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comparison of outcomes between complete and incomplete congenital duodenal obstruction

World Journal of Gastroenterology 2019年第28期25卷 3787-3797页

作者： Stefan Gfroerer Till-Martin Theilen henning c fiegel Anoosh Esmaeili Udo Rolle Department of Pediatric Surgery and Pediatric Urology University Hospital Frankfurt Frankfurt 60590 Germany Department of Pediatric cardiology University Hospital Frankfurt Frankfurt 60590 Germany

BAcKGROUND congenital duodenal obstruction (cDO) can be complete (ccDO) or incomplete (IcDO). To date there is no outcome analysis available that compares both subtypes. AIM To quantify and compare the association between ccDO and IcDO with outcome parameters. METHODS We retrospectively reviewed all patients who underwent operative repair of ccDO or IcDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between ccDO (n = 27;atresia type 1-3, annular pancreas) and IcDO (n=23;annular pancreas, web, Ladd′s bands). RESULTS In total, 50 patients who underwent cDO repair were enrolled and followed for a median of 5.2 and 3.9 years (ccDO and IcDO, resp.). ccDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%;ccDO vs IcDO, Pciated congenital heart disease (cHD), more extensive preoperative radiologic diagnostics, higher morbidity according to clavien-Dindo classification and comprehensive complication index (all P≤0.01). The subgroup analysis of patients without cHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the ccDO group (PcONcLUSION ccDO and IcDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated cHD, preoperative diagnostics and morbidity. The degree of cDO in mature patients without cHD influences the postoperative initiation of enteral feeding.

关键词： congenital duodenal obstruction Duodenal atresia Duodenal stenosis Prenatal ultrasonographic detection rate clinical presentation Preoperative diagnostics Adverse events Outcome

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comparison of perioperative outcomes between laparoscopic and open partial splenectomy in children and adolescents

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 979-987页

作者： Mohamed Makansi Martin Hutter Till-Martin Theilen henning c fiegel Udo Rolle Stefan Gfroerer Department of Pediatric Surgery and Pediatric Urology University Hospital FrankfurtFrankfurt am Main 60590Germany Department of Pediatric Surgery and Pediatric Urology Helios Clinic Berlin-BuchBerlin 13125Germany

BAcKGROUND In order to avoid consequences of total splenectomy,partial splenectomy(PS)is increasingly *** purpose of this study was to compare perioperative outcomes of laparoscopic PS(LPS)and open PS(OPS)in children and *** To compare perioperative outcomes of patients with LPS and *** After institutional review board approval,a total of 26 patients that underwent LPS or OPS between January 2008 and July 2018 were identified from the database of our tertiary referral *** total,10 patients had LPS,and 16 patients underwent *** loss was calculated by Mercuriali’s *** scores,analgesic requirements and complications were *** Wilcoxon rank sum test was used for *** compare categorical variables,Fisher’s exact test was *** LPS was performed in 10 patients;16 patients had ***(except for body mass index and duration of follow-up),indicating primary disease,preoperative spleen size and postoperative spleen volume,perioperative hematological parameters,postoperative pain scores,analgesic requirements,adverse events according to the clavien-Dindo classification and the comprehensive complication index,median time from operation to initiation of feeds,median time from operation to full feeds,median time from operation to mobilization and median length of hospital stay did not differ between LPS and ***(range)operative time(min)was longer in LPS compared to the OPS group[185(135-298)vs 144(112-270),respectively;P=0.048].calculated perioperative blood loss(mL of red blood cell count)was higher in the LPS group compared to OPS[87(-45-777)vs-37(-114-553),respectively;P=0.039].cONcLUSION This is the first study that compared outcomes of LPS and *** operative approaches had comparable perioperative *** appears to be a viable alternative to OPS.

