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Intrahepatic cholestasis without jaundice

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Hepatobiliary & Pancreatic Diseases International 2009年第1期8卷 103-105页

作者： Thomas Namdar andreas Raffel Stefan andreas Topp Jan Schulte am Esch Günther Fürst Wolfram Trudo Knoefel Claus Ferdinand Eisenberger Department of General Visceral and Pediatric Surgery Heinrich-Heine University Institute of Diagnostic Radiology Heinrich-Heine University

BACKGROUND:Cholangiocarcinoma(CC),the most common biliary tract malignancy,is frequently seen in advanced unresectable stages and is typically localized *** diagnosis is unusual because of nonspecific *** jaundice is usually the first sign of tumor. METHOD:We present a patient with a CC(Klatskin tumor) with a complete biliary drainage by an aberrant bile duct without jaundice. RESULTS:A 67-year-old woman presented with persisting elevation of liver *** tests showed a Klatskin tumor typeⅡ.A curative right hepatic trisegmentectomy was performed after liver volume augmentation by preoperative vein embolization. CONCLUSIONS:A direct drainage of the right posterior bile duct into the common bile duct as an aberrant hepatic duct is a rare variation and is present in less than 5%of the *** case of persistently perturbed liver function tests,an aberrant bile duct can cover up severe intrahepatic cholestasis and even obscure the diagnosis of a Klatskin *** to now it has not been described in the literature.

关键词： Klatskin tumor hyperbilirubinemia cholangiocarcinoma

Small intestine bleeding due to multifocal angiosarcoma

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World Journal of Gastroenterology 2012年第44期18卷 6494-6500页

作者： Luisa Zacarias Fhrding Arne Macher Stefan Braunstein Wolfram Trudo Knoefel Stefan andreas Topp Department of General Visceral and Pediatric SurgeryHeinrich-Heine-UniversityDüsseldorfMoorenstrasse 540225 DüsseldorfGermany Institute of Pathology Heinrich-Heine-UniversityDüsseldorfMoorenstrasse 540225 DüsseldorfGermany

We report a case of an 84-year-old male patient with primary small intestinal *** patient initially presented with anemia and *** endoscopy revealed no signs of upper or lower active gastrointestinal *** patient had been diagnosed 3 years previously with an aortic dilation,which was treated with a *** tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding,leading to operative stent explantation and aortic ***,an aorto-intestinal fistula was not found,and the intestinal bleeding did not arrest *** constant need for blood transfusions made an exploratory laparotomy imperative,which showed multiple bleeding sites,predominately in the jejunal wall.A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was *** histological analysis revealed a lessdifferentiated tumor with characteristic CD31,cytokeratin,and vimentin expression,which led to the diagnosis of small intestinal ***,the infiltrated part of the jejunum was successfully resected in a subsequent operation,and adjuvant chemotherapy with paclitaxel was *** of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high *** diagnosis and treatment are essential to improve outcome.A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity,nonspecific symptoms of altered intestinal function,nonspecific abdominal pain,severe melena,and acute abdominal ***,a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim.

关键词： Gastrointestinal bleeding Small intestine Angiosarcoma Small intestinal neoplasm

Surveying the Oligomeric State of Arabidopsis thaliana Chloroplasts

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Molecular Plant 2017年第1期10卷 197-211页

作者： Peter K. Lundquist Otho Mantegazza Anja Stefanski Kai Stuhler andreas P.M. Weber institute for Plant Biochemistry Molecular Proteomics La_boratory BMFZ Cluster of Excellence on Plant Sciences (CEPLAS) Heinrich-Heine-University UniversitatsstraBe 1 40225 Duseldorf Germany present address: Plant Biology Division The Samuel Roberts Noble Foundation Ardmore OK 73401 USA

