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Your search keyword '"Daniel Hofmann"' showing total 3 results
Start Over Author "Daniel Hofmann" Journal european journal of pediatric surgery
3 results on '"Daniel Hofmann"'

1. Laparoscopic versus Open Inguinal Hernia Repair Is Feasible in Infants with Caudal Anesthesia and Spontaneous Respiration

Author

Rim Kiblawi, Christiane Beck, Oliver Keil, Nagoud Schukfeh, Alejandro Daniel Hofmann, Benno Manfred Ure, and Joachim Friedrich Kuebler

Subjects
Pediatrics, Perinatology and Child Health, Surgery
Abstract

Introduction Minimally invasive surgery (i.e., laparoscopy) and minimally invasive anesthesia (i.e., caudal anesthesia with spontaneous respiration) have separately shown benefits for inguinal hernia repair in infants, yet to what degree these techniques can be combined remains unknown. This study investigated whether laparoscopy impacts the feasibility of performing caudal anesthesia with spontaneous respiration in infants. Methods Prospectively collected data of all infants less than 12 months old and over 3 kg weight who underwent laparoscopic indirect hernia repair (LAP) at our department from 2019 to 2021 were compared with a historical control-matched group of infants who underwent open repair (OPEN) from 2017 to 2021. We assessed the patients' characteristics, anesthesia, and surgical data as well as intra- and postoperative complications. Results A total of 87 infants were included (LAP n = 29, OPEN n = 58). Caudal anesthesia with spontaneous respiration was feasible in 62.1% of cases (LAP n = 55.2%, OPEN n = 65.5%; nonsignificant). Neither group registered anesthetic intra- or postoperative complications. Sedatives were utilized in 97% of LAP patients versus 56.9% of OPEN patients (p Conclusion This is the first comparative study on caudal anesthesia and spontaneous respiration in infants undergoing laparoscopic versus open inguinal hernia surgery. Laparoscopy increased the need for ventilatory support and sedatives but did not significantly impair the feasibility of caudal anesthesia and spontaneous respiration.

Published
2022
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3. The Role of Activin Receptor-Like Kinase 1 Signaling in the Pulmonary Vasculature of Experimental Diaphragmatic Hernia.

Author

Daniel Hofmann, Alejandro, Zimmer, Julia, Toshiaki Takahashi, Gosemann, Jan-Hendrik, Puri, Prem, Hofmann, Alejandro Daniel, and Takahashi, Toshiaki

Subjects
*NEONATAL death, *DIAPHRAGMATIC hernia, *PULMONARY hypoplasia, *PULMONARY hypertension, *ACTIVIN receptor-like kinase 1, *ENDOTHELIAL cells, *POLYMERASE chain reaction, *DIAGNOSIS, *ANIMAL experimentation, *BIOCHEMISTRY, *CELL receptors, *CELLULAR signal transduction, *GENETIC disorders, *PHENOMENOLOGY, *MICROSCOPY, *PULMONARY artery, *RATS, *STATISTICAL sampling, *WESTERN immunoblotting, *PHENYL ethers, *DISEASE complications
Abstract

Aim: The high morbidity and mortality in newborn infants diagnosed with congenital diaphragmatic hernia (CDH) is widely recognized to be due to pulmonary hypoplasia and persistent pulmonary hypertension (PH). The underlying structural and molecular pathomechanisms causing PH are not fully understood. Recently, activin receptor-like kinase 1 (ALK-1), an endothelial cell (EC) receptor, has been implicated in the pathogenesis of PH. ALK-1 transmits signals via a Smad pathway stimulating EC proliferation and migration leading to structural lung remodeling consecutively resulting in PH. Increased pulmonary expression of ALK-1 has been reported in patients with severe PH as well as in experimental models of PH. We designed this study to investigate the hypothesis that pulmonary ALK-1 expression is increased in nitrofen-induced CDH.Methods: Pregnant rats were exposed to nitrofen or vehicle on D9. Fetuses were sacrificed on D21 and divided into nitrofen (n = 16) and control group (n = 16). Quantitative real-time polymerase chain reaction, Western blotting, and confocal-immunofluorescence microscopy were performed to determine pulmonary gene and protein expression as well as vascular localization of expressed ALK-1.Results: Pulmonary gene expression levels of ALK-1 were significantly upregulated in nitrofen-treated lung tissue compared with controls. Western blotting showed increased pulmonary protein expression for ALK-1 in the CDH group when compared with control lung tissue. Confocal microscopy demonstrated markedly increased medial and adventitial thickness of pulmonary arteries in the CDH group and revealed increased ALK-1 protein expression of the pulmonary vasculature of CDH pups compared with controls.Conclusion: Upregulated gene and increased protein expression of ALK-1 in the pulmonary vasculature of nitrofen-induced CDH suggest that increased expression of ALK-1 may play a crucial role in the molecular pathogenesis of vascular remodeling induced PH in experimental CDH. [ABSTRACT FROM AUTHOR]

Published
2016
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