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H Neugebauer

Publications and source records attributed to H Neugebauer.

At least 19 recordsLinked to original sources
PubMed2002

[Arterial vascular injury of the diaphragm caused by serial rib fracture].

About 10% of all trauma patients sustain rib fractures. The average age is 58. Men are more often affected than women. Hemothorax, pneumothorax, and lesions of the lung are not uncommon. Very rare are injuries of the pericardium, aorta, and subclavia caused by fractured ribs. We present a very unusual case where a broken rib caused a severe diaphragmatic hemorrhage with a hemothorax and acute hypovolemia. The primary chest X-ray was thought to be without pathology. Arterial bleeding without exact localization could be found with computed tomography. Thoracotomy revealed the correct diagnosis and the cause of bleeding.

Aged↗
PubMed1999

Seventy cases of injuries of the small intestine caused by blunt abdominal trauma: a retrospective study from 1970 to 1994.

BACKGROUND: Injuries of the hollow viscera are far less common in blunt abdominal trauma than in penetrating abdominal trauma. This article is a 25-year retrospective study of 70 patients with injuries of the small intestine caused by blunt trauma. All patients were treated surgically at the trauma hospital (Unfallkrankenhaus) in Graz. In our series, blunt abdominal trauma causing hollow viscus injuries occurred in conjunction with multiple trauma in 68.8% of cases. The overall mortality rate was 25.7%. METHODS: The following methods were used for evaluating the intestinal injury: detailed history of the accident and examination of the patients (e.g., transverse abdominal bruise) diagnostic peritoneal lavage before 1984, abdominal sonography since 1984, computed tomography, and laboratory tests. RESULTS: Prognosis and results depended partly on the general condition of the patient, as well as the timeliness of diagnosis and surgical management of the small bowel injury. Delays in diagnosis were common because of the overall condition of the patient, as well as the difficulty in establishing a definitive diagnosis by using current radiologic and serologic modalities. CONCLUSION: It should be stated that the high mortality of small bowel injuries after blunt abdominal trauma justifies an aggressive approach to diagnosis and surgical treatment of these injuries. This article focuses on injury mechanisms and current concepts in diagnosis and the therapy of small intestine lacerations in blunt abdominal trauma.

Accidents↗
PubMed1996

Multihandicapped blind and partially sighted children in south Germany. I: Prevalence, impairments and ophthalmological findings.

Data on prevalence, impairments, neuropaediatric and ophthalmologic findings are reported in a population-based study of 239 multihandicapped blind and partially sighted children in South Germany born between 1981 and 1987. With a prevalence of 0.67 per 1000 live births this type of impairment was rare. However, most children in this series were very severely impaired with very low developmental age and several additional impairments. Most children had lesions of the visual pathways without significant involvement of the eyes. Ophthalmological and neuroradiological findings indicated that optic nerve atrophy and lesions of the posterior visual pathways frequently coexisted.

Birth Weight↗
PubMed1995

[Experiences with using the soft cast in injuries of the fibular ligament of the upper ankle joint].

From June 1993 until October 1994, 75 persons with recent ruptures in the region of the fibular ligament at the ankle joint were treated with a Softcast at our hospital. The patients were divided into a surgical and a conservative group: 33 patients were operated on and 42 were treated conservatively; 49 persons were male, 26 female. Both groups were initially treated with a conventional cast, and after the first week a Softcast was used. Surgery was performed whenever X-ray examination showed a difference of more than 10 degrees in supinatory subluxation between the unstable ankle and the intact one or anterior instability of more than 10 mm. In 55 of these patients follow up by clinical and X-ray examination was possible after an average period of 14.5 months after trauma and treatment. For the clinical follow-up the 100-point Pförringer-Stolz score was used (6), and the X-ray examination was performed under constant conditions by means of these standardized conditions, excellent and good results were achieved in more than 95% of the patients. The authors recommend the semi-rigid immobilization with Softcast in both operatively and conservatively treated patients with ruptures of the lateral ankle ligaments.

Adult↗
PubMed1993

[The psychosocial status of HIV-positive mothers and their children].

