Increased Elasticity Modulus of Polymeric Materials Is a Source of Surface Alterations in the Human Body.

The introduction of alloplastic materials (meshes) in hernia surgery has improved patient outcome by a radical reduction of hernia recurrence rate, but discussion about the biocompatibility of these implanted materials continues since observations of surface alterations of polypropylene and other alloplastic materials were published. This study intends to investigate if additives supplemented to alloplastic mesh materials merge into the solution and become analyzable. Four polypropylene and one polyester alloplastic material were incubated in different media for three weeks: distilled water, saline solution, urea solution, formalin, and hydrogen peroxide.

Sutureless open vascular anastomosis connector: An experimental study.

The objective of this study was to assess the safety of a new developed sutureless vascular adapter system in a porcine model. In five pigs, 4-cm-long polyester prosthesis (6 mm diameter) were implanted and anastomosed with the newly developed adapter proximally and suture anastomosis distally. The integration of the adapter was investigated in comparison to the suture anastomosis.

Delayed Graft Function 5 Months After Living Donor Kidney Transplantation.

Background: Delayed graft function is a clinical term to describe the failure of the transplanted kidney to function immediately after transplantation.

Case Report: A 59-year-old woman suffered from a rare case of delayed graft function lasting 148 days after unrelated living donor kidney transplantation. Until now, 15 years after transplantation, organ function is still good, with serum creatinine levels about 1.

Long-term survival after simultaneous pancreas-kidney transplantation with primary function of at least one year--a single-center experience.

Background: Simultaneous pancreas-kidney transplantation has been established as the treatment of choice for type 1 diabetes patients with renal dysfunction. Patient 1-year survival better than 95% has been achieved using this kind of transplantation. According to the postoperative complication rate (5% mortality), recipients appear to have a survival benefit not earlier than 2 years after transplantation.

Theodor Billroth's vision and Karl Ziegler's action: commemoration of the 40th day of death and the 50th anniversary of conferment of Nobel Prize for Chemistry of Karl Ziegler.

Alloplastic materials are broadly used in modern surgery. Until the middle of the 20th century, metal materials and especially silver were used because of their antimicrobial properties. With the development of a new catalytic process for the production of high-density polyethylene and polypropylene materials, a new era of prosthesis was introduced.

Short term and long term results after open vs. laparoscopic appendectomy in childhood and adolescence: a subgroup analysis.

Background: A comparative study was performed to compare quality of life after laparoscopic and open appendectomy in children and adolescents in a German General Hospital. The same study population was re-evaluated regarding their quality of life several years after operation.

Methods: Children and adolescents (n = 158) who underwent appendectomy for acute appendicitis between 1999 and 2001 were retrospectively analysed.

Laparoscopic versus open appendectomy--quality of life 7 years after surgery.

Background: In spite of the widespread use of laparoscopic appendectomy, there is an ongoing debate on the advantages of this method when compared to open appendectomy. In the evaluation of a postoperative procedure, long-term quality of life is essential.

Patients And Methods: From 1999 to 2001, 493 patients diagnosed with acute appendicitis were operated in a German general district hospital and included in an observational study.

Self-fixating mesh for the Lichtenstein procedure--a prestudy.

Introduction: Secure fixation of the mesh in groin hernia repair is essential to avoid mesh dislocation. The fixation, however, is also thought to be a source of chronic postoperative pain. We tested the new self-fixating mesh Parietene progrip vs.

Animal models of pancreatic cancer for drug research.

Background: The operative and conservative results of therapy in pancreatic ductal adenocarcinoma remain appallingly poor. This underlines the demand for further research for effective anticancer drugs. The various animal models remain the essential method for the determination of efficacy of substances during preclinical phase.

Open versus laparoscopic incisional hernia repair: something different from a meta-analysis.

Background: Incisional hernias after laparotomy are a large financial burden for society as well as for the patients suffering from pain and limitations of activity over time. The introduction of alloplastic materials such as polypropylene seems to improve the results. The question of whether to apply open or laparoscopic implantation of the mesh is of ongoing interest.

Characterisation of a novel matrix metalloproteinase inhibitor on pancreatic adenocarcinoma cells in vitro and in an orthotopic pancreatic cancer model in vivo.

Matrix metalloproteinases (MMPs) play a central role in tissue maintenance, inflammation and during tumour invasion and metastasis. The impact of MMPs in cancer has encouraged the development of novel MMP-inhibitors without adverse effects on the cell viability. We describe here the synthesis and characterisation of a triazine-derivative as a highly potent MMP-inhibitor.

Open versus laparoscopic appendicectomy: a critical review.

Background: The benefit of laparoscopic appendicectomy remains unclear. We have analysed available randomised studies comparing laparoscopic and open appendicectomy regarding their clinical pitfalls and statistical relevance.

Methods: Thirty eight studies were analysed in terms of the following aspects: A.

A modified random oligonucleotide-based combination therapy for adjuvant treatment of pancreatic ductal adenocarcinoma.

