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Biomedical subjects

E Balzar

Publications and source records attributed to E Balzar.

At least 37 records · Page 2Linked to original sources

[Primary lymphedema in the nephrotic syndrome: case report].

The aim of this case report is to discuss possible connections between the development of a hypoproteinaemic oedema due to the nephrotic syndrome and the occurrence of lymphoedema. Two patients (a three year-old girl and a seven year-old boy) developed lymphoedema of one leg one year after the onset of the nephrotic syndrome. The case of the six year-old girl is presented. Malignancy was excluded by clinical investigation. Direct lymphography failed to show any peripheral lymph-vessels; indirect lymphography (i.c. infusion of a newly-developed contrast medium) revealed hypoplasia of the peripheral lymph-collectors. The development of lymphoedema 12-18 months after the appearance of the nephrotic syndrome supports the hypothesis that the increase in extravascular fluid, which is caused by a reduced oncotic pressure in the plasma, may trigger off the development of lymphoedema if there is a primary defect of the lymphatic system.

Child↗

[Ocular findings in hemodialysis and following kidney transplantation in childhood and adolescence].

Between August 1980 and January 1987, 23 patients undergoing treatment for chronic renal failure underwent eye examinations. Hemodialysis and subsequent kidney transplants were performed in 18 patients; in two patients a kidney transplant was performed alone, and in three others hemodialysis without transplant. The interval between dialysis and transplantation averaged 23.1 months, the mean follow-up after transplantation 20 months. Patients who underwent hemodialysis alone were followed up for periods of two, three and 85 months. The patients' ages when hemodialysis treatment was first instituted ranged from six to 17 years (average 11.8 years). The mean age at the time kidney transplants were performed was 13.6 years (ranging from one to 17 years). Seventeen patients had conjunctival and corneal infiltrations in the area of the palpebral fissure. In two cases infiltrations were confined to the conjunctiva. Four patients had no pathologic changes, in either the cornea or the conjunctiva. Slitlamp examination revealed subcapsular losses of lens transparency in eight patients; these losses were manifested by delicate punctiform and patchy configurations. In nine cases fundus ophthalmoscopy revealed constricted retinal arteries. Within the period of observation all but one of the patients had unchanged vision. The one exception (cystinosis) had reduced visual acuity due to an accumulation of crystalline inclusions in the cornea.

Adolescent↗

Acute renal failure in children. An ultrasonographic-clinical study.

Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception of those in the neonatal age group (12%). Improvement in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +/- 1.40 S.D.) and group B (5.95 mg% +/- 1.96 S.D.), p less than 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity.

Acute Kidney Injury↗

[Urolithiasis in pediatrics: analysis of 34 patients].

The increasing incidence of urolithiasis makes it important to report about 34 children with urolithiasis seen between 1976 and 1986 at the Department of Pediatrics, University Medical School Vienna. At the time of the first diagnosis 59 percent of the patients were less than 7 years of age; 62 percent of our patients were males. Recurrent chronic urinary tract infection in 32 percent, metabolic disorder (secondary hyperoxaluria 5, idiopathic hypercalciuria 3, cystinuria 2, hyperuricuria 2) in 27 percent were evaluated; in 13 patients the origin of calculi was idiopathic. Most infectious stones contained magnesium ammonium phosphate, most idiopathic stones calcium oxalate. In 21 patients (62%) surgical treatment, in one patient extracorporal shock wave lithotripsie was realized. Adequate metaphylaxis (general, dietetic, medicementous) can lower the rate of occurrence of stone formation.

Adolescent↗

[Familial juvenile nephronophthisis--a cause of chronic renal failure in childhood].

Familial juvenile nephronophthisis (FJN) represents an important cause of chronic renal insufficiency in the first two decades of life. Its frequency is reported to vary between 7 and 20% of all cases of terminal renal failure in childhood. Usually the onset is insidious, with polyuria, polydipsia and anaemia being the main clinical features. The diagnosis is based on clinical, laboratory and pathological findings. The purpose of our report is to emphasize the importance of this pathological entity with respect to the clinical symptoms and signs and diagnostic approach on the basis of the case reports of four patients.

Adolescent↗

Identification of a major sialoprotein in the glycocalyx of human visceral glomerular epithelial cells.

Glomerular visceral epithelial cells are endowed with a sialic acid-rich surface coat (the "glomerular epithelial polyanion"), which in rat tissue contains the sialoprotein podocalyxin. We have identified a major membrane sialoprotein in human glomeruli that is similar to rat podocalyxin in its sialic acid-dependent binding of wheat germ agglutinin and in its localization on the surface of glomerular epithelial and endothelial cells, as shown by immunoelectron microscopy, using the monoclonal antibody PHM5. Differences in the sialoproteins of the two species are indicated by the discrepancy of their apparent molecular weights in sodium dodecyl sulfate gels, by the lack of cross reactivity of their specific antibodies, and by the lack of homology of their proteolytic peptide maps. It is therefore possible that the human glomerular sialoprotein and rat podocalyxin are evolutionarily distinct, but have similar functions.

Animals↗

[Spinal lipoma with a dural closure defect as a cause of neurogenic bladder and chronic renal failure].

It is reported on a 6-year-old boy, in whom 3 years after the appearance of a neurogenic disturbance of the urinary bladder a lipoma in the spinal canal of the inferior thoracic region was diagnosed myelographically. The operative removal of the growing and displacing fatty tissue which by a (congenital?) dural gap continued in epidural direction indeed resulted in a far-reaching regression of the paresis of the lower extremities, not, however, in an improvement of the urological picture of the disease. The renal insufficiency caused by the hydronephrosis was no more reversible, which emphasizes the importance of the early diagnosis of this relatively infrequent malformation.

Child↗

Quantitative EEG: investigation in children with end stage renal disease before and after haemodialysis.

Changes in brain function of 9 children (6 males and 3 females) ages 7 to 14 years (mean 12 years) with end stage renal disease (ESRD) were investigated before and after haemodialysis treatment, utilizing computer assisted spectral analysis of the scalp-recorded EEG. A control group of age-matched healthy children was studied as well. Statistical analyses demonstrated that ESRD children exhibited more Delta and Theta activity, less Beta activity, a slower dominant frequency of the Alpha activity as well as a slower centroid of the total activity before treatment than the controls. These findings suggest a deterioration of vigilance as characterized by Head. Haemodialysis decreased slow activity and increased Alpha and Beta activity, thereby inducing an improvement of brain function.

Adolescent↗

High levels of plasma protein C in nephrotic syndrome.

In patients with severe nephrotic syndrome determinations of plasma protein C: Ag levels (8 patients: 5 adults, 3 children) and protein C activity (3 out of 8 patients) revealed significantly elevated plasma protein C concentrations. Furthermore we observed a significant inverse correlation of protein C: Ag to AT III: Ag levels. No protein C: Ag could be detected in the urine of two patients studied. We conclude from our data, that changes of plasma protein C do not contribute to the high thrombotic tendency in nephrotic syndrome.

Adolescent↗

[Sonography of the uretero-vesical junction and the urinary bladder in children].

Sonography of the ureterovesical junction and of the urinary bladder is described on the basis of examinations of 41 children. This included all distended bladder walls, ureteral dilations, ureteroceles and a rhabdomyosarcoma. Sonographic imaging presents difficulties in visualising ureters less than 6 mm wide, and in case of normal uretero-vesical junctions. Sonography cannot assess a versicoureteral reflux. Sonography should not be used in the first diagnosis of nephrourological changes as an alternative to radiological methods, since this may result in overlooking relevant curable changes in children. Sonography is particularly valuable in clarifying renal insufficiency and in following up children with nephrourological disease.

Adolescent↗

[Use of direct magnification technic of the hand radiograph in children with chronic renal insufficiency].

The characteristic changes of renal osteopathy in the hand are shown by the X-rays of seven children with end stage renal disease using the direct magnification technique. All children had pathologic conditions in the hands. Most frequently tunnelation , spiculae in the phalanges and metaphyseal translucent bands in the forearm were seen. Less constantly acroosteolyses and generalized osteoporosis could be observed. The X-rays of the hands using the direct magnification technique with rare earth film-screen system and a microfocus X-ray tube are sufficient to determine renal osteopathy. If clinical symptoms are present, X-rays of other parts of the skeleton are necessary. By using the above mentioned radiologic technique the radiographic diagnostic effort could be minimized.

Adolescent↗

[X-ray skeletal changes in children with chronic renal insufficiency].

The typical changes of renal osteopathy are shown in the X-rays of 7 children with end-stage renal disease treated with chronic intermittent hemodialysis. The exact evaluation of the granular structural changes of the cranium, the evidence of osteomalacia because of the hazy appearance of the vertebrae and the broadening of the sacroiliac joints depend highly on subjective judgement and the technical X-ray procedures used. Unmistakable radiological diagnoses can be made when a broadening of the metaphyseal zones, epiphysiolysis as well as characteristic changes in the finger phalanges (acro-osteolyses, spicula, tunnelation) are present.

Adolescent↗

[Acute cortical blindness: a reversible complication of acute kidney failure in a child with burns].

An 11 year old boy was admitted to the Department of Pediatrics Medical School of Vienna with 2nd and 3rd degree burns covering 30% of his body. He presented with complications--high fever, vomiting, diarrhea and dehydration--which had led to acute renal failure. After 6 hemodialyses renal function recovered after two weeks and the patient entered a polyuric phase. In connection with a transient dehydration the patient showed a sudden bilateral cortical blindness. The computerized tomogram (CT) showed vague evidence of an occipital cortical ischemia. We assume that several factors have played a role in this sudden occurrence. As a result of hypovolemia and coincident anemia and electrolyte inbalance, cerebral edema and cortical tissue hypoxia with emphasis in the occipital cortical region developed in the brain possibly already damaged by burn injury. A complete reversal of the clinical state was achieved. The patient was discharged with normal vision and normalized renal function.

Acute Disease↗

[Results of antireflux-surgery in children according to Leadbetter-Politano].

The indications for operation and results of antireflux-operation according to Leadbetter-Politano method are discussed in a retrospective evaluation of 80 children. Age of child, grade of reflux, cystoscopic findings of ureteral orifices and therapeutic success in treatment of urinary tract infection are the main criteria for the indication to surgical intervention. The operation was successful in 79 out of 80 children. Three of them needed a corrective operation. The number of postoperative complications was in accordance with results in the literature. The incidence of postoperative recurrence of urinary tract infection in 7.5% was relatively low.

Child↗

[Haemodialysis in children (author's transl)].

Thirty four children, aged 2 to 15 years, were treated by haemodialysis between 1967 and 1978. Eleven children suffered from acute renal failure. Twenty three children with end-stage chronic renal disease were treated over periods ranging from 1 week to 19 months. All children were dialysed in a renal unit for adult patients awaiting renal transplantation. Our results refer especially to the technical equipment for paediatric dialysis and to the problems of blood access. The medical problems of chronic uraemia and chronic intermittent haemodialysis in children are discussed. From our experience we conclude that a sufficient degree of rehabilitation can be reached only in a paediatric dialysis unit.

Acute Kidney Injury↗