We studied the psycho-social circumstances of HIV-positive women and their children, who were born between January 1, 1984 and June 30, 1991 and are being treated at the Department of Pediatrics. We interviewed 19 women out of 21 families using the problem-centered interview technique according to Witzel. 29 out of 30 children were older than 18 months. Four children were HIV-positive and the serology of one patient aged 12 months who had been perinatally exposed was yet unclarified. The study showed massive problems within these families, such as considerable partner problems, drug abuse and social isolation. Furthermore, there was a lack of child care to relieve the mothers. The predominance of drug problems and insufficient experience of social institutions with the problematic nature of HIV-infection in mothers and children require more efficient preventive measures.

Child↗
PubMed1992

Air trapping from torsion of a congenital cyst of the lung.

Report on a case of congenital cyst of the lung which was attached to the pleura of the right upper lobe and because of torsion of its pedicle produced air trapping and mediastinal shift. Etiology, diagnosis and surgical indications are reviewed from the literature. No similar case has been previously reported.

Child, Preschool↗
PubMed1992

Pattern of Sertoli cell degeneration in cryptorchid prepubertal testes.

Seventy-three testicular biopsies from 54 children (aged 2 months-14 years) with undescended testes were examined by light and electron microscopy. The biopsies included abdominal, inguinally fixed, inguinally moveable, and retractile testes. Alterations in Sertoli cell morphology were found in all biopsies. The alterations included dilated elements of rough endoplasmic reticulum, vacuolization of the cytoplasm, mitochondria with poorly preserved cristae, increase in electron density of the matrix, elongation of the nuclei, and irregularities of the nuclear membrane. According to the numerical appearance of these cells and to the extent of lesions in single Sertoli cells, seven phases in the continuous process of tubular alteration were distinguished. The most severe tubular damaged (phase VII) occurred when the seminiferous epithelium consisted exclusively of necrotic cells. All phases of tubular alterations were seen regularly in each of the biopsies investigated. Germ cells occurred only in phases I-IV and were never observed in tubules in phases V-VII. Significant differences became evident between inguinal and retractile testes by morphometric evaluation. It was demonstrated that the number of germ cells per cross-sectioned tubule (S/T value) correlated negatively with the percentage of tubules in phases V-VII. In contrast to inguinal testes, a complete absence of Sertoli cells and an S/T value less than 0.1 were never found in retractile testes and the percentage of tubules in phases V-VII was reduced significantly compared with inguinal testes. Our findings indicate that (i) maldescended testis in patients between 1 and 15 years-of-age is associated with a special pattern of Sertoli cell degeneration; (ii) Sertoli cell degeneration is a continuous process, which can lead eventually to complete dissolution of the seminiferous epithelium; (iii) total degeneration is not related to age but is dependent on testicular position; (iv) a defined phase of degeneration excludes germ cell development, and therefore enhanced Sertoli cell degeneration in cryptorchid testes must also account for the reduction in germ cell number.

Adolescent↗
PubMed1991

[Panarteritis nodosa with secondary hyperaldosteronism involving renal arterioles].

A case of a 6 year old girl with angiographically and bioptically verified systemic polyarteritis nodosa is reported. Secondary hyperaldosteronism due to involvement of small and medium-sized renal arteries caused severe hypertension and left ventricular hypertrophy, and together with abdominal complaints, loss of weight, livedo reticularis and elevated titers of streptococcal antibodies formed the clinical pattern of the disease. It may be assumed, that there is a correlation between the recurrent streptococcal infections and the development of systemic polyarteritis nodosa by hypersensitivity or disordered immunologic reactivity. Therapy and short time follow up is reported. For treatment of hypertension an angiotensin converting encyme inhibitor was used, which immediately slowed down the maximal stimulated plasmarenin-angiotensin system.

Aldosterone↗
PubMed1991

[Penoscrotal hypospadias with XXYY chromosome pattern].

