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Biomedical subjects

E Horcher

Publications and source records attributed to E Horcher.

At least 37 records · Page 2Linked to original sources
PubMed1998

Neurenteric cyst mimicking pleurodynia: an unusual case of thoracic pain in a child.

This study reports an 8-year-old boy with chronic recurring thoracic pain. Magnetic resonance imaging of the spine revealed an intradural cyst at T1-T2. Despite severe compression of the spinal cord, there was no neurologic deficit. After minimally invasive cystectomy, the patient recovered completely. Histological examination established the diagnosis of a neurenteric cyst. The clinical, pathohistologic, and radiologic aspects are discussed, and the decisive role of magnetic resonance imaging in the diagnosis of intraspinal cyst is emphasized.

Child↗
PubMed1998

Diagnostic value of tissue polypeptide-specific antigen (TPS) in neuroblastoma and Wilms' tumour.

Although tissue polypeptide-specific antigen (TPS) has been described as a potentially useful serum marker of tumour activity in adult epithelial tumours, few data are available for childhood malignancies. Neuroblastomas and Wilms' tumours are the commonest types of solid malignancies found in the retroperitoneum of children. At this time, a widely used marker for Wilms' tumour is not available. Using an enzyme-linked immunosorbent assay (ELISA) kit, serum TPS levels in 23 children with neuroblastomas, nine with Wilms' tumours and 22 with benign tumours were evaluated to test the usefulness of the marker in identifying malignancies. Compared with healthy children (n = 110), the preoperative least-square means (LSM) of serum TPS were considerably elevated in both neuroblastoma (LSM = 209 U l(-1)) and Wilms' tumour (LSM = 235 U l(-1)), whereas values in benign tumours were only slightly elevated. Although the Wilms' tumours were associated with higher preoperative serum TPS levels, there was no statistically significant difference compared with neuroblastomas. Receiver operating characteristic analysis (ROC curves) showed a high sensitivity and specificity for both malignancies. Successful treatment resulted in decrease in TPS serum values. Serum TPS measurements in children presenting with abdominal masses can help in diagnosing the two commonest extracranial solid malignancies of childhood. Furthermore, TPS could acquire a pivotal role in monitoring therapy.

Analysis of Variance↗
PubMed1997

Tissue polypeptide-specific antigen in pediatric patients: assessment of normal values.

Measurement of serum concentrations of tissue polypeptide-specific Antigen (TPS) has been demonstrated to the useful in diagnosis and monitoring of adult epithelial tumors. So far, no data have been available on normal or pathologic TPS values in children. Therefore, the present study was designed to evaluate the normal values of TPS in childhood. Using a commercial enzyme linked immunosorbent assay (ELISA) kit, serum TPS was determined in 361 healthy children. Median (M) TPS was found to be 107 U/l at birth (n = 124). By the end of the first week, the value rose to M = 150 U/l (n = 68) and then continuously decreased with age (1 week-1 year, n = 45, M = 88 U/l; 1-7 years, n = 75, M = 51 U/l) until reaching the adult level (8-18 years, n = 49, M = 34 U/l). Additionally, the serum TPS values of 45 mothers right after delivery (M = 161 U/l) were assessed, and there was no correlation to the marker levels determined in the cord blood of their children. The age-dependent distribution of serum TPS in healthy children must be taken into account in the clinical application of this tumor marker.

Adolescent↗
PubMed1996

Effective pain relief with continuous intrapleural bupivacaine after thoracotomy in infants and children.

The effect of continuous intrapleural bupivacaine on pain relief after lateral thoracotomy was studied in nine infants (< or = 15 kg body weight) and 11 children (> 15 kg body weight). An intrapleural catheter was inserted under direct vision during surgery. After extubation, the patients were transferred to the ICU where vital signs and pain scores were monitored. An intrapleural infusion of bupivacaine 0.25% with adrenaline was given at a loading dose of 0.625 mg.kg-1 body weight followed by a continuous infusion with a starting rate of 1.25 mg.kg-1.h-1. Haemodynamic and respiratory parameters did not differ significantly from control values throughout the study period in either group. The mean infusion rate could be reduced stepwise in both groups to 0.75 +/- 0.32 mg.kg-1.h-1 and 0.73 +/- 0.38 mg.kg-1.h-1 respectively. The pain score indicated a rapid onset of analgesia in both groups and remained low during the study period. The degree of analgesia amongst other factors was position dependent. The lack of any recognizable side effects or complications related to this method has been most encouraging. Only one child required a supplementary dose of an opioid. We conclude that continuous intrapleural access has proved to be a safe and suitable route for pain relief in infants and children following thoracotomy.

