonstrate that SARS-CoV-2 vaccination entails acquisition of tissue memory and residency features in organs distant from the inoculation site, thereby contributing to our understanding of how local tissue protection might be accomplished.
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Affiliation(s)
- Vanessa Proß
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Arne Sattler
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sören Lukassen
- Center of Digital Health, Berlin Institute of Health and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Laura Tóth
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Linda Marie Laura Thole
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Janine Siegle
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Carolin Stahl
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - An He
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Georg Damm
- Department of Hepatobiliary Surgery and Visceral Transplantation, University Hospital, Leipzig University, Leipzig, Germany
| | - Daniel Seehofer
- Department of Hepatobiliary Surgery and Visceral Transplantation, University Hospital, Leipzig University, Leipzig, Germany
| | - Christina Götz
- Department of Hepatobiliary Surgery and Visceral Transplantation, University Hospital, Leipzig University, Leipzig, Germany
| | - Christian Bayerl
- Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pia Jäger
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | | | | | | | - Hermann Herbst
- Department of Pathology, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Katharina Beyer
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dominik Laue
- Department of Traumatology and Reconstructive Surgery, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jan Krönke
- Department of Hematology, Oncology and Cancer Immunology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan Braune
- Department of Hematology, Oncology and Cancer Immunology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Rosseck
- Institute of Pathology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Beatrice Kittner
- Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Frank Friedersdorff
- Department of Urology, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Mandy Hubatsch
- Department of Urology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Weinberger
- Department of Urology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nils Lachmann
- Institute of Transfusion Medicine, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Veit Maria Hofmann
- Department of Otolaryngology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Eva Schrezenmeier
- Department of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- BIH Charité Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Carolin Ludwig
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Hubert Schrezenmeier
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Transfusion Service Baden-Württemberg-Hessen and University Hospital Ulm, Ulm, Germany
| | - Katharina Jechow
- Center of Digital Health, Berlin Institute of Health and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Conrad
- Center of Digital Health, Berlin Institute of Health and Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Katja Kotsch
- Department of General and Visceral Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Jäger P, Claassen K. Obesity in the context of migration and socio-economic risk factors – a multivariate epidemiologic analysis. Ann Epidemiol 2022; 76:108-113. [DOI: 10.1016/j.annepidem.2022.09.008] [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] [Received: 03/25/2022] [Revised: 08/29/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022]
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Toenges R, Greinix H, Lawitschka A, Halter J, Baumgartner A, Simon A, Arends J, Jäger P, Middeke M, Hilgendorf I, Klein S, Wagner-Drouet EM, Schmid C, Bug G, Wolff D. Current practice in nutrition after allogeneic hematopoietic stem cell transplantation - Results from a survey among hematopoietic stem cell transplant centers. Clin Nutr 2021; 40:1571-1577. [PMID: 33744601 DOI: 10.1016/j.clnu.2021.02.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 11/04/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allogeneic hematopoietic stem cell transplantation (alloHSCT) is frequently associated with impaired oral intake and malnutrition, which potentially increases morbidity and mortality. Therefore, nutrition is one of the major challenges in the post-transplant period. METHODS To document the current clinical approach in nutritional treatment, we designed a questionnaire concerning the current practice in nutrition after alloHSCT and distributed it to German speaking centers performing alloHSCT in Germany, Austria and Switzerland between November 2018 and March 2020. Twenty-eight (39%) of 72 contacted centers completed the survey, 23 from Germany, two from Austria and three from Switzerland, representing 50% of alloHSCT activity within the participating countries in 2018. RESULTS All centers reported having nutritional guidelines for patients undergoing alloHSCT, whereby 86% (n = 24) provided a low-microbial diet during the neutropenic phase. The criteria to start parenteral nutrition (PN) directly after alloHSCT seemed to be consistent, 75% (n = 21) of the corresponding centers started PN if the oral nutritional intake or the bodyweight dropped below a certain limit. In the setting of intestinal graft-versus-host disease (GvHD) the current practice appeared to be more heterogenous. About 64% (n = 18) of the centers followed a special diet, added food stepwise modulated by GvHD symptoms, while only four centers regularly stopped oral intake completely (intestinal GvHD grade >1). Half of the centers (54%, n = 15) applied a lactose-free diet, followed by 43% (n = 12) which provided fat- and 18% (n = 5) gluten-free food in patients with intestinal GvHD. Supplementation of micronutrients in acute intestinal GvHD patients was performed by 54% (n = 15) of the centers, whereas vitamin D (89%, n = 25) and vitamin B12 (68%, n = 19) was added regularly independently of the presence of GvHD. Only 5 (18%) participating centers ever observed a food-associated infection during hospitalization, whereas food-associated infections were reported to occur more often in the outpatient setting (64%, n = 18). CONCLUSION The survey documented a general consensus about the need for nutritional guidelines for patients undergoing alloHSCT. However, the nutritional treatment in clinical practice (i.e. lactose-, gluten- or fat-free in intestinal GvHD) as well as the use of food supplements was very heterogeneous. In line with current general recommendations the centers seemed to focus on safe food handling practice rather than providing a strict neutropenic diet. More high-quality data are required to provide evidence-based nutrition to patients during and after alloHSCT.
