Langenbeck's archives of surgery
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Langenbecks Arch Surg · Sep 2007
ReviewImmune response of severely injured patients--influence of surgical intervention and therapeutic impact.
[corrected] Severe injury leads to a severe deterioration of the patients' immune response. The changes of the immune response after severe injury include a broad range of immune functions and may result in a status of immunosuppression, which could favor infectious complications. Therefore, immunostimulating therapies have been introduced in the therapy for severely injured patients in clinical and experimental settings. ⋯ Immunomodulating therapies in trauma patients exist on an experimental level with inconsistent results. The general management of trauma patients includes strategies that have been developed also on the basis of immunological considerations.
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Langenbecks Arch Surg · Sep 2007
Comparative StudyComparison and validation of scoring systems in a cohort of patients treated for perforated peptic ulcer.
The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic ulcer referred to an academic department of general surgery in a tertiary reference center. ⋯ MPM II that predicted mortality at admission is better than the other systems in predicting mortality. Results also indicate the importance of maintenance of systemic perfusion of the patient at the early phases of peptic ulcer perforation.
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Langenbecks Arch Surg · Sep 2007
The use of vacuum assisted closure (VAC) in soft tissue injuries after high energy pelvic trauma.
Application of vacuum-assisted closure (VAC) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. ⋯ High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closure.
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Langenbecks Arch Surg · Jul 2007
Case ReportsExpandable metal stents as an alternative treatment of cuff-related tracheal stenosis in tracheostomy-dependent ventilated patients: a prospective study of nine cases and description of the complications.
In long-term intubated patients, cuff-related tracheal injury is occasionally complicated by tracheal stricture. To keep the airway patent, bougienage and deployment of stents are adopted in patients unfit for surgery. ⋯ EMS appears to have a role to play in tracheostomy-dependent ventilated patients with benign tracheal stenoses in whom there are no other reasonable options.
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Langenbecks Arch Surg · May 2007
Alleviation of ischemia-reperfusion injury in rat liver transplantation by induction of small interference RNA targeting Fas.
Cellular apoptosis plays an important role in ischemia-reperfusion (I/R) injury during organ transplantation. Synthetic small interference RNA (siRNA) targeting apoptotic receptor Fas has proven effective to protect mice against hepatitis and renal I/R injury. The objective of this study is to investigate the silencing impact of Fas siRNA to alleviate I/R injury in rat liver transplantation. ⋯ Fas-mediated apoptosis play an important role in I/R injury of rat liver transplantation. Silencing Fas by hydrodynamic injection of siRNA holds therapeutic promise to limit I/R injury.