Abstract:
BACKGROUND/PURPOSE:Currently, the reason for hepatobiliary dysfunction associated with long-term total parenteral nutrition (TPN) is much debated and still unclear. No agreement can be achieved about whether bacteriotoxins and sepsis, enteral starvation, consequences of abdominal operations, or the TPN solution itself is the real cause for the disease. Animal models were criticized for their short period of TPN and their failure to demonstrate cholestasis and bile duct proliferation. The aim of this study was to establish an animal model for long-term TPN in which the same alterations of the hepatobiliary system as observed in humans could be produced. METHODS:In this model, rabbits could be kept for the first time under continuous TPN for 4 weeks. Three serial liver biopsy sections were taken operatively from each animal and biochemical analyses were performed four times. A control group of enterally fed rabbits underwent exactly the same procedure in respect to operations and handling, so that differences in macroscopical, biochemical, and histological changes between both groups could be attributed exclusively to TPN. RESULTS:Only in the TPN group gallbladder distension developed in all animals after 1 week. After 3 and 4 weeks, viscous dark bile, sludge and stones, a slight rise in direct bilirubin, and a decline in plasma albumin and alkaline phosphatase was noted. In both groups liver biopsy results showed a similar degree of mild portal inflammation and single-cell necrosis at equivalent time points. These changes could be caused by antiseptics, antibiotics, anesthesia, and operations. Although mild to moderate proliferative changes and no hydropic degeneration developed in the control group during the same time, the TPN group generated marked proliferative and degenerative changes. We noted as early as 1 week after starting TPN a severe hydropic degeneration in 90% of the animals. Fibrosis and bile duct proliferation increased from a slight degree after 1 week up to a moderate to severe degree after 3 and 4 weeks, respectively. CONCLUSIONS:The hepatobiliary alterations associated with TPN in children, which cannot be separated clinically from consequences of multiple other factors, can almost identically be reproduced in our rabbit model as a clear consequence of TPN. Furthermore, the hydropic degeneration of the liver cells begins in zone 3 and is an early predominant feature of hepatobiliary dysfunction in rabbits and infants. It must be rated as a response to a direct cytotoxic effect on the liver cell.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Loff S,Waag KL,Kränzlin B,Zovko D,Dzakovic A,Jester I,Wirth H,Wessel Ldoi
10.1016/s0022-3468(98)90189-0subject
Has Abstractpub_date
1998-05-01 00:00:00pages
694-9issue
5eissn
0022-3468issn
1531-5037pii
S0022-3468(98)90189-0journal_volume
33pub_type
杂志文章abstract:PURPOSE:Implementation of a nonaccidental trauma (NAT) screening guideline for the evaluation of infants admitted with an unwitnessed head injury has eliminated screening disparities. This study sought to determine the overall NAT rate and key predictive factors using this guideline. METHODS:All infants screened via t...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.02.014
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND/PURPOSE:Gastroesophageal reflux is common in children with severe neurological impairment. Fundoplication may produce symptomatic improvement but has a high failure rate. Esophagogastric dissociation (EGD) is an alternative procedure for treatment of gastroesophageal reflux. The aim of this study is to evalu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.03.004
更新日期:2005-06-01 00:00:00
abstract::Every year in the United States, 1.6 to 3.8 million concussions occur secondary to injuries sustained during sports and recreational activities. Major advances have been made in terms of identifying specific clinical profiles following concussion. Nevertheless, there are continued misunderstandings regarding this inju...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.10.011
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Our objective was to evaluate the accuracy of acoustic radiation force impulse (ARFI) elastography in determining extent of liver fibrosis in pediatric patients with short bowel syndrome (SBS). METHODS:This prospective cohort study included pediatric patients with SBS who underwent ultrasound with ARFI meas...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.03.016
更新日期:2017-06-01 00:00:00
abstract::The embryological development of the hepatobiliary bud presupposes that biliary and duodenal malformations are often associated. On the other hand, the association of biliary atresia with more distal small bowel malformations, possibly due to a vascular accident, seems to be fortuitous. We herewith report such a case ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80534-x
更新日期:1983-04-01 00:00:00