Analgesia↗
PubMed1995

Regression and progression in neuroblastoma. Does genetics predict tumour behaviour?

Neuroblastoma (NB) is a heterogeneous disease. The clinical course may range from spontaneous regression and maturation to very aggressive behaviour. Stage 4s is a unique subcategory of NB, generally associated with good prognosis, despite skin and/or liver involvement and the frequent presence of tumour cells in the bone marrow. Another type of NB is the locally invasive tumour without bone and bone marrow involvement which can also have a good prognosis, irrespective of lymph node involvement. Unfortunately, there is only limited biological information on such tumours which have not been treated with cytotoxic therapy despite lymph node involvement, residual tumour mass after surgery and/or bone marrow infiltration. In order to find specific genetic changes common to NBs with a benign clinical course, we studied the genetic abnormalities of these tumours and compared them with highly aggressive tumours. We analysed a series of 54 localised and stage 4s tumours by means of in situ hybridisation performed on fresh cells or on paraffin embedded tissues. In addition, we performed classical cytogenetics, Southern blotting and PCR analysis on fresh tumour tissue. The majority of patients had been treated with surgery alone, and in a number of patients tumour resection was incomplete. Deletions at 1p36 and amplifications of the MYCN oncogene were absent, and diploidy or tetraploidy were not seen in any case, with residual localised tumours possessing a favourable outcome. Unexpectedly, one patient with a tetraploid 4s tumour without any genetic structural changes not receiving any cytotoxic treatment, did well. Interestingly, this genetic spectrum contrasted with that of progressing tumours, in which most had genetic aberrations, the deletion at 1p36 being the most common event. These data, although limited, suggest that an intact 1p36 (recognised by D1Z2), the absence of MYCN amplification and near-triploidy (at least in localised tumours), represent prerequisites for spontaneous regression and/or maturation.

Adolescent↗
PubMed1993

Recent evaluation of prognostic risk factors in esophageal atresia--a multicenter review of 223 cases.

In this study, 223 cases of esophageal atresia (Type IIIb: 85.7%; Type II: 5.8%; Type IIIc: 4.0%; Type IIIa: 2.2%; Type IV: 2.2%) from 6 pediatric surgery centers of Austria, were retrospectively examined for the following parameters and their influence on the prognosis: Birth weight (2494.7 +/- 702.0 g), gestation week (range 27-42 weeks; mean 37.3 +/- 3.1 weeks), sex (male: n = 128; female: n = 95), long-gap atresia (> or = 2 cm: n = 33), Tracheomalacia (n = 16), associated malformations (n = 122; cardiac 27.4%, renal 17.9%, skeletal 17.0%, anal: 10.3%, intestinal 9.9%, mediastinal 7.6%, chromosomal 2.2%), preoperative aspiration (n = 92), pneumonia (n = 96), anastomotic insufficiency (n = 45), empyema (n = 5), mediastinitis (n = 8), sepsis (n = 32), other medical complications (n = 122, in 80 infants), other surgical complications (n = 57). The mortality rate was 41.3% overall, from 1975 to 1991; however, it was 25% from 1987 to 1991 and 0% in 1991. A statistically significant correlation was found between prognosis and the following factors: Cardiac malformations (p = 0.0001), medical complications except aspiration and pneumonia (p = 0.0001), empyema (p = 0.0081), mediastinitis (p = 0.0214), and sepsis (p = 0.0295). These 5 significant factors were given different points and a prognostic score was calculated by the addition of these points. This score was predictive for survival in 90.6% of cases and for mortality in 94% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Austria↗
PubMed1990

[Pediatric surgery emphasis in diseases of the mediastinum].

Airway obstruction, dysphagia and mediastinal masses are the most common causes for surgery of the mediastinum in the pediatric age group. From 1976-1990, 82 children underwent such surgery: 7 tracheoplasties, 4 endotracheal resection of a membrane, 6 stenoses due to haemangioma or lymphangioma, 2 papillomatosis of the trachea, 8 pexes of the aorta or the innominate artery due to tracheomalacia, 7 vascular rings (4 right descendent aorta, 3 double aortic arch), 4 congenital esophageal stenoses, 44 mediastinal tumors (20 malignant, 24 benign lesions).

Airway Obstruction↗
PubMed1987

Scimitar syndrome and associated pulmonary sequestration: report of a successfully corrected case.

