{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:19:55Z","timestamp":1790266795477,"version":"4.1.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T00:00:00Z","timestamp":1542931200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2019,5]]},"DOI":"10.1007\/s00066-018-1401-4","type":"journal-article","created":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T05:25:36Z","timestamp":1542950736000},"page":"441-446","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A\u00a0fatal case of Fournier\u2019s gangrene during neoadjuvant radiotherapy for rectal cancer","Entwicklung eines t\u00f6dlichen Fournier-Gangr\u00e4ns w\u00e4hrend neoadjuvanter Bestrahlung eines Rektumkarzinoms"],"prefix":"10.1007","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-4270","authenticated-orcid":false,"given":"Rainer Johannes","family":"Klement","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhart A.","family":"Sweeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,11,23]]},"reference":[{"key":"1401_CR1","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1046\/j.1464-410x.1998.00532.x","volume":"81","author":"GL Smith","year":"1998","unstructured":"Smith GL, Bunker CB, Dinneen MD (1998) Fournier\u2019s gangrene. Br J Urol 81:347\u2013355","journal-title":"Br J Urol"},{"key":"1401_CR2","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1046\/j.1365-2168.2000.01497.x","volume":"87","author":"N Eke","year":"2000","unstructured":"Eke N (2000) Fournier\u2019s gangrene: a review of 1726 cases. Br J Surg 87:718\u2013728. \n                    https:\/\/doi.org\/10.1046\/j.1365-2168.2000.01497.x","journal-title":"Br J Surg"},{"key":"1401_CR3","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.urology.2004.05.034","volume":"64","author":"KS Nabha","year":"2004","unstructured":"Nabha KS, Badwan K, Kerfoot BP (2004) Fournier\u2019s gangrene as a\u00a0complication of steroid enema use for treatment of radiation proctitis. Urology 64:587\u2013588. \n                    https:\/\/doi.org\/10.1016\/j.urology.2004.05.034","journal-title":"Urology"},{"key":"1401_CR4","doi-asserted-by":"publisher","first-page":"9002","DOI":"10.3748\/wjg.v21.i30.9002","volume":"21","author":"T Bruketa","year":"2015","unstructured":"Bruketa T, Majerovic M, Augustin G (2015) Rectal cancer and Fournier\u2019s gangrene\u2014current knowledge and therapeutic options. World J Gastroenterol 21:9002\u20139020. \n                    https:\/\/doi.org\/10.3748\/wjg.v21.i30.9002","journal-title":"World J Gastroenterol"},{"key":"1401_CR5","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1093\/omcr\/omx101","volume":"2018","author":"M Pittaka","year":"2018","unstructured":"Pittaka M, Georgiou C, Polyviou P et\u00a0al (2018) Fournier Gangrene in a\u00a0patient receiving chemo\u2013radiation for rectal cancer. Oxf Med Case Reports 2018:68\u201369. \n                    https:\/\/doi.org\/10.1093\/omcr\/omx101","journal-title":"Oxf Med Case Reports"},{"key":"1401_CR6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1007\/s15010-008-8169-x","volume":"37","author":"R Czymek","year":"2009","unstructured":"Czymek R, Hildebrand P, Kleemann M et\u00a0al (2009) New insights into the epidemiology and etiology of Fournier\u2019s gangrene: a review of 33 patients. Infection 37:306\u2013312. \n                    https:\/\/doi.org\/10.1007\/s15010-008-8169-x","journal-title":"Infection"},{"key":"1401_CR7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.clnesp.2015.11.001","volume":"12","author":"RJ Klement","year":"2016","unstructured":"Klement RJ, Sweeney RA (2016) Impact of a ketogenic diet intervention during radiotherapy on body composition: II. Protocol of a randomised phase I study (KETOCOMP). Clin Nutr ESPEN 12:e1\u2013e6. \n                    https:\/\/doi.org\/10.1016\/j.clnesp.2015.11.001","journal-title":"Clin Nutr ESPEN"},{"key":"1401_CR8","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.clnu.2016.07.015","volume":"36","author":"J Arends","year":"2017","unstructured":"Arends J, Bachmann P, Baracos V et\u00a0al (2017) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36:11\u201348. \n                    https:\/\/doi.org\/10.1016\/j.clnu.2016.07.015","journal-title":"Clin Nutr"},{"key":"1401_CR9","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1093\/ajcn\/80.6.1634","volume":"80","author":"D Gupta","year":"2004","unstructured":"Gupta D, Lammersfeld CA, Burrows JL et\u00a0al (2004) Bioelectrical impedance phase angle in clinical practice: implications for prognosis in advanced colorectal cancer. Am J Clin Nutr 80:1634\u20131638","journal-title":"Am J Clin Nutr"},{"key":"1401_CR10","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1007\/s00134-016-4468-3","volume":"42","author":"R Thibault","year":"2016","unstructured":"Thibault R, Makhlouf A\u2011M, Mulliez A et al (2016) Fat-free mass at admission predicts 28-day mortality in intensive care unit patients: the international prospective observational study Phase Angle Project. Intensive Care Med 42:1445\u20131453. \n                    https:\/\/doi.org\/10.1007\/s00134-016-4468-3","journal-title":"Intensive Care Med"},{"key":"1401_CR11","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13613-017-0284-3","volume":"7","author":"S Tanaka","year":"2017","unstructured":"Tanaka S, Labreuche J, Drumez E et\u00a0al (2017) Low HDL levels