abstract:INTRODUCTION:Bacterial intestinal translocation plays an important role in neonatal sepsis. We aimed to elucidate the importance of such translocation in causing central line associated blood stream infection (CLABSI) in patients undergoing gastrointestinal surgery (GIS). METHODS:Using a database of pediatric patients...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.02.012
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is the most severe form of functional intestinal obstruction in the newborn. To date, multivisceral transplantation has been the only accepted treatment modality for these patients, and the results have met with marginal success. We report the...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.09.073
更新日期:2008-02-01 00:00:00
abstract:PURPOSE:Neurologically impaired children with severe gastroesophageal reflux disease (GERD) are a challenging group of patients. We theorized that a laparoscopic gastroesophageal dissociation (LGED) may decrease reflux-related readmissions and healthcare visits, and improve quality of life (QOL) for them and their care...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2017.10.010
更新日期:2017-10-09 00:00:00
abstract:PURPOSE:The mortality rate for pediatric trauma patients cared for in adult trauma centers has been shown, by means of TRISS methodology, not to differ significantly from that of the Major Trauma Outcome Study (MTOS). The question remains, however, whether the outcome of injured children is better in a designated pedia...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(96)90322-x
更新日期:1996-01-01 00:00:00
abstract::According to Gitlin, alpha-fetoprotein (AFP), albumin, prealbumin, alpha-1-antitrypsin and transferrin are normal products of the human yolk sac. They are expected to reappear in human endodermal sinus tumor (yolk sac tumor). The synthesis of alpha-fetoprotein and other serum proteins by human endodermal sinus tumor w...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(78)80207-3
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND:The authors have shown previously that experimental neuroblastoma is partially inhibited (48%) by antivascular endothelial growth factor (anti-VEGF) antibody. The topoisomerase-I inhibitor, topotecan, has been shown to have antiangiogenic activity when administered in a low-dose, high-frequency regimen. We h...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2002.30855
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:The incidence of children developing recurrent sacrococcygeal teratoma (SCT) is 2-35%. Serum alpha-fetoprotein (AFP) is often used as a tumor marker for (malignant) recurrences of SCT and could potentially be used during routine follow-up after SCT resection. However, the diagnostic accuracy of serum AFP lev...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.03.014
更新日期:2020-09-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the frequency of thrombophilic disorders in children and adolescents with portal vein thrombosis (PVT) as well as assessing the hereditary character of this disorder. METHODS:A 2-year prospective study was carried out in pediatric PVT patients (n = 14), their parents (n =...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.05.005
更新日期:2004-09-01 00:00:00
abstract::A 17-year-old boy with insulin-dependent diabetes mellitus developed ketoacidosis and transitory shock. After resolution of his metabolic imbalance, he developed an acute abdomen prompting exploratory surgery. A section of necrotic ileum was found and resected. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90798-c
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:Failure of the gut barrier and endotoxemia have been implicated in sepsis and multiple organ failure (MOF) syndromes in adults. The contributions of endotoxin (ETX) and proinflammatory cytokines (CKs) to the pathophysiology of disease and the outcomes of infants in the neonatal intensive care unit (N...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2006.10.038
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:This report reviews our experience using peritoneal drainage (PD) as initial therapy for intestinal perforation in premature infants with and without necrotizing enterocolitis (NEC). METHODS:A chart review was conducted of 18 consecutive premature infants who underwent PD for intestinal perforation ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90245-2
更新日期:1999-01-01 00:00:00
abstract::The author reports four newborns with large gastroschisis, in whom primary fascial closure could not be accomplished. They were successfully treated by primary repair with Gore-Tex patch. Gore-Tex patch closure is a safe and good alternative in large abdominal wall defects when primary fascial repair is not feasible. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90023-e
更新日期:1993-05-01 00:00:00
