Biomedical subjects

J Mayr

Publications and source records attributed to J Mayr.

67 records · Page 4Linked to original sources

PubMed1994

Surgical strategies in very-low-birthweight neonates with necrotizing enterocolitis.

Very-low-birthweight (VLBW) neonates are more prone to complications and death than term infants are. In a 15-year period, 19 neonates with VLBW were operated on for necrotizing enterocolitis (NEC). Indications for operation were pneumoperitoneum in 12 and deterioration of general condition in 7. Bowel resection and intestinal diversion was performed in 12, a lateral enterostomy at the site of perforation was created in 5, and 2 neonates with necrosis of the whole bowel underwent an exploratory laparotomy without any further surgical treatment. Surgical complications were found in one-third of the patients. The mortality rate was significantly higher when the ileum was affected. The survival rate was 68%. Prior to 1984 the survival rate was 37% (3/8); subsequently, it has improved to 91% (10/11) as a result of improved intensive therapy.

Anastomosis, Surgical↗

PubMed1994

Psychosocial and psychomotoric development of very low birthweight infants with necrotizing enterocolitis.

UNLABELLED: Twenty-six very low birthweight infants (VLBI) were treated for necrotizing enterocolitis (NEC). We investigated their consecutive health problems and psychosocial development. METHOD: One to 13 years after onset of NEC, follow-up studies were performed in 12 of the surviving children. Identical follow-up studies were performed in 6 VLBI who had been operated on for diseases other than NEC (control group). We used a detailed interview, a Denver test and a drawing test. RESULTS: Five children of the NEC group had major persistent health problems that impaired their psychomotoric and psychosocial development (including hearing impairment, concomitant strabismus, early onset bronchial asthma). Nine of 12 VLBI of the NEC group showed signs of reduced social contact, logopaedic problems and minimal partial skill reductions. CONCLUSION: We found similar results in both children who suffered from NEC and in a small control group of VLBI who had not suffered from NEC, therefore impaired psychomotoric and psychosocial development is probably due to prematurity.

Child↗

PubMed1994

[Equestrian accidents in children and adolescents].

The rate of pediatric equestrian injuries is relatively low, but the severity of injuries is greater than in many other pediatric sport activities. In a 4-year period the charts of 109 patients up through the age of 15 years, who were admitted for equestrian-related injuries were reviewed. Falls from horses are the most frequent cause of injuries and responsible for their anatomic localization and type of injury. In our study the upper extremity was the most common (38%) area injured and head injuries comprised the second largest group with 36%. Forty percent of all injuries were fractures, 72% of which were fractures of long bones. The circumstances surrounding the accident and mechanisms of these injuries were analyzed. Effective safety measures such as improved equestrian helmets and adequate training in dealing with horses could reduce the risk of injuries.

Adolescent↗

PubMed1994

[2 years results of conservative therapy of unstable fractures of the pelvic ring in children].

Unstable fractures of the pelvic ring in children are usually treated conservatively. The results of this therapy were evaluated retrospectively in 17 children who had been under 13 years old at the time of injury. All but 4 of the children had additional injuries. The pelvic fracture had a rotational instability in 9 patients and was vertically unstable in 8 patients. The follow-up period was 2-25 years. Clinical results were good provided that there was a good radiological result with only minimal asymmetry of the pelvic ring or none at all. Functional leg length differences and scoliotic deformation of the lumbar spine due to traumatic and/or growth-related asymmetry of the pelvis caused chronic low back pain in 5 of 8 patients. Only fracture healing in a near-anatomical position can ensure good clinical results in pelvic fractures in children. Considering the results presented here, operative reduction has to be recommended when reduction cannot be achieved by conservative means. However, there is no proof that open reduction and internal fixation provide better results than conservative therapy in unstable pelvic ring fractures in children.

Adolescent↗

PubMed1993

Course of pubic tubercle--centre of testicle distance in children with and without testicular maldescent.