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Affiliation(s)
- R Toenges
- Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt, Germany.
| | - H Greinix
- Division of Hematology, Medical University of Graz, Austria.
| | | | - J Halter
- Dept. of Hematology, University Hospital Basel, Switzerland.
| | - A Baumgartner
- Dept. of Endocrinology, Medical University Klinik Kantonsspital Aarau, Aarau, Switzerland.
| | - A Simon
- Pediatric Oncology and Hematology, Saarland University Hospital, Saar, Homburg, Germany.
| | - J Arends
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - P Jäger
- Department of Hematology, Oncology and Clinical Immunology, University Hospital Duesseldorf, Medical Faculty, Duesseldorf, Germany.
| | - M Middeke
- Dept. of Internal Medicine I, University Hospital Dresden, Dresden, Germany.
| | - I Hilgendorf
- Universitätsklinikum Jena, Klinik für Innere Medizin II, Abteilung für Hämatologie und Internistische Onkologie, Jena, Germany.
| | - S Klein
- III. Medizinische Klinik Hämatologie und Onkologie Universitätsmedizin Mannheim, Mannheim, Germany.
| | - E M Wagner-Drouet
- 3rd Medical Dept., Hematology, Oncology and Pneumology, University Medical Center Mainz, Germany.
| | - C Schmid
- Department of Hematology and Oncology, Universitätsklinikum Augsburg, Augsburg, Germany.
| | - G Bug
- Department of Medicine, Hematology/Oncology, Goethe-University, 60590 Frankfurt, Germany.
| | - D Wolff
- Dept. of Internal Medicine III, University Hospital, Regensburg, Germany.
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Wolicki A, Jäger P, Deska T, Senkal M. Sphincter-saving therapy for fistula-in-ano: long-term follow-up after FiLaC ®. Tech Coloproctol 2020; 25:177-184. [PMID: 32865716 DOI: 10.1007/s10151-020-02332-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/17/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The treatment of anal fistula remains a challenge between maintaining continence and radical surgery to prevent recurrence. Fistula-tract Laser Closure (FiLaC®) is a sphincter-saving technique using a radial emitting laser fibre to close the fistula tract. The aim of this study was to report long-term outcomes in patients who received FiLaC® therapy for transsphincteric and intersphincteric anal fistula between January 2011 and December 2017. METHODS A retrospective study was performed on patients who were treated with FiLaC®- for a transsphincteric and intersphincteric anal fistula at our institution between January 2011 and December 2017. In all patients, the FiLaC® procedure was combined with a closure of the internal orifice using a simple 3-0 Z stitch. Patient characteristics, previous proctological history, healing rates, failures and postoperative continence were investigated. RESULTS The study included 83 patients [mean age 50.01 ± 14.59 years. 64 (77.1%) males] with a mean follow-up period of 41.99 (± 21.59) months (range 4-87 months). Thirteen patients (15.7%) had a recurrent fistula. 65 patients (78.3%) had undergone prior abscess drainage with insertion of a seton. The primary healing rate was 74.7% (62 of 83 patients) overall. Eleven (13.3%) of the 21 patients (25.3%) who failed FiLaC®-therapy underwent a second operation. In eight cases, Re-FiLaC® and in three cases, fistulectomy with closure of the internal orifice was performed. Afterwards 6 (54.5%) of these 11 patients could be considered cured: 3 who had fistulectomy and three who had Re-FiLaC® treatment. The overall healing rate after second FiLaC® was 78.3% (65 of 83 patients) while the overall healing rate for FiLaC® therapy combined with any second procedure was 81.9% (68 of 83 patients). The follow-up period in this group of 11 patients who received re-operation was 38 months (range 13-84 months). Changes in continence occurred in eight patients (9.6%). No patient reported major incontinence postoperatively. CONCLUSIONS The FiLaC® procedure is associated with good healing rates in long-term follow-up and should be considered as a treatment option for transsphincteric and intersphincteric anal fistulae, especially due to the low complication rate and low risk of sphincter injury.
