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Biomedical subjects

E Willich

Publications and source records attributed to E Willich.

At least 37 records · Page 2Linked to original sources

[Osteonecroses in children with chronic renal diseases before and after kidney transplantation (author's transl)].

From 1969 to 1980 202 children suffering from chronic renal insufficiency underwent treatment in the Children's Hospital of Heidelberg University. In 36 patients kidney transplantation were performed. Two children developed femoral head necroses before transplantation without corticosteroid therapy. Three patients developed femoral head necroses in one or both sides within one to 24 months after kidney transplantation. All children with femoral head necrosis were suffering from congenital renal disease and had a history of severe renal osteodystrophy which was followed by severe coxa vara. Coxa vara and the resulting faulty loading seem to be essential factors for the development of femoral head necrosis in patients with renal insufficiency before and after kidney transplantation.

Adolescent↗

Nephrocalcinosis in radiographs, computed tomography, sonography and histology.

In 12 patients with nephrocalcinosis, radiographs were compared with computed tomography, sonography and histology. Computed tomography detects nephrocalcinosis at a very early stage of the disease, gives a better picture of the density and extent of nephrocalcinosis and may detect other findings (e. g. cysts). Radiographs may show many more details than computed tomography; they seem to be more suitable for observing the course of the disease and have a lower radiation dose. Sonography has not been helpful in the diagnosis of nephrocalcinosis. Histology correlates only moderately with the degree of nephrocalcinosis demonstrated in radiographs and computed tomography.

Adolescent↗

Radiological kidney size in childhood.

Kidney length (KL), renal area and renal parenchymal area were measured on i.v. urograms of 255 children without apparent kidney disease age 0 to 14 years. These parameters were compared with age, body height, body surface area and the distance between the 1st and 4th lumbar vertebral body. In addition, renal parenchymal thickness was determined at the upper and lower poles. Mean values for normal KL were significantly greater on the left side than on the right side requiring separate growth charts. A mean increase in KL of 6.3 mm for the left and 6.0 mm for the right kidney was calculated for a change of 10 cm body height. A small kidney is defined by a KL below--2 SD for the corresponding body height and/or a quotient of right KL/left KL outside +/- 2 SD from the mean value. Localised loss of renal parenchyma is reflected by an increased or decreased quotient of the upper to the lower polar thickness and reduction of total kidney mass by a diminished bipolar parenchymal thickness related to body height.

Adolescent↗

The determination of bone age in the elbow as compared to the hand. A study in 390 children.

In a prospective study, bone age (BA) from both hand and elbow was assessed in 390 children, aged 6-15 years, in order to determine: (a) whether or not BA assessment from the hand and from the elbow give comparable results, and (b) whether the accuracy of predicting skeletal age from the hand may be improved by the additional BA determination in the elbow. BA assessment in the hand was performed according to the method of Greulich and Pyle while the standards of Schinz and Baensch were used for the elbow. Statistical analysis of data was carried out according to age groups as well as according to groups of clinical diagnoses. With only one exception in the group of so-called "healthy individuals", there was no difference between "hand age" and "elbow age". Thus, except in a very small group of subjects, both methods of BA assessment were found to be equivalent in predicting skeletal age in children between 6-15 years. Equivocal results were obtained regarding the question of whether the accuracy of BA assessment in the hand may be improved by the simultaneous BA determination from the elbow. Until further studies on larger statistical material provide more conclusive information in this matter, we feel that the combined determination of BA in the hand and elbow is not warranted for clinical purposes.

Adolescent↗

[Unusual skeletal changes in acute lymphoblastic leukemia in children (author's transl)].

During the early phase of their disease three children with acute lymphoblastic leukemia showed unusual skeletal changes radiologically. Mainly osteolysis in the lower jaw, opacity of the sinus, decreased hight of the vertebrae, and a unilateral necrosis of the head of the femur. These skeletal alterations are much more common in other diseases than in acute lymphoblastic leukemia.

Bone Diseases↗

[Renal duplication in childhood. Incidence and clinical significance (author's transl)].

Renal duplication is the most common malformation within the urinary tract system and as such a particular challenge to the pediatrician with regard to diagnosis and therapy. It is discovered either by chance or in relation to chronically recurring urinary tract infections. Urinary tract infection is the main clinical symptom in 2/3 of all the patients with renal duplication. Incidence, age-and sex-distribution, predilection of side or bilateral occurrence, configuration of the ureter and the statistically significant combination with vesico-uretral reflux show systematic regularities and are discussed in connection with the literature. Ureterocele, concrements, obstructions or hydronephrosis often are consequences of renal duplication or, as with hydronephrosis, correlated malformations like aplasia, hypoplasia, malrotation, horseshoe kidney or duplication of the urethra. There is a causative relation between renal duplication and tumors or tuberculosis. Other correlated malformations are particularly heart malformations or myelomeningocele. It depends on the severity of the disease whether therapy will be symptomatic or operative. Between 1968 and 1974 we saw 114 children with renal duplication.