in sepsis versus trauma patients in intensive care unit. Ann Intensive Care 7:4\u201311. \n                    https:\/\/doi.org\/10.1186\/s13613-017-0284-3","journal-title":"Ann Intensive Care"},{"key":"1401_CR12","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.nut.2017.09.015","volume":"47","author":"ACG Bermudes","year":"2018","unstructured":"Bermudes ACG, de Carvalho WB, Zamberlan P et\u00a0al (2018) Changes in lipid metabolism in pediatric patients with severe sepsis and septic shock. Nutrition 47:104\u2013109. \n                    https:\/\/doi.org\/10.1016\/j.nut.2017.09.015","journal-title":"Nutrition"},{"key":"1401_CR13","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/01.shk.0000111661.09279.82","volume":"21","author":"A Wu","year":"2004","unstructured":"Wu A, Hinds CJ, Thiemermann C (2004) High-density lipoproteins in sepsis and septic shock: metabolism, actions, and therapeutic applications. Shock 21:210\u2013221. \n                    https:\/\/doi.org\/10.1097\/01.shk.0000111661.09279.82","journal-title":"Shock"},{"key":"1401_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3389\/fphar.2015.00244","volume":"6","author":"EE Morin","year":"2015","unstructured":"Morin EE, Guo L, Schwendeman A, Li XA (2015) HDL in sepsis - risk factor and therapeutic approach. Front Pharmacol 6:1\u20139. \n                    https:\/\/doi.org\/10.3389\/fphar.2015.00244","journal-title":"Front Pharmacol"},{"key":"1401_CR15","doi-asserted-by":"publisher","first-page":"e193","DOI":"10.1038\/oncsis.2016.2","volume":"5","author":"RJ Klement","year":"2016","unstructured":"Klement RJ, Fink MK (2016) Dietary and pharmacological modification of the insulin\/IGF-1 system: exploiting the full repertoire against cancer. Oncogenesis 5:e193. \n                    https:\/\/doi.org\/10.1038\/oncsis.2016.2","journal-title":"Oncogenesis"},{"key":"1401_CR16","doi-asserted-by":"publisher","first-page":"797","DOI":"10.3892\/etm.2017.4553","volume":"14","author":"L Xu","year":"2017","unstructured":"Xu L, Zhang W, Sun R et al (2017) IGF-1 may predict the severity and outcome of patients with sepsis and be associated with microRNA-1 level changes. Exp Ther Med 14:797\u2013804. \n                    https:\/\/doi.org\/10.3892\/etm.2017.4553","journal-title":"Exp Ther Med"},{"key":"1401_CR17","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1177\/0883073813487595","volume":"28","author":"SA Masino","year":"2013","unstructured":"Masino SA, Ruskin DN (2013) Ketogenic diets and pain. J\u00a0Child Neurol 28:993\u20131001. \n                    https:\/\/doi.org\/10.1177\/0883073813487595","journal-title":"J Child Neurol"},{"key":"1401_CR18","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1038\/nm.3804","volume":"21","author":"YH Youm","year":"2015","unstructured":"Youm YH, Nguyen KY, Grant RW et al (2015) The ketone metabolite \u03b2\u2011hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nat Med 21:263\u2013269. \n                    https:\/\/doi.org\/10.1038\/nm.3804","journal-title":"Nat Med"},{"key":"1401_CR19","doi-asserted-by":"publisher","first-page":"66444","DOI":"10.18632\/oncotarget.12119","volume":"7","author":"HR Bae","year":"2016","unstructured":"Bae HR, Kim DH, Park MH et al (2016) \u03b2\u2011Hydroxybutyrate suppresses inflammasome formation by ameliorating endoplasmic reticulum stress via AMPK activation. Oncotarget 7:66444\u201366454. \n                    https:\/\/doi.org\/10.18632\/oncotarget.12119","journal-title":"Oncotarget"},{"key":"1401_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2249.2011.04440.x","volume":"166","author":"P Menu","year":"2011","unstructured":"Menu P, Vince JE (2011) The NLRP3 inflammasome in health and disease: the good, the bad and the ugly. Clin Exp Immunol 166:1\u201315. \n                    https:\/\/doi.org\/10.1111\/j.1365-2249.2011.04440.x","journal-title":"Clin Exp Immunol"},{"key":"1401_CR21","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1016\/j.cell.2016.07.026","volume":"166","author":"A Wang","year":"2016","unstructured":"Wang A, Huen SC, Luan HH et\u00a0al (2016) Opposing effects of fasting metabolism on tissue tolerance in bacterial and viral inflammation. Cell 166:1512\u20131518. \n                    https:\/\/doi.org\/10.1016\/j.cell.2016.07.026","journal-title":"Cell"}],"container-title":["Strahlentherapie und Onkologie"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-018-1401-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00066-018-1401-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-018-1401-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,22]],"date-time":"2019-11-22T19:06:19Z","timestamp":1574449579000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00066-018-1401-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,23]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["1401"],"URL":"https:\/\/doi.org\/10.1007\/s00066-018-1401-4","relation":{},"ISSN":["0179-7158","1439-099X"],"issn-type":[{"value":"0179-7158","type":"print"},{"value":"1439-099X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,23]]},"assertion":[{"value":"18 August 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 November 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"R.J.\u00a0Klement, G.\u00a0Sch\u00e4fer, and R.A.\u00a0Sweeney declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}