Biomedical subjects

S Kellnar

Publications and source records attributed to S Kellnar.

At least 19 recordsLinked to original sources

PubMed2003

Congenital atresia of the portal vein and extrahepatic portocaval shunt associated with benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and atrial septal defect.

A rare case of congenital atresia of the portal vein and ductus venosus, extrahepatic portocaval shunt, benign neonatal hemangiomatosis, congenital adrenal hyperplasia, and an atrial septal defect is reported. Twenty-two cases of congenital extrahepatic end-to-side shunts have been described before. Although additional anomalies are common in this type of shunt, hemangiomatosis has been described only once. Adrenal hyperplasia has never been reported in this anomaly.

Abnormalities, Multiple↗

PubMed1998

Fetal adrenal transplants respond to ACTH and prevent addisonian crisis in adrenalectomized rats.

The present study investigates whether fetal adrenal transplants into the omentum of adrenalectomized rats will be integrated into the recipient's endocrine system to provide competent adrenocortical function. The results demonstrate that fetal adrenals graft with a rich vascular supply, mature histologically, and produce increasing levels of corticosterone. When bilateral adrenalectomy is performed in the recipient, survival is prolonged and addisonian crisis can be prevented. Moreover, adrenocorticotrophic hormone levels decrease with increasing levels of corticosterone, indicating that the fetal grafts are integrated into the physiological pituitary-adrenocortical feedback system.

Adrenal Glands↗

PubMed1997

Thoracoscopic surgery of the oesophagus in rats: a training concept for the treatment of tracheo-oesophageal malformations in preterm infants

In extremely preterm babies with type Vogt III b oesophageal atresia, the primary operative management can be restricted to a gastrostomy and ligation of the fistula. Some of these patients, however, may not even tolerate a thoracotomy or placement on the operating table. We developed a minimally invasive procedure to prepare and ligate the oesophagus thoracoscopically and perform laparoscopic gastrostomy in a rat model. In 15 operations we observed only one complication. This study implies that after adequate practice, thoracoscopic dissection of the oesophagus with ligation of a tracheo-oesophageal fistula could be performed even in every small infants.

Journal Article↗

PubMed1997

Atypical hemihepatectomy during primary CDH-repair in a neonate on ECMO.

We report the case of a newborn with a large left-sided congenital diaphragmatic hernia (CDH) who required extra corporeal membrane oxygenation (ECMO) for severe respiratory insufficiency. CDH repair had to be performed on bypass circulation. Intraoperatively, an atypical hemihepatectomy of the herniated lobe was conducted, because reposition of the liver led to a kinking of the vena cava and to a torsion of the right lobe, resulting in ischemia and compromised venous flow. The extraordinary anatomical indication and the potential danger of uncontrollable bleeding are discussed.

Extracorporeal Membrane Oxygenation↗

PubMed1997

Thoracoscopic surgery of the oesophagus in rats: a training concept for the treatment of tracheo-oesophageal malformations in preterm infants.

Animals↗

PubMed1996

Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy.

Patient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. PCA proved to be a safe and feasible method with few complications (2% of medical complications, no abort of application, 17 technical checks in a total running time of 4125 h). Acceptance by patients was high and children of all age groups worked the system properly. Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P < 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.

Analgesia, Patient-Controlled↗

PubMed1996

[Surgery of atresia of the gastrointestinal tract].

The most common sites of atresia in the gastrointestinal tract are the oesophagus, the duodenum and the anorectum. Surgical intervention is always necessary. Because of the rapid progress in surgical techniques and peri- and postoperative intensive care management, lethality has been minimized, even when treating very small premature infants. In the meantime, the surgical intervention itself is no longer the great risk it was; associated congenital malformations such as complex cardial defects are now much greater risks.

Anastomosis, Surgical↗

PubMed1995

Ventriculoscopy-aided implantation of ventricular shunts in patients with hydrocephalus.

Ventriculoscopy represents a new concept in the surgical treatment of children with hydrocephalus. Optimal catheter position can now be achieved with the help of a new method consisting of endoscopically controlled implantation of ventricular shunts. In addition, interventional ventriculoscopy enables or improves new operative procedures such as the fenestration of intracranial cysts or the removal of dislodged parts of catheter tips from the corresponding ventricle under direct optical control. Ventriculoscopy has been performed on 17 pediatric patients, with no complications to date.

Catheterization↗

PubMed1994

Transplantation of fetal adrenal glands in syngeneic rat strains.

In a syngeneic rat model we investigated the feasibility of fetal adrenal gland transplantation into adult recipient animals. We determined the optimal site of graft implantation by morphological criteria. Transplantation into the omentum majus proved superior to transplantation underneath the fascia of the rectus abdominis muscle possibly due to superior access to vascular supply. We assessed transplant function by sequential determinations of serum corticosterone, aldosterone, sodium and body weight. We compared rats which received syngeneic fetal adrenal transplants and underwent excision of their own adrenal glands four weeks thereafter to control animals without adrenalectomy or transplantation and to adrenalectomized animals without prior transplantation. The total study period was 16 weeks. Whereas all adrenalectomized rats without prior transplantation died within 2 weeks, all the animals which had received fetal adrenal grafts survived. Their serum sodium remained within normal limits. Weight gain and serum corticosterone levels were decreased when compared to control animals. Aldosterone levels dropped intermittently but had normalized by 16 weeks. We conclude that fetal adrenal grafts may be able to substitute for the animals' own adrenal glands in the syngeneic model.

Adrenal Glands↗

PubMed1994

Endoscopic appendectomy in childhood--technical aspects.