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Affiliation(s)
- A Wolicki
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr University Bochum, Marienplatz 2, 58452, Witten, Germany.
| | - P Jäger
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr University Bochum, Marienplatz 2, 58452, Witten, Germany
| | - T Deska
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr University Bochum, Marienplatz 2, 58452, Witten, Germany
| | - M Senkal
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr University Bochum, Marienplatz 2, 58452, Witten, Germany
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Jäger P, Wolicki A, Spohnholz J, Senkal M. Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women. Int J Environ Res Public Health 2020; 17:E2734. [PMID: 32326591 PMCID: PMC7216185 DOI: 10.3390/ijerph17082734] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 12/20/2022]
Abstract
This systematic literature review aims to point out sex-specific special features that are important in the bariatric treatment of women suffering from severe obesity. A systematic literature search was carried out according to Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. After the literature selection, the following categories were determined: sexuality and sexual function; contraception; fertility; sex hormones and polycystic ovary syndrome; menopause and osteoporosis; pregnancy and breastfeeding; pelvic floor disorders and urinary incontinence; female-specific cancer; and metabolism, outcome, and quality of life. For each category, the current status of research is illuminated and implications for bariatric treatment are determined. A summary that includes key messages is given for each subsection. An overall result of this paper is an understanding that sex-specific risks that follow or result from bariatric surgery should be considered more in aftercare. In order to increase the evidence, further research focusing on sex-specific differences in the outcome of bariatric surgery and promising treatment approaches to female-specific diseases is needed. Nevertheless, bariatric surgery shows good potential in the treatment of sex-specific aspects for severely obese women that goes far beyond mere weight loss and reduction of metabolic risks.
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Affiliation(s)
- Pia Jäger
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Annina Wolicki
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Johannes Spohnholz
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Metin Senkal
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
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Jäger P. Letter to the editor: Selection bias not discussed concerning the article "PTSD of rape after IS (Islamic State) captivity" by J. I. Kizilhan, published in: Archives of Women's Mental Health 2018 Oct; 21(5):517-524. doi: https://doi.org/10.1007/s00737-018-0824-3. Epub 2018 Mar 10. Arch Womens Ment Health 2020; 23:223-224. [PMID: 30721362 DOI: 10.1007/s00737-019-0946-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Pia Jäger
- Social Policy and Social Economy Section, Faculty of Social Science, Ruhr-University Bochum, Universitätsstr. 150, 44801, Bochum, Germany. .,Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Netherlands.
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Abstract
BACKGROUND The stapled hemorrhoidopexy is reported to have a low recurrence while treating the major hemorrhoidal symptoms of bleeding and prolapse. The aim of this study is to obtain long-term results on the outcome of the stapled hemorrhoidopexy. METHODS All patients with a hemorrhoidal disease grade III, who underwent stapled hemorrhoidopexy from May 1999-December 2003, were included. Data collection was based on a standardized telephone interview. In the questionnaire, we recorded information regarding the postoperative recurrence and severity of hemorrhoidal symptoms (defined as bleeding, prolapse, burning, itching and moisture), further hemorrhoidal treatments and functional results (incontinence, fecal urgency and outlet obstruction) as well as patients' satisfaction. RESULTS Of the 257 patients, who underwent stapled hemorrhoidopexy, follow-up data were available in 140 patients. In 47.4% of the patients, a recurrence of at least one hemorrhoidal symptom was registered, whereas this recurrence was observed in 47.3% of these patients more than 10 years postoperatively. A surgical re-intervention was necessary in 15.2%. We found a postoperative new incontinence in 15.5%, a fecal urgency in 28.0% and an outlet obstruction in 9.4%. Of all patients, 62.3% were "very satisfied" with the operation. CONCLUSIONS The results of the study revealed a relatively high recurrence of hemorrhoidal symptoms after a mean follow-up of 15 years with a high recurrence rate more than 10 years postoperatively. In consideration of not negligible risk of incontinence, fecal urgency and outlet obstruction, the indication for a stapled hemorrhoidopexy should be made well considered. However, patients' satisfaction is very high.
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Affiliation(s)
- Ralph Schneider
- Department of Surgery and Center for Minimal Invasive Surgery, Kliniken Essen-Mitte, Henricistrasse 92, 45136, Essen, Germany.
