@article{KrannichThereseBroscheitetal.2012, author = {Krannich, Jens-Holger and Therese, Tobias and Broscheit, Jens and Leyh, Rainer and M{\"u}llges, Wolfgang}, title = {Diabetes severely affects attentional performance after coronary artery bypass grafting}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75320}, year = {2012}, abstract = {Background: Diabetes is a risk factor for (micro) vascular damage of the brain, too. Therefore cognitive performance after coronary artery bypass grafting may be hypothesized worse in diabetics. To avoid observational errors a reliable tool for testing attentional performance was used. We evaluated whether diabetes mellitus disposes to distinct cognitive dysfunction after coronary artery bypass grafting (CABG). Methods: Three aspects in attentional performance were prospectively tested with three different tests (alertness: composed of un-cued and cued reaction, divided attention, and selective attention) by a computerized tool one day before and seven days after CABG in a highly selected cohort of 30 males, 10 of whom had diabetes. Statistical comparisons were done with analysis of variance for repeated measurements and Fisher´s LSD. Results: Prior to CABG there was no statistically meaningful difference between diabetics and non-diabetics. Postoperatively, diabetic patients performed significantly worse than non-diabetics in tests for un-cued (p=0.01) and cued alertness (p=0.03). Test performance in divided attention was worse after CABG but independent of diabetes status. Selective attention was neither affected by diabetes status nor by CABG itself. Conclusions: Diabetes may have an impact on cognitive performance after CABG. More severe deficits in alertness may point to underlying microvascular disease.}, subject = {Medizin}, language = {en} } @article{KlingelhoefferKaemmererKoospaletal.2012, author = {Klingelhoeffer, Chr{\´i}stoph and K{\"a}mmerer, Ulrike and Koospal, Monika and M{\"u}hling, Bettina and Schneider, Manuela and Kapp, Michaela and K{\"u}bler, Alexander, and Germer, Christoph-Thomas and Otto, Christoph}, title = {Natural resistance to ascorbic acid induced oxidative stress is mainly mediated by catalase activity in human cancer cells and catalase-silencing sensitizes to oxidative stress}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75142}, year = {2012}, abstract = {Background: Ascorbic acid demonstrates a cytotoxic effect by generating hydrogen peroxide, a reactive oxygen species (ROS) involved in oxidative cell stress. A panel of eleven human cancer cell lines, glioblastoma and carcinoma, were exposed to serial dilutions of ascorbic acid (5-100 mmol/L). The purpose of this study was to analyse the impact of catalase, an important hydrogen peroxide-detoxifying enzyme, on the resistance of cancer cells to ascorbic acid mediated oxidative stress. Methods: Effective concentration (EC50) values, which indicate the concentration of ascorbic acid that reduced the number of viable cells by 50\%, were detected with the crystal violet assay. The level of intracellular catalase protein and enzyme activity was determined. Expression of catalase was silenced by catalase-specific short hairpin RNA (sh-RNA) in BT-20 breast carcinoma cells. Oxidative cell stress induced apoptosis was measured by a caspase luminescent assay. Results: The tested human cancer cell lines demonstrated obvious differences in their resistance to ascorbic acid mediated oxidative cell stress. Forty-five percent of the cell lines had an EC50>20 mmol/L and fifty-five percent had an EC50<20 mmol/L. With an EC50 of 2.6-5.5 mmol/L, glioblastoma cells were the most susceptible cancer cell lines analysed in this study. A correlation between catalase activity and the susceptibility to ascorbic acid was observed. To study the possible protective role of catalase on the resistance of cancer cells to oxidative cell stress, the expression of catalase in the breast carcinoma cell line BT-20, which cells were highly resistant to the exposure to ascorbic acid (EC50: 94,9 mmol/L), was silenced with specific sh-RNA. The effect was that catalase-silenced BT-20 cells (BT-20 KD-CAT) became more susceptible to high concentrations of ascorbic acid (50 and 100 mmol/L). Conclusions: Fifty-five percent of the human cancer cell lines tested were unable to protect themselves against oxidative stress mediated by ascorbic acid induced hydrogen peroxide production. The antioxidative enzyme catalase is important to protect cancer cells against cytotoxic hydrogen peroxide. Silenced catalase expression increased the susceptibility of the formerly resistant cancer cell line BT-20 to oxidative stress.