Blue native-PAGE （BN-PAGE） resolves protein complexes in their native state. When combined with immu- noblotting, it can be used to identify the presence of high molecular weight complexes at high resolution for any protein, given a suitable antibody. To identify proteins in high molecular weight complexes on a large scale and to bypass the requirement for specific antibodies, we applied a tandem mass spectrometry （MS/MS） approach to BN-PAGE-resolved chloroplasts. Fractionation of the gel into six bands allowed iden- tification and label-free quantification of 1000 chloroplast proteins with native molecular weight separation. Significantly, this approach achieves a depth of identification comparable with traditional shotgun proteo- mic analyses of chloroplasts, indicating much of the known chloroplast proteome is amenable to MS/MS identification under our fractionation scheme. By limiting the number of fractionation bands to six, we facil- itate scaled-up comparative analyses, as we demonstrate with the reticulata chloroplast mutant displaying a reticulated leaf phenotype. Our comparative proteomics approach identified a candidate interacting protein of RETICULATA as well as effects on lipid remodeling proteins, amino acid metabolic enzymes, and plastid division machinery. We additionally highlight selected proteins from each sub-compartment of the chloroplast that provide novel insight on known or hypothesized protein complexes to further illus- trate the utility of this approach. Our results demonstrate the high sensitivity and reproducibility of this technique, which is anticipated to be widely adaptable to other sub-cellular compartments.

关键词： chloroplast blue native-PAGE comparative proteomics protein complex oligomeric state,RETICULATA

New multi protein patterns differentiate liver fibrosis stages and hepatocellular carcinoma in chronic hepatitis C serum samples

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World Journal of Gastroenterology 2006年第47期12卷 7604-7612页

作者： Thomas Gbel Sonja Vorderwülbecke Katarzyna Hauck Holger Fey Dieter Hussinger andreas Erhardt Klinik für Gastroenterologie Hepatologie und InfektiologieHeinrich-Heine-UniversitatDusseldorfMoorenstr.eD-40225 DusseldorfGermany Ciphergen Biosystems Neuendorfstr.24aD-16761 Hennigsdorf bei berlinGermany

AIM： To identify a multi serum protein pattern as well as single protein markers using surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry （SELDI-TOF-MS） for detection and differentiation of liver fibrosis （F1-F2）, liver cirrhosis （F4） and hepatocellular carcinoma （HCC） in patients with chronic hepatitis C virus （HCV）. METHODS： Serum samples of 39 patients with F1/F2 fibrosis, 44 patients with F4 fibrosis, 34 patients with HCC were applied to CM10 arrays and analyzed using the SELDI-TOF ProteinChip System （PBS-Ⅱc; Ciphergen Biosystems） after anion-exchange fractionation. All patients had chronic hepatitis C and histologically confirmed fibrosis stage/HCC. Data were analyzed for protein patterns by multivariate statistical techniques and artificial neural networks. RESULTS： A 4 peptide/protein multimarker panel （7486, 12843, 44293 and 53598 Da） correctly identified HCCs with a sensitivity of 100% and specificity of 85% in a two way-comparison of HCV-cirrhosis versus HCV-HCC training samples （AUROC 0.943）. Sensitivity and specificity for identification of HCC were 68% and 80% for random test samples. Cirrhotic patients could be discriminated against patients with F1 or F2 fibrosis using a 5 peptide/protein multimarker pattern （2873, 6646, 7775, 10525 and 67867 Da） with a specificity of 100% and a sensitivity of 85% in training samples （AUROC 0.976） and a sensitivity and specificity of 80% and 67% for random test samples. Combination of the biomarker classifiers with APR/score and alfa-fetopotein （AFP） improved the diagnostic performance. The 6646 Da marker protein for liver fibrosis was identified as apolipoprotein C-I. CONCLUSION： SELDI-TOF-MS technology combined with protein pattern analysis seems a valuable approach for the identification of liver cirrhosis and hepatocellular carcinoma in patients with chronic hepatitis C. Host probably a combination of different serum markers will help to identify liver cirrhosis and early-stage hep

关键词： Hepatocellular carcinoma Hepatitis C virus Apolipoprotein C- I Proteomics Surface-enhanced laser desorption/ionisation

Rapid generation of recombinant Pseudomonas putida secondary metabolite producers using yTREX

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Synthetic and Systems Biotechnology 2017年第4期2卷 310-319页