The aim of this study was to establish whether a more precise classification of the different types of testicular maldescent could be made by using the measurement of pubic tubercle-centre of testicle distance. The pubic tubercle-centre of testicle distance was determined in 77 healthy children. The results were obtained in children aged 1 month to 15 years. The results were compared to the distances obtained in 47 children with testicular maldescent. The distance between pubic tubercle and centre of testicle represents an objective parameter in the examination of testicular maldescent. It is used to determine the testicular position precisely, and by comparing it to our graphs of normal values, it is possible to find pathological results. Our graphs of normal values for pubic tubercle-centre of testicle distance for different age groups, weight groups and body length groups in children can also be used to record the effect of hormonal or surgical therapy. Surprisingly there exists no obvious growth of the pubic tubercle-centre of testicle distance within the first seven years of life. By comparing the measurement of the pubic tubercle-centre of testicle distance of a child with testicular maldescent to our graphs of normal values, it is easy to find an objective parameter for the initiation of therapy, or for the decision to wait and see. By comparing a series of measurements of one case to our graphs of normal values, it is possible to set ideal intervals for consultations.

Adolescent↗

PubMed1993

Recent evaluation of prognostic risk factors in esophageal atresia--a multicenter review of 223 cases.

In this study, 223 cases of esophageal atresia (Type IIIb: 85.7%; Type II: 5.8%; Type IIIc: 4.0%; Type IIIa: 2.2%; Type IV: 2.2%) from 6 pediatric surgery centers of Austria, were retrospectively examined for the following parameters and their influence on the prognosis: Birth weight (2494.7 +/- 702.0 g), gestation week (range 27-42 weeks; mean 37.3 +/- 3.1 weeks), sex (male: n = 128; female: n = 95), long-gap atresia (> or = 2 cm: n = 33), Tracheomalacia (n = 16), associated malformations (n = 122; cardiac 27.4%, renal 17.9%, skeletal 17.0%, anal: 10.3%, intestinal 9.9%, mediastinal 7.6%, chromosomal 2.2%), preoperative aspiration (n = 92), pneumonia (n = 96), anastomotic insufficiency (n = 45), empyema (n = 5), mediastinitis (n = 8), sepsis (n = 32), other medical complications (n = 122, in 80 infants), other surgical complications (n = 57). The mortality rate was 41.3% overall, from 1975 to 1991; however, it was 25% from 1987 to 1991 and 0% in 1991. A statistically significant correlation was found between prognosis and the following factors: Cardiac malformations (p = 0.0001), medical complications except aspiration and pneumonia (p = 0.0001), empyema (p = 0.0081), mediastinitis (p = 0.0214), and sepsis (p = 0.0295). These 5 significant factors were given different points and a prognostic score was calculated by the addition of these points. This score was predictive for survival in 90.6% of cases and for mortality in 94% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Austria↗

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↗

PubMed1986

[Immunologic findings in oral pertussis vaccination].

Whooping cough specific surface IgA antibodies, agglutinating serum IgG antibodies and the in vitro lymphocyte reactivity to Bordetella pertussis germs were investigated in newborns and infants both unvaccinated and parenterally and orally immunized against whooping cough. Furthermore the E-rosette formation and the lymphocyte reactivity to phytohaemagglutinin, pokeweed mitogen and concanavalin A were studied. Only oral pertussis immunisation effected a local immune reaction with formation of secretory surface IgA antibodies in the saliva and prevented the postnatal disappearance of the Bordetella pertussis specific IgG antibodies seen in unvaccinated infants. From the third month of life the lymphocyte reactivity to a Bordetella pertussis germ suspension resulted in measurable stimulation following oral whooping cough vaccination. After the third month of life the pertussis stimulation indices of the orally immunized infants remained above the values for adults with a history of whooping cough and were equivalent to those for the parenterally immunized infants.

Administration, Oral↗

PubMed1974