}, subject = {Medizin}, language = {en} } @article{StraussMoskalenkoTiurbeetal.2012, author = {Strauss, Armin and Moskalenko, Vasily and Tiurbe, Christian and Chodnevskaja, Irina and Timm, Stephan and Wiegering, Verena A. and Germer, Chrioph Thomas and Ulrichs, Karin}, title = {Goettingen Minipigs (GMP): Comparison of Two Different Models for Inducing Diabetes}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75119}, year = {2012}, abstract = {Purpose: Preclinical experiments on large animals are indispensable for evaluating the effectiveness of diabetes therapies. Miniature swine are well suited for such studies due to their physiological and pathophysiological responses. Methods: We compare two methods for inducing diabetes in Goettingen minipigs (GMP), in five with the beta cell toxin streptozotocin (STZ) and in five other GMP by total pancreatectomy (PE). Glucose homeostasis was assessed with the intravenous glucose-tolerance test (IVGTT) and continual monitoring of interstitial glucose levels. At conclusion of the observation period, the pancreata were examined histologically. Three non-diabetic GMP served as control group. Results: The IVGTT revealed markedly diabetic profiles in both GMP groups. STZ-GMP were found to harbor residual C-peptides and scattered insulin-positive cells in the pancreas. PE-GMP survived the total pancreatectomy only with intensive postoperative care. Conclusions: Although both methods reliably induced diabetes in GMP, the PE-GMP clearly had more health problems and required a greater expenditure of time and resources. The PE-GMP model, however, was better at eliminating endogenous insulin and C-peptide than the STZ-GMP model.}, subject = {G{\"o}ttingen}, language = {en} } @article{MuysomsCampanelliChampaultetal.2012, author = {Muysoms, F. and Campanelli, G. and Champault, G. and DeBeaux, A. C. and Dietz, U. A. and Jeekel, J. and Klinge, U. and K{\"a}ckerling, F. and Mandala, M. and Montgomery, A. and Morales Conde, S. and Puppe, F. and Simmermacher, R. K. J. and Asmieta Aski, M. and Miserez, M.}, title = {EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair}, series = {Hernia}, volume = {16}, journal = {Hernia}, number = {3}, doi = {10.1007/s10029-012-0912-7}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126691}, pages = {239-250}, year = {2012}, abstract = {BACKGROUND: Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of studies and meta-analyses in this field of surgery difficult. MATERIALS AND METHODS: Under the auspices of the board of the European Hernia Society and following the previously published classifications on inguinal and on ventral hernias, a working group was formed to create an online platform for registration and outcome measurement of operations for ventral abdominal wall hernias. Development of such a registry involved reaching agreement about clear definitions and classifications on patient variables, surgical procedures and mesh materials used, as well as outcome parameters. The EuraHS working group (European registry for abdominal wall hernias) comprised of a multinational European expert panel with specific interest in abdominal wall hernias. Over five working group meetings, consensus was reached on definitions for the data to be recorded in the registry. RESULTS: A set of well-described definitions was made. The previously reported EHS classifications of hernias will be used. Risk factors for recurrences and co-morbidities of patients were listed. A new severity of comorbidity score was defined. Post-operative complications were classified according to existing classifications as described for other fields of surgery. A new 3-dimensional numerical quality-of-life score, EuraHS-QoL score, was defined. An online platform is created based on the definitions and classifications, which can be used by individual surgeons, surgical teams or for multicentre studies. A EuraHS website is constructed with easy access to all the definitions, classifications and results from the database. CONCLUSION: An online platform for registration and outcome measurement of abdominal wall hernia repairs with clear definitions and classifications is offered to the surgical community. It is hoped that this registry could lead to better evidence-based guidelines for treatment of abdominal wall hernias based on hernia variables, patient variables, available hernia repair materials and techniques.}, language = {en} } @article{DietzWichelmannWunderetal.2012, author = {Dietz, U. A. and Wichelmann, C. and Wunder, C. and Kauczok, J. and Spor, L. and Strauß, A. and Wildenauer, R. and Jurowich, C. and Germer, C. T.}, title = {Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia}, series = {Hernia}, volume = {16}, journal = {Hernia}, number = {4}, doi = {10.1007/s10029-012-0919-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126732}, pages = {451-460}, year = {2012}, abstract = {Purpose Once open abdomen therapy has succeeded, the problem of closing the abdominal wall must be addressed. We present a new four-stage procedure involving the application of a two-component mesh and vacuum conditioning for abdominal wall closure of even large defects. The aim is to prevent the development of a giant ventral hernia and the eventual need for the repair of the abdominal wall. Methods Nineteen of 62 patients treated by open abdomen over a two-year period could not receive primary abdominal wall closure. To achieve closure in these patients, we applied the following four-stage procedure: stage 1: abdominal damage control and conditioning of the abdominal wall; stage 2: attachment of a tailored two-component mesh of polyglycolic acid (PGA) and large pore polypropylene (PP) in intraperitoneal position (IPOM) plus placement of a vacuum bandage; stage 3: vacuum therapy for 3-4 weeks to allow granulation of the mesh and optimization of dermatotraction; stage 4: final skin suture. During stage 3, eligible patients were weaned from respirator and mobilized. Results The abdominal wall gap in the 19 patients ranged in size from 240 cm2 to more than 900 cm2. An average of 3.44 