作者： andreas Domrose Robin Weihmann Stephan Thies Karl-Erich Jaeger Thomas Drepper Anita Loeschcke Institute of Molecular Enzyme Technology Heinrich Heine University DüsseldorfForschungszentrum JülichJülichGermany Bioeconomy Science Center(BioSC) Forschungszentrum JülichJülichGermany Institute of Bio-and Geosciences(IBG-1) Forschungszentrum JülichJülichGermany

Microbial secondary metabolites represent a rich source of valuable compounds with a variety of applications in medicine or *** exploitation of this wealth of chemicals requires the functional expression of the respective biosynthetic genes in amenable heterologous *** have previously established the TREX system which facilitates the transfer,integration and expression of biosynthetic gene clusters in various bacterial ***,we describe the yTREX system,a new tool adapted for one-step yeast recombinational cloning of gene *** show that with yTREX,Pseudomonas putida secondary metabolite production strains can rapidly be constructed by random targeting of chromosomal promoters by Tn5 *** of this approach was corroborated by prodigiosin production after yTREX cloning,transfer and expression of the respective biosynthesis genes from Serratia ***,the applicability of the system for effective pathway rerouting by gene cluster adaptation was demonstrated using the violacein biosynthesis gene cluster from Chromobacterium violaceum,producing pathway metabolites violacein,deoxyviolacein,prodeoxyviolacein,and *** producing both prodigiosin and violaceins could be readily identified among clones obtained after random chromosomal integration by their strong ***,the addition of a promoter-less reporter gene enabled facile detection also of phenazine-producing clones after transfer of the respective phenazine-1-carboxylic acid biosynthesis genes from Pseudomonas *** compounds accumulated to substantial titers in the mg *** thus corroborate here the suitability of *** for the biosynthesis of diverse natural products,and demonstrate that the yTREX system effectively enables the rapid generation of secondary metabolite producing bacteria by activation of heterologous gene clusters,applicable for natural compound discovery and combinatorial biosy

关键词： Synthetic biology Yeast recombinational cloning Tn5 transposition Heterologous gene cluster expression Secondary metabolite production Pseudomonas putida

Generation of polarized particle beams at relativistic laser intensities

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High Power Laser Science and Engineering 2020年第4期8卷 44-58页

作者： Markus Büscher Anna Hiitzen Liangliang Ji andreas Lehrach Peter Griinberg Institut(PGI-6) Forschungszentrum JiilichJiilichGermany Institut fur Laser-und Plasmaphysik Heinrich-Heine-Universitat DiisseldorfDUsseldorfGermany State Key Laboratory of High Field Laser Physics Shanghai Institute of Optics and Fine MechanicsChinese Academy of SciencesShanghai 201800China CAS Center for Excellence in Ultra-intense Laser Science Shanghai 201800China JARA-FAME(Forces and Matter Experiments) Forschungszentrum Jiilich and RWTH Aachen UniversityAachenGermany Institut fur Kemphysik(IKP-4) Forschungszentrum JiilichJiilichGermany

The acceleration of polarized electrons,positrons,protons and ions in strong laser and plasma fields is a very attractive option for obtaining polarized beams in the multi-mega-electron volt ***,there has been substantial progress in the understanding of the dominant mechanisms leading to high degrees of polarization,in the numerical modeling of these processes and in their experimental *** review paper presents an overview on the current state of the field,and on the concepts of polarized laser–plasma accelerators and of beam polarimetry.

关键词： high power laser laser-driven plasma accelerator laser-plasma interactions PIC simulations polarized particle beams

Photorespiration Is Crucial for Dynamic Response of Photosynthetic Metabolism and Stomatal Movement to Altered C02 Availability

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Molecular Plant 2017年第1期10卷 47-61页

