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World Journal of Gastroenterology 2006年第26期12卷 4250-4252页

作者： Stefan Fritz Thilo hackert hendrik Blaker werner hartwig Lutz Schneider Markus W Buchler jens werner Departments of General and Visceral Surgery University of heidelberg Germany Departments of Pathology University of heidelberg Germany

Von Meyenburg complexes are benign liver lesions consisting of adenomatous bile duct proliferates. We present two patients suffering from esophageal cancer accompanied by the occurrence of yon Meyenburg complexes. Preoperative computerized tomography （CT） of the liver had not shown these lesions. In one of the patients, diffuse nodular manifestation was found in both liver lobes, mimicking diffuse hepatic metastases. Intraoperative frozen section revealed the benign nature of the lesions in both cases. The patients underwent esophageal resection without complications. To the best of our knowledge, the coincidence of von Meyenburg complexes and esophageal cancer has never been reported before. This uncommon entity should be taken into consideration as a differential diagnosis of liver lesions in malignancies. It underlines the importance of intraoperative frozen section for liver lesions of unknown origin.

关键词： Von Meyenburg complexes Bile duct hamartomas Esophageal carcinoma Liver metastasis

Value of three-dimensional reconstructions in pancreatic carcinoma using multidetector CT:Initial results

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World Journal of Gastroenterology 2009年第46期15卷 5827-5832页

作者： Miriam Klauβ Max Schbinger Ivo Wolf jens werner hans-Peter Meinzer hans-Ulrich Kauczor Lars Grenacher Department of Diagnostic and Interventional Radiology University of Heidelberg Department of Medical and Biological Informatics German Cancer Research Center(DKFZ) Surgical Clinic University of Heidelberg

AIM:To evaluate the use of three-dimensional imaging of pancreatic carcinoma using multidetector computed tomography(CT)in a prospective ***:Ten patients with suspected pancreatic tumors were examined prospectively using multidetec-tor CT(Somatom Sensation 16,Siemens,Erlangen,Germany).The images were evaluated for the pres-ence of a pancreatic carcinoma and invasion of the peripancreatic vessels and surrounding *** the isotropic CT data sets,a three-dimensional image was created with automatic vascular analysis and semi-automatic segmentation of the organs and pancreatic tumor by a *** CT examinations and the three-dimensional images were presented to the sur-geon directly before and during the patient's operation using the Medical Imaging Interaction Toolkit-based software "ReLiver".Immediately after surgery,the value of the two images was judged by the *** operation and the histological results served as the gold ***:Nine patients had a pancreatic carcinoma(all pT3),and one patient had a serous *** tumor inf iltrated the superior mesenteric *** inf iltration was correctly *** carcinomas were *** comparison to the CT image with axial and coronal reconstructions,the three-dimensional image was judged by the surgeons as better for operation planning and consistently described as ***:A 3D-image of the pancreas repre-sents an invaluable aid to the ***,the 3D-software must be further developed in order to be integrated into daily clinical routine.

关键词： Pancreatic carcinoma 3D-reconstruction Multidetector computed tomography Pancreatic carcinomainvasion Segmentation

The Sandfish's Skin:Morphology,Chemistry and Reconstruction

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Journal of Bionic Engineering 2007年第1期4卷 1-9页

作者： werner Baumgartner Friederike Saxe Agnes Weth David hajas Darwin Sigumonrong jens Emmerlich Martin Singheiser Wolfgang Bhme Jochen M. Schneider Department of Cellular Neurobionics RWTH-Aachen Kopernikusstr. 16 52056 Aachen Germany Material Chemistry RWTH-Aachen Kopernikusstr. 16 52056 Aachen Germany Institute of Zoology RWTH-Aachen Kopernikusstr. 16 52056 Aachen Germany Zoologisches Forschungsmuseum Alexander Koenig (ZFMK) Adenauerallee 160 53113 Bonn Germany

The sandfish is a lizard having the remarkable ability to move in desert sand in a swimming-like fashion. The most outstanding adaptations to this mode of life are the low friction behaviour and the extensive abrasion resistance of the sandfish skin against sand, outperforming even steel. We investigated the topography, the composition and the mechanical properties of sandfish scales. These consist of glycosylated keratins with high amount of sulphur but no hard inorganic material, such as silicates or lime. Remarkably, atomic force microscopy shows an almost complete absence of attractive forces between the scale surface and a silicon tip, suggesting that this is responsible for the unusual tribological properties. The unusual glycosylation of the keratins was found to be absolutely necessary for the described phenomenon. The scales were dissolved and reconstituted on a polymer surface resulting in properties similar to the original scale. Thus, we provide a pathway towards exploitation of the reconstituted scale material for future engineering applications.

