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Biomedical subjects

H Wiersbitzky

Publications and source records attributed to H Wiersbitzky.

At least 37 records · Page 2Linked to original sources

The eosinophilic granulocyte count in the respiratory secretions of children with chronic nonspecific respiratory diseases.

We performed cytologic evaluations of 6116 nasal and/or bronchial smears from 4510 patients (average age: 7.6 years; 3 months--17 years) suffering from different kinds of chronic nonspecific respiratory diseases (CNSRD); in 137 children (average age: 4.8 years) undergoing bronchologic examinations under general anesthesia we compared the findings with those for bronchoalveolar lavage (BAL). Nasal smears of 77 healthy children at a day care center (control group) were analysed four times per year for "significant secretory eosinophilia" (SEE; i.e. more than 13% eosinophils). We found: 1. Healthy children do not have such "SSE" in contrast to children with CNSRD who show different frequencies of "SSE" depending on the age of the child and the specific kind (diagnosis) of CNSRD. 2. 4.6% of infants (first year of life) were found to have SSE with a statistically significant correlation to increase in the following 10 years up to 50% of all children (p less than 0.001). 3. We found SSE in 4.41% of cases with relapsing bronchitis, in 7.14% (8.3% resp.) with chronic bronchitis, in 6.49% (9.2% resp.) with relapsing or chronic obstructive bronchitis and in 46.05% (55.3% resp.) with bronchial asthma (p less than 0.001). 4. The intensity of obstructive symptoms (nose: rhinitis; bronchus: dyspnoea) did not correlate with the number of eosinophils in the secretions. 5. Only the smear cytograms (nose/bronchus) enabled us to detect "SSE" whereas BAL cytograms were too insensitive (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Parvovirus B 19 infection and associated arthritis in children and adolescents].

The commonest clinical manifestation of an acute parvovirus B 19 infection is "infectious erythema (E.i.)". Both in connection with "E.i." and without typical skin symptoms, transient arthralgias can be observed relatively frequently. Moreover, patients suffering from juvenile chronic arthritis (jcA) have now been described, in whom the initial symptoms were closely related to an acute parvo B 19 infection. Fife of our own patients with arthropathies of different kinds and a well documented acute parvovirus B 19 infection are presented here and all the relevant contemporary scientific problems are discussed.

Adult↗

[High-grade tracheomalacia and tracheal stenosis in congenital esophageal atresia with lower esophagotracheal fistula (Type III b)].

Stenosis and malacia of the trachea wall can provoke chronic stridor and/or chronic bronchitis, but usually stenosis and malacia only exist separately. The finding of an infant born with atresia of the oesophagus and a lower tracheoesophageal fistula which was cured by surgery on the 1st day of life are discussed. During the following 8 months we observed persistent stridor, chronic cough and (4-times) relapsing episodes of respiratory insufficiency ("nearly-sudden-infant-death-syndrome"/NSIDS) due to gastrooesophageal reflux (GER with aspiration) and severe tracheomalacia combined with tracheostenosis and bacterial infections (Pseudomonas aeruginosa). The strategy of therapy for GER and for the tracheal abnormality are discussed.

Esophageal Atresia↗

The pediatric bronchopneumonologic consultation centres (dispensaries) for children and adolescents suffering from chronic nonspecific respiratory diseases (CNSRD) in the G.D.R.

A survey is given of the three-level health service for young patient with chronic nonspecific respiratory diseases (CNSRD) in the GDR. The expected prevalence of the diseases in the young population (0-18 years) is 2-3% and still higher in regions with heavy air pollution. The pediatric working group of bronchopneumonology (in the Pediatric Society of the GDR) has organized a country-wide system of pediatric bronchopneumonologic consultation centres in the form of district (2nd level) and county dispensaries (3rd level) helping the local primary care pediatricians and general practitioners (1st level) in diagnostics, therapy and surveillance of such patients. The bronchopneumonologic county centres with all modern diagnostic and therapeutic facilities have a capacity which is sufficient for our country. However the function of the primary care doctors (to spot such children and refer them to the dispensaries), that of the district dispensaries (so far only 50-65% of expected patients in control!), and the availability of lung function test equipment and special bronchoscopic aids for infants and small children (in the county centres) needs to be improved.

Adolescent↗

[Congenital toxoplasmosis with delayed immune response].

In typical cases the diagnosis "toxoplasmosis connata" is based on clinical symptoms and positive serological findings. When the infection of the fetus occurred a short time before birth the neonate seems still normal and the disease develops in the postnatal period. In such cases the specific antibody production may be delayed. We present a case report with well documented first infection of the mother between the 15th and 30th gestational week but with no specific treatment. The baby was born without clinical signs of a toxoplasmosis infection and developed the disease 2-3 weeks later; the serological test (complement fixation test, KBR) was negative at the 24th postnatal day. Specific antimicrobial therapy could be started after serological conversion between the 4th and 5th postnatal week. Problems of diagnostics and delayed therapy are discussed.

Animals↗

[Intrathoracic gastric duplication with intrapulmonary abscesses and perforation into the bronchial system--pathologico-anatomic peculiarities and diagnostic problems].

Gastric and enteric cysts represent genuine duplications. With regard to their genesis opinions are divided. These duplications may perforate into the lung parenchyma and/or the bronchial system, giving rise to specific symptoms. The only possible therapy is complete extirpation. The intrapulmonary metastases are drained and aspirated and can be cured without loss of lung tissue. A report is given on a thoracic cystic gastric duplication with haemorrhagic inflammation of the mucous membrane associated with erosions in a 8-week old boy. Clinically, the duplication was reflected by poor general health, dyspnea and tachypnea. The perforation into the bronchial system caused respiratory insufficiency. Using antibiotic therapy, immune substitution and surgery in combination, the boy was cured. The morphological findings, causative embryological factors, and diagnostic possibilities and problems are discussed.

Bronchi↗