European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes
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The purpose of this study is to evaluate the functional and radiological outcomes of patients with unstable displaced proximal humeral fractures treated with closed reduction and percutaneous pinning (CRPP) fixation. ⋯ CRPP fixation is a feasible treatment option for unstable displaced proximal humeral fractures, especially for 2- and 3-part fractures in elderly patients. Although technically demanding, it offers reliable stability without extensive soft tissue dissection, allowing the early painless range of motion. This technique could also promote bone healing, prevent ischemic osteonecrosis of the head of humerus and lead to few complications.
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Newly developed vagal stimulation probes permit continuous intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid resection. Complete signal loss indicates damage of the nerve. There is no other criterion so far to warn before imminent nerve function impairment. ⋯ The parameters signal amplitude, latency and stimulation threshold cannot be used as reliable warning criteria for nerve function impairment during thyroid resection. Loss of signal remains the most important criterion for the surgeon. The coupling of the signal change to operational procedure may be beneficial in difficult thyroid preparation. This gives the surgeon the possibility to react immediately in the case of signal loss.
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To elaborate the impact of new haemostatic agents we developed an instrument for the pressure-controlled induction of blunt liver injuries in a porcine animal model. ⋯ We developed a pressure-controlled clamp that allows for the induction of blunt liver traumas with highly reproducible injuries with a positive correlation with blood loss and survival.
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Acute rejection (AR) after liver transplantation is a cell-mediated immune response that takes place within the allograft and results in graft dysfunction and failure, but the molecular mechanisms about hepatocyte dysfunction remain poorly understood. Here we characterized global protein expression changes in liver allograft during AR. ⋯ This study uncovered new mechanistic insights into graft dysfunction in AR of liver allograft. Several significantly altered protein expressions act coordinately in hepatocyte dysfunction by depressed energy, enhanced oxidative stress-induced molecular damage and restrained biotransformation. The present findings may open new avenues for the understanding and prevention of graft dysfunction and failure during AR.
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The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. ⋯ Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy.