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Pediatric Surgery International

Urinary bladder auto augmentation using INTEGRA® and SURGISIS®: an experimental model
Tue, 03 Nov 2009 14:18:10 -0000
Abstract Objective  We present our experience with an experimental urinary bladder auto augmentation model using SURGISIS® and INTEGRA® (collagen layer) in comparison with seromuscular enterocystoplasty. The aim of the study was to evaluate the change in compliance and elasticity of the urinary bladder. Materials and methods  Eighteen lambs were divided into three different groups. Auto augmentation was performed using the seromuscular layer of small bowel, SURGISIS® or the collagen layer of INTEGRA®. After 3 months of the initial procedure, the lambs were re-operated, the bladder compliance was measured and the urinary bladder was submitted for histological examination and assessment of elasticity. The lambs were euthanized. Results  The postoperative period was uneventful in 17 lambs except for intestinal obstruction in one lamb from the seromuscular enterocystoplasty group. A statistically significant difference in compliance was observed with SURGISIS® and the INTEGRA®. Histologically, there was neovascularization in all the specimens from the SURGISIS® and INTEGRA® groups with the presence of fibrosis in the SURGISIS® group. The INTEGRA® group showed better elastic properties than the SURGISIS®. Conclusions  Urinary bladder auto augmentation using the collagen layer of INTEGRA® showed better functional and histological results when compared with SURGISIS® and demucosalized enterocystoplasty in the present model. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2521-9Authors Gera Parshotam Kumar, Princess Margaret Hospital for Children Perth AustraliaAndrew Barker, Princess Margaret Hospital for Children Perth AustraliaSaeed Ahmed, Princess Margaret Hospital for Children Perth AustraliaJevon Gerath, Princess Margaret Hospital for Children Perth AustraliaJillian Orford, Princess Margaret Hospital for Children Perth Australia Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Disruption of calreticulin-mediated cellular adhesion signaling in the cadmium-induced omphalocele in the chick model
Thu, 29 Oct 2009 06:56:53 -0000
Abstract Purpose  Administration of cadmium (Cd) causes omphalocele in the chick embryo. The earliest histological changes in the chick Cd model are the breakdown of adherens junctions (AJs). Calreticulin (CRT) plays a key role in Ca2+ signaling and cell adhesion. Ca2+ signaling in the Cd chick model is known to be altered. The calcium-dependent adhesion molecule, E-cadherin, and its associate, β-catenin, are key components of AJs regulated by CRT. CRT knockouts display omphalocele. We hypothesized that CRT, E-cadherin and β-catenin are downregulated during early embryogenesis in the Cd chick model. Methods  After 60 h (H) incubation, chicks were harvested 1H, 4H, and 8H post treatment with saline or Cd and divided into controls and Cd. RT-PCR was performed to evaluate mRNA levels of CRT, E-cadherin and β-catenin in the Cd chick model. Results  The mRNA levels of CRT were significantly decreased in the Cd group at 1H compared to controls (p < 0.05). The mRNA levels of E-cadherin and β-catenin were significantly decreased at 4H in the Cd group compared to controls (p < 0.05). There were no significant differences at 8H. Conclusion  Downregulation of CRT, E-cadherin and β-catenin genes may cause omphalocele in the Cd chick model by disrupting CRT-mediated Ca2+ signaling and AJs. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2505-9Authors Takashi Doi, Our Lady’s Children’s Hospital The Children’s Research Centre Dublin 12 IrelandPrem Puri, Our Lady’s Children’s Hospital The Children’s Research Centre Dublin 12 IrelandJohn Bannigan, University College Dublin School of Medicine and Medical Science, Conway Institute of Biomolecular and Biomedical Research Dublin IrelandJennifer Thompson, University College Dublin School of Medicine and Medical Science, Conway Institute of Biomolecular and Biomedical Research Dublin Ireland Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Transglutaminases, involucrin, and loricrin as markers of epidermal differentiation in skin substitutes derived from human sweat gland cells
Sat, 24 Oct 2009 16:57:09 -0000
Abstract Background/Purpose  In a multi-project research line, we are currently testing whether a morphologically and functionally near normal epidermis can be cultured from human sweat gland (SG) cells and be used as a skin substitute. The present study focuses on the stratum corneum of the epidermis that assumes a vital barrier function for the skin. The main process in the formation of the cornified cell envelope in human epidermis, i.e. crosslinking of proteins and lipids, is catalyzed by several transglutaminases (TG). Therefore, we compared the expression patterns of various TG and their substrates in SG-derived versus keratinocyte-derived epidermal substitutes. Methods  Sweat gland cells, keratinocytes, and fibroblasts were isolated from human skin samples and cultivated separately to generate epidermal substitutes. These were transplanted onto the back of athymic rats. After 2 weeks, the transplants were excised and analyzed histologically as well as by indirect immunofluorescence. We looked at the expression of TG1, 3, 5, and their substrates involucrin and loricrin (=markers of epidermal differentiation) in SG-derived and keratinocyte-derived skin substitutes as well as in normal skin. Results  The SG cell-derived epidermis was near normal anatomically, formed a cornified cell envelope and demonstrated TG1, 3, and 5 as well as involucrin and loricrin expression patterns similar to those found in keratinocyte-derived epidermis and normal control skin. Conclusion  These findings support the thesis that SG cells have the potential to form a near normal stratified epidermal analog that might be used as a skin substitute. The expression of TG1 and 3, not normally expressed in human SG, suggests the presence of re-programmed SG cells and/or stem cells capable of both de novo generating and maintaining an epidermis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2517-5Authors Sasha Tharakan, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandLuca Pontiggia, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandThomas Biedermann, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandSophie Böttcher-Haberzeth, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandClemens Schiestl, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandErnst Reichmann, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich SwitzerlandMartin Meuli, University Children’s Hospital Tissue Biology Research Unit, Department of Surgery Zurich Switzerland Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Microscopic magnetic resonance in congenital diaphragmatic hernia and associated malformations in rats
Fri, 23 Oct 2009 18:53:21 -0000
Abstract Background/aim  The research on congenital diaphragmatic hernia (CDH) is often carried out on the nitrofen fetal rat model in which most investigations involve microdissections and fastidious assessment of serial sections of different anatomic areas. Current microscopic magnetic resonance (MMR) equipment allows detailed anatomic studies of alive, fresh or fixed fetuses. The purpose of the present study was to demonstrate that CDH itself and most of the associated malformations are adequately imaged and measured by MMR. Materials and methods  Fetuses from pregnant rats treated with either i.g. vehicle (control, n = 10) or 100 mg nitrofen (only those with CDH, n = 18) on E9.5 were recovered on E21 (term = E22) and total body was scanned by MMR under sedation in a 7 T MRI system (Bruker Medical, Ettlingen, Germany). CDH was detected with a coronal multislice fast spin echo sequence with a long repetition time and short effective echo time. Oblique MPR and 3D reconstructions were used. All studies were processed with attention to the hernia and its contents and the structure of the tracheobronchial tree and the lung, the heart and great vessels, the thymus and cervico-thoracic vertebrae. The findings in both groups were compared. Results  Congenital diaphragmatic hernia, lung hypoplasia and parenchymal features were clearly depicted. Tracheal ring anomalies were also demonstrated. The thymus was significantly smaller in CDH pups (2.9 × 1 × 2.4 mm) than in controls (4 × 1.3 × 2.8 mm) (p < 0.01). MRI was particularly performant for imaging cardiovascular anomalies: 4 double aortic arches, 3 Fallots, 3 right aortic arches, 3 ventricular septal defects and 1 aberrant subclavian artery. Conclusions  Microscopic magnetic resonance involves refined and expensive equipment but it provides a powerful research tool for the study of CDH and other malformations in rat fetuses. Further work on this area is warranted. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2518-4Authors Montserrat Bret, Hospital Universitario La Paz Department of Radiology Madrid SpainAna Lourdes Luis, Hospital Universitario La Paz Department of Pediatric Surgery Paseo de la Castellana 261 28046 Madrid SpainEmilio Cuesta, Hospital Universitario La Paz Department of Radiology Madrid SpainFederica Pederiva, Hospital Universitario La Paz Department of Pediatric Surgery Paseo de la Castellana 261 28046 Madrid SpainRosa Aras, Hospital Universitario La Paz Department of Pediatric Surgery Paseo de la Castellana 261 28046 Madrid SpainLeopoldo Martinez, Hospital Universitario La Paz Department of Pediatric Surgery Paseo de la Castellana 261 28046 Madrid SpainJuan A. Tovar, Hospital Universitario La Paz Department of Pediatric Surgery Paseo de la Castellana 261 28046 Madrid Spain Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Effect of simvastatin on intestinal recovery following gut ischemia–reperfusion injury in a rat
Fri, 23 Oct 2009 18:53:19 -0000
