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Search Results: 1 - 10 of 44875 matches for " Michael Keese "
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Placement of an aortomonoiliac stent graft without femorofemoral revascularization in endovascular aneurysm repair: a case report
Michael Keese, Marco Niedergethmann, Stefan Schoenberg, Steffen Diehl
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-365
Abstract: We report the case of an 80-year-old Caucasian man who presented with an unusually configured, symptomatic infrarenal aortic aneurysm. His aneurysm showed an erosion of the fourth lumbar vertebra and a severely arteriosclerotic pelvic axis. A high thigh amputation of his right leg had been performed 15 months previously. On his right side, occlusion of his external iliac artery, common femoral artery, and deep femoral artery had occurred. His aneurysm was treated by a left-sided aortomonoiliac stent graft without femorofemoral revascularization, resulting in occlusions of both internal iliac arteries. No ischemic symptoms appeared, although perfusion of his right side was maintained only over epigastric collaterals.The placement of aortomonoiliac stent grafts for endovascular treatment of infrarenal aortic aneurysms without contralateral revascularization is a feasible treatment option in isolated cases. In this report, access problems and revascularization options in endovascular aneurysm repair are discussed.The trend in the care of patients with an infrarenal aortic aneurysm is to administer endovascular treatment when feasible. This is because grade 1 evidence indicates a decrease in postoperative morbidity, a shorter hospital stay, a quicker recovery time, and a significantly lower early postoperative mortality when endovascular aneurysm repair (EVAR) is chosen as treatment [1]. However, EVAR does not improve long-term survival and has been associated with a need for continued surveillance and reinterventions at substantially increased costs. Thus, especially in high-risk patients, the emphasis has shifted toward improving patient fitness before considering any treatment of aortic aneurysms. Especially when patients present with a symptomatic aortic aneurysm or (contained) rupture, the question of whether an endovascular intervention is advisable arises. Erosion of a vertebra is considered a radiological sign of a pending rupture [2]. Survival statistics indica
Chronic mesenteric ischemia: Time to remember open revascularization
Michael Keese,Thomas Schmitz-Rixen,Thomas Schmandra
World Journal of Gastroenterology , 2013, DOI: 10.3748/wjg.v19.i9.1333
Abstract: Chronic mesenteric ischemia is caused by stenosis or occlusion of one or more visceral arteries. It represents a therapeutic challenge and diagnosis and treatment require close interdisciplinary cooperation between gastroenterologist, vascular surgeon and radiologist. Although endovascular treatment modalities have been developed, the number of restenoses ultimately resulting in treatment failure is high. In patients fit for open surgery, the visceral arteries should be revascularized conventionally. These patients will then experience long term relief from the symptoms, a better quality of life and a better overall survival.
Case report: late perianal mucinous adenocarcinoma after Crohn's disease proctectomy: an oncological rarity
Michael Keese, Walter Back, Dietmar Dinter, Rainer Gladisch, Andreas Joos, Pablo Palma
World Journal of Surgical Oncology , 2005, DOI: 10.1186/1477-7819-3-42
Abstract: We report the case of a 50-year old female with a mucinous adenocarcinoma forming in the perineum eleven years after proctocolectomy for Crohn's disease. The patient was readmitted with perineal pain, leucocytosis and a perineal mass highly suspicious of abscess formation in the MRI-Scan. Histological examination revealed a mucinous adenocarcinoma. Exenteration including vagina, uterus and ovaries together with the coccygeal-bone was performed.Mucinous adenocarcinoma formation is a rare complication of Crohn's disease and so far unreported after proctocolectomy.As in ulcerative colitis, there is an increased incidence of colorectal carcinoma in Crohn's disease [1]. An increased risk of cancer in patients with Crohn's disease has been shown to be related to an early onset and a prolonged duration of the inflammatory bowel disease [2]. Furthermore, several cases have been reported in which carcinoma formation originated from ano-rectal fistulas which are commonly associated with Crohn's disease [3]. While carcinoma formation originating from anorectal fistulas is generally considered as a rare event, these tumors are most commonly either