Biomedical subjects
Publications and source records attributed to H Jung.
Complications in diagnostic mediastinoscopy are between 0, 7 percent and 1,8 per cent. Lesions of the great vessels end letal in most cases. A possibility is reported how to treat lesions of the tracheobronchial system in emergency cases with lyophilised dura and a histoacryl-adhesive for tissue.
Because of premature labour, probability of fetal retardation, discrepance at term of delivery, Rh-incompatibility or EPH-gestosis 185 patients were hospitalized. 76 pregnant women received twice 1.5 ml Celestan Depot i.m. (4.5 betamethasone acetate and 6mg betamethasome dinatrium phosphate per injection) within an interval of 24 hours. It was necessary to maintain a tocolysis for at least 48 hours as a minimum after the first injection of Celestan Depot. The other 109 patients without treatment of glucocorticoids were considered as a controlgroup. We could show that antepartum application of betamethasone before the 38. week of gestation was associated with a reduction of RDS in our premature infants. Only one baby of the betamethasone-treated infants died of hyaline membrane disease during the first 7 days of life compared with 11 of the control group. In 11 patients patients amniocentesis was performed before the first injection of glucocorticoids and was repeated 2 to 7 days later. The amniotid fluid lecithin phosphorus concentration was determined. In the same period of pregnancy and the same iterval the lecithin phosphours level of amniotic fluid was analysed in 11 other patients who were not rreated with glucocorticoids. The difference between amniotic fluid lecithin phosphorus concentration in the first and second anslysis was found significant by a level of significance of alpha = 5%. There was no evidence of an influence of the therapy with Celestan Depot on this increase. The excretion of oestorgens in the urine of 24 hours was analysed in 22 gradidae before and 7 days after the treatment with betamethasone. The oestogen values of the day before application of betamethasone served as baseline figures. All patients showed a market fall in urinary oestrogens excretion, especially after the second day of therapy. After day 2 the values returned rapidly to baseline values. There were no differences between treated and control groups in Apgar scores at birth or in the incidence of icterus neonatroum (bilirubine level is greater that 10 mg% in the serum). The results of our study support the hypothesis that in humans glucocorticoid administration to the fetus accelerates lung maturation. Relatively brief intrauterine exposure of human infants to pharmacological doses of betamethasone was associated with a substantial reduction in the incidense of RDS.
Advances in electrotechniques and optics in the last years have led to the use of fiberoptic endoscopes in the examination of the nasopharynx. A modified photo-endoscopic method is reported, utilizing a Hopkins' lens system which is introduced intraorally. A robot-reflex camera with variable optics and focal distance is used for photographic documentation of nasopharyngeal findings. The efficiency of the method is demonstrated by selected clinical examples.
In treating childhood lymphosarcoma, high-dose combination chemotherapy is most effective, when given as long-term therapy. The most important advances of the therapeutic regimen described here are not only obtaining complete remissions but to have them maintained; the side-effects of the intensive therapy are well to be kept under control. Besides, some of the drugs are effective against the severe complications, leucemic transformation and sacromatous meningiosis. The median time of complete remission in our own patients with head and neck primaries is already 63 weeks; in comparison, that of a former group of children was 11 weeks.
The head and neck region is - among the body regions - one of the most frequently affected one by malignant primaries in childhood and adolescence. The diagnosis of malignant lymphomas (Hodgkin's and non-Hodgkin's type) predominanted (55 cases) in the own case material of 94 patients. Besides, there were 21 tumors of mesenchymal origin, 11 neuroepithelial tumors and 5 cases of histiocytosis X. The first symptoms are often discret (painless swelling) and they represent one of the major problems in handling childhood tumors. An optimal therapy, which resulted in longterm cures in the majority of the own patients, is based on an intensive team-work of pediatricians and ENT-doctors. One of the important points for successful treatment is individualizing the intensity of each of the effectful modern therapeutic modalities.
Most cases of primary malignant tumors of bone occur in children and adolescents. There are several types to be classified according to clinical and radiological findings and histologic diagnosis Ewing's sarcoma and osteogenic sarcoma; chondrosarcoma, malignant tumor of cartilage, is also classified in this group of tumors. Incidence, age-and-sex-distribution clinical presentation, and diagnostic procedures are reported for the different types of tumors, with special reference to primary localization in the skull. Different therapeutic modalities are discussed. Cure rates in these highly malignant tumors are still low, but evidently improving.
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