关键词： Laparoscopic vs open Laparoscopy Partial splenectomy Perioperative outcome children Adolescents

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Hepatocytic differentiation of mesenchymal stem cells in cocultures with fetal liver cells

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World Journal of Gastroenterology 2006年第15期12卷 2394-2397页

作者： claudia Lange Helge Bruns Dietrich Kluth Axel R Zander henning c fiegel center of Bone Marrow Transplantation University Hospital Hamburg-Eppendorf Martinistrasse 52D-20246 HamburgGermany Department of Pediatric Surgery University Hospital Hamburg-Eppendorf Martinistrasse 52D-20246 HamburgGermany Department of Pediatric Surgery University Hospital Hamburg-Eppendorf Martinistrasse 52D-20246 Hamburg Germany

瞄准：为了与胎儿的肝细胞(FLc ) 和可能性在合作文化调查间充质的干细胞(MSc ) 的 hepatocytic 区别膨胀，区分了 hepatocytic 房间。方法：MSc 被制动火箭与绿荧光灯的蛋白质(GFP ) 标记病毒的基因转导变异。同种细胞的显著 MSc 在用... 详细信息

瞄准：为了与胎儿的肝细胞(FLc ) 和可能性在合作文化调查间充质的干细胞(MSc ) 的 hepatocytic 区别膨胀，区分了 hepatocytic 房间。方法：MSc 被制动火箭与绿荧光灯的蛋白质(GFP ) 标记病毒的基因转导变异。同种细胞的显著 MSc 在用与干细胞补充的fibronectin涂的培养皿和媒介刺激条件的肝下面是也有教养的因素( ScF )， hepatocyte 生长因素( HGF )，表皮的生长因素( EGF )，和成纤维细胞生长因素 4 ( FGF-4 )独自一个，或在刚孤立的 FLc 的存在。在合作文化的房间被收获，并且 GFP+ 或 GFP- 房间用荧光被分开激活的房间排序。为肝 specific 标记 cytokeratin-18 (cK-18 ) 的反向的抄写聚合酶链反应(RT-PcR )( 法新社) ，白朊，和 alpha-fetoprotein 在不同房间人口被执行。结果：在指定文化条件下面，与 FLc co 有教养的老鼠 MSc 超过二个星期表示了白朊， cK-18，和 AFP-RNA。在 wk 3， MSc 失去了 hepatocytic 基因表示，可能由于 cocultured FLc 的增生。FLc 也在合作文化和一个很高的生长潜力显示出稳定的肝 specific 基因表情。结论：从骨髓的老鼠 MSc 能面对 FLc 在试管内区分 hepatocytic 房间，在合作文化的 MSc 的存在也为 FLc 的扩大和区别提供有益的环境。

关键词：细胞分化间叶干细胞细胞培养胎儿肝脏

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Liver-specific gene expression in mesenchymal stem cells is induced by liver cells

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World Journal of Gastroenterology 2005年第29期11卷 4497-4504页

作者： claudia Lange Philipp Bassler Michael V. Lioznov Helge Bruns Dietrich Kluth Axel R. Zander henning c. fiegel center of Bone Marrow Transplantation University Hospital Hamburg-Eppendorf Martinistrasse 52 D-20246 Hamburg Germany Department of Pediatric Surgery University Hospital Hamburg-Eppendorf Martinistrasse 52 D-20246 Hamburg Germany

