Does the transplantation process modify the immunogenicity of fetal adrenal grafts in rat?

The concept that fetal tissue transplants enjoy an immunologic privilege grounds on the primary immaturity of major histocompatibility complex (MHC) expression. However, experiences in human organ transplantation reveal that the immunogenicity of any graft could be modified by external factors such as ischemia. Consequently, the question arises, whether the process of transplantation modifies the immunogenicity of fetal grafts.

[Minimally invasive funnel chest correction: initial experiences and critical evaluation of this fascinating technique].

The discussion about the surgical correction of funnel chest deformities enjoys a great renaissance since D. Nuss presented a new, minimal invasive technique. Although his method has gained wide acceptance among patients and pediatric surgeon the question arises, whether it can be considered as the Golden Standard' already.

Reduced prevalence of Plasmodium falciparum infection and of concomitant anaemia in pregnant women with heterozygous G6PD deficiency.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency confers protection against malaria in children, yet its role in malaria in pregnancy is unknown. In a cross-sectional study among 529 pregnant Ghanaian women, Plasmodium falciparum infection, anaemia and G6PD genotypes were assessed. Of these, 30.

Laparoscopic resection of a congenital liver cyst and simultaneous closure of a diaphragmatic defect in a 5-month-old infant.

Congenital liver cysts are an unusual finding and present a difficult diagnostic challenge. In a 5-month-old infant, routine echocardiography detected a cystic lesion (3 cm in diameter) just below the diaphragm. All conventional diagnostics, including magnetic resonance imaging (MRI), failed to clarify its etiology definitively.

Organ-specific maturation of the major histocompatibility antigens in rats.

The essential role of major histocompatibility complex (MHC) class I and II in the process of rejection has been documented, and some studies suggest that fetal transplants could enjoy an organ-specific immunologic privilege. However, little is known as to when these antigens develop in fetal organs and which tissues mainly present them. This study investigated the dynamics of immunogenicity in the developing transplant organs of rats.

[Perioperative pain therapy. Deficiencies in children and adolescents].

Present studies reveal that postoperative pain management for children is still insufficient in Germany. This situation is not only caused by a lack of knowledge, but, mainly, by a deficiency of standardized protocols in the hospitals and the lack of administrative responsibility. This article describes a specific concept for postoperative pain management in children.

Minimally invasive repair of pectus excavatum--the Nuss procedure. A European multicentre experience.

Since the first description in 1998, the minimally invasive repair of pectus excavatum has gained increasing acceptance. The aim of this survey is to report on the experiences of eight European centres with this technique. 172 patients with a mean age of 15.

Novel products of the HUD, HUC, NNP-1 and alpha-internexin genes identified by autologous antibody screening of a pediatric neuroblastoma library.

Autologous serological screening of a cDNA expression library (SEREX) derived from childhood neuroblastoma led to the identification of 10 different antigens, including 6 novel gene products. The novel antigen 018INX was derived from a small open reading frame in a region of alpha-internexin mRNA that was previously described as 3' untranslated region. 018INX thus represents a novel type of tumor antigen.

Testosterone-producing adrenocortical neoplasm in a 6-year-old boy.

Adrenal tumours that predominantly secrete testosterone are virtually unknown in prepubertal male patients. We present the case of a 6-year-old boy with premature sexual development and markedly elevated serum testosterone, but normal urinary steroid levels. Diagnostic imaging demonstrated a spherical tumour of the left adrenal gland.

Plasmodium falciparum pfcrt and pfmdr1 polymorphisms are associated with the pfdhfr N108 pyrimethamine-resistance mutation in isolates from Ghana.

The Plasmodium falciparum chloroquine resistance transporter gene (pfcrt) T76 and multidrug resistance gene analogue (pfmdr1) Y86 mutations are associated with chloroquine(CQ)-resistance. In isolates from 172 pregnant women living in the area of Agogo, Ghana, pfcrt T76 was detected in 69% and pfmdr1 Y86 in 66%. Pfcrt T76 but not pfmdr1 Y86 was more prevalent in samples from women with residual CQ in urine or serum.

Short report: increased susceptibility to Plasmodium malariae in pregnant alpha(+)-thalassemic women.

The influence of alpha(+)-thalassemia on malaria in pregnancy was assessed in a cross-sectional study of 530 women in Ghana. Plasmodial infections, alpha(+)-thalassemia, serum levels of C-reactive protein, and antimalarial drugs in urine were determined. The alpha-globin genotypes did not correlate with the prevalence of Plasmodium falciparum-infection and parasite densities.

Multiple intestinal stenoses and peripheral gangrene: a combination of two rare surgical complications in a child with Kawasaki disease.

Kawasaki disease (KD) often presents with a challenging variety of clinical symptoms. Severe gastrointestinal complications are rare and mainly appear as pseudo-obstruction. However, the authors report the unique case of a 4-month-old girl with KD suffering from a mechanical ileus.

Elastic stable intramedullary nailing (ESIN) provides good long-term results in pediatric long-bone fractures.

The present study evaluates the long-term outcome of elastic stable intramedullary nailing (ESIN) in children with long-bone shaft fractures. 70 patients were examined, the present mean age of patients was 12.7 (+/- 3.

Anaemia in pregnant Ghanaian women: importance of malaria, iron deficiency, and haemoglobinopathies.

In sub-Saharan Africa, anaemia in pregnancy results from multiple causes including malaria, iron deficiency and haemoglobinopathies. In a cross-sectional study among 530 pregnant women in Ghana in November-December 1998, red blood cell indices were analysed with respect to malaria, serum concentrations of ferritin and C-reactive protein (CRP), and the haemoglobin and alpha-globin genotypes. Anaemia (haemoglobin [Hb] < 11 g/dL) was found in 54% of the women; 63% harboured malaria parasites at predominantly low numbers.

Proliferation, zonal maturation, and steroid production of fetal adrenal transplants in adrenalectomized rats.

The present study investigated the histologic maturation, proliferative capacity, and steroid production of fetal adrenal transplants (Tx) in adrenalectomized rats. A pair of fetal adrenal glands (18-20 days of gestation) was transplanted into the omentum of syngeneic Lewis rats (n = 45). Four weeks later, in 5 animals the grafts were excised for morphologic evaluation.

Organ-specific distribution of major histocompatibility antigens in rats.

The present study systematically investigated the expression and distribution of the major histocompatibility complex (MHC) classes I and II in the rat. About 150 native tissue probes from eight adult Lewis rats were taken, representative for most organs, tissues, and the vascular system. MHC expression was analyzed by two monoclonal antibodies (mAb) generated against the non-polymorphic determinants of rat MHC class I (Ox-18) and class II (Ox-6).

Submicroscopic Plasmodium falciparum infections in pregnancy in Ghana.

Malarial parasitaemia below the threshold of microscopy but detectable by polymerase chain reaction (PCR) assays is common in endemic regions. This study was conducted to examine prevalence, predictors, and effects of submicroscopic Plasmodium falciparum infections in pregnancy. In a cross-sectional study among 530 pregnant women in Ghana, plasmodial infections were assessed by microscopy and PCR assays.

Integration of chiropractic education into a hospital setting: A South African experiences.

This article examines differences between chiropractic and medical internship experiences, both internationally and in South Africa. The South African hospital experience is described, and the future is discussed.

Laparoscopically assisted performance of gastrostomy--a simple, safe and minimal invasive technique.

We developed a new and simple technique for a gastrostomy, which combines the benefits of the laparoscopic and open approach: under visual control, the correct site at the gastric wall is defined laparoscopically and, via a second trocar, the stomach is pulled out onto the abdominal wall to insert a Kasper catheter and place the sutures. Evaluated in a rat model, this procedure demonstrates safety and surgical feasibility on the grounds of a minimal invasive access. The case report of a 1-year-old boy may also prove the clinical benefit.

Laparoscopy combined with conventional operative techniques.

In order to establish minimal invasive methods further, it should be guaranteed that laparoscopy is not only performed in a few pediatric surgical centers. A simple approach to gain experience would be the performance of diagnostic laparoscopy. However, benefit could be increased if the surgeon combines the minimal invasive laparoscopy to establish the diagnosis with the conventional surgical technique to continue.

Cryopreservation and transplantation of fetal adrenal glands in adrenalectomized rats.

In a syngeneic rat model, the present study investigated the cryobiology of fetal adrenal glands and compared the endocrinological function of cryopreserved versus fresh fetal adrenal transplants in the adrenalectomized hosts. Ultrastructural studies showed no significant tissue damage by the cryopreserving technique: cellular membranes were intact, the mitochondria showed discrete swelling and vacuoles were found in the endoplasmatic reticulum. Following transplantation, maturation and bilateral adrenalectomy in the host, assessment of endocrinological parameters demonstrated that survival was prolonged and Addison crisis could be prevented in both transplant groups with no significant difference between fresh versus cryopreserved grafts.

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.

Fetal adrenal transplantation: success of a laparoscopic technique in rats.

Background/purpose: The present study investigates a new laparoscopic technique for fetal adrenal transplantation in rats.

Results: The procedure was successful in 9 of 10 cases (one hole in the omentum) with no postoperative complications. On examination 4 weeks postoperatively, all but one graft showed macroscopic integrity, vascular supply, and histological maturation to normal zonal differentiation.

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.

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.