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Biomedical subjects

J Hager

Publications and source records attributed to J Hager.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Endoscopic percutaneous placement of a guide thread for bouginage treatment of the esophagus following 3d degree chemical burn: a new method without laparotomy].

For successful treatment of third degree caustic burns of the esophagus, early bouginage and cortisone medication are mandatory. We use Rehbein bougies under guidance of a orogastric thread. To place this, laparotomy had been required so far. A new procedure for endoscopic gastrostomy is described to avoid the laparotomy. This method was performed in 7 children and one adult. There were no complications. The introduced procedure is recommended as a simple and safe technique, using endoscopy for thread placement as well as for diagnostic evaluation.

Burns, Chemical↗
PubMed1989

[Germ cell tumors in childhood].

This report concerns 33 infants and children with germ cell tumours = teratomas treated between 1968 and 1986. The primary site of the tumour was sacrococcygeal in 12 and the ovaries in 10. Malignancy occurred in 9 out of 33 (= 27%) patients. To prevent malignant transformation, early surgical intervention has to be performed in benign tumours. For immature subtypes as well as incomplete tumour extirpation a short-term follow-up should be mandatory. The recent change of treatment in malignant teratomas (protochemotherapy, delayed tumour extirpation, improved drugs, second-look operation)--based on cooperative interdisciplinary therapy studies--is discussed. Ultrasound and tumour markers are recommended as good indicators for diagnostic and follow-up studies.

Adolescent↗
PubMed1989

[Anomalies associated with ano-rectal malformations. Apropos of 67 cases].

Anorectal malformations are accompanied by associated anomalies in about 75%; their frequency and variety influence prognosis and survival rate. All kinds of associated anomalies are possible, but there are some typical combinations (like the Vater-association). In our series of 67 neonates (43 low and 24 high or intermediate atresias) we observed 64% of associated anomalies. They were more frequent in high or intermediate atresias (21 out of 24 cases). A low birth weight which is typical for this group affects the prognosis as well as the associated anomalies. 11 out of our 67 patients (= 16%) died; 11 of these weighed less than 2,500 g, and 3 even less than 1,800 g. Prematurity was the reason for the death of 4 neonates, 7 died because of associated anomalies.

Anal Canal↗
PubMed1989

Light and electronmicroscopic examination of calf lung tissue after left ventricular assisted circulation with the spindle pump.

The influence of the spindle pump, a nonpulsatile blood pump, used as LVAD on calf lung tissue was examined by means of the actual 16th protoype which was applied in 3 "acute" tests up to 13 hours of pumping duration and 8 prolonged experiments with pumping periods up to 63 hours. Samples were taken during the operation and after exitus of the test animal and investigated by light and electronmicroscopy. Histological findings of tissue changes could be ascribed to mechanical manipulations and shock-like influences. Regardless of the time of nonpulsatile perfusion this tissue damage remained within an acceptable range, indicating the absence of a deleterious effect of nonpulsatile flow.

Animals↗
PubMed1988

Left heart assistance with the spindle pump.

The spindle pump--a new attempt at assisted circulation--was developed to prevent the main problems of nonpulsatile blood pumps, i.e. traumatic hemolysis, thrombus formation and sealing. It was essential to achieve adequate output with the lowest possible speed in order to minimize traumatic hemolysis. The result was a spindle pump with three windings in a U-shaped housing driven by an electric motor. Many tests were necessary to establish a prototype. The spindle was completely redesigned several times to reach an acceptable volume output and corresponding pressure output. In animal experiments this final prototype working as a LVAD, with a speed of 5400 RPM circulates 4 liters/min against BP of 110 mmHg. The hemolysis rate has been low in acute and survival experiments (27 hours up to now), and is between 25 and 30 mg/100 ml of free hemoglobin, thus within the normal range.

Animals↗
PubMed1987

[Diagnosis and therapy of non-parasitic splenic cysts in children].

Splenic cysts of various types are rare surgical abnormalities. The diagnostic and therapeutic procedures are discussed with special reference to the author's clinical material consisting of six children with non-parasitic cysts. Sonography and, in special cases, CT are the most important methods of examination. The desirability of conserving the spleen, while removing the cyst, is stressed.

Adolescent↗
PubMed1987

[Experiences with the Port-A-Cath system, a fully implantable central venous access system, in children].

The Port-A-Cath-system is a totally implantable catheter system for central venous access. It consists of a subcutaneous injection port, fixed on the pectoral fascia, and a silicone catheter, positioned via a jugular vein into the right atrium. This system was utilised in 14 children (between 10 weeks and 14 years of age) for administration of chemotherapy, total parenteral nutrition, delivery of drugs or blood products, and venous blood sampling over a 15 months period. The device presents only few problems in respect of biocompatibility. Three complications occurred: one case of sepsis, one of catheter dislocation and one of catheter occlusion. The advantage of the total implantability of the system and the low complication rate are attractive alternatives to other methods of prolonged central venous access.

Adolescent↗
PubMed1986

[Treatment of gastroduodenal ulcers in children].