关键词： Sandfish Skink Scincus scincus tribology nanoindentation keratin abrasion

Noninvasive indocyanine green plasma disappearance rate predicts early complications,graft failure or death after liver transplantation

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hepatobiliary & Pancreatic Diseases International 2011年第4期10卷 362-368页

作者： Lutz Schneider Martin Spiegel Sebastian Latanowicz Markus A Weigand Jan Schmidt jens werner Wolfgang Stremmel Christoph Eisenbach Department of General Surgery University of HeidelbergIm Neuenheimer Feld 110Heidelberg 69110Germany Department of Gastroenterology University of HeidelbergIm Neuenheimer Feld 410Heidelberg 69120Germany Department of Anaesthesiology University of HeidelbergIm Neuenheimer Feld 110Heidelberg 69110Germany

BACKGROUND:Early detection of graft malfunction or postoperative complications is essential to save patients and organs after orthotopic liver transplantation (OLT).Predictive tests for graft dysfunction are needed to enable earlier implementation of organ-saving interventions following *** study was undertaken to assess the value of indocyanine green plasma disappearance rates (ICG-PDRs) for predicting postoperative complications,graft dysfunction and patient survival following ***:Eighty-six patients undergoing OLT were included in this single-centre ***-PDR was assessed daily for the first 7 days following *** were graft loss or death within 30 days and postoperative complications,graft loss,or death within 30 ***:Postoperative complications of 31 patients included deaths (12 patients) or graft ***-PDR was significantly different in patients whose endpoints were graft loss or death beginning from day 3 and in those whose endpoints were graft loss,death,or postoperative complications beginning from day 4 after *** day 7 measurements,receiver operating characteristic curve analysis revealed an ICG-PDR cut-off for predicting death or graft loss of 9.6% per min (a sensitivity of 75.0%,a specificity of 72.6%,positive predictive value 0.35 negative predictive value 0.94).For prediction of graft loss,death or postoperative complications,the ICG-PDR cut-off was 12.3%per min (a sensitivity of 68.9%,a specificity of 66.7%,positive predictive value 0.57,negative predictive value 0.77).CONCLUSIONS:ICG-PDR measurements on postoperative day 7 are predictive of early patient outcomes following *** added value over that of routinely determined laboratory parameters is low.

关键词： indocyanine green liver function liver transplantation

CT diagnosis of recurrence after pancreatic cancer:Is there a pattern?

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World Journal of Gastroenterology 2011年第9期17卷 1126-1134页

作者： Tobias heye Nicola Zausig Miriam Klauss Reinhard Singer jens werner Gtz Martin Richter hans-Ulrich Kauczor Lars Grenacher Department of Diagnostic and Interventional Radiology University Hospital Department of Surgery University Hospital Department of Diagnostic and Interventional Radiology Katharinen Hospital

AIM:To investigate predilection sites of recurrence of pancreatic cancer by computed tomography(CT)in follow-up after surgery. METhODS:Seventy seven patients with recurrence after pancreatic cancer surgery were retrospectively *** operative technique,R-status,T-stage and development of tumor markers were evaluated. Two radiologists analyzed CT scans with consensus *** of local recurrence,lymph node recurrence and organ metastases were *** and progression of findings on follow-up CT were con-sidered as reference standard. RESULTS:The mean follow-up interval was 3.9± 1.8 mo,with a mean relapse-free interval of 12.9± 10.4 *** predominant site of recurrence was local (65%),followed by lymph node(17%),liver metastasis (11%)and peritoneal carcinosis(7%).Local recurrence emerged at the superior mesenteric artery(n=28),the hepatic artery(n=8),in an area defined by the surrounding vessels:celiac trunk,portal vein,inferior vena cava(n=22),and in a space limited by the mesenteric artery,portal vein and inferior vena cava(n=17). Lymph node recurrence occurred in the mesenteric root and left lateral to the *** was confirmed by surgery(n=22)and follow-up CT(n=55).Tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)]increased in accordance with signs of recurrence in most cases(86%CA19-9;79.2% CEA). CONCLUSION:Specific changes of local and lymph node recurrence can be found in the course of the cardinal peripancreatic *** superior mesenteric artery is the leading structure for recurrence.

