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Biomedical subjects

E Willich

Publications and source records attributed to E Willich.

At least 19 recordsLinked to original sources
PubMed1991

Spinal growth after irradiation for Wilm's tumour.

Between 1960 and 1983, 82 children were treated for Wilm's tumour at our hospital. The secondary effects and changes in the skeleton have been assessed. Radiotherapy was found to cause growth disturbances and osteochondrosis of variable degree, but not osteonecrosis. Since irradiation produces late damage, it should be applied symmetrically to the spine and the dose limited as far as is possible. A long follow up is necessary since skeletal damage can only be assessed after the end of growth.

Child, Preschool↗
PubMed1990

[Vertebral changes after irradiation for Wilms' tumor in early childhood. A retrospective interdisciplinary long-term study of 82 children].

82 children with nephroblastomas, who had therapy between 1960 and 1983, underwent continuous follow-up examinations until 1988. 79 children who survived had been treated with nephrectomy followed by radiation therapy (n = 72) and chemotherapy (n = 72). 64 of these patients had a combination of both post-surgical treatments. Radiotherapy was performed with cobalt-60 until 1977, followed by high-energy photon and electron beam therapy since 1978. In the beginning the dose applied in each patient within five to seven weeks was 46.5 Gy. Since 1972 it was reduced to 42.8 Gy and after 1978 to 32.3 Gy. The overall survival rate between 1960 and 1988 was 65% and rising to 91% since 1980. 47 children had spinal X-ray examinations at regular intervals for more than two years and 28 of these patients could be followed up to 20 years after radiotherapy. 39 children who had been irradiated before the age of 2 1/2 years developed a more pronounced degree of scoliosis and lumbar kyphosis with a higher incidence. 1500 spinal radiograms were evaluated. Measurements of the second lumbar vertebra, which was constantly situated within the target volume, were compared with those of the eight thoracic vertebral body outside the radiation field, and the curvature of the spine was analysed. Late radiation injuries of the spine could be reduced by involving the whole vertebral diameter into the radiation beam, by the use of high-energy radiation techniques and by excluding children under the age of one year from radiotherapy. However, disturbances of spinal growth cannot always be prevented.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Skeletal age determination in adolescence and the 3d decade of life].

The determination of bone age of hand and wrist focussing primarily on bone centre development is limited to childhood and during this period has diagnostic significance as well as therapeutic consequences. At puberty the fusion of epiphyseal growth plates is more important: it reflects the termination of growth and the biological stage of development. An extension of knowledge can be obtained by correlating age beyond 18 years into the third decade of life. This allows sex determination and reflects maturation processes through the appearance and fusion of the apophyses of the iliac crest and the ischial bone. The indications are mainly forensic and for an individual's identification.

Adolescent↗
PubMed1985

Absence of prognostic significance of skeletal involvement in acute lymphocytic leukemia and non-Hodgkin lymphoma in children.

Over a period of 6 years 88 children with acute lymphocytic leukemia and malignant non-Hodgkin lymphoma were treated according to the West-Berlin protocol. In 72 children skeletal surveys were performed initially and these showed leukemic bone changes in 31 patients. Follow-up was obtained in 70 patients for up to 8 years after diagnosis: 20 of these patients died and of these 8 showed initial skeletal involvement. In 17 children relapses occurred and 10 of them had bone lesions at first presentation. There was no significant correlation between the extent of the skeletal involvement and the survival time as calculated by life table analysis.

Adolescent↗
PubMed1985

[Skeletal manifestations of malignant, nonosseous tumors in childhood].

Skeletal involvement in childhood nonosseous tumors can be due to primary involvement, arrosion or metastasis, secondary due to therapy induced alterations or osteomyelitis following diminished immunity. The occurence of bone changes differs widely from those in adults. Neuroblastoma, rhabdomyosarcoma and malignant lymphoma are discussed in detail. Rare tumors are listed for synopsis. As diagnostic screening method skeletal scintigraphy is recommended, whereas in localized disease X-rays should be performed. Beside roentgenmorphology-particularly in primary disease-localisation, frequency and age dependency may give essential diagnostic hints. Prognosis depends on primary tumor.

Adolescent↗
PubMed1984

[Fold formations in the proximal ureter].

Over a period of thirteen years in 28 children (age 4 weeks to 11 years) mucosal membranes of the proximal ureter were diagnosed by intravenous urography. In 61% of all cases the anomalies were demonstrated within the first year of life. Predominantly boys were affected (75%). Most of the associated anomalies (n = 15) were related to the urogenital system (n = 7). The membranes were bilateral in 12 cases and either separate (n = 15) or multiple (n = 25), resulting in a cork-screw-like structure. Minor signs of obstruction of the corresponding renal pelvis were found in 45%, independent of the number of membranes. Urinary tract infection (UTI) occurred in half of all cases. Kidney length was not reduced in any child. The mean serum creatinin (SCR) level was 0.6 +/- 0.4 mg/dl. Surgical correction was never performed. The clinical follow-up investigation (n = 14) after a mean period of 5.1 (1-14) years revealed recurrent UTI in only 2 patients. The mean SCR level remained normal (0.5 +/- 0.3 mg/dl). The tendency of involution of the membranes, supposed by the clinically benign course, is demonstrated to serve as an example. Although a predisposing effect to UTI cannot be excluded, ureteral membranes must be regarded as harmless and transitory anomalies of the growing ureter in childhood which do not require urologic intervention.

Child↗
PubMed1983

Condensing osteitis of the clavicle in childhood: a rare sclerotic bone lesion. Review of literature and report of seven patients.

Seven children and adolescents with sclerotic and periosteal alterations of the clavicle are reported, two of them in detail. Malignancies and bacterial inflammatory processes, which were first suspected, could be excluded. Clinical and radiographic features as well as differential diagnosis are discussed, as is the pertinent literature. The etiology of this uncommon bone lesion, which is described under different names, could not be clarified.

Adolescent↗
PubMed1983

[Roentgen diagnosis of structural changes in the pubic area in children and adolescents. Personal case reports, differential diagnosis and literature review].

Structural changes in the pubic bone often are difficult to interpret. The radiologic appearance is very different. The differentiation between inflammatory and malignant processes is hardly to distinguish. We are reporting ten patients with osseous changes in the os pubic (4 Ewing's sarcoma, 1 osteosarcoma, 1 Morbus Hodgkin, 1 osteochondronecrosis, 2 osteochondritis, 1 subchronic osteomyelitis). Two patients with Ewing's sarcoma who were initially treated for osteomyelitis are described in detail. Differential diagnosis and previous literature are reviewed.

Adolescent↗
PubMed1982

[Modern x-ray apparatus for pediatric radiology (Pädiatrix) (author's transl)].

First experiences with the new apparatus "Pädiatrix" in pediatric radiology are reported. The apparatus is especially constructed for babies and children. X-ray pictures can be taken close-up and in distance with the tube above the table. Fluoroscopy can be performed with image intensivier. X-ray pictures with Bucky-diaphragm by the technique of middle and normal size and oblique or horizontal direction are to be made. Tomography and zonography can be done. The apparatus has proven useful for clinical radiological diagnostics after three years of experience.

Child↗