作者： Marion Eisenhut Andrea Brautigam Stefan Timm Alexandra Florian Takayuki Tohge Alisdair R. Fernie Hermann Bauwe andreas P.M. Weber Institute of Plant Biochemistry Cluster of Excellence on Plant Sciences Heinrich Heine University 40225 Dusseldorf Germany Department of Plant Physiology University of Rostock Albert-Einstein-StraBe 3 18051 Rostock Germany Department of Molecular Physiology Max-Planck Institute for Molecular Plant Physiology 14476 Potsdam-Golm Germany Present address: IPK Gatersleben Network Analysis and Modeling Corrensstrasse 3 06466 Seeland Germany

The photorespiratory pathway or photorespiration is an essential process in oxygenic photosynthetic or- ganisms, which can reduce the efficiency of photosynthetic carbon assimilation and is hence frequently considered as a wasteful process. By comparing the response of the wild-type plants and mutants impaired in photorespiration to a shift in ambient C02 concentrations, we demonstrate that photorespiration also plays a beneficial role during short-term acclimation to reduced C02 availability. The wild-type plants re- sponded with few differentially expressed genes, mostly involved in drought stress, which is likely a conse- quence of enhanced opening of stomata and concomitant water loss upon a shift toward low C02. In contrast, mutants with impaired activity of photorespiratory enzymes were highly stressed and not able to adjust stomatal conductance to reduced external C02 availability. The transcriptional response of mutant plants was congruent, indicating a general reprogramming to deal with the consequences of reduced C02 availability, signaled by enhanced oxygenation of ribulose-l,5-bisphosphate and amplified by the artificially impaired photorespiratory metabolism. Central in this reprogramming was the pro- nounced reallocation of resources from growth processes to stress responses. Taken together, our results indicate that unrestricted photorespiratory metabolism is a prerequisite for rapid physiological acclimation to a reduction in C02 availability.

关键词： photorespiration starvation stress stomata transcription Arabidopsis thaliana

Small bowel volvulus as a complication of von Recklinghausen's disease:A case report

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World Journal of Gastroenterology 2014年第24期20卷 7979-7983页

作者： Thomas Artur Werner Feride Krpil Martin Olaf Schoppe Patric Krpil Wolfram Trudo Knoefel andreas Krieg Department of Surgery (A) HeinrichHeine-University and University Hospital Duesseldorf40225 DuesseldorfGermany Institute of Pathology Heinrich-Heine-University and University Hospital Duesseldorf40225 DuesseldorfGermany Institute of Diagnostic and Interventional Radiology Heinrich-Heine-University and University Hospital Duesseldorf40225 DuesseldorfGermany

We report the case of a 25-year-old male with Neurofibromatosis type I (NF-1), who presented at the time of admission with clinical findings of an acute abdomen caused by a mechanical obstruction. Computerized tomography showed a volvulus of the terminal ileum with mesenteric swirling as the cause of the patient’s symptoms. Consecutive exploratory laparotomy confirmed the diagnosis and 70 cm of the small intestine was resected due to an affection of the mesentery by multiple neurofibromas. The gastrointestinal tract is affected in approximately 10% of patients with NF-1, however the mesentery is almost always spared. Here we describe the unique case of a patient with a volvulus caused by mesenteric manifestation of von Recklinghausen’s disease, emphasizing the role of surgery in a team of multidisciplinary specialists to treat this multiorganic disease.

关键词： Volvulus Obstruction Von Recklinghausen´ s disease Neurofibromatosis type I Mesenteric neurofibromas

Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

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World Journal of Orthopedics 2017年第10期8卷 790-797页

作者： Lars V von Engelhardt Michael Manzke andreas Breil-Wirth Timm J Filler Joerg Jerosch Faculty of Health University of Witten/Herdecke Department of Orthopedics Trauma Surgery and Sports MedicineJohanna Etienne Hospital Department of Anatomy Heinrich-Heine University of Duesseldorf

AIM To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS *** Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation(CoR) was assessed and compared to the CoR of the prosthesis by using the MediC AD~? software. Additionally, the pre-and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS Both, the Constant and DASH scores improved signifi-cantly from 11% to 75% and from 70 to 30 points, P 0.05). The pre-and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neckshaft angle showed no significant changes(P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome *** TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.

关键词： Anatomical shoulder arthroplasty Stemless Omarthrosis Total shoulder replacement Joint geometry