Since March 1992 we initially performed 87 laparoscopic appendectomies applying two cat-gut loops for ligation of the stump. Since we postoperatively found abscess formation twice, we modified the technique in the following aspects: After the introduction of the scope at the umbilicus, 2 working trocars with a diameter of a 5 mm are placed in the left lower quadrant of the abdomen, so that the surgeon can skeletonize the appendix bimanually until it can be dissected with an Endo-GIA. This procedure we carried out in 41 cases and did not see any postoperative complications yet. Thus we consider it an appropriate alternative to conventional surgery.

Adolescent↗

PubMed1992

Fetal intestinal transplantation: a new therapeutic approach in short-bowel syndrome.

Intraperitoneally transplanted fetal rat intestine can be anastomosed to the intestine of the host after 4 weeks of maturation. In syngeneic transplant combinations morphological findings as well as functional parameters suggest that the intestinal transplant might provide a substitute for normal intestinal tissue. Four weeks after fetal intestinal transplantation in adult Lewis rats we resected the total small bowel of the host and interposed the matured transplant. Resection of total small bowel without transplant interposition led to a decline of body weight in control animals but was prevented in the transplanted group. After total small bowel resection and cecectomy (a lethal resection in the control group) we found a 40% (4/10) survival in the group in which the transplant had been anastomosed to the remaining bowel.

Animals↗

PubMed1992

Intraperitoneal fetal small bowel transplantation as therapy for the short bowel syndrome: an animal experimental study.

After demonstration of the morphologic integrity of fetal rat intestinal transplant and in vitro evidence of both digestive and resorptive function in the transplanted small bowel, in another experimental approach we tried to assess intestinal function in vivo. In this experiment, fetal intestinal grafts were placed in host animals and allowed to mature for 4 weeks. Then we resected the whole small bowel of the host from the ligament of Treitz to the ileo-cecal valve, afterwards interposing the matured fetal intestinal segment. A control group of animals (their small bowels were resected but they received no graft replacement) showed massive weight loss. The animals with fetal small bowel transplant replacement thrived. This shows that in the rat model fetal small bowel, previously transplanted into a host, can be an actual functioning substitute for normal small bowel.

Animals↗

PubMed1990

Allogeneic transplantation of fetal rat intestine: anastomosis to the normal bowel of the host.

We have examined the functional integrity of the transplanted fetal rat intestine following anastomosis of the transplant to the intestine of the host after successful allogeneic transplantation of fetal rat intestine into the peritoneal cavity of the host. In the syngeneic group all the 10 animals survived after end-to-side anastomosis. After end-to-end anastomosis 11 of 20 rats survived in the syngeneic group. In the allogeneic group we saw a marked host versus graft reaction (HVGR) after end-to-end anastomosis when treated orally with cyclosporin A in a dosage of 10 mg/kg per day. After administering the cyclosporin A parenterally, the survival rate in the allogeneic group after end-to-end anastomosis was 45%.

Anastomosis, Surgical↗

PubMed1989

[Intraoperative sonographic diagnosis of the ventricular position of shunt systems in infants with hydrocephalus].

Intraoperative ultrasound is performed in hydrocephalic newborn who were undergoing placement of a ventriculoperitoneal shunt. It is possible to show intraoperatively the tip of the ventriculoperitoneal shunt tube. By this method the optimal positioning of shunt tube is assured and the postoperative complication rate may be reduced. The use of this method is demonstrated by case reports.

Cerebral Ventricles↗

PubMed1989

[Differential "adrenal gland tumor-adrenal gland hemorrhage" diagnosis. A sonographic follow-up].

A case report with typical sonographic follow-up findings of adrenal hemorrhage in neonates is presented. The most important follow-up criteria to differentiate adrenal malignoma from hemorrhage sonographically are significant reduction of size, loss of echogenity as well as formation of a capsula within the first 10 days of life. Otherwise - even with insignificant laboratory findings - malignoma, especially congenital neuroblastoma, has to be suspected.

Adrenal Gland Diseases↗

PubMed1988

[Intraperitoneal fetal small intestine transplantation in allogeneic rat strains].

We demonstrated the possibility of a successful transplant of foetal rat small intestine into the peritoneal cavity of adult rats. Several combinations of rat strains with defined genetic differences were chosen. On the whole, in more than 66 percent of the performed transplantations a successful adequate growth of the transplants was noted. Oral application of Cyclosporin A (20 mg/kg/d) as immunosuppressive to prevent allograft rejection was necessary only in the combination across major genetic barriers. The preoperative insertion of a 7-0 non-absorbable thread into the lumen of the transplant helped to develop a tubular segment of small intestine which can be anastomosed to the intestinal continuity of the host in a second stage operation.

Animals↗

PubMed1988

[Intraoperative sonography for the localization of kidney calculi in children].

Application and technique of intraoperative ultrasound performed during paediatric surgery has proved useful in localising renal calculi. Using ultrasound rather than X-rays has the advantage that it can be used during the entire operation without any radiation exposure. Concrements can also be seen with ultrasound that do not usually show up when using conventional radiography.

Child↗

PubMed1987

[Autologous transfusion of blood deep frozen in the interim in childhood].

In the report we describe a method of reducing the number of transfusions of heterologous blood in patients with a surgical correction of chest walls. In 71 children between 2 and 17 years of age, 10-15% of total blood volume were withdrawn 3-4 weeks before the operation, deep frozen and thawed at the appropriate time to be ready for retransfusion. This arrangement reduced the need of heterologous blood significantly from 18.6% (prior to the introduction of the method) to 4.2%.

Adolescent↗