Abstract Background  Pleiotropic (lipid lowering-independent) effects of statins are attributed to their antiinflammatory, antioxidant, and/or vascular actions. Extensive studies in various experimental models have established that pretreatment with simvastatin significantly protects heart and kidney injured by ischemia–reperfusion (IR). The purpose of the present study was to examine the effect of simvastatin on intestinal recovery and enterocyte turnover after intestinal IR injury in rats. Methods  Male Sprague–Dawley rats were divided into three experimental groups: (1) sham rats underwent laparotomy, (2) IR-rats underwent occlusion of both superior mesenteric artery and portal vein for 30 min followed by 48 h of reperfusion, and (3) IR-SIM rats underwent IR and were treated with oral simvastatin (10 mg/kg) given by gavage immediately before and 24 h after operation. Intestinal structural changes, Park’s injury score, enterocyte proliferation and enterocyte apoptosis were determined 24 h following IR. A non-parametric Kruskal–Wallis ANOVA test was used for statistical analysis with P less than 0.05 considered statistically significant. Results  Treatment with simvastatin resulted in a significant increase in bowel and mucosal weight in ileum, villus height and crypt depth in jejunum and ileum compared to IR animals. IR-SIM rats had also a significantly lower intestinal injury score as well as lower apoptotic index in jejunum and ileum compared to IR animals. Conclusions  Treatment with simvastatin prevents gut mucosal damage and inhibits programmed cell death following intestinal IR in a rat. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2508-6Authors Nadav Slijper, Technion-Israel Institute of Technology Laboratory of Intestinal Adaptation and Recovery, The Bruce Rappaport Faculty of Medicine Haifa IsraelIgor Sukhotnik, Technion-Israel Institute of Technology Laboratory of Intestinal Adaptation and Recovery, The Bruce Rappaport Faculty of Medicine Haifa IsraelElena Chemodanov, Bnai Zion Medical Center Department of Pathology Haifa IsraelYulia Bashenko, Technion-Israel Institute of Technology Laboratory of Intestinal Adaptation and Recovery, The Bruce Rappaport Faculty of Medicine Haifa IsraelRon Shaoul, Rambam Medical Center Pediatric Gastroenterology and Nutrition Unit, Meyer Children’s Hospital Haifa IsraelArnold G. Coran, University of Michigan Medical School Section of Pediatric Surgery, C.S. Mott Children’s Hospital Ann Arbor MI USAJorge Mogilner, Bnai Zion Medical Center Department of Pediatric Surgery B 47 Golomb St. P.O.B. 4940 31048 Haifa Israel Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358
Altered expression of c-kit-positive cells in the ureterovesical junction after surgically created vesicoureteral reflux
Fri, 23 Oct 2009 18:53:18 -0000
Abstract Purpose  Peristaltic contractions propel urine unidirectionally from the renal pelvis trough the ureter and into the bladder. A morphologically and functionally competent ureterovesical junction prevents vesicoureteral reflux (VUR). According to current knowledge, pyeloureteral peristalsis is driven by atypical muscle cells within the upper urinary tract. Another likely relevant cell population, which is c-kit-positive, has been shown to be present within the whole urinary tract. Morphological changes of c-kit-positive cells have been described in VUR and pyeloureteral junction (PUJ) obstruction. Nevertheless, the functional importance of c-kit-positive interstitial cells has not yet been elucidated fully. Therefore, we investigated the influence of experimentally created VUR on the expression of c-kit-positive cells. Materials and methods  We created left-sided unilateral VUR in eight Vietnamese pigs using an open surgical technique. The VUR was shown to be grade II–III by voiding cystourethrogram (VCUG), 1 and 6 months after the procedure. The animals were killed after 6 months. The vesicoureteral junction and the distal ureters were excised and fixed in 4% PFA. Paraffin sections were stained using c-kit immunohistochemistry. A quantitative evaluation was performed by two independent investigators. The unaffected, contralateral, nonrefluxing ureters served as controls. Results  We identified two types of c-kit-immunoreactive cells within the ureterovesical junction and distal ureter. The first group was comprised of round-shaped cells with substantial intracellular granulas, which resembled mast cells. Mast cells were found in the subepithelial region as well as between the muscle bundles. The number of mast cells was slightly increased in the VUR group. The second group consisted of spindle-shaped, bipolar ICC-like cells, which were seen mainly in the submucosal and muscular layers. The number of spindle-shaped c-kit-immunoreactive cells was markedly decreased in the refluxing ureter compared to the controls. Conclusions  Surgically created VUR leads to altered expression of c-kit-positive cells. The altered distribution of c-kit-positive ICC-like cells might further contribute to the impairment of coordinated pyeloureteral peristalsis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2487-7Authors Zsolt Oberritter, University of Pecs Department of Paediatric Surgery Pecs HungaryUdo Rolle, Johann Wolfgang-Goethe University Department of Paediatric Surgery Frankfurt GermanyZsolt Juhasz, University of Pecs Department of Paediatric Surgery Pecs HungaryTamas Cserni, University College of Dublin Children’s Research Centre Dublin IrelandPrem Puri, University College of Dublin Children’s Research Centre Dublin Ireland Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358

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