Abnormalities, Multiple↗

[A new bile contrast in pediatrics (author's transl)].

Biligram was used for 42 cholegraphies in children aged 2 months to 15 years. A 35% concentration of Biligram was given as intravenous injection in 14 children, a 17% or 3,4% concentration as an intravenous infusion in 16 or 12 patients, respectively. The quality of x-ray films with both Biligram 35% and 17% was equally good whereas Biligram 3,4% gave a weak contrast only. The best time for taking films was 30 and 60 min after injection of Biligram. Allergic reactions or an effect on liver enzymes were not observed.

Biliary Tract Diseases↗

[X-ray diagnosis and differential diagnosis of mediastinal tumors in childhood (author's transl)].

Symptoms, microscopy and frequency of mediastinal tumors in children are different from those in adults. The radiologic diagnosis of mediastinal tumors depends on evaluation of tumor site, density, and shape. Demonstration of calcifications or bony elements in combination with skeletal anomalies or destructions, pleural effusions, and differentiation of cystic and solid tumors are helpful. The radiologic criteria are also very important regarding prognosis and therapy. Many diagnostic methods are available. The venocavography and computer tomography are especially helpful.--We studied 184 mediastinal tumors in children and will discuss them according to topographic aspects; emphasis will be placed on differential diagnosis and the possibilities of diagnostic failure.

Age Factors↗

Upper calyx reno-vascular obstruction in children: Fraley's syndrome.

Intrarenal vascular obstruction of the upper calyceal infundibulum has been distinguished by Fraley as an entity separate from an asymptomatic vascular impression. Clinically, this form of intrarenal vascular obstruction presents as nephralgia or hematuria. This infundibular obstruction is caused by normal renal vessels, usually the upper segmental artery: radiologically, the vessels produce a constant well-defined filling defect in the infundibulum at IVP, and, the upper calyx group is distended and shows delay in emptying. We found this condition in 14 children from 1968-1975. Control studies showed no progression in the radiological findings, even over a long period. In one of our cases angiography was indicated to exclude tumour or cyst; in another case, surgery was necessary. Complications are urinary tract infection or stone formation. Therefore, children with Fraley's syndrome require regular clinical examination.

Child↗

[Intravenous cholangio-cystography during childhood (author's transl)].

Twenty-five intravenous cholangio-cystograms were carried out in children aged 2 to 15 years (10 by injection, 15 by infusion). Total bilirubin, GOT, GPT, GLDH and alkaline phosphatase were determined before and after injection of the contrast medium. The contrast media used were "Biligram for infusion" (17%) and "biligram for injection" (35%). Contrast dose per kilo body weight depends on the age of the patient: a) For infusion: infants 1.6 ml/kg/KG, small children 1.2 ml/kgKG, older children 0.8 ml/kg/KG. b) for injection: infants 0.8 ml/kg/KG, small children 0.6 ml/kg/KG, older children 0.4 ml/kg/KG. Both methods, in the above doses, provided good demonstration of the biliary tree and gall bladder. Films were taken at 30 minutes, 60 minutes and 90 minutes after the end of the injection, and 40 minutes after a fatty meal. No allergic reactions were observed, nor any effect on the liver enzymes.

Administration, Intranasal↗

[Skeletal changes in Down's syndrome. A correlation between radiological and cytogenetic findings (author's transl)].

One hundred and two patients with Down's syndrome aged one day to 17 years were examined radiologically, seven of these repeatedly. Films obtained included the chest in two planes, lateral spine, left hand and pelvis. The following features were noted; the number of paired ribs, ossification centres in the manubrium, height of lumbar vertebral bodies, shortening of the phalanges, bone age and calculation of the acetabula and ilial angle and ilial index. In all patients the chromosomes were examined in order to determine the cytogenetic type. The following features were found to be more common in Down's syndrome than in normals: abnormal ossification of the manubrium (33%), aplasia of the twelfth rib (18%), high lumbar vertebral bodies (50%), brachymesophalangia of the fifth ray (62%) and changes in skeletal maturation (acceleration or retardation in 48%). Changes in the pelvis were typical; with increasing age, the acetabular angle falls and the ilial angle increases. The most striking skeletal changes were found in 84 patients with trisomy 21.

Adolescent↗