Gastroduodenal ulcers are probably no rarity in children. Clinically relevant are only those showing complications: either bleeding or perforation. They should be taken into consideration in the differential diagnosis of vague or chronic abdominal pain. Endoscopy is a reliable way of examination. Treatment should be conservative, leaving surgical therapy only for unmitigable bleeding, perforation and failing conservative management. The treatment of 34 children (in an age between one day and 14 years) is discussed. 26-17 of whom had bleeding ulcers--were treated conservatively, 8 had to be operated upon. 5 children suffered from a relapse (2 with bleeding), but conservative therapy led to the lesion's healing in these cases.

Adolescent↗
PubMed1986

[Under what conditions can splenic rupture be treated conservatively?].

In children even a certain splenic rupture allows an expectant attitude provided that circulation is stable, abdominal symptoms recede, and an intensive care over several days including ultrasound sonography is assured. We were able to proceed in this manner in five out of 37 children; without an operation we reached the restitution of the spleen.

Adolescent↗
PubMed1986

Closure of gastroschisis by mesh skin grafts in problem cases.

Closure of gastroschisis can be achieved by primary adaptation of the abdominal wall, by implanting a dura patch or by covering the protruding gut with a silastic pouch. In the Pediatric Surgical Department of the University of Innsbruck this last method was used in 14 of 18 cases during the last 8 years. In three children multiple complications and infection resulted in the necessary removal of the silastic pouch from the still protruding gut. Lacking any other alternative, the defect was covered with mesh skin grafts, which took well and permanently closed the abdominal wall.

Abdominal Muscles↗
PubMed1986

[Aberrant course of the left pulmonary artery--a contribution to a rare disease picture].

An anomalous left pulmonary artery obstructs the right main bronchus and/or the trachea. Depending on the severity of the obstruction, symptoms range from a more or less disturbing stridor over attacks of shortness of breath to a life-threatening or even lethal apnoea. An 18-month-old girl suffering from a mild form of this anomaly is presented. The diagnostic and therapeutic possibilities are discussed. After exact clarification of the characteristics of the pulmonary sling, exclusion of associated aberrations, and considering good experience with a former case a conservative approach is recommended if the patient is not substantially impaired.

Bronchial Diseases↗
PubMed1986

Computer-tomographical appearances of the Chiari malformations of the posterior fossa.

The computer-tomography appearances of the Chiari I-III malformations are reviewed. The study is based on a series of 35 cases of Chiari I malformation, 116 cases of Chiari II malformation, and one case of Chiari III malformation. In our experience, a reliable diagnosis of all three types of malformation is possible on computer tomography. However, nuclear magnetic resonance imaging does reveal more detail and may become more important in the diagnosis of malformations of the posterior fossa structures.

Arnold-Chiari Malformation↗
PubMed1986

[Ischemic damage of the testis as a complication of incarcerated hernia in the infant].

The possibility of atrophy of testicular tissue after torsion of testis is well known. To a lesser extent it is known that an incarcerated inguinal hernia carries the risk of ischemia of the testis by pressure on the testicular vessels. Incarceration of an inguinal hernia is most common in premature and young babies. When it occurs a reposition should be tried, but, if unsuccessful an urgent operation is indicated. Between 1979 and 1983 we operated on 36 boys under the age of one with an unreducible inguinal hernia. As sign of partial or total tissue destruction the follow-ups showed a smaller testis on the operated side in five cases and a total atrophy in four cases. Early operation of inguinal hernias in babies seems to be the best prophylaxis of this above mentioned complication of an otherwise rather harmless anomaly.

Child, Preschool↗
PubMed1985

[Value of sonography for acute diagnosis and for further examination of blunt abdominal trauma in children].

For the investigation of the abdomen following blunt trauma there are, in addition to clinical examination, peritoneal lavage, laparoscopy, sonography, CT and scintigraphy. Sonography has proved particularly reliable without stressing the patient. This has been demonstrated by the examination of 73 children in whom there was only one false positive and no false negative finding. Sonography is valuable not only as a diagnostic method, but is useful for the follow-up of patients with intraperitoneal or retroperitoneal injuries. Particularly in children, a conservative attitude is often justifiable, since recovery frequently follows without surgery (seven out of 30 children in our clinical material, who had sonographic evidence of parenchymal injuries).

Abdominal Injuries↗
PubMed1985

[Thromboembolism complications in ventriculo-atrial drainage of cerebrospinal fluid in childhood].

This report wants to call attention to the possible risks of thromboembolic complications of ventriculo-atrial shunts (Spitz-Holter valve). Among 126 children with ventriculo-atrial shunt we found four patients with severe thromboembolic complications. Two children died. The diagnostic and therapeutic possibilities are mentioned. Prophylaxis (prevention of infection, anticoagulation therapy and frequent followup investigation) is discussed; especially echocardiography is very useful for the early discovery of thrombotic deposits on the atrial catheter.

Cerebrospinal Fluid Shunts↗