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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  128. Kongress der Deutschen Gesellschaft für Chirurgie; 20110503-20110506; München; DOC11dgch784 /20110520/
    Publication Date: 2011-05-20
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  128. Kongress der Deutschen Gesellschaft für Chirurgie; 20110503-20110506; München; DOC11dgch805 /20110520/
    Publication Date: 2011-05-20
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  128. Kongress der Deutschen Gesellschaft für Chirurgie; 20110503-20110506; München; DOC11dgch672 /20110520/
    Publication Date: 2011-05-20
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
    ISSN: 1573-2665
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The transplacental supply of nutrients is interrupted at birth, which diverts maternal metabolism to lactation. After birth, energy homeostasis is rapidly regained through milk nutrients which supply the newborn with the fatty acids and ketone bodies required for neonatal development. However, immediately after birth and before the onset of suckling there is a time lapse in which the newborn undergoes a unique kind of starvation. During this period glucose is scarce and ketone bodies are not available owing to the delay in ketogenesis. Under these circumstances, the newborn is supplied with another metabolic fuel, lactate, which is utilized as a source of energy and carbon skeletons. Neonatal rat lung, heart, liver and brain utilize lactate for energy production and lipogenesis. Lactate is also utilized by the brain of human babies with type I glycogenosis. Both rat neurons and astrocytes in primary culture actively use lactate as an oxidizable substrate and as a precursor of phospholipids and sterols. Lactate oxidation is enhanced by dichloroacetate, an inhibitor of the pyruvate dehydrogenase kinase in neurons but not in astrocytes, suggesting that the pyruvate dehydrogenase is regulated differently in each type of cell. Despite the low activity of this enzyme in newborn brain, pyruvate decarboxylation is the main fate of glucose in both neurons and astrocytes. The occurrence of a yeast-like pyruvate decarboxylase activity in neonatal brain may explain these results.
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  • 5
    ISSN: 1435-2451
    Keywords: Intraoperative autotransfusion ; Massive bleeding ; Emergency surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In der Chirurgischen Univeristätsklinik Granada (Spanien) wurde bei 359 traumatisierten Patienten intraoperativ eine Autotransfusion durchgeführt. Je nach Blutverlust wurden die Patienten in 2 Gruppen eingeteilt. Gruppe I (Blutverlust ≤ 2000 ml), Gruppe II (Blutverlust 〉 2000 ml). Bei Patienten der Gruppe I konnten wir auf die Gabe von Fremdblut verzichten. So konnten die erheblichen Risiken der homologen Bluttransfusion verbeugt werden. Makroskopische Hämoglobinurie trat nur bei Patienten auf, bei denen ein Autotransfusionssystem wie das von Solcotrans, Viavae usw. angewandt wurde. Mit dem Bentley-System wurde keine makroskopische Hämoglobinurie nachgewiesen. Bei Patienten der Gruppe II (Blutverlust 〉2000 ml) mußten wir in allen Fallen neben dem retransfundierten Eigenblut, homologes Blut transfundieren. Wenn die Transfusionsmenge insgesamt 4000 ml überschreitet, kommt es zu einer vermehrten Blutungsneigung, so daß eine Behandlung mittels Frischplasma, Thrombozytenkonzentraten and/oder Fibrinogen erforderlich wird. Die Letalität bei Gruppe II war sehr hoch, aber die Patienten starben an ihren schwerwiegenden Verletzungen oder an postoperativen Komplikationen, die nicht auf die Autotransfusion zurückzuführen waren. Eine Ausnahme bildeten 3 Patienten (massiv autotransfundiert von 12 000 bis 25 000 ml), die an Nierenversagen durch akute tubuläre Nekrose verstarben. Indikation fur die intraoperative Autotransfusion ist, ohne Zweifel, die traumatische intraabdominelle und/oder thorakale Verletzungen die mit hohen Blutverlusten einhergehen.
    Notes: Summary In the University Hospital of Granada (Spain), 359 surgical trauma patients underwent intraoperative autotransfusion. The patients were divided into 2 groups, according to their blood loss: group I (blood loss ≤2000 ml) and group II (blood loss 〉 2000 ml). Patients from group I did not require homologous blood transfusion. So the high risk involved in this type of transfusion was avoided. Macroscopic haemoglobinuria was only found in those patients where the Solcotrans, Viavae type of autotransfusion system was used; with the Bentley ATS system, no macroscopic haemoglobinuria was registered. With patients from group II, however, that is, those with a blood loss of more than 2000 ml, we had to fall back on homologous transfusion in addition to retransfusing autologous blood. When the transfusion exceeds 4000 ml there is increasing bleeding, which requires treatment with fresh frozen plasma, platelets and/or fibrinogen. The mortality rate of patients in group II was very high but the patients died from the severity of their injuries or from postoperative complications which were not due to autotransfusion in itself with the exception of 3 patients who underwent massive autotransfusion (12 000 to 25 000 ml) and died from acute renal failure. The main indication for intraoperative autotransfusion is without doubt abdominal and thoracic trauma which lead to high blood loss.
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  • 6
    ISSN: 1437-9813
    Keywords: Testicle ; Maldescent ; Nitrofen ; Germ cell ; Sertoli cell
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the rat model of nitrofen-induced congenital diaphragmatic hernia, we found the testicles in a high abdominal position in many male animals, and undertook to investigate whether the teratogen interferes with testicular descent and development. Male fetuses from time-mated Wistar rats treated intragastrically with 100 mg nitrofen dissolved in oil on day 9.5 of gestation were compared with control fetuses from mothers receiving only vehicle. The litters were recovered by cesarean section on days 17, 19, and 21 of gestation; the position of the testicles in male animals was recorded, and their volume was measured prior to histological assessment of mean tubular diameter, number of germ cells per tubule, and degree of collagenization of the tunica albuginea. Testicular maldescent was present in 100% of nitrofen-exposed fetuses on the 17th gestational day, 77% of those recovered on day 19, and 41% of those near term (21st day), whereas all control animals but 1 had “descended” gonads on all three days. Testicular volume was significantly decreased in treated fetuses on the 21st gestational day, and the mean tubular diameter was significantly decreased in all three age groups. Experimental and control animals had similar numbers of germ cells per tubule. The albuginea layer had apparently normal collagen content in all groups. These findings suggest that prenatal exposure to nitrofen interferes with both transabdominal descent of the testicle (transinguinal descent is postnatal in the rodent) and its normal development. Previous evidence and the present results authorize speculation on the possible role of nitrofen-induced prenatal thyroid hypofunction in the pathogenesis of maldescent and maldevelopment in this model, since thyroid hormones act directly on Sertoli cells, which secrete müllerian inhibiting substance, which is likely responsible for transabdominal descent.
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  • 7
    ISSN: 1437-9813
    Keywords: Key words Biliary atresia ; Hepatic portoenterostomy ; Long-term follow-up ; Liver transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The outcome of 18 biliary atresia (BA) patients (5 male, 13 female; age range 10.7–22.5 years; mean 15.4±0.7 years) treated with hepatic portoenterostomy (HPE) and jaundice-free for more than 10 years without liver transplantation (LT) is analyzed retrospectively. Eight of these patients subsequently required LT (age at LT 12.8±0.5 years, range 10.5–15.2 years); 3 children (aged 11.6, 13.2 and 14.1 years, respectively) had episodes of gastrointestinal variceal bleeding associated with other signs of severe disease and are now candidates for LT; and among the 7 asymptomatic patients (age range 11.2–22.5 years; mean 15.9±2.1 years), 5 had sonographic and biochemical signs of moderate portal hypertension (PH). In order to analyze whether the age at transplantation influences the survival of children transplanted for BA, we also reviewed the outcome of 71 BA patients transplanted at our hospital between 1986 and 1996. All the children older than 10 years at the time of LT were alive; only patients younger than 10 years died following LT (n= 15). We conclude that the natural outcome of extrahepatic BA is toward PH, fibrosis, and cirrhosis, even in those cases successfully treated with HPE. In our experience, the results of sequential treatment with HPE and LT were excellent.
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  • 8
    ISSN: 1437-9813
    Keywords: Key words Esophagus ; Atresia ; Notochord ; Adriamycin ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Esophageal atresia (EA) is often accompanied by vertebral defects and other anomalies. The adriamycin rat model of EA has disclosed the embryology of the malformation and shown that the vertebrae and notochord are also abnormal. This study describes the nature of notochord malformations in rat embryos exposed to adriamycin. Time-mated rats received either 1.75 mg/kg adriamycin or vehicle i.p. on gestational days (E) 6 to 9; E-12, E-12.5, and E-13 embryos were harvested, embedded in paraffin, and serially sectioned at 3 μm in transverse plane from the head to the stomach for subsequent PAS staining. The findings in both groups were compared at the three endpoints. Control embryos had neither tracheoesophageal nor notochord malformations. On day 12, only 11/36 adriamycin embryos were normal; 7/36 had abnormal notochords, 11/36 had EA, and 7/36 had both. The corresponding figures for 12.5 days were 12/27, 0/27, 7/27, and 8/27 and those for the day 13 7/23, 5/23, 3/23, and 8/23. The malformed notochords were thickened, bifurcated, or trifurcated in the sagittal plane. The simultaneous presence of notochord and esophageal malformations suggests a direct link between both defects, but our observation of isolated occurrence of both shows that they reflect two expressions of the profound disturbance of embryonic para-axial organization responsible for the cluster of malformations rather than a cause-effect association.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Pediatric surgery international 13 (1998), S. 307-307 
    ISSN: 1437-9813
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
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  • 10
    ISSN: 1437-9813
    Keywords: Key words Adriamycin ; Apoptosis ; Embryogenesis ; Esophageal atresia ; Notochord ; VATER association
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The adriamycin-induced rat model of the VATER association has provided a means of studying the morphogenesis of a variety of major congenital structural abnormalities similar to those seen in humans with the VATER association. Most interest has been centered on the foregut, where the model has clarified some aspects of the development of esophageal atresia (EA), tracheal agenesis, and other communicating bronchopulmonary foregut malformations. It has demonstrated aberrations in the nerve supply to the esophagus in EA and allowed the study of tracheomalacia. A relationship between an abnormal notochord, foregut abnormalities, and vertebral defects has been shown, and the model has reignited interest in the role of the notochord as a regional organizer of axial development. The normal temporospatial characteristics of apoptosis during fore- and hindgut development is disturbed in this model, resulting in abnormal morphology. The indications are that this model will continue to clarify the processes that lead to many of the structural congenital abnormalities that are seen in infants born with the VATER association.
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