Publications by authors named "Hardy Krause"

7 Publications

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Outcome after Hypospadias Repair: Evaluation Using the Hypospadias Objective Penile Evaluation Score.

Eur J Pediatr Surg 2018 Jun 15;28(3):268-272. Epub 2017 May 15.

Division of Pediatric Surgery, Department of General, Abdominal & Vascular Surgery, University Hospital, Magdeburg, Sachsen-Anhalt, Germany.

Introduction:  The Hypospadias Objective Penile Evaluation Score (HOPE-Score) is a concise and reproducible way to describe hypospadias severity. We classified boys undergoing primary hypospadias repair to determine the correlation between the HOPE-Score and the severity of hypospadias first and the outcome after surgery second.

Materials And Methods:  Patients who underwent primary hypospadias repair from 2005 to 2014 were identified. An independent physician assessed retrospectively the HOPE-Score, using photographies of the patients before, after primary surgery, and after all necessary surgeries. The correlation between the HOPE-Score and the severity of hypospadias, on the one hand, and the outcome after surgery, on the other hand, were analyzed.

Results:  The HOPE-Score was assessed preoperatively for 79 boys, postoperatively for 66, and after all necessary surgeries for 21 patients. Mean HOPE-Score reached 30.2 ± 5.9 before surgery, 42.2 ± 6.1 after primary surgery, and 43.7 ± 3.4 after all necessary surgeries. A significant correlation between the HOPE-Score and the severity of hypospadias before surgery was observed. The boys with glanular hypospadias scored significantly higher (36.3 ± 5.4) than those with distal (29.6 ± 4.4) and proximal hypospadias (21.1 ± 3.5). Furthermore, a significant correlation between the HOPE-Score and the outcome after hypospadias repair was observed. Patients who needed no reintervention after primary hypospadias repair scored significantly higher postoperatively (45.1 ± 5.4) than those who needed a second (40.8 ± 4.2) or more than two surgeries (36.9 ± 7.4).

Conclusion:  The HOPE-Score is a good system to assess the severity of hypospadias and the cosmetic outcome after hypospadias repair.
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http://dx.doi.org/10.1055/s-0037-1602252DOI Listing
June 2018

T Cells of Infants Are Mature, but Hyporeactive Due to Limited Ca2+ Influx.

PLoS One 2016 28;11(11):e0166633. Epub 2016 Nov 28.

Department of Experimental Pediatrics, University Hospital, Otto-von-Guericke University, Magdeburg, Germany.

CD4 T cells in human infants and adults differ in the initiation and strength of their responses. The molecular basis for these differences is not yet understood. To address this the principle key molecular events of TCR- and CD28-induced signaling in naive CD4 T cells, such as Ca2+ influx, NFAT expression, phosphorylation and translocation into the nucleus, ERK activation and IL-2 response, were analyzed over at least the first 3 years of life. We report dramatically reduced IL-2 and TNFα responses in naive CD31+ T cells during infancy. Looking at the obligatory Ca2+ influx required to induce T cell activation and proliferation, we demonstrate characteristic patterns of impairment for each stage of infancy that are partly due to the differential usage of Ca2+ stores. Consistent with those findings, translocation of NFATc2 is limited, but still dependent on Ca2+ influx as demonstrated by sensitivity to cyclosporin A (CsA) treatment. Thus weak Ca2+ influx functions as a catalyst for the implementation of restricted IL-2 response in T cells during infancy. Our studies also define limited mobilization of Ca2+ ions as a characteristic property of T cells during infancy. This work adds to our understanding of infants' poor T cell responsiveness against pathogens.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166633PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125607PMC
June 2017

Surgical Treatment Results In Gastroschisis Based On Preterm Delivery Within The 34th Week Of Gestation By Caesarean Section.

Pol Przegl Chir 2015 Jul;87(7):346-56

Unlabelled: The aim of the study was to assess the value of the today's appropriate approach, preterm delivery in the 34th week of gestation by Caesarean section and subsequent surgical intervention at the perinatal center, in daily practice of pediatric surgery with regard to early postoperative and mid-term outcome.

Material And Methods: Over the time period of 9 years, all consecutive cases diagnosed with gastroschisis at the perinatal center, University Hospital of Magdeburg, were born by Caesarean section within the 34th week of gestation followed by surgical intervention. The registered data were compared with those published by other groups.

Results: Overall, there were 19 cases through the investigation period from 01/01/2006 to 12/31/2014. The mean duration of gestation was 237.9 days. The mean birth weight was 2,276 g. In all individuals, a primary closure with no artificial material was achieved. The duration of postoperative artificial respiration was 2.3 days. Oral uptake could be initiated on the 10th postoperative day on average. The mean hospital stay was 37 days. There was no lethality. As complications, postoperative (iv catheter-associated) sepsis occurred in one case and relaparotomy became necessary in a further case because of no possible completion of enteral nutrition by 20 days after primary closure (complication and relaparotomy rate, 10.5% and 5.26%, respectively).

Conclusions: The data indicate that in case of gastroschisis, primary closure can be more frequently achieved by section within the 34th week of gestation. Under the prediction of an optimal neonatological care, the risks of a preterm delivery by a planned section appear to be manageable.
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http://dx.doi.org/10.1515/pjs-2015-0068DOI Listing
July 2015

Correspondence (letter to the editor): scheme not possible.

Authors:
Hardy Krause

Dtsch Arztebl Int 2010 Feb 12;107(6):100; author reply 101. Epub 2010 Feb 12.

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http://dx.doi.org/10.3238/arztebl.2010.0100aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2832111PMC
February 2010

Meconium-induced periorchitis.

BMJ Case Rep 2009 1;2009. Epub 2009 Sep 1.

University Hospital, Magdeburg (Germany), Division of Pediatric Surgery, Department of Surgery, Leipziger Strasse 44, Magdeburg, 39120, Germany.

A testicular tumour-like lesion or a solid extratesticular mass are serious postnatal problems with a broad spectrum of inflammatory or tumorous causes and possible differential diagnoses. In this case report, an extraordinary case of a newborn boy with a rare cause of a periorchitis is described.A premature boy infant (25-year-old mother with obesity) was diagnosed as having a disturbance of prosperity. A plain film of the abdomen showed a dilated intestine (no pathological findings in abdominal ultrasound, in particular, no ascites). After 3 postnatal months of clinical observation at the hospital including temporary parenteral nutrition, hydrocele at both sides was diagnosed. Therefore, the boy underwent surgical exploration. Intraoperatively, the processus vaginalis peritonei was surprisingly filled with meconium; because of that, the situs was extensively rinsed. In addition, the boy underwent an operation for the right and left hydrocele. The testes were preserved (on follow-up investigation there were no further problems).Pathohistological investigation confirmed meconium periorchitis, which is a rare postnatal disease and which can only develop in cases of former meconium peritonitis and if the processus vaginalis peritonei is open. The precise details of cause and pathophysiology in this case may significantly help in avoiding unnecessary orchiectomy.
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http://dx.doi.org/10.1136/bcr.04.2009.1801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3029514PMC
November 2011

Successful topical therapy with voriconazole: pseudallescheriasis after injury.

J Trauma 2007 May;62(5):1295-7

Institute of Medical Microbiology and the Department of Pediatric Surgery, Otto-von-Guericke University Magdeburg, Germany.

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http://dx.doi.org/10.1097/01.ta.0000195444.54418.9aDOI Listing
May 2007

Implantation of human demineralized bone matrix (DBM) for the treatment of juvenile bone cysts.

Oper Orthop Traumatol 2006 Mar;18(1):19-33

Klinik für Kinderchirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg.

Objective: Definitive bony consolidation in juvenile bone cysts. Prevention of pathologic fractures. Preservation of limb function.

Indications: Juvenile bone cysts at all sites.

Contraindications: Malignant cystic lesions.

Surgical Technique: After opening and curettage, the cyst is packed with human demineralized bone matrix (DBM).

Postoperative Management: Clinical and radiologic checks after 1, 4, and 6 months, followed by further 6-monthly checks.

Results: Over a period of 2 years, nine cysts packed with DBM showed almost totally osteodense images after an average of 8 months, with no other significant changes (follow-up period: 24 months). A typical decrease in cyst transparency on the plain radiographs was already detectable in all patients after 3-4 months. Marked cortical remodeling was visible after 6 months. A significant complication in one cyst in the distal tibial region was a pathologic fracture following distortion trauma; this occurred after 5 months, probably because of insufficient filling of the cyst. The fractured limb was immobilized in a lower-leg cast and healed sufficiently for stable weight bearing after 12 weeks.
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http://dx.doi.org/10.1007/s00064-006-1160-8DOI Listing
March 2006