| | - Pia Jäger
- Department of Surgery and Center for Minimal Invasive Surgery, Kliniken Essen-Mitte, Henricistrasse 92, 45136, Essen, Germany
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Jäger P, Claassen K, Ott N, Brand A. Does the Electronic Health Card for Asylum Seekers Lead to an Excessive Use of the Health System? Results of a Survey in Two Municipalities of the German Ruhr Area. Int J Environ Res Public Health 2019; 16:E1178. [PMID: 30986920 PMCID: PMC6479464 DOI: 10.3390/ijerph16071178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The initial and intermediate-term access of refugees to healthcare in Germany is limited. A previous study showed that the obligation to request healthcare vouchers at the social security offices decreases the asylum seekers' consultation rate of ambulant physicians. The introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers is considered skeptically by some municipalities and federal states, among other reasons due to the fear of an overuse of health care services by asylum seekers. The aim of this study is to further evaluate the data of the authors' initial study with a new focus on inpatient care as well as a differentiation of the ambulant consultation rate into general practitioners and outpatient specialists. METHODS The now-differentiated consultation rate of the initial study as well as the asylum seekers' use of inpatient care are compared to the values of the sex- and age-corrected autochthonous population as given by the German Health Interview and Examination Survey for Adults (DEGS1). A mean difference test (student's t-test) is used for comparison and significance testing. RESULTS Asylum seekers who were in possession of the EHIC were significantly less likely to visit their ambulant general practitioners and specialists than the German autochthonous population. Simultaneously, this difference is partly compensated for by their more frequent use of impatient care. CONCLUSIONS There is no indication that the EHIC leads to an overuse of healthcare services.
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Affiliation(s)
- Pia Jäger
- Section for Social Policy and Social Economy, Faculty of Social Sciences, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.
- Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboidomein 30, 6229 CT Maastricht, The Netherlands.
| | - Kevin Claassen
- Department of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany.
| | - Notburga Ott
- Section for Social Policy and Social Economy, Faculty of Social Sciences, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.
| | - Angela Brand
- Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboidomein 30, 6229 CT Maastricht, The Netherlands.
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Claassen K, Jäger P. Impact of the Introduction of the Electronic Health Insurance Card on the Use of Medical Services by Asylum Seekers in Germany. Int J Environ Res Public Health 2018; 15:E856. [PMID: 29693623 PMCID: PMC5981895 DOI: 10.3390/ijerph15050856] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 11/17/2022]
Abstract
Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers.
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Affiliation(s)
- Kevin Claassen
- Faculty of Social Sciences, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.
| | - Pia Jäger
- Department of Psychiatry Psychotherapy and Preventative Medicine, Faculty of Medicine, LWL-University Hospital, Ruhr-University Bochum, Universitätsstr. 150, 44801 Bochum, Germany.
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Abstract
Summary
Objectives:
Pleural thickenings as biomarker of exposure to asbestos may evolve into malignant pleural mesothelioma. Foritsearly stage, pleurectomy with perioperative treatment can reduce morbidity and mortality. The diagnosis is based on a visual investigation of CT images, which is a time-consuming and subjective procedure. Our aim is to develop an automatic image processing approach to detect and quantitatively assess pleural thickenings.
Methods:
We first segment the lung areas, and identify the pleural contours. A convexity model is then used together with a Hounsfield unit threshold to detect pleural thickenings. The assessment of the detected pleural thickenings is based on a spline-based model of the healthy pleura.
Results:
Tests were carried out on 14 data sets from three patients. In all cases, pleural contours were reliably identified, and pleural thickenings detected. PC-based Computation times were 85 min for a data set of 716 slices, 35 min for 401 slices, and 4 min for 75 slices, resulting in an average computation time of about 5.2 s per slice. Visualizations of pleurae and detected thickeningswere provided.
Conclusion:
Results obtained so far indicate that our approach is able to assist physicians in the tedious task of finding and quantifying pleural thickenings in CT data. In the next step, our system will undergo an evaluation in a clinical test setting using routine CT data to quantifyits performance.
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Affiliation(s)
- Kraisorn Chaisaowong
- Institute fo Imaging and Computer Vision, RWTH Aachen University, Aachen, Germany.