mucinous carcinomas or squamous cell carcinomas [4]. The causative relationship between anorectal fistulas and cancer is not known. Cancer development in these cases remains a diagnostic challenge especially if carcinomas arise in the midst of abscess formation [5]. We report late formation of a mucinous adenocarcinoma in a patient with Crohn's disease who presented severe perineal fistulous lesions after proctocolectomy.In October 2004 a 50-year old woman was admitted presenting with gluteal and perineal fistula formation after proctocolectomy eleven years earlier. The clinical examination showed a single fistula opening on the perineum with purulent secretion. A second opening was found on the posterior wall of the vagina.The MRI-scanning revealed a large formation in the lower pelvis reaching to the sacrum. This mass showed a thick
Microscopy of bacterial translocation during small bowel obstruction and ischemia in vivo – a new animal model
Stephan Samel, Michael Keese, Martha Kleczka, Sybille Lanig, Norbert Gretz, Mathias Hafner, J?rg Sturm, Stefan Post
BMC Surgery , 2002, DOI: 10.1186/1471-2482-2-6
Abstract: In anaesthetized male Wistar rats, 0.5 ml of a suspension of green fluorescent protein-transfected E. coli was administered by intraluminal injection in a model of small bowel obstruction. Animals were randomly subjected to non-ischemic or ischemic bowel obstruction. Ischemia was induced by selective clamping of the terminal mesenteric vessels feeding the obstructed bowel loop. Time intervals necessary for translocation of E. coli into the submucosal stroma and the muscularis propria was assessed using intravital microscopy.Bacterial translocation into the submucosa and muscularis propria took a mean of 36 ± 8 min and 80 ± 10 min, respectively, in small bowel obstruction. Intestinal ischemia significantly accelerated bacterial translocation into the submucosa (11 ± 5 min, p < 0.0001) and muscularis (66 ± 7 min; p = 0.004). Green fluorescent protein-transfected E. coli were visible in frozen sections of small bowel, mesentery, liver and spleen taken two hours after E. coli administration.Intravital microscopy of fluorescent bacteria is a novel approach to study bacterial translocation in vivo. We have applied this technique to define minimal bacterial transit time as a functional parameter of intestinal barrier function.Bacterial translocation has been defined as the passage of viable bacteria from the gut lumen to extraintestinal organs [1]. Major conditions contributing to bacterial translocation are a breakdown of the intestinal barrier, an impairment of host immune defense and a loss of the colonization resistance [2,3] with bacterial overgrowth in the intestinal tract [4]. Gut bacteria may penetrate the mucosa – that consists of a tight lining of enterocytes covering the villi and M-cells in the depth of the crypts [5] – by different mechanisms specific to each species [6]. However, when the mucosa is injured and the intestinal barrier is compromised [7] an unspecific and unlimited translocation of intestinal micro-organisms can occur [8]. Intestinal barrier dis
cis,trans,cis,cis-7-tert-Butyldimethylsilyloxy-4,10-dimethyltetracyclo[5.4.1.04,12.010,12]dodecan-2-one
Philipp Weyermann,Reinhart Keese,Helen Stoeckli-Evans
Acta Crystallographica Section E , 2010, DOI: 10.1107/s1600536810000887
Abstract: In the structure of the title compound, C20H34O2Si, a cis,trans,cis,cis-[4.5.5.5]fenestrane derivative, the geometry of the central C(C)4 substructure shows considerable distortion from an ideal tetrahedral arrangement towards planarity, with two opposite bridgehead bond angles of 128.87 (18) and 122.83 (17)°. The other bridgehead angle of the trans-bicyclo[3.3.0]octane subunit is also large [126.57 (19)°].
(RSS)-[N-Hydroxyethyloxy]-hexafluoroVal–MeLeu–Ala tert-butyl ester
Marcel K. Eberle,Helen Stoeckli-Evans,Reinhart Keese
Acta Crystallographica Section E , 2009, DOI: 10.1107/s1600536809042974
Abstract: The title compound [systematic name: (2S,5S,8R)-tert-butyl 8-(1,1,1,3,3,3-hexafluoropropan-2-yl)-12-hydroxy-5-isobutyl-2,6-dimethyl-4,7-dioxo-10-oxa-3,6,9-triazadodecanoate], C21H36F6N3O6, is a tripeptide crystallizing in the chiral orthorhombic spacegroup P212121. The absolute configuration (R) of the chiral center in the hexafluorovaline unit is based on the known stereochemistry of MeLeu and Ala (SS). The N-hydroxyethyloxy substituent of hexafluorovaline is positionally disordered [occupancy ratio 0.543 (9):0.457 (9)]. In the solid state structure there are N—H...F and N—H...O intramolecular hydrogen bonds supporting the coiled structure of this tripeptide with the three hydrophobic substituents on the outside.
Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I Urgencia quirúrgica por sangrado intestinal debido a tumor intestinal de nervios autónomos asociados a neurofibromatosis tipo I
M. Keese,T. Riester,K. Schwenke,D. Dinter
Revista Espa?ola de Enfermedades Digestivas , 2007,
Abstract: We describe a surgical emergency due to GI-bleeding caused by gastrointestinal autonomic nerve tumours (GANT's) in a patient with von Recklinghausen's disease. A 72 year old female patient with von Recklinghausen's disease was admitted with maelena. Endoscopy showed no active bleeding in the stomach and the colon. Therefore an angio-CT-scan was performed which revealed masses of the proximal jejunum as source of bleeding. Laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. The source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. Immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for C-Kit (CD 117), CD 34, and a locally positive staining for synaptophysine and S100. This case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von Recklinghausen's disease. Se describe una urgencia quirúrgica por sangrado intestinal debido a tumor gastrointestinal de nervios autónomos (GANT) asociado a enfermedad de von Recklinghausen. Una mujer de 72 a os con neurofibromatosis fue ingresada con signos de melena. La endoscopia digestiva alta y baja fue negativa. Se indicó TAC con contraste que advirtió tumores yeyunales como causa del sangrado. Se realizó laparotomía y resección de un segmento de 20 cm de yeyuno que incluía varios tumores. La causa del sangrado activo fue lesión en mucosa intestinal por erosión tumoral. El análisis por inmunohistoquímica de la pieza mostró diferenciación neuronal, con células fusiformes con tinción positiva para el C-Kit (CD 117), CD 34. Esta nota clínica pone de manifiesto la asociación entre la neurofibromatosis y los tumores estromales y debe alertar a gastroenterólogos y cirujanos sobre las posibles manifestaciones intestinales en pacientes con enfermedad de von Recklinghausen.
Computing annular Khovanov homology
Hilary Hunt,Hannah Keese,Anthony Licata,Scott Morrison
Mathematics , 2015,
Abstract: We define a third grading on Khovanov homology, which is an invariant of annular links but changes by $\pm 1$ under stabilization. We illustrate the use of our computer implementation, and give some example calculations.
Acute GI bleeding by multiple jejunal gastrointestinal autonomic nerve tumour associated with neurofibromatosis type I
Keese,M.; Riester,T.; Schwenke,K.; Dinter,D.; Back,W.; Palma,P.;
Revista Espa?ola de Enfermedades Digestivas , 2007, DOI: 10.4321/S1130-01082007001000010
Abstract: we describe a surgical emergency due to gi-bleeding caused by gastrointestinal autonomic nerve tumours (gant's) in a patient with von recklinghausen's disease. a 72 year old female patient with von recklinghausen's disease was admitted with maelena. endoscopy showed no active bleeding in the stomach and the colon. therefore an angio-ct-scan was performed which revealed masses of the proximal jejunum as source of bleeding. laparotomy was indicated and a 20 cm segment of jejunum which carried multiple extraluminal tumours was resected. the source of the bleeding was a 2 cm tumour which had eroded the mucosal surface. immunohistologically, evidence of neuronal differentiation could be shown in the spindle-formed cells with positive staining for c-kit (cd 117), cd 34, and a locally positive staining for synaptophysine and s100. this case report illustrates the association between neurofibromatosis and stromal tumours and should alert surgeons and gastroenterologist about gastrointestinal manifestations in patients with von recklinghausen's disease.
Nucleotide sequence of coat protein gene for GPV isolate of barley yellow dwarf virus and construction of expression plasmid for plant
CHENG Zhuomin HE Xiaoyuan,WU MaosenZHOU Guanghe,
CHENG Zhuomin HE Xiaoyuan
,WU MaosenZHOU Guanghe(Paul Keese and P. M. Waterhouse

中国科学C辑(英文版) , 1996,
Abstract: GPV is a Chinese serotype isolate of barley yellow dwarf virus (BYDV) that has no reaction with antiserum of MAV, PAV, SGV, RPV and RMV. The sequence of the coat protein (CP) of GPV isolate of BYDV was identified and its amino acid sequence was deduced. The coding region for the putative GPV CP is 603 bases nucleotides and encodes a Mr 22218 (22 ku) protein. The same as MAV, PAV and RPV, GPV contained a second ORF within the coat protein coding region. This protein of 17024 Mr (17 ku) is thought to correspond to the Virion protein genome linked (Vpg). Sequence comparisons of the CP coding region between the GPV isolate of BYDV and other isolates of BYDV have been done. The nucleotide and ammo acid sequence homology of GPV has a greater identity to the sequence of RPV than those of PAV and MAV. The GPV CP sequence shared 83.7% of nucleotide similarity and 77.5% of deduced amino add similarity, whereas that of the PAV and MAV shared 56.9%. 53.2% and 44.1%. 43.8% respectively. According to BYDV-GPV CP sequence, two primers were designed. The cDNA of CP was produced by RT-PCR. Full-length cDNA of CP was inserted into plasmid to construct expression plasmids named pPPI1. pPPI2 and pPPI5 based on different promoters. The recombinant plasmids were identified by using α-32P-dATP labelled CP probe. α-32P-ATP labelled GPV RNA probe and sequencing to confirm real GPV CP gene cDNA in plasmids.
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