AIM: The origin of putative liver cells from distinct bone marrow stem cells, e.g. hematopoietic stem cells or multipotent adult progenitor cells was found in recent in vitro studies. cell culture experiments revealed a key role of growth factors for the induction of liver-specific genes in stem cell cultures. We investigated the potential of rat mesenchymal stem cells (MSc) from bone marrow to differentiate into hepatocytic cells in vitro. Furthermore,we assessed the influence of cocultured liver cells on induction of liver-specific gene ***: Mesenchymal stem cells were marked with green fluorescent protein (GFP) by retroviral gene transduction. clonal marked MSc were either cultured under liver stimulating conditions using fibronectin-coated culture dishes and medium supplemented with ScF, HGF,EGF, and FGF-4 alone, or in presence of freshly isolated rat liver cells. cells in cocultures were harvested and GFP+ or GFP- cells were separated using fluorescence activated cell sorting. RT-PcR analysis for the stem cell marker Thy1 and the hepatocytic markers cK-18, albumin, cK-19,and AFP was performed in the different cell ***: Under the specified culture conditions, rat MSc cocultured with liver cells expressed albumin-, cK-18,cK-19, and AFP-RNA over 3 weeks, whereas MSc cultured alone did not show liver specific gene ***: The results indicate that (1) rat MSc from bone marrow can differentiate towards hepatocytic lineage in vitro, and (2) that the microenvironment plays a decisive role for the induction of hepatic differentiation of rMSc.

关键词：肝脏疾病肝细胞基因表达间叶细胞

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L1 is a potential marker for poorly-differentiated pancreatic neuroendocrine carcinoma

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World Journal of Gastroenterology 2006年第1期12卷 94-98页

作者： Jussuf T Kaifi Ulrich Zinnkann Emre F Yekebas Paulus G Schurr Uta Reichelt Robin Wachowiak henning c fiegel Susann Petri Melitta Schachner Jakob RIzbicki Department of General Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany Institute for Pathology University Medical Center Hamburg-EppendorfHamburgGermany Department of Pediatric Surgery University Medical Center Hamburg-EppendorfHamburgGermany center for Molecular Neurobiology University Medical Center Hamburg-EppendorfHamburgGermany

瞄准：在胰腺的神经内分泌肿瘤决定 L1 的表示并且相关它与这个肿瘤的分类。方法：我们回顾地在原发性瘤或转移的石蜡节上由免疫组织化学在胰腺的神经内分泌肿瘤的 63 种情况中分析了 L1 表示。染色被过氧化物酶技术对人的 L1 与单音的... 详细信息

瞄准：在胰腺的神经内分泌肿瘤决定 L1 的表示并且相关它与这个肿瘤的分类。方法：我们回顾地在原发性瘤或转移的石蜡节上由免疫组织化学在胰腺的神经内分泌肿瘤的 63 种情况中分析了 L1 表示。染色被过氧化物酶技术对人的 L1 与单音的同种细胞的抗体 UJ127.11 执行。所有肿瘤被分类根据分类同样区分得好的神经内分泌肿瘤和癌或糟糕区分的神经内分泌癌。结果：L1 在 5 被检测(7.9%) 63 个胰腺的神经内分泌肿瘤。(44.4%) 四 9 糟糕区分的癌表示了 L1。相反，仅仅(1.9%) 1 为 L1 54 个区分得好的肿瘤或癌是积极的。没有表示在正常胰腺的织物的 Langerhans 小岛房间被发现。生气桌子分析显示出在 L1 表示和胰(P<0.01 ) 的神经内分泌肿瘤的分类之间的一个重要协会。结论：L1 明确地在被知道有最糟的预后的糟糕区分的胰腺的神经内分泌癌被表示。L1 可能是为与胰腺的神经内分泌癌诊断的病人的风险预言的一个标记。

关键词：电势神经内分泌癌胰腺肿瘤细胞分化

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ITPK1 is an InsP/ADP phosphotransferase that controls phosphate signaling in Arabidopsis

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Molecular Plant 2024年第7期17卷 1151-1157页

作者： Esther Riemer Danye Qiu Debabrata Laha Robert K.Harmel Philipp Gaugler Verena Gaugler Michael Frei Mohammad-Reza Hajirezaei Nargis Parvin Laha Lukas Krusenbaum Robin Schneider Adolfo Saiardi Dorothea Fiedler henning J.Jessen Gabriel Schaaf Ricardo F.H.Giehi 不详

(Molecular Plant 14,1864-1880;November 12021)We identified a mistake made when calculating the absolute concentrations of inositol(pyro)phosphates derived from cE-ESl-MS measurements reported in the originally published version of our *** to a calculation error when determining concentrations per fresh biomass,the absolute values shown in the manuscript are approximately 30-fold lower than they should *** mistake affects Figures 2D,3c,4c,and 7D and Figures S4,S11B,S13,and *** all conclusions made in the article referred to relative differences between genotypes and treatments,they remained unaffected by these mistakes.