abstract:PURPOSE:The aim of this study was to identify the most accurate prenatal predictors of outcomes and need for fetal surgery for fetuses with high-risk lung masses and vascular tumors. METHODS:The records of all fetuses with high-risk lung mass (congenital cystic adenomatoid malformation-volume ratio > 1.6 or findings o...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.10.019
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Intrathyroidal thymic tissue may be misinterpreted as a thyroid lesion in children, leading to invasive tests or resection. We sought to describe the characteristic imaging features of these lesions and to evaluate the safety of non-operative management. METHODS:A retrospective review of all patient...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2018.02.011
更新日期:2018-05-01 00:00:00
abstract::A rare case of VACTEL syndrome with antenatally diagnosed duodenal atresia is reported. We performed one-staged radial surgery for the esophageal atresia with tracheoesophageal fistula and duodenal atresia. The prognosis of VACTEL syndrome with duodenal atresia is very poor. This is the first reported case cured opera...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(89)80104-6
更新日期:1989-11-01 00:00:00
abstract::Newly developed diagnostic techniques allowed us to select a fetus with potentially reversible renal damage from the usually fatal group with bilateral hydronephrosis and severe oligohydramnios early in gestation. Fetal surgery to marsupialize the fetal bladder at 24 weeks gestation restored normal amniotic fluid dyna...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80221-x
更新日期:1987-06-01 00:00:00
abstract:PURPOSE:The aim of this study was to review the surgical complications of pancreatectomy for persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI). METHODS:A retrospective review was conducted of patients undergoing pancreatectomy for PHHI in one institution over the past 13 years. RESULTS:The records of 48 pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2003.50001
更新日期:2003-01-01 00:00:00
abstract::The bowel function of 46 patients who had undergone internal sphincter-saving posterior sagittal anorectoplasty (PSARP) was evaluated by a questionnaire 3 to 10 years after the closure of the colostomy. The bowel function was assessed by a multivariate scoring method. All patients had also been followed up clinically ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90064-0
更新日期:1995-03-01 00:00:00
abstract::Three newborn boys presented with features suggestive of classic low anorectal abnormality. However, during surgery they were found to have an intermediate anorectal abnormality and a rectoperineal fistula rather than an anocutaneous fistula. The surgical treatment of these infants is discussed. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90085-x
更新日期:1994-04-01 00:00:00
abstract::The effect of whole bowel irrigation (WBI) with a polyethylene glycol electrolyte lavage solution (PEG-ELS; 27 children) was compared to the WBI with two electrolytic solutions: normal saline with added potassium chloride (NS; 25 children) and Ringer's injection (RI; 29 children). The PEG-ELS required less volume and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80423-8
更新日期:1988-08-01 00:00:00
abstract::Paediatric surgeons in Australia and New Zealand have had a close relationship with the British Association of Paediatric Surgeons (BAPS). In the first 15 years after the foundation of BAPS, 17 Australian and one New Zealand paediatric surgeons became members of BAPS, of whom, 11 are still alive. Currently, 32 Austral...
journal_title:Journal of pediatric surgery
pub_type: 历史文章,杂志文章
doi:10.1016/s0022-3468(03)00073-3
更新日期:2003-07-01 00:00:00
abstract::Mucosal perforation during Fredet-Ramstedt pyloromyotomy traditionally has been repaired with muscular and mucosal reapproximation, pyloric rotation, and repeat myotomy. The purpose of this study was to determine whether simple mucosal closure is a safe alternative repair technique for such a perforation. The authors ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90398-4
更新日期:1995-10-01 00:00:00
abstract:PURPOSE:The aim of the study was to evaluate our recent experience in treating esophageal atresia (EA) and the outcomes observed at a single center for pediatric surgery. MATERIALS AND METHODS:The records of infants with EA from 2006 to 2009 were reviewed. Birth weight, associated anomalies, details of management, com...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.05.017
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We develo...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.10.036
更新日期:2017-01-01 00:00:00
abstract::Carcinoma of the breast is rarely encountered in the male population and is even less prevalent in the pediatric male population. Studies have suggested an association between male breast carcinoma and gynecomastia, but conflicting results have been shown. Only 3 cases of carcinoma in situ associated with bilateral gy...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2011.06.010
更新日期:2011-09-01 00:00:00