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11
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Jäger P. Psychische Diagnostik bei Kindern und Jugendlichen mit Fluchthintergrund im kommunalen Vorsorgesetting – Potenziale der Schuleingangsuntersuchung. ACTA ACUST UNITED AC 2018. [DOI: 10.5771/2509-9485-2018-2-231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Rautenberg C, Pechtel S, Geyh S, Jäger P, Haas R, Germing U, Kobbe G, Schroeder T. Peripheral Blood WT1 Expression Refines Prognostic Information for MDS Patients Within the IPSS-R Risk Categories Very Low, Low and Intermediate. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30373-9] [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: 12/01/2022]
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13
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Foerster EC, Bino M, Jäger P, von Schulthess GK. Renal morphology and function before and after shock wave lithotripsy at 1.5 T with gadolinium-DTPA. Contrib Nephrol 2015; 56:135-40. [PMID: 3608488 DOI: 10.1159/000413794] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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14
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Jäger P. Revision of the genus Sinopoda Jäger, 1999 in Laos with discovery of the first eyeless huntsman spider species (Sparassidae: Heteropodinae). Zootaxa 2012. [DOI: 10.11646/33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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16
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Jäger P. New large-sized cave-dwelling Heteropoda species from Asia, with notes on their relationships (Araneae: Sparassidae: Heteropodinae). REV SUISSE ZOOL 2005. [DOI: 10.5962/bhl.part.80288] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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17
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Schultheiss U, Jäger P, Döhler H, Eurich-Menden B. Effects of water protection measures on the profitability of farms. Water Sci Technol 2005; 51:383-391. [PMID: 15850212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The effect of different management measures on the nutrient losses from crop and animal husbandry systems, in particular nitrogen, and on the total income of model farming enterprises was investigated. Such measures are considered as powerful options for meeting the requirements of "cross compliance" within the Agenda 2000 midterm review of the CAP. Optimisation of the storage and handling of animal manure was shown to be the most important and cost effective measure to reduce nutrient losses on farms. Other measures such as protein and phosphorus adapted feeding, maintaining a year-round cover crop on arable land and conservation tillage were also effective and it is recommended that these are adopted into farming practices. In general, measures that have both a high potential to reduce nutrient losses and are cheap to apply, and therefore have little effect on the overall profitability of farms, should be given priority in water protection policies.
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Affiliation(s)
- U Schultheiss
- Association for Technology and Structures in Agriculture (KTBL) Bartningstrasse 49, 64289 Darmstadt.
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18
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Nocito A, Bubendorf L, Tinner EM, Süess K, Wagner U, Forster T, Kononen J, Fijan A, Bruderer J, Schmid U, Ackermann D, Maurer R, Alund G, Knönagel H, Rist M, Anabitarte M, Hering F, Hardmeier T, Schoenenberger AJ, Flury R, Jäger P, Fehr JL, Schraml P, Moch H, Mihatsch MJ, Gasser T, Sauter G. Microarrays of bladder cancer tissue are highly representative of proliferation index and histological grade. J Pathol 2001. [PMID: 11439368 DOI: 10.1002/1096-9896(200107)194:3<349::aid-path887>3.0.co;2-d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The number of genes suggested to play a role in cancer biology is rapidly increasing. To be able to test a large number of molecular parameters in sufficiently large series of primary tumours, a tissue microarray (TMA) approach has been developed where samples from up to 1000 tumours can be simultaneously analysed on one glass slide. Because of the small size of the individual arrayed tissue samples (diameter 0.6 mm), the question arises of whether these specimens are representative of their donor tumours. To investigate how representative are the results obtained on TMAs, a set of 2317 bladder tumours that had been previously analysed for histological grade and Ki67 labelling index (LI) was used to construct four replica TMAs from different areas of each tumour. Clinical follow-up information was available from 1092 patients. The histological grade and the Ki67 LI were determined for every arrayed tumour sample (4x2317 analyses each). Despite discrepancies in individual cases, the grade and Ki67 information obtained on minute arrayed samples were highly similar to the data obtained on large sections (p<0.0001). Most importantly, every individual association between grade or Ki67 LI and tumour stage or prognosis (recurrence, progression, tumour-specific survival) that was observed in large section analysis could be fully reproduced on all four replica TMAs. These results show that intra-tumour heterogeneity does not significantly affect the ability to detect clinico-pathological correlations on TMAs, probably because of the large number of tumours that can be included in TMA studies. TMAs are a powerful tool for rapid identification of the biological or clinical significance of molecular alterations in bladder cancer and other tumour types.
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Affiliation(s)
- A Nocito
- Institute for Pathology, University of Basel, Schoenbeinstrasse 40, CH-4003 Basel, Switzerland
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19
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Nocito A, Bubendorf L, Tinner EM, Süess K, Wagner U, Forster T, Kononen J, Fijan A, Bruderer J, Schmid U, Ackermann D, Maurer R, Alund G, Knönagel H, Rist M, Anabitarte M, Hering F, Hardmeier T, Schoenenberger AJ, Flury R, Jäger P, Fehr JL, Schraml P, Moch H, Mihatsch MJ, Gasser T, Sauter G. Microarrays of bladder cancer tissue are highly representative of proliferation index and histological grade. J Pathol 2001; 194:349-57. [PMID: 11439368 DOI: 10.1002/1096-9896(200107)194:3<349::aid-path887>3.0.co;2-d] [Citation(s) in RCA: 223] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The number of genes suggested to play a role in cancer biology is rapidly increasing. To be able to test a large number of molecular parameters in sufficiently large series of primary tumours, a tissue microarray (TMA) approach has been developed where samples from up to 1000 tumours can be simultaneously analysed on one glass slide. Because of the small size of the individual arrayed tissue samples (diameter 0.6 mm), the question arises of whether these specimens are representative of their donor tumours. To investigate how representative are the results obtained on TMAs, a set of 2317 bladder tumours that had been previously analysed for histological grade and Ki67 labelling index (LI) was used to construct four replica TMAs from different areas of each tumour. Clinical follow-up information was available from 1092 patients. The histological grade and the Ki67 LI were determined for every arrayed tumour sample (4x2317 analyses each). Despite discrepancies in individual cases, the grade and Ki67 information obtained on minute arrayed samples were highly similar to the data obtained on large sections (p<0.0001). Most importantly, every individual association between grade or Ki67 LI and tumour stage or prognosis (recurrence, progression, tumour-specific survival) that was observed in large section analysis could be fully reproduced on all four replica TMAs. These results show that intra-tumour heterogeneity does not significantly affect the ability to detect clinico-pathological correlations on TMAs, probably because of the large number of tumours that can be included in TMA studies. TMAs are a powerful tool for rapid identification of the biological or clinical significance of molecular alterations in bladder cancer and other tumour types.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Adult
- Aged
- Carcinoma, Adenosquamous/genetics
- Carcinoma, Adenosquamous/mortality
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Small Cell/genetics
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/pathology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/mortality
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Transitional Cell/genetics
- Carcinoma, Transitional Cell/mortality
- Carcinoma, Transitional Cell/pathology
- Chi-Square Distribution
- Female
- Follow-Up Studies
- Humans
- Immunohistochemistry
- Ki-67 Antigen/analysis
- Male
- Middle Aged
- Oligonucleotide Array Sequence Analysis
- Prognosis
- Retrospective Studies
- Sarcoma/genetics
- Sarcoma/mortality
- Sarcoma/pathology
- Survival Analysis
- Urinary Bladder Neoplasms/genetics
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
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Affiliation(s)
- A Nocito
- Institute for Pathology, University of Basel, Schoenbeinstrasse 40, CH-4003 Basel, Switzerland
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20
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Simon R, Richter J, Wagner U, Fijan A, Bruderer J, Schmid U, Ackermann D, Maurer R, Alund G, Knönagel H, Rist M, Wilber K, Anabitarte M, Hering F, Hardmeier T, Schönenberger A, Flury R, Jäger P, Fehr JL, Schraml P, Moch H, Mihatsch MJ, Gasser T, Sauter G. High-throughput tissue microarray analysis of 3p25 (RAF1) and 8p12 (FGFR1) copy number alterations in urinary bladder cancer. Cancer Res 2001; 61:4514-9. [PMID: 11389083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Studies by comparative genomic hybridization revealed that the chromosomal regions 3p25 and 8p11-p12 are recurrently amplified in bladder cancer. To investigate the prevalence of DNA copy number alterations in these chromosomal regions and study their clinical significance, we used probes for the RAF1 (3p25) and FGFR1 (8p12) genes for fluorescence in situ hybridization. A tissue microarray containing 2317 tumors was analyzed. The analysis revealed RAF1 amplification in 4.0% and FGFR1 amplification in 3.4% of interpretable tumors. In addition, deletions were found at the 3p25 locus in 2.2% and at the 8p11-12 locus in 9.9% of interpretable tumors. Both amplifications and deletions of RAF1 and FGFR1 were significantly associated with high tumor grade (P < 0.0001), advanced stage (P < 0.0001), and poor survival (P < 0.05) if tumors of all of the stages where analyzed together. RAF1 amplifications were associated with subsequent tumor progression in pT1 carcinomas (P < 0.05). The marked differences in the frequency of all of the analyzed changes between pTa grade 1/grade 2 and pT1-4 carcinomas support the concept of these tumor groups representing different tumor entities.
