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Biomedical subjects

M Gruner

Publications and source records attributed to M Gruner.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Relationship between transversal joint guidance and buccal curve morphology].

The relationship between the morphology of the curvature of laterotrusion facets and tooth-guided tracings of the mediotrusive condyle path was studied in 20 probands with normal function. The varying inclinations of the dominant laterotrusion facets in cuspid-protected or group-guided occlusion has no bearing on the angle of the mediotrusive paths relative to the horizontal plane. The morphology of the buccal curve allows no predictions as to the direction of the mediotrusive path curvature. Only the movements of the idling condyle were influenced by the type of occlusal guidance. In lateral excursive movements of the mandible with the teeth in contact group-guidance frequently resulted in an upward movement of the laterotrusive condyle and thus to a compression of the intraarticular soft tissues. Although valid conclusions regarding any type of interdependence are impossible unless we are able to measure real tooth and joint movements simultaneously, the results of our study contradict other hypotheses at any rate.

Dental Occlusion, Balanced↗
PubMed1990

[Obstructive anuria in children. Apropos of 22 cases].

The authors report twenty-two cases of obstructive anuria observed in children. Causes were diverse: 