This is the report of a boy, 2 years and 4 months of age who presented with an penoscrotal hypospadia with normal appearing testes. Physical examination and routine laboratory tests revealed--besides a broad base of the nose and clinodactyly--no abnormality. The boy exhibits a normal speech development with retarded global intellectual development. Investigation of the hormon status revealed a disturbance of testosteron secretion and a hypergonadotropic hypogonadism. Chromosomal analysis in lymphocyte cultures revealed a XXYY karyotyp. This chromosomal pattern is seen in 3% of patients with Klinefelter syndrom; the estimated frequency is 1 in 25,000 population. A combination of an XXYY chromosomal pattern with a penoscrotal hypospadia has not been reported in the literature so far.

Child, Preschool↗
PubMed1989

[Ligament lesions of the knee joint in childhood].

As a matter of principle, all lesions of the knee associated with haemarthrosis must be examined for internal injuries. Ligament ruptures are rare; usually, there are bony ligament tears that show up on x-ray film. Examination of ligament stability in children is useful only if the x-ray is negative and after the knee joint has been punctured under anaesthesia, and can be justified only in that case. Diagnosis is possible only by means of x-ray films taken in forced extreme joint position in two planes, with lateral comparison. Treatment of all non-dislocated ligament tears is conservative; slight dislocations can be tolerated in cruciate and capsular ligaments, since the epiphyseal cartilage is not affected. Surgery should be performed only if tears are considerably dislocated. Proximal tears of collateral ligaments are epiphyseal fractures that can be treated conservatively only if there is no dislocation; if they are dislocated, surgery is absolutely mandatory.

Child↗
PubMed1977

[Active scoliosis in a modified Milwaukee brace (author's transl)].

On the basis of new insights in sport-medicine active exercises in the Milwaukee brace have been developed which enable the patient to straighten out his spine "on command". The first exercises serves the straightening. A skin-stimulus (spearing) makes the patient straighten his spine actively. First the doctor, later the parents, stimulate with a prick near the thoracic bulge. The patients learn to withdraw the gibbus from it. To re-inforce muscular power, an isometric resistance is exerted after correction. The second exercise corresponds to the well-known active extension with the extension-bandage of Krämer, but this effect is achieved with a modification of the brace. The pelvic girdle contains two shallow holes into which grips can be inserted. The lenght of these grips is so arranged that the power of the arms can be used to best effect. This exercise, too, will later be carried out against the resistance of a sandbag weighing 2-4 kg which is put on the patient's head. Both exercises have the great advantage that they seem to make sense to the patient and will be gladly and regularly carried out. They also encourage the young girls to wear the brace with more hope for success.

Adolescent↗
PubMed1976

[Scoliosis, metabolism and growth of the vertebral column (author's transl)].

Modern investigators incline to the opinion, that more biochemical than biomechanical disorders take part in cause of the "idiopathic'' scolioses. It seems, however, that there is not only one cause but more in some subgroups. Idiopathic scolioses, which have symptomes of arachnodactyly, seem to be a big one of these subgroups. These cases allow to state a hypothesis, in which kind a disordered metabolism leads to a deviation of the spine. This hypothesis is basing on the fact, that the enchondral growth in the length and the periostal growth in the width of "long bones'' are not regulated in the same endocrinological kind and that the enchondral growth of the vertebral-bodies-column happens in cranio-caudal direction, the enchondral growth of the vertebral-archies-column, however, in anterior-posterior direction. If the balance between enchondral and periostal growth is disturbed, you can see typical chances on the long bones, which resemble either an "arachnodactyly" or a "chondrodysplasy". The same disturbance will cause a "kyphosis" respectively a "lordosis" (or scoliosis) on the vertebral spine; either the bodies-column or the archies-column will become longer (higher). The results of metabolism research are suitable to these facts. If the balance between enchondral and periostal growth,--basing on a dysbolism,--is disturbed in such a kind, that the vertebral-bodies-column is growing faster than the vertebral-archies-column, the vertebral spine is forced to change into a lordosis respectively into a scoliosis. If you want to cure an idiopathic scoliosis, you first have to remove or to paralyse the dysbolism. The aim of all research has to be to find an effective chemotherapeutical treatment of mindst a part of all idiopathic scolioses.

Achondroplasia↗