vacuum dressing changes over 19 days were required to achieve 60-100 \% granulation of the surface area, so final skin suture could be made. Already in stage 3, 14 patients (73.68 \%) could be weaned from respirator an average of 6.78 days after placement of the two-component mesh; 6 patients (31.57 \%) could be mobilized on the edge of the bed and/or to a bedside chair after an average of 13 days. No mesh-related hematomas, seromas, or intestinal fistulas were observed. Conclusion The four-stage procedure presented here is a viable option for achieving abdominal wall closure in patients treated with open abdomen, enabling us to avoid the development of planned giant ventral hernias. It has few complications and has the special advantage of allowing mobilization of the patients before final skin closure. Long-term course in a large number of patients must still confirm this result.}, language = {en} } @article{DietzWichelmannWunderetal.2012, author = {Dietz, U. A. and Wichelmann, C. and Wunder, C. and Kauczok, J. and Spor, L. and Strauß, A. and Wildenauer, R. and Jurowich, C. and Germer, C. T.}, title = {Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia}, series = {Hernia}, volume = {16}, journal = {Hernia}, number = {4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124686}, pages = {451-460}, year = {2012}, abstract = {Purpose Once open abdomen therapy has succeeded, the problem of closing the abdominal wall must be addressed. We present a new four-stage procedure involving the application of a two-component mesh and vacuum conditioning for abdominal wall closure of even large defects. The aim is to prevent the development of a giant ventral hernia and the eventual need for the repair of the abdominal wall. Methods Nineteen of 62 patients treated by open abdomen over a two-year period could not receive primary abdominal wall closure. To achieve closure in these patients, we applied the following four-stage procedure: stage 1: abdominal damage control and conditioning of the abdominal wall; stage 2: attachment of a tailored two-component mesh of polyglycolic acid (PGA) and large pore polypropylene (PP) in intraperitoneal position (IPOM) plus placement of a vacuum bandage; stage 3: vacuum therapy for 3-4 weeks to allow granulation of the mesh and optimization of dermatotraction; stage 4: final skin suture. During stage 3, eligible patients were weaned from respirator and mobilized. Results The abdominal wall gap in the 19 patients ranged in size from 240 cm2 to more than 900 cm2. An average of 3.44 vacuum dressing changes over 19 days were required to achieve 60-100 \% granulation of the surface area, so final skin suture could be made. Already in stage 3, 14 patients (73.68 \%) could be weaned from respirator an average of 6.78 days after placement of the two-component mesh; 6 patients (31.57 \%) could be mobilized on the edge of the bed and/or to a bedside chair after an average of 13 days. No mesh-related hematomas, seromas, or intestinal fistulas were observed. Conclusion The four-stage procedure presented here is a viable option for achieving abdominal wall closure in patients treated with open abdomen, enabling us to avoid the development of planned giant ventral hernias. It has few complications and has the special advantage of allowing mobilization of the patients before final skin closure. Long-term course in a large number of patients must still confirm this result.}, language = {en} } @article{MuysomsCampanelliChampaultetal.2012, author = {Muysoms, F. and Campanelli, G. and Champault, G. G. and DeBeaux, A. C. and Dietz, U. A. and Jeekel, J. and Klinge, U. and K{\"o}ckerling, F. and Mandala, V. and Montgomery, A. and Morales Conde, S. and Puppe, F. and Simmermacher, R. K. J. and Śmietański, M. and Miserez, M.}, title = {EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair}, series = {Hernia}, volume = {16}, journal = {Hernia}, number = {3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124728}, pages = {239-250}, year = {2012}, abstract = {Background Although the repair of ventral abdominal wall hernias is one of the most commonly performed operations, many aspects of their treatment are still under debate or poorly studied. In addition, there is a lack of good definitions and classifications that make the evaluation of studies and meta-analyses in this field of surgery difficult. Materials and methods Under the auspices of the board of the European Hernia Society and following the previously published classifications on inguinal and on ventral hernias, a working group was formed to create an online platform for registration and outcome measurement of operations for ventral abdominal wall hernias. Development of such a registry involved reaching agreement about clear definitions and classifications on patient variables, surgical procedures and mesh materials used, as well as outcome parameters. The EuraHS working group (European registry for abdominal wall hernias) comprised of a multinational European expert panel with specific interest in abdominal wall hernias. Over five working group meetings, consensus was reached on definitions for the data to be recorded in the registry. Results A set of well-described definitions was made. The previously reported EHS classifications of hernias will be used. Risk factors for recurrences and co-morbidities of patients were listed. A