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Affiliation(s)
- R Simon
- Institute for Pathology and Urologic Clinics, University of Basel, Schoenbeinstrasse 40, CH-4031 Basel, Switzerland
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21
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Jäger P, Zysset AC. [The information platform of the SSO (Société Suisse d'Odonto-Stomatologie]. Schweiz Monatsschr Zahnmed 2001; 110:1102-3, 1128-9. [PMID: 11203368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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22
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Jäger P. [Patients afraid of the office]. Schweiz Monatsschr Zahnmed 2000; 109:1091, 1117. [PMID: 10939925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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23
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Jäger P. [Yes to quality directives]. Schweiz Monatsschr Zahnmed 2000; 110:167-8, 197-8. [PMID: 10744515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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24
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Jäger P. [Swiss dental fees are doing harm]. Schweiz Monatsschr Zahnmed 2000; 110:989-90, 1021-2. [PMID: 11203116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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25
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Jäger P. [The image of the dentist and the dead season]. Schweiz Monatsschr Zahnmed 2000; 110:1041, 1043. [PMID: 11203365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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26
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Jäger P. [Compulsion versus freedom]. Schweiz Monatsschr Zahnmed 1999; 109:721, 723. [PMID: 10484716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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27
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Jäger P. [Tinguely's public health service]. Schweiz Monatsschr Zahnmed 1999; 109:225, 227. [PMID: 10223886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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28
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Jäger P. [Dental students sought]. Schweiz Monatsschr Zahnmed 1999; 109:58, 79-80. [PMID: 10049104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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29
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Jäger P. [The Frey law (Marc Frey)]. Schweiz Monatsschr Zahnmed 1999; 109:7. [PMID: 10049105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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30
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Jäger P. [The SSO on the Internet. Société Suisse d'Odonto-Stomatologie]. Schweiz Monatsschr Zahnmed 1999; 108:1117-8, 1153. [PMID: 9882240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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31
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Jäger P. [Dentistry--no theme?]. Schweiz Monatsschr Zahnmed 1999; 108:1067, 1069. [PMID: 9882239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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32
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Jäger P. [Oral surgeons found a society]. Schweiz Monatsschr Zahnmed 1999; 109:1225-6, 1247-8. [PMID: 10651581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
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33
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Jäger P. [Is the dentist working with one foot in the grave?]. Schweiz Monatsschr Zahnmed 1998; 108:1005-6, 1027-8. [PMID: 9867613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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34
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Jäger P. [The current situation in the offering of medico-dental care benefits in Switzerland]. Schweiz Monatsschr Zahnmed 1998; 108:145-6. [PMID: 9556444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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35
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Jäger P. [For a systematic follow-up in the EMS and institutions]. Schweiz Monatsschr Zahnmed 1998; 107:1097-8, 1100. [PMID: 9471714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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36
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Jäger P. [A greater risk for less dental care. What would be the consequences of a closure of the Basel Center for Dentistry?]. Schweiz Monatsschr Zahnmed 1998; 107:1117-9. [PMID: 9471715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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37
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Jäger P. [LAMal: medical-dental allowances are also of concern to physicians]. Rev Med Suisse Romande 1998; 118:77-9. [PMID: 9528327] [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] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- P Jäger
- Service de presse et d'information, Berne
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38
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Jäger P. [Homes: systematic care care desired]. Schweiz Monatsschr Zahnmed 1997; 107:923-4, 926. [PMID: 9411723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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39
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Schmoker E, Jäger P. [Dentists analyze themselves]. Schweiz Monatsschr Zahnmed 1996; 106:585-592. [PMID: 8767719] [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] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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40
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Jäger P. [A reduced life expectancy for dentists?]. Schweiz Monatsschr Zahnmed 1995; 105:1597-1624. [PMID: 8553045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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41
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Stüssi E, Bischof HJ, Lucchinetti E, Herzog R, Gerber H, Kramers I, Stalder H, Kriemler S, Casez JP, Jäger P. [Development and adaptation of tensile strength by bones in the extremities in response to physical training exemplified by the tibia]. Sportverletz Sportschaden 1994; 8:103-10. [PMID: 7974160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Results from an in vivo assessment of the bending stiffness of human tibiae with a new method demonstrate that bone mineral measurements are not a suitable predictor to evaluate changes of mechanical properties of long bones. In a study on 559 male military recruits, the bone mineral at tibial shaft resulted in a mean increase of +1.8% during 15 weeks of exercise. The bending stiffness however increased about 25%. An additional test 24 months later on a sample indicated that the increase of bone mineral content was only due to the natural maturation of bone. The bending stiffness however, decreased by about 6% demonstrating the earlier training effect. No correlation between bone mineral and bending stiffness could be found neither in absolute values nor in difference between the three measurements. At the same time first results of a normative study on children (9 to 18 years old, male and female) and on women (up to 80 years old) are presented.