关键词： Pancreatic cancer Recurrence Computed tomography Follow-up Tumor marker

Eckfeld Maar:Window into an Eocene Terrestrial habitat in Central Europe

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Acta Geologica Sinica(English Edition) 2010年第4期84卷 984-1009页

作者： herbert LUTZ Uwe KAULFUSS Torsten WAPPLER werner LhNERTZ Volker WILDE Dieter F.MERTZ jens MINGRAM jens L.FRANZEN herbert FRANKENhUSER Martin KOZIOL Mainz Natural history Museum/State Collection for Natural history of Rhineland-Palatinate MainzGermany Department of Geology University of OtagoDunedinNew Zealand Section Palaeontology Steinmann InstituteUniversity of BonnBonnGermany hermann-Josef-Kolleg Steinfeld Kall-SteinfeldGermany Section Palaeobotanik Senckenberg Research Institute and Natural History MuseumFrankfurt am MainGermany Institute for Geosciences Johannes Gutenberg University MainzMainzGermany Section Climate Dynamics and Landscape Evolution Helmholtz Centre Potsdam GFZ German Research Centre for GeosciencesPotsdamGermany Jakobistr. Titisee-NeustadtGermany Maarmuseum Manderscheid/State Collection for Natural history of Rhineland-Palatinate ManderscheidGermany

To mark the occasion of the 175th anniversary of the Rheinische Naturforschende Gesellschaft in 2009 and of the centennial of the Mainz Natural history Museum in 2010, we present a short account of our present knowledge of the Eckfeld Maar after 20 years of continuous research. This paper does not attempt to include all of the detailed results on the geology of the Eckfeld site or its biota. To date, nearly 250 papers and books have been published since the start of our project. An up-to-date list of these publications can be found at ***.

关键词： maar lake Eocene central Europe fossil Rhenish shield

Pancreatic panniculitis and elevated serum lipase in metastasized acinar cell carcinoma of the pancreas: A case report and review of literature

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World Journal of Clinical Cases 2020年第21期8卷 5304-5312页

作者： Rainer Christoph Miksch Tobias S Schiergens Maximilian Weniger Matthias Ilmer Philipp M Kazmierczak Markus O Guba Martin K Angele jens werner Jan G D'haese Department of General Visceraland Transplantation SurgeryLudwig-Maximilians-University MunichMunich 81377BavariaGermany Department of General Visceral Transplantat Vasc&Thorac Surg Campus GrosshadernUniversity of MunichMunich 81377Germany Department of General Ludwig Maximilians-University(LMU)Munich 81377Germany Department of Radiology Ludwig-Maximilians-University MunichMunich 81377Germany Department of Surgery University of MunichKlinikum GrosshadernMunich University HospitalMunich 81377Germany Department of General University of MunichKlinikum GrosshadernHospital of the University of MunichMunich 81377Germany Department of General Klinikum Univ MunchenKlin Allgemeine Viszeral Transplantat Gefass&ThStandort GrosshadernLudwig-Maximilians-University(LMU)Munich 81377Germany

BACKGROUND Pancreatic panniculitis is an extremely rare condition associated with different underlying pancreatic disorders and characterized by subcutaneous fat necrosis induced by elevated serum lipase *** lesions usually affect the lower extremities and may precede abdominal symptoms of pancreatic *** cell carcinoma(ACC)of the pancreas is a rare pancreatic neoplasm,accounting for only 1%-2%of pancreatic tumors in *** present the case of a 72-year-old man with ACC of the pancreatic head and synchronous liver *** the primary tumor and liver metastases were *** lipase was elevated before surgery and decreased to normal *** serum lipase levels at follow-up led to the diagnosis of hepatic *** disease progression was then accompanied by pancreatic panniculitis,with subcutaneous fat necrosis and acute *** the best of our knowledge,only 4 cases have been reported in the literature and each showed a similar association of serum lipase levels with pancreatic panniculitis and progression of *** Clinical symptoms and progression of ACC may correlate with serum lipase levels,suggesting potential usefulness as a follow-up biomarker.