new severity of comorbidity score was defined. Post-operative complications were classified according to existing classifications as described for other fields of surgery. A new 3-dimensional numerical quality-of-life score, EuraHS-QoL score, was defined. An online platform is created based on the definitions and classifications, which can be used by individual surgeons, surgical teams or for multicentre studies. A EuraHS website is constructed with easy access to all the definitions, classifications and results from the database. Conclusion An online platform for registration and outcome measurement of abdominal wall hernia repairs with clear definitions and classifications is offered to the surgical community. It is hoped that this registry could lead to better evidence-based guidelines for treatment of abdominal wall hernias based on hernia variables, patient variables, available hernia repair materials and techniques.}, language = {en} } @article{ZwinkJenetzkySchmiedekeetal.2012, author = {Zwink, Nadine and Jenetzky, Ekkehart and Schmiedeke, Eberhard and Schmidt, Dominik and M{\"a}rzheuser, Schmidt and Grasshoff-Derr, Sabine and Holland-Cunz, Stefan and Weih, Sandra and Hosie, Stuart and Reifferscheid, Peter and Ameis, Helen and Kujath, Christina and Rissmann, Anke and Obermayr, Florian and Schwarzer, Nicole and Bartels, Enrika and Reutter, Heiko and Brenner, Hermann}, title = {Assisted reproductive techniques and the risk of anorectal malformations: a German case-control study}, series = {Orphanet Journal of Rare Diseases}, volume = {7}, journal = {Orphanet Journal of Rare Diseases}, number = {65}, organization = {CURE-Net Consortium}, doi = {10.1186/1750-1172-7-65}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134036}, year = {2012}, abstract = {Background: The use of assisted reproductive techniques (ART) for treatment of infertility is increasing rapidly worldwide. However, various health effects have been reported including a higher risk of congenital malformations. Therefore, we assessed the risk of anorectal malformations (ARM) after in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: Data of the German Network for Congenital Uro-REctal malformations (CURE-Net) were compared to nationwide data of the German IVF register and the Federal Statistical Office (DESTATIS). Odds ratios (95\% confidence intervals) were determined to quantify associations using multivariable logistic regression accounting for potential confounding or interaction by plurality of births. Results: In total, 295 ARM patients born between 1997 and 2011 in Germany, who were recruited through participating pediatric surgeries from all over Germany and the German self-help organisation SoMA, were included. Controls were all German live-births (n = 10,069,986) born between 1997 and 2010. Overall, 30 cases (10\%) and 129,982 controls (1\%) were born after IVF or ICSI, which translates to an odds ratio (95\% confidence interval) of 8.7 (5.9-12.6) between ART and ARM in bivariate analyses. Separate analyses showed a significantly increased risk for ARM after IVF (OR, 10.9; 95\% CI, 6.2-19.0; P < 0.0001) as well as after ICSI (OR, 7.5; 95\% CI, 4.6-12.2; P < 0.0001). Furthermore, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed strong associations with ART (ORs 4.9, 11.9 and 7.9, respectively). After stratification for plurality of birth, the corresponding odds ratios (95\% confidence intervals) were 7.7 (4.6-12.7) for singletons and 4.9 (2.4-10.1) for multiple births. Conclusions: There is a strongly increased risk for ARM among children born after ART. Elevations of risk were seen after both IVF and ICSI. Further, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed increased risks in each group. An increased risk of ARM was also seen among both singletons and multiple births.}, language = {en} } @article{RaslanAlbertWeissenbergerErnestusetal.2012, author = {Raslan, Furat and Albert-Weißenberger, Christiane and Ernestus, Ralf-Ingo and Kleinschnitz, Christoph and Sir{\´e}n, Anna-Leena}, title = {Focal brain trauma in the cryogenic lesion model in mice}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75419}, year = {2012}, abstract = {The method to induce unilateral cryogenic lesions was first described in 1958 by Klatzo. We describe here an adaptation of this model that allows reliable measurement of lesion volume and vasogenic edema by 2, 3, 5-triphenyltetrazolium chloride-staining and Evans blue extravasation in mice. A copper or aluminium cylinder with a tip diameter of 2.5 mm is cooled with liquid nitrogen and placed on the exposed skull bone over the parietal cortex (coordinates from bregma: 1.5 mm posterior, 1.5 mm lateral). The tip diameter and the contact time between the tip and the parietal skull determine the extent of cryolesion. Due to an early damage of the blood brain barrier, the cryogenic cortical injury is characterized by vasogenic edema, marked brain swelling, and inflammation. The lesion grows during the first 24 hours, a process involving complex interactions between endothelial cells, immune cells, cerebral blood flow, and the intracranial pressure. These contribute substantially to the damage from the initial injury. The major advantage of the cryogenic lesion model is the circumscribed and highly reproducible lesion size and location.}, subject = {Medizin}, language = {en} }