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Gerlach J, Botsch M, Kardassis D, Lemmens P, Schön M, Janke J, Puhl G, Unger J, Kraemer M, Busse B, Böhmer C, Belal R, Ingenlath M, Kosan M, Kosan B, Sültmann J, Patzold A, Tietze S, Rossaint R, Müller C, Mönch E, Sauer I, Neuhaus P. Experimental Evaluation of a Cell Module for Hybrid Liver Support. Int J Artif Organs 2018. [DOI: 10.1177/039139880102401105] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim of the study was to evaluate a hybrid liver support system in a porcine model of acute liver failure, after hepatectomy. Pigs with a body weight of 70±18 kg underwent total hepatectomy and porto - cavo - caval shunting as well as ligation of the bile duct and the hepatic artery. Control animals were connected to the system (including capillary membrane plasma separation) containing a four compartment bioreactor with integral oxygenation and decentralized mass exchange but without liver cells. The treatment group received hybrid liver support with the same system including 370±42 g primary isolated porcine parenchymal liver cells in co-culture with hepatocyte nursing cells, tissue engineered to liver- like structures at high density. Treatment started after complete recovery from anesthesia and was performed continuously. A positive influence on peripheral vascular resistance and a reduced need of catecholamine dosage was observed in the treatment group. Hybrid liver support with a cell module upscaled for clinical application significantly prolonged survival time in animals after hepatectomy with the longest survival being 26 hours in the control group an 57 hours in the treatment group.
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Affiliation(s)
| | | | | | - P. Lemmens
- Clinic for Surgery Havelhöhe, Berlin - Germany
| | | | - J. Janke
- Clinic for Anaesthesiology and Intensive Care Medicine
| | | | - J. Unger
- Clinic for Anaesthesiology and Intensive, Care Medicine, RWTH Aachen - Germany
| | | | | | | | | | | | | | | | | | | | | | - R. Rossaint
- Clinic for Anaesthesiology and Intensive, Care Medicine, RWTH Aachen - Germany
| | | | - E. Mönch
- Clinic for Pediatrics, Charité, Campus Virchow Klinikum, Humboldt University of Berlin, Berlin - Germany
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Grewe P, Lahr D, Kohsik A, Dyck E, Markowitsch HJ, Bien CG, Botsch M, Piefke M. Real-life memory and spatial navigation in patients with focal epilepsy: ecological validity of a virtual reality supermarket task. Epilepsy Behav 2014; 31:57-66. [PMID: 24361763 DOI: 10.1016/j.yebeh.2013.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 11/06/2013] [Accepted: 11/12/2013] [Indexed: 11/16/2022]
Abstract
Ecological assessment and training of real-life cognitive functions such as visual-spatial abilities in patients with epilepsy remain challenging. Some studies have applied virtual reality (VR) paradigms, but external validity of VR programs has not sufficiently been proven. Patients with focal epilepsy (EG, n=14) accomplished an 8-day program in a VR supermarket, which consisted of learning and buying items on a shopping list. Performance of the EG was compared with that of healthy controls (HCG, n=19). A comprehensive neuropsychological examination was administered. Real-life performance was investigated in a real supermarket. Learning in the VR supermarket was significantly impaired in the EG on different VR measures. Delayed free recall of products did not differ between the EG and the HCG. Virtual reality scores were correlated with neuropsychological measures of visual-spatial cognition, subjective estimates of memory, and performance in the real supermarket. The data indicate that our VR approach allows for the assessment of real-life visual-spatial memory and cognition in patients with focal epilepsy. The multimodal, active, and complex VR paradigm may particularly enhance visual-spatial cognitive resources.
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Affiliation(s)
- P Grewe
- Physiological Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany; Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany; Bethel Epilepsy Centre, Mara Hospital, Bielefeld, Germany.
| | - D Lahr
- Bethel Epilepsy Centre, Mara Hospital, Bielefeld, Germany
| | - A Kohsik
- Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany
| | - E Dyck
- Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany; Computer Graphics and Geometry Processing, Faculty of Technology, Bielefeld University, Bielefeld, Germany
| | - H J Markowitsch
- Physiological Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany; Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany
| | - C G Bien
- Bethel Epilepsy Centre, Mara Hospital, Bielefeld, Germany
| | - M Botsch
- Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany; Computer Graphics and Geometry Processing, Faculty of Technology, Bielefeld University, Bielefeld, Germany
| | - M Piefke
- Physiological Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany; Center of Excellence Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany; Neurobiology and Genetics of Behavior, Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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Grewe P, Risius O, Lahr D, Ohmann H, Dyck E, Bien CG, Botsch M, Piefke M. Evaluation eines Trainingsprogramms in der Virtuellen Realität für visuell-räumliche Fähigkeiten bei Patienten mit symptomatisch fokaler Epilepsie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gerlach JC, Botsch M, Kardassis D, Lemmens P, Schön M, Janke J, Puhl G, Unger J, Kraemer M, Busse B, Böhmer C, Belal R, Ingenlath M, Kosan M, Kosan B, Sültmann J, Patzold A, Tietze S, Rossaint R, Müller C, Mönch E, Sauer IM, Neuhaus P. Experimental evaluation of a cell module for hybrid liver support. Int J Artif Organs 2001; 24:793-8. [PMID: 11797849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Aim of the study was to evaluate a hybrid liver support system in a porcine model of acute liver failure, after hepatectomy. Pigs with a body weight of 70+/-18 kg underwent total hepatectomy and porto-cavo-caval shunting as well as ligation of the bile duct and the hepatic artery. Control animals were connected to the system (including capillary membrane plasma separation) containing a four compartment bioreactor with integral oxygenation and decentralized mass exchange but without liver cells. The treatment group received hybrid liver support with the same system including 370+/-42 g primary isolated porcine parenchymal liver cells in co-culture with hepatocyte nursing cells, tissue engineered to liver- like structures at high density. Treatment started after complete recovery from anesthesia and was performed continuously. A positive influence on peripheral vascular resistance and a reduced need of catecholamine dosage was observed in the treatment group. Hybrid liver support with a cell module upscaled for clinical application significantly prolonged survival time in animals after hepatectomy with the longest survival being 26 hours in the control group an 57 hours in the treatment group.
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Affiliation(s)
- J C Gerlach
- Clinic for Surgery, Humboldt University of Berlin, Germany.
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Schurr MO, Buess GF, Wieth F, Saile HJ, Botsch M. Ergonomic surgeon's chair for use during minimally invasive surgery. Surg Laparosc Endosc Percutan Tech 1999; 9:244-7. [PMID: 10871169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The characteristic working situation in laparoscopic surgery involves elongated instruments and limited mobility of the surgeon during the operation. These circumstances require new technical solutions to enhance the surgeon's comfort. In other surgical fields with special ergonomic situations, such as microsurgery, some surgeons prefer to operate from a seated position at the operating room table. We developed a new surgeon's chair dedicated to the ergonomic and functional requirements of laparoscopic surgery. The chair allows the surgeon to maintain a semi-standing position during the operation. Foot pedals for high frequency and suction/irrigation are integrated into the base of the chair. The pedals are purposely aligned to be comparable to foot pedals in a car. The chair is driven by electromotors, controlled with a special foot switch that operates independent of assisting personnel during surgery. Initial clinical testing of the chair could prove the theory that supporting the surgeon with a cockpit type of operating room chair helps to avoid fatigue during long endoscopic procedures. Such assistance is especially important in combination with robotic devices for use during solo surgery.
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Affiliation(s)
- M O Schurr
- Section for Minimally Invasive Surgery, Eberhard-Karls University, Tuebingen, Germany
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