关键词： ipt Arabidopsis absolute

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changes of smooth muscle contractile filaments in small bowel atresia

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World Journal of Gastroenterology 2012年第24期18卷 3099-3104页

作者： Stefan Gfroerer henning fiegel Priya Ramachandran Udo Rolle Roman Metzger Department of Paediatric Surgery Goethe-University Frankfurt60590 FrankfurtGermany Kanchi Kamakoti childs Trust Hospital Chennai 600034India Department of Paediatric Surgery University of Leipzig04317 LeipzigGermany

AIM:To investigate morphological changes of intestinal smooth muscle contractile fibres in small bowel atresia ***:Resected small bowel specimens from small bowel atresia patients(n = 12) were divided into three sections(proximal,atretic and distal).Standard histology hematoxylin-eosin staining and enzyme immunohistochemistry was performed to visualize smooth muscle contractile markers-smooth muscle actin(SMA) and desmin using conventional paraffin sections of the proximal and distal *** bowel from agematched patients(n = 2) undergoing Meckel's diverticulum resection served as ***:The smooth muscle coat in the proximal bowel of small bowel atresia patients was thickened compared with control tissue,but the distal bowel was *** of smooth muscle contractile fibres SMA and desmin within the proximal bowel was slightly reduced compared with the distal bowel and control *** were no major differences in the architecture of the smooth muscle within the proximal bowel and the distal *** proximal and distal bowel in small bowel atresia patients revealed only minimal differences regarding smooth muscle morphology and the presence of smooth muscle contractile filament ***:changes in smooth muscle contractile filaments do not appear to play a major role in postoperative motility disorders in small bowel atresia.

关键词：平滑肌收缩小肠闭锁形态学变化组织学免疫组化肌动蛋白石蜡切片

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Differential changes in intrinsic innervation and interstitial cells of cajal in small bowel atresia in newborns

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World Journal of Gastroenterology 2010年第45期16卷 5716-5721页

作者： Stefan Gfroerer Roman Metzger henning fiegel Priya Ramachandran Udo Rolle Department of Paediatric Surgery Johann Wolfgang Goethe-University Frankfurt/MTheodor-Stern-Kai 760590 Frankfurt/MGermany Department of Paediatric Surgery University of Leipzig04103 LeipzigGermany Department of Pediatric Surgery Kanchi Kamakoti Childs Trust Hospital12-A ChennaiIndia

AIM: To investigate morphological changes of the enteric nervous system (ENS) and the interstitial cells of cajal (Iccs) in small bowel ***: Resected small bowel specimens from affected patients (n = 7) were divided into three parts (proximal, atretic, distal). Standard histology and enzyme immunohistochemistry anti-S100, anti-protein gene product (PGP) 9.5, anti-neurofilament (NF), antic-kit-receptor (cD117) was carried out on conventional paraffin sections of the proximal and distal part. RESULTS: The neuronal and glial markers (PGP 9.5, NF, S-100) were expressed in hypertrophied ganglia and nerve fibres within the myenteric and submucosal plexuses. Furthermore, the submucous plexus contained typical giant ganglia. The innervation pattern of the proximal bowel resembled intestinal neuronal dysplasia. The density of myenteric Iccs was clearly reduced in the proximal bowel, whereas a moderate number of muscular Iccs were found. The anti-cD117 immunore- action revealed additional numerous mast cells. The distal bowel demonstrated normal morphology and density of the ENS, the Iccs and the mast ***: The proximal and distal bowel in small bowel atresia revealed clear changes in morphology and density of the ENS and Iccs.