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Affiliation(s)
- E Stüssi
- Laboratorium für Biomechanik, ETH Zürich, Schlieren
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42
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Herzog U, Jäger P. [Consistency between insurance systems and prophylaxis]. Schweiz Monatsschr Zahnmed 1993; 103:891-927. [PMID: 8102810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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43
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van Welie RT, van Duyn P, Lamme EK, Jäger P, van Baar BL, Vermeulen NP. Determination of tetrahydrophtalimide and 2-thiothiazolidine-4-carboxylic acid, urinary metabolites of the fungicide captan, in rats and humans. Int Arch Occup Environ Health 1991; 63:181-6. [PMID: 1917068 DOI: 10.1007/bf00381566] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Capillary gas chromatographic (GC) methods using sulphur and mass selective detection for the qualitative and quantitative determination of tetrahydrophtalimide (THPI) and 2-thiothiazolidine-4-carboxylic acid (TTCA), urinary metabolites of the fungicide captan in rat and humans, were developed. Urinary detection limits were 2.7 micrograms/l for THPI and 110 micrograms/l for TTCA. Intraperitoneal and oral administration of captan to rats resulted in a 48-h cumulative urinary excretion of THPI of 1%-2% and 3%-9% of the dose, respectively. Cumulative urinary excretion of TTCA over 48 h ranged from 2% to 5% of the captan dose for the respective routes of administration. In urine of non-exposed human subjects, neither THPI nor TTCA could be detected. In urine of fruit-growers who were occupationally exposed to captan, both THPI and TTCA could be detected. Based on these results, THPI and TTCA are proposed as promising parameters for the biological monitoring of occupational exposure to captan.
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Affiliation(s)
- R T van Welie
- Department of Pharmacochemistry, Free University, Amsterdam, The Netherlands
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44
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Arnold S, Jäger P, DiBartola SP, Lott-Stolz G, Hauser B, Hubler M, Casal M, Fairburn A, Rüsch P. Treatment of urinary incontinence in dogs by endoscopic injection of Teflon. J Am Vet Med Assoc 1989; 195:1369-74. [PMID: 2684938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Twenty-two dogs with urethral sphincter incompetence, nonresponsive to phenylpropanolamine administration, were treated by urethral submucosal injection of Teflon. Urinary continence was achieved in all dogs for at least 2 months. Urinary incontinence recurred in 14 dogs (64%) and was controlled by a second Teflon injection in 11 of 12 dogs (92%). Minor complications included transient stranguria, with or without hematuria, after 4 of 35 injection procedures. One dog had temporary partial urethral obstruction after treatment.
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Affiliation(s)
- S Arnold
- Department of Gynecology, Veterinary Medical Faculty of Zurich, Switzerland
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45
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Kikinis R, von Schulthess GK, Jäger P, Dürr R, Bino M, Kuoni W, Kübler O. Normal and hydronephrotic kidney: evaluation of renal function with contrast-enhanced MR imaging. Radiology 1987; 165:837-42. [PMID: 3685363 DOI: 10.1148/radiology.165.3.3685363] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.2] [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: 01/06/2023]
Abstract
Four healthy volunteers and six patients with hydronephrosis underwent magnetic resonance (MR) imaging after the injection of gadolinium-diethylenetriaminepenta-aceticacid for the assessment of renal function. Coronal angulated 10-second images were obtained during suspended respiration (inspiratory apnea) and showed excellent anatomic detail. In healthy volunteers, the renal cortex showed an increase in signal intensity after Gd-DTPA injection, and the renal medulla showed a precipitous decrease in intensity approximately 1 minute after injection, followed by a gradual increase in intensity. The renal pelvis showed a gradual decrease in intensity after several minutes, with occasional signal-void areas in adjacent structures. In patients with hydronephrosis, the decrease in intensity in the medulla and pelvis was not observed; instead, an increase in intensity occurred. The physiologic function of glomerular filtration and in vitro results of serial dilutions of Gd-DTPA suggest that the decrease in intensity is due to T2 and susceptibility effects occurring at high concentrations of Gd-DTPA.
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Affiliation(s)
- R Kikinis
- Department of Radiology, University Hospital, Zurich, Switzerland
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46
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Rüschoff J, Chudoba I, Köhler A, Jäger P. Pathologisch-anatomische Untersuchung von Chorionbiopsiegewebe. Arch Gynecol Obstet 1987. [DOI: 10.1007/bf01783360] [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: 11/29/2022]
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47
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Abstract
A simple technique which results in good quality early mitotic stages of amniotic fluid (AF) cells is presented. Two days after trypsinization AF cell cultures are incubated for 4 h in culture medium containing 20 U/ml liquemin. During the last hour 5 micrograms/ml ethidium bromide (EB) is added and 15 min before harvest 0.04 micrograms/ml colcemid is applied as usual. G-banded and Q-banded chromosomes corresponding to at least 550-850 bands per haploid genome can be obtained in sufficient numbers.
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Inhoffen HH, Jäger P, Mählhop R. [Chlorophyll and hemin. XXXII. Partial synthesis of rhodin-g 7 -trimethylester from chlorin-6e 6 -trimethylester, at the same time, termination of the Havard synthesis of chlorophyll a to chlorophyll b]. Justus Liebigs Ann Chem 1971; 749:109-16. [PMID: 5564787 DOI: 10.1002/jlac.19717490112] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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