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Biomedical subjects

E Ring-Mrozik

Publications and source records attributed to E Ring-Mrozik.

24 records · Page 2Linked to original sources

[Vesico-intestinal fissure with meningocystocele--attempt at clarifying an embryologic connection].

The treatment of a boy is reported, who suffered from a combination of vesico-intestinal fissure and meningocystocele. Because five of seven patients known to us since 1969 had a similar combination, it should be analysed whether there exists an etiological or embryological connection. Therefore the pertinent literature and clinical data of known patients was collected and evaluated. It can be shown that also in the literature a coincidence of 75% of vesico-intestinal fissure and meningomyelocele is reported and both are caused during the 4th week of embryological development. Vesico-intestinal fissure is a disturbance of mesodermal inflow into the lower abdominal wall. The cause for meningocystocele is an abnormal cell proliferation of the neural anlage. Despite a number of possible clues an etiological connection could not be proved.

Abnormalities, Multiple↗

[Therapy of postoperative complications following abdominoperineal or abdominosacroperineal pull-through surgery in anal atresia].

In 144 pull-through-operations performed for anorectal-atresia, following complications were observed: pneumonia 11%, sepsis 8.3%, peritonitis 5%, bowel obstruction 5%, osteomyelitis 1%, retraction of the pulled-through colon 4%, anal stenosis 16%, secondary megacolon 9%, fistula relapse 8%, mucosal prolapse 4%. Recto-urethral, recto-vesical- and recto-vaginal fistula relapses are managed by interposition of the gracile muscle. Anal stenoses and secondary megacolon are prevented by a sufficiently long postoperative bougienage.

Anus, Imperforate↗

Magnetic resonance imaging in children suffering from spina bifida.

22 children with myelomeningocele (MMC) were examined by magnetic resonance imaging (MRI). After operative closure a tethered cord was found in 78% of the patients. A primary tethered cord was detected in all patients where a lipomyelomeningocele had not been operated on yet. Additional malformations shown by MRI were hydromyelia and diastematomyelia. No correlation could be found between the degree of morphologic changes and the clinical course. In covered MMCs, MRI investigation is recommended as method of choice before operation. After operative closure a control-MRI should be performed after three months. If there are no pathological findings, further follow-up should be done by ultrasound investigation twice a year.

Adolescent↗

Historical aspects of hydrocephalus.

From early days on physicians took interest in hydrocephaly because of its grotesque appearance. Already Hippocrates recommended decompression-trepanation for the treatment of hydrocephalus. Only since anatomy and pathophysiology of hydrocephalus as well as production and absorption of the cerebrospinal fluid was clarified, more effective operative techniques could be developed. Conservative treatment was unsuccessful or was useful only as temporary or adjuvant therapy supporting surgical procedures. A great variety of operative methods was described since the middle of 19th century which yielded, however, unsatisfactory results in most instances. Results improved since the introduction of effective valve systems in combination with ventriculoatrial and ventriculoperitoneal shunts. Despite of improved results, the treatment of hydrocephalus remains problematic as is shown by the still high complication rate and the restless search for more effective ways of treatment.

Bibliographies as Topic↗

[The value of C-reative protein analysis for the differential diagnosis of non-acute appendicitis].

Appendicitis is one of the most common causes for laparatomy in children. Diagnosis can be very problematic, especially if appendicitis is combined with gastro-enteritis. Furthermore, difficulties can be encountered in diagnosis of diseases such as mucoviscidosis, leukosis, immunosuppressive or chemotherapy are present. In addition to the common clinical examination we have to look for other methods to complete the indication for appendectomy. Therefore in 1985 we added the CRP-determination to our diagnostics for patients with suspected appendicitis. In a retrospective study 269 patients who had signs of acute appendicitis were examined. We found that the determination of the CRP-level, in conjunction with the standard parameters of appendicitis, represents a valuable addition to the diagnostic armamentarium. However our data shows, that the CRP-level in itself cannot be regarded as a sole criteria for an unambiguous diagnosis of non-acute appendicitis, as it is the case with any other appendicitis parameter.

Acute Disease↗

One-year treatment with recombinant human growth hormone of children with meningomyelocele and growth hormone deficiency: a comparison of supine length and arm span.

Growth retardation and precocious puberty are frequently found in children with meningomyelocele (MMC). Lower limb contractions, spasticity and kyphoscoliosis may lead to disproportionate short stature. Most of these patients have structural brain defects or hydrocephalus which can cause growth hormone deficiency. In this study, 19 children aged between 3.5 and 12.8 years with MMC and growth hormone (GH) deficiency were treated with recombinant human GH for a period of 12 months. Supine length, arm span and growth velocity were compared before, and after 6 and 12 months of treatment with rhGH (daily dose 2.0 IU/m2 BSA s.c.). Mean supine length standard deviation score (SDS) increased by +0.8 SDS after 6 months and +1.2 SDS after 12 months of therapy. Mean arm span standard deviation score increased by +0.9 SDS and +1.3 SDS. Growth velocity increased in supine length from 3.3 cm/yr (-2.1 SDS) to 8.4 cm/yr (+2.4 SDS) and in arm span from 4.8 cm/yr (-1.3 SDS) to 8.6 cm/yr (+3.1 SDS) in the first 6 months and was 8.1 cm/yr (+2.4 SDS) and 8.3 cm/yr (+2.6 SDS) after 12 months of therapy. Linear correlation between SDS growth velocity supine length and SDS growth velocity arm span during one year of treatment was excellent (r = 0.65, p < 0.0025). We surmise that body proportions do not deteriorate when growth velocity is stimulated in MMC patients. Both supine length and arm span measurements are necessary to document growth in children with spinal dysraphism.

Age Determination by Skeleton↗