关键词： Small bowel atresia Enteric nervous system Gastrointestinal motility Interstitial cells of cajal

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complications of newborn enterostomies

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World Journal of clinical cases 2018年第16期6卷 1101-1110页

作者： Lea Wolf Stefan Gfroerer henning fiegel Udo Rolle Department of Pediatric Surgery University Hospital Frankfurt Goethe-University Frankfurt am Main

AIM To evaluate the occurrence and severity of enterostomy complications in newborns suffering from different intestinal *** A 10-year retrospective cohort study(2008-2017) investigated newborns that underwent enterostomy formation and reversal for different intestinal disorders. Only infants less than 28 d old at the time of enterostomy creation were included in the study(corrected age was applied in the cases of preterm neonates). The patients were divided into two groups according to their underlying diseases. Group 1 included infants suffering from necrotizing enterocolitis(NEc), whereas Group 2 included newborns diagnosed with intestinal disorders other than NEc, such as meconium obstruction, anorectal malformation, focal intestinal perforation, ileus, intestinal atresia and volvulus. The primary outcome measure was enterostomy-related morbidity. The data were analyzed statistically using Pearson's χ2 test or Fisher's exact test for categorical variables and the Wilcoxon-Mann-Whitney U-Test for continuous variables. RESULTS In total, 76 infants met the inclusion criteria and were evaluated for enterostomy-related complications. Neither group showed significant differences regarding gender, gestational age, weight at birth or weight at enterostomy formation. Infants suffering from NEc(Group 1) were significantly older at enterostomy for-mation than the neonates of Group 2 [median(range), 11(2-75) d vs 4(1-101) d, P = 0.004)]. Significantly more ileostomies were created in Group 1 [47(92.2%) vs 16(64.0%), P = 0.007], whereas colostomies were performed significantly more often in Group 2 [2(3.9%) vs 8(32.0%), P = 0.002]. The initiation of enteral nutrition after enterostomy was significantly later in Group 1 infants than in Group 2 infants [median(range), 5(3-13) vs 3(1-9), P complications in patients of both groups after enterostomy formation was 80.3%, with rates of 86.3% in Group 1 and 68.0% in Group 2(P =

关键词： Enterostomy closure Enterostomy Stoma Necrotizing enterocolitis Neonates complications Enterostomy formation

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Abdominal cocoon in children: A case report and review of literature

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World Journal of Gastroenterology 2021年第37期27卷 6332-6344页

作者： Daniel Keese Andrea Schmedding Kerstin Saalabian Georgy Lakshin henning fiegel Udo Rolle Goethe-University Frankfurt Department of Paediatric Surgery and Paediatric UrologyUniversity HospitalFrankfurt 60590Germany

BAcKGROUND Abdominal cocoon or“encapsulating peritoneal sclerosis”(EPS)is an uncommon and rare cause of intestinal *** a few cases have been reported in paediatric ***,EPS is described as the primary form in young adolescent girls from tropical and subtropical countries because of viral peritonitis due to retrograde menstruation or a history of peritoneal *** patients are asymptomatic or present with abdominal pain,which is likely to occur secondary to subacute bowel *** at imaging,such as ultrasound,computed tomography,and magnetic resonance imaging,are often *** diagnosed,EPS is characterized by total or partial encasement of the bowel within a thick fibrocollagenous membrane that envelopes the small intestine in the form of a cocoon because of chronic intraabdominal fibroinflammatory *** membrane forms a fibrous tissue sheet that covers,fixes,and finely constricts the gut,compromising its *** SUMMARY We present a case of EPS in a 12-year-old boy 8 wk after primary surgery for resection of symptomatic jejunal *** was no history of peritoneal dialysis or drug *** In this report,we sought to highlight the diagnostic,surgical,and histopathological characteristics and review the current literature on EPS in paediatric patients.

关键词： Abdominal cocoon Peritoneal encapsulation Encapsulating peritoneal sclerosis Intestinal obstruction children case report

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