Anti-cancer therapy in pancreatic ductal adenocarcinoma (PDAC) is mostly based on surgical removal or palliative therapy using antimetabolites, like 5'-fluorouracil or gemcitabine. Adjuvant treatment using these chemotherapeutics has recently proven a beneficial concept, though general survival rates are still poor. Most recently, combination therapy of gemcitabine with other targeted drugs was evaluated in clinical trials.

Adjuvant treatment of pancreatic carcinoma in a clinically adapted mouse resection model.

Background: The high rate of local recurrence after radical resection of pancreatic adenocarcinoma fosters intensive efforts to develop new approaches for adjuvant treatment. The established animal models show significant limitations in simulating an adjuvant therapeutic setting. For optimal approximation to the clinical situation we therefore improved a murine orthotopic human xenotransplantation model.

Significant growth inhibition of orthotopic pancreatic ductal adenocarcinoma by CpG oligonucleotides in immunodeficient mice.

Background/aims: The high rate of local recurrence after radical resection of pancreatic ductal adenocarcinoma fosters intensive efforts to develop new approaches for adjuvant treatment. Antisense and modified oligodeoxynucleotides (ODNs) have demonstrated significant tumour growth inhibitory effects in preclinical systems. Our aim was to evaluate the possible therapeutic potential of ODNs containing unmethylated deoxycytidyl-deoxyguanosine dinucleotides (CpG motifs).

Differential effect of tacrolimus on dermal and intestinal wound healing.

Tacrolimus, used in organ transplantation, inhibits cellular immune function. Little is known about the effect on dermal and colonic healing. Groups of 10 rats underwent dorsal skin incision, and polyvinyl alcohol sponges were implanted subcutaneously.

Comparative investigation of alloplastic materials for hernia repair with improved methodology.

Background: A variety of alloplastic materials are used for hernia repair. We discuss the long-term stability and possible shrinkage of these materials. In the past, measurement of pore sizes was used to study the physical properties of alloplastic meshes.

Single-shot antithymocyte globuline and daclizumab induction in simultaneous pancreas and kidney transplant recipient: three-year results.

Since 1996, preoperative single-shot dose antithymocyte globuline (ATG) with prednisolone (PRD), mycophenolate mofetile (MMF), and tacrolimus (TAC) is the favorite induction therapy in our center. In a series of 25 first simultaneous pancreas and kidney transplant (SPK) recipients, 5 doses of daclizumab were administered in addition to standard induction. Here we present our 3-year experience.

Neoquadruple induction with antithymocyte globulin/azathioprine/cyclosporine/prednisolone in simultaneous pancreas and kidney transplant recipients: 8.5-year results.

Ten years ago therapy with antithymocyte globulin or OKT3, azathioprine, cyclosporine, and prednisolone was the most common induction treatment for simultaneous pancreas/ kidney (SPK) recipients. Although immunosuppression was started after surgery, there was a high incidence of acute rejection episodes. In 1995, we modified the application of antithymocyte globulin and prednisolone by starting prior to reperfusion.

Precoating of alloplastic materials with living human fibroblasts--a feasibility study.

Background: The use of alloplastic materials such as polypropylene and polyester has reduced the recurrence of abdominal wall hernias. Concomitantly, new problems have arisen such as inflammatory response against the implanted material and the development of enteric fistulas in case of direct contact of the bowel to polypropylene and polyester. A precoating of the PP with collagen and other absorbable materials seems to reduce the incidence of adhesions and fistulas.

[Open versus laparoscopic operation for perforated appendicitis--a comparative study].

Introduction: Laparoscopic therapy of complicated appendicitis is still discussed controversially. This retrospective study compared the clinical results of open and laparoscopic appendectomy in a single centre.

Patients And Methods: Within a period of three years (1999 to 2001) 493 patients with suspected acute appendicitis were operated prospectively at a German district hospital (250 open appendectomies, 243 laparoscopic appendectomies).

[Combined pancreas kidney transplantation after isolated kidney transplantation].

Simultaneous pancreas kidney transplantation (SPK) is an established therapy for type 1 diabetics with end stage or preterminal renal disease. SPK is superior to isolated kidney transplantation (KTX) in diabetic patients. Even pancreas-re-transplantations are more common in these patients now, mostly after SPK.

Single-shot antithymocyte globulin (ATG) induction for pancreas/kidney transplantation: ATG-Fresenius versus Thymoglobulin.

Single-shot antithymocyte globulin (ATG) prior to reperfusion followed by tacrolimus (TAC), mycophenolate mofetil (MMF), and prednisolone (PRD) is an established induction therapy in simultaneous pancreas kidney transplant (SPK) recipients. We retrospectively analyzed 6-month data from 105 patients who received their first SPK. From January 1996 to December 2000, ATG-Fresenius was used.

Donors with a maximum body weight of 50 kg for simultaneous pancreas-kidney transplantation.

Introduction: Pediatric donors are rarely used for simultaneous pancreas-kidney transplantation (SPK). But the age of the donors may be less important than the body weight (BW). Therefore we retrospectively analyzed our data on SPK donors with a maximum BW of 50 kg.

[Pancreas removal by external teams].

Combined pancreas and kidney transplantation is an established procedure for terminal or preterminal, uremic, type 1 diabetics. The current procurement technique allows simultaneous recovery of liver and pancreas. One problem is the assessment of organ quality.