Collagenmatrizes - Unterschiede in der Textur und Auswirkungen auf die Collagenneosynthese bei Kindern mit Verbrühung/Verbrennung

In recent years the possibility to engineer cells in vitro has encountered significant progress. This engineering of cellular states, which is tightly coupled to the field of stem cell research, is considered to be a very useful technology for the generation of specialised cells for drug development, disease modelling, or regenerative medicine. One important part of this process is the quality control, i.e. the detailed characterisation of the end products, to ensure that the transformed cells are similar to their in vivo counterparts. Many markers and functional assays exist that can be used for quality control of these cells. However, most of them focus on specific, relatively narrow properties of the cells, neglecting a global overall comparison to the desired cell type.Here, we present a genome-wide gene expression microarray based approach to cell characterisation, providing complementary information to the commonly used single gene or morphological markers. We use a dimension reduction approach to localise newly generated microarray data in the high dimensional expression space. Using a combination of unsupervised and supervised dimension reduction methods, we establish a two-scale map of global gene expression with phenotypic interpretation of the coordinates.This two-scale map is used to characterise several different samples. It is first validated on a dataset of 24 different tissues and cell lines as well as on two datasets of artificially mixed tissues. Using these datasets, it is shown that the developed method outperforms three existing methods for RNA based global cell characterisation and that it provides increased information compared to the purely unsupervised or purely supervised dimension reduction methods. Application of the two-scale map to characterise in vitro transformed cells prooves to be useful in providing complementary information to the typical marker based or morphological criteria. In this respect, we could identify two examples of in vitro transformed cells where the transformation process is incomplete on a global expression level. Furthermore, we can show that in vitro differentiation of pluripotent stem cells results in immature cells that are similar to embryonic of fetal tissues of the respective type.Using microarray data from artificial mixtures of different tissues, we can observe clear non-linear effects in the data that fit well to the current understanding of the relationship between the RNA content of cells and the measurement signal of microarrays. Such non-linear effects are currently not captured by the proposed linear dimension reduction approach and give important hints for further improvements of the method.In addition to quality control of in vitro transformed cells, the two-scale decomposition approach developed in this thesis may also be useful for a number of other applications, such as the analysis of drug response profiles or disease progression

Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children

The purpose of our retrospective study was to describe the efficacy and the advantages of laparoscopic approach to treat incarcerated inguinal hernia (IIH) in pediatric patients. In a 2-year period, 601 children underwent a laparoscopic inguinal hernia repair, 46 (7.6 %) of them presented an IIH. Our study will be focused on these 46 patients: 30 boys and 16 girls (age range 1 month-8 years). Twenty-one/46 hernias (45.6 %) were reduced preoperatively and then operated laparoscopically (RH), 25/46 (54.4 %) were irreducible and they were operated directly in laparoscopy (IRH). We have no conversions in our series. The length of surgery in RH group was in median 23 min and in IRH group was in median 30 min. Hospital stay was variable between 6 h and 3 days (median 36 h).With a minimum follow-up of 14 months, we had 2/46 recurrences (4.3 %). The laparoscopic approach to IIH appears easy to perform from the technical point of view. The 3 main advantages of laparoscopic approach are that all edematous tissue are surgically bypassed and the cord structures are not touched; the reduction is performed under direct visual control, and above all, an inspection of the incarcerated organ is performed at the end of procedure

Laparoscopic repair of incarcerated inguinal hernia. A safe and effective procedure to adopt in children

BACKGROUND: The purpose of our retrospective study was to describe the efficacy and the advantages of laparoscopic approach to treat incarcerated inguinal hernia (IIH) in pediatric patients. METHODS: In a 2-year period, 601 children underwent a laparoscopic inguinal hernia repair, 46 (7.6 %) of them presented an IIH. Our study will be focused on these 46 patients: 30 boys and 16 girls (age range 1 month-8 years). RESULTS: Twenty-one/46 hernias (45.6 %) were reduced preoperatively and then operated laparoscopically (RH), 25/46 (54.4 %) were irreducible and they were operated directly in laparoscopy (IRH). We have no conversions in our series. The length of surgery in RH group was in median 23 min and in IRH group was in median 30 min. Hospital stay was variable between 6 h and 3 days (median 36 h).With a minimum follow-up of 14 months, we had 2/46 recurrences (4.3 %). CONCLUSION: The laparoscopic approach to IIH appears easy to perform from the technical point of view. The 3 main advantages of laparoscopic approach are that all edematous tissue are surgically bypassed and the cord structures are not touched; the reduction is performed under direct visual control, and above all, an inspection of the incarcerated organ is performed at the end of procedure

Laparoscopic inguinal hernia repair in premature babies weighing 3 kg or less.

PURPOSE: This retrospective study aims to evaluate the feasibility, safety and complication rate of laparoscopic inguinal hernia repair for small babies weighing 3 kg or less. METHODS: A retrospective analysis was performed on the surgical charts of 67 infants (47 boys and 20 girls) weighing 3 kg or less who underwent laparoscopic hernia repair in a 3-year period. A regular 5-mm scope was used for visualization, and 2 or 3-mm instruments were used for the closure of the inner inguinal ring using 3/0 non-absorbable suture. The median weight at surgery was 2,600 g (range 1,450-3,000 g). All except three were premature. RESULTS: Of the 67 infants, 15 (22.3 %) presented with an irreducible hernia. In three cases of irreducible hernias, we also performed a transumbilical appendectomy at the end of the hernia repair. Minor problems related with anesthesia were noted in four cases. Hernia recurrence was observed in three patients (4.4 %). No cases of testicular atrophy occurred. In 10 boys, we observed 12 cases of high testes, only 4 testes requiring subsequent orchiopexy. CONCLUSIONS: Laparoscopic inguinal hernia repair for babies weighing 3 kg or less is feasible, safe and perhaps even less technically demanding than open inguinal herniotomy