关键词： Pancreatic panniculitis Lipase Acinar cell carcinoma Pancreatic cancer Case report

Radioembolization for neuroendocrine liver metastases is safe and effective prior to major hepatic resection

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hepatobiliary Surgery and Nutrition 2020年第3期9卷 312-321页

作者： Florian Bosch harun Ilhan Vanessa Pfahler Michael Thomas Thomas Knosel Valentin Eibl Sebastian Pratschke Peter Bartenstein Max Seidensticker Christoph J.Auernhammer Christine Spitzweg Markus O.Guba jens werner Martin K.Angele Department of General Visceraland Transplant SurgeryLudwig-Maximilians-University MunichMunichGermany Interdisciplinary Center of Neuroendocrine Tumors of the Gastro Entero Pancreatic System Ludwig-Maximilians-University MunichMunichGermany Department of Nuclear Medicine University HospitalLudwig-Maximilians-University MunichMunichGermany Department of Radiology Ludwig-Maximilians-University MunichMunichGermany Institute of Pathology Ludwig-Maximilians-University MunichMunichGermany Department of Internal Medicine 4 Ludwig-Maximilians-University MunichMunichGermany

Background:Radioembolization(RE)is well established in the treatment of neuroendocrine liver *** surgery is rarely performed after RE,although liver resection is the gold standard in the treatment of localized neuroendocrine liver ***,aim of the present study was to evaluate the safety and feasibility of liver resection after RE in a homogenous ***:From a prospective surgical(n=494)and nuclear medical(n=138)database patients with NELM who underwent liver resection and/or RE were *** September 2011 and December 2017 eight patients could be identified who underwent liver resection after RE(mean therapeutic activity of 1,746 Mbq).Overall and progression free survival were evaluated as well as epidemiological and perioperative *** surgical specimens were analyzed for necrosis,fibrosis,inflammation,and ***:The mean hepatic tumor load of patients,who had liver surgery after RE,was 31.4%with a mean Ki-67 proliferation index of 5.9%.The majority of these patients(7/8)received whole liver RE prior to liver resection,which did not increase morbidity and mortality compared to a surgical *** for RE were oncological(6/8)or carcinoid syndrome associated reasons(2/8).Mean overall survival was 25.1 months after RE and subsequent *** necrosis in radioembolized lesions was 29.4%without evidence of fibrosis and inflammation in hepatic ***:This is the first study analyzing the multimodal therapeutic approach of liver resection following whole liver *** treatment algorithm is safe,does not lead to an increased morbidity and is associated with a favorable oncological ***,patient selection remains a key issue.

关键词： Radioembolization(RE) neuroendocrine tumor liver surgery

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巨大十二指肠憩室切除的手术技巧

中国普通外科杂志 2011年第4期20卷 398-401页

作者：余枭杨永超李小荣余灿向开敏 werner jens 中南大学湘雅三医院普通外科湖南长沙410013 德国海德堡大学外科医院欧洲胰腺外科中心海德堡69120

目的探讨巨大十二指肠憩室外科治疗方法。方法对笔者工作单位及德国海德堡大学外科医院经外科手术治疗的6例巨大十二指肠憩室患者的临床资料进行回顾性分析。结果全组6例巨大十二指肠憩室,其中4例采取十二指肠憩室切除+经胃十二指肠造... 详细信息

目的探讨巨大十二指肠憩室外科治疗方法。方法对笔者工作单位及德国海德堡大学外科医院经外科手术治疗的6例巨大十二指肠憩室患者的临床资料进行回顾性分析。结果全组6例巨大十二指肠憩室,其中4例采取十二指肠憩室切除+经胃十二指肠造瘘术治疗,另2例采用憩室旷置术,即Billroth-II式胃大部切除+胃空肠Roux-en-Y吻合术。术后均未发生胰瘘、胆瘘、急性胰腺炎及十二指肠瘘等并发症,顺利出院。术后随访3个月至1年半,无1例再出现右上腹部胀痛、不适等症状。结论巨大十二指肠憩室采取十二指肠憩室切除并经胃十二指肠造瘘术,具有手术效果良好,并发症少等优点。

关键词：憩室,十二指肠/诊断憩室,十二指肠/外科学