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Biomedical subjects

E Gottschalk

Publications and source records attributed to E Gottschalk.

At least 19 recordsLinked to original sources
PubMed1991

[Obstructive uropathies in early childhood--surgical intervention as renal protection].

Anomalies in the urinary tract can be noticed early by prenatal sonography. In the case of obstruction, a decompressive procedure can follow immediately after birth. Long-term results of renal function in cases of pyeloureteral obstructions after 6-10 years make it clear that results are better the earlier pyelon resection is performed. In cases of obstructive megaureter, operative procedures are indicated for severe disturbances of ureteral transport. Progressive renal and ureteral wall destruction is promoted by performing operations too late.

Child, Preschool↗
PubMed1990

[Experiences with nesidioblastosis].

Highly differentiated processes relating to insulin-generating cells of the endocrine pancreas are covered by the term of nesidioblastosis. The disease is primarily characterised by persistent hypoglycaemia, and it affects newborns and young infants. Diffuse nesidioblastosis is predominant, as compared to focal processes. So called ductulo-insular complexes are characteristic immunohistochemical manifestations. While dietary and medicamentous therapies (diazoxide) usually failed to be effective, surgical removal so far has worked better than any other approach (subtotal and total pancreatectomy). Adequate early diagnosis should be established and pancreatectomy performed even before irreversible cerebral damage is caused by glucose deficit. Operations for subtotal or total pancreatectomy were performed on five children with nesidioblastosis at the Department of Paediatric Surgery in Erfurt, over the last two years. Epilepsy continued to be manifest in one of the five. Success eventually depends on close cooperation between paediatrics and paediatric surgery.

Combined Modality Therapy↗
PubMed1990

[Clinical aspects, diagnosis and therapy of nesidioblastosis].

Hyperinsulinemia due to an excessive secretion of insulin independent on normal regulation is the most frequent cause of persistent neonatal hypoglycemia. We report on clinical course, diagnostic procedures and treatment of nesidioblastosis in three patients. Main symptoms observed in newborn period were hypoglycemia, respiratory embarrassment, cyanosis and convulsions. Primary treatment was started by continuous infusion of glucose, administration of diazoxide and prednisolone or glucagon. Most important investigations were performed simultaneously. In all three children subtotal resection of pancreas was necessary, because there was no constant blood glucose level. Histological specimens confirmed diagnosis. In two of three patients pancreatectomy followed. One suffers from diabetes mellitus, the other one fed normally, has stable blood glucose level possibly due to existence of extrapancreatic insulin producing cells.

Child, Preschool↗
PubMed1988

[Hamartoma of the liver in childhood].

Liver hamartoma is one of the very rare findings in childhood. It is a dysontogenetic malformation that grows clinically manifest with tumour-like appearance in the first or second year of age. Cystic and solid formations are described in this report. Findings are usually clearly delimited from clinically intact liver parenchyma. In surgical extirpation, that delimitation should be stringently observed to avoid unnecessary blood loss. The prognosis generally is good and should not be jeopardised by delay of surgical therapy. Reported are two cases of liver hamartoma, with both patients being laparotomised at the age of one and a half years.

Hamartoma↗
PubMed1987

[Ultrastructure of the distal ureter in congenital malformations in childhood].

Ultramicroscopical examinations were performed in ten children with reflux or obstructive megaureter. Resected parts of ureters were used for investigation in connection with reconstructive procedures. Whereas in case of an obstructive megaureter an intramural and juxtavesical localised functionless narrow ureteral segment is characterised by "nexus close contacts" and dissociation of muscle cells with interposition of fibrous tissue, progredient pathonexual changes in the sense of a reversible nexus-distension and irreversible nexus-rupture were seen in megaureters with reflux. Dissociation of muscle cells is combined with typical epithelial and adventitial pathological structures. In congenital megaureter, disturbances in the electric syncytium occur in connection with nexus injury, followed by pathological innervation. Interruption of muscle autonomy and innervation in the wall structure of such congenital ureteral malformations play an ominous role in the sequence of pathogenetic factors.

Child↗
PubMed1986

[Therapeutic problems in bile duct atresia].

Existence and patency of the intrahepatic bile ducts during the first weeks of age call for early surgery, before any further chance of active treatment will be lost due to obstruction. Every case of icterus persistent four to five weeks from birth should be an indication for laparotomy. Surgical treatment today is primarily characterised by hepatoportojejunostomy (Kasai II) and lymphodigestive shunt (Schweizer). 2 of 8 children survived five and seven years. All lethal courses had been due to progressive liver, cirrhosis and cirrhosis in conjunction with cholestasis. Hepatoportojejunostomy is considered to be the adequate surgical method. Lymphodigestive shunt is rejected as an exclusive approach and is accepted only when used in combination with hepatoportojejunostomy. Liver transplantation is likely to bear therapeutic promise in cases of insufficient shunt.

Bile Ducts, Intrahepatic↗
PubMed1985

[Gonadal and extragonadal yolk sac tumor].

Yolk-sac tumours are germ-cell tumours with gonadal and extragonadal location. Histologically they consist of primitive cellular forms configurated as a loose network. These tumours are of extreme malignancy and should be treated as radical as possible. Surgery should be combined with anticancer chemotherapy. However, with adequate treatment only children suffering from testicular tumours and not older than 2 years of life have a fair chance to survive. 3 cases are dealt with in detail.

Castration↗
PubMed1985

[Operative therapy of a refluxing double ureter in childhood].

Surgical methods for repairing the bilateral vesico-ureteral reflux have to be adapted to the pathomorphological and pathodynamic variety of refluxing ureters. Ureteroureterostomy can be performed in the cranial section of the ureter in order to check the local situation of the kidney and its macroscopic structure. But the distal localisation of the uretero-ureteral anastomosis proves to be favourable too. The operation according to Politano-Leadbetter is the method of choice to correct the reflux. It is only in therapy-resistent pyuria with decompensation of the kidneys that temporary supravesical urine-derivation has turned out to be an advantage because the possibility of organ-conservation by surgery later is still preserved.

Child↗
PubMed1985

[Urgent pulmonary interventions in early childhood].

The article deals with life threatening anomalies oft he lung in newborns which can only be cured by urgent surgical intervention. The clinical symptomatology is characterized in nearly all cases by intrathoracic displacement of healthy lung tissue. Own observations in connection with literature are dealt with.

Bronchi↗
PubMed1981

[Surgical indication in myelomeningoceles (author's transl)].

Myelomeningoceles underlie critical indication for surgical closure. Clearcut contra indications such as total congenital hydrocephalus, intracranial haemorrhage and cerebral bith-traumatic lesions, severe forms of gibbus and the combination with other severe malformations eliminate the right of active surgery. The conservative treatment neither corresponds to therapeutic nihilism nor is it the inevitability of a lethal outcome. The author does not agree with conceptions such as selection of criteria of selection according to Lorber.

Adolescent↗