A case of scimitar syndrome with pulmonary sequestration is reported. Anomalous pulmonary venous return from the right lung to the infradiaphragmatic vena cava inferior was diagnosed by pulmonary angiogram and sequestration of the right lower lobe was confirmed by aortogram. Venous return from the sequestrated lung was partly into the vena cava inferior and partly into the left atrium. Successful repair was achieved by resection of the sequestrated lobe and direct reimplantation of the scimitar vein into the left atrium. Accurate preoperative diagnosis and intraoperative evaluation of the anatomy is mandatory to correct this rare anomaly.

Angiography↗
PubMed1987

Effect of cefotaxime, ceftriaxone and latamoxef on blood coagulation in patients on parenteral nutrition.

Plasmatic coagulation parameters were studied in patients on parenteral cephalosporins with different hepatic pharmacokinetics. Sixty patients received either cefotaxime (4 g/day), ceftriaxone (2 g/day) or latamoxef (4 g/day) pre- and postoperatively for at least 5 days at random. They received parenteral nutrition without vitamin K supply and had no oral intake. A significant drop (p less than 0.05) in vitamin-K-dependent coagulation factors was recorded in patients treated with latamoxef, while patients receiving ceftriaxone and cefotaxime did not exhibit a significant change in their plasmatic coagulation parameters. Interference of some cephalosporins with the vitamin-K-dependent hepatic metabolism of clotting factors seems to be likely, rather than a suppression of intestinal vitamin K production by the intestinal microflora.

Aged↗
PubMed1987

[Nonsurgical removal of iatrogenic intracardiac foreign bodies. A study in a 5-month-old infant].

The development of new techniques and special catheter instruments permit iatrogenically embolized polyethylene catheter fragments to be retrieved nonsurgically. A case is reported in which a fragment of a central venous catheter was removed from the right atrium and ventricle by a DORMIA catheter in a 5-month-old child. The literature concerning nonsurgical retrieval of catheters is reviewed and indications for removal and complications discussed.

Cardiac Catheterization↗
PubMed1986

[Benign and malignant intra-abdominal tumors in childhood].

31 children with intraperitoneal masses were operated upon during a 10 year period between 1975 to 1985, 15 tumors were malignant (3 hepatoblastomas, 6 NHL, 3 RMS, 1 mesothelioma, 1 teratocarcinoma of the ovary, 1 haemangioendothelioma of the liver). 16 benign lesions included 3 solitary liver cysts, 2 haemangiomas of the liver, 2 parasitic cysts, 3 ovarian cysts, 2 choledochal cysts, 2 intraperitoneal encapsulations, 1 mesenteric cyst, 1 duplication of the intestine. Half of the benign masses were found in the first month of life, two thirds (69%) under 1 year of age, later the malignant tumors are more frequent.

Abdominal Neoplasms↗
PubMed1983

Neonatal nesidioblastosis--diagnosis and preoperative management.

Two infants were admitted for severe, intractable hypoglycemia. "Fasting" tests lasting 45 and 30 minutes respectively revealed hypoglycemia with inappropriately elevated levels of plasma insulin and plasma C-peptide. Subsequently, somatostatin was infused to test the individual sensitivity of the B-cells. Basal and glucose-induced insulin and C-peptide secretion were significantly reduced. Preoperative treatment with somatostatin was introduced, which controlled the hypoglycemia. In both patients, subtotal pancreatectomy was effective in restoring normal glucose homeostasis.

Blood Glucose↗
PubMed1983

Classical seminoma in a case of testicular feminization syndrome.

The appearance of a seminoma in a 16-year-old patient with testicular feminization syndrome is reported. There is a high incidence of malignant degeneration of the gonads associated with this syndrome. The consensus is that exploration and gonadectomy are indicated immediately after puberty.

Adolescent↗
PubMed1982

[Wide gap esophageal atresia without esophagotracheal fistula (author's transl)].

Standard treatment of infants with "wide gap" esophageal atresia usually requires a staged procedure consisting of gastrostomy at birth (with or without cervical esophagostomy) and then a bowel interposition between the oesophagus and stomach at 1 year of age. Because this approach procedures significant morbidity and swallowing dysfunction, an alternative method for treating the wide gap atresia is recommended. The upper and lower esophageal pouch can be elongated by preoperative bougienage. This technique allows successful primary esophageal reconstruction in infants with wide gap esophageal atresia previously considered uncorrectable except by use of colonic or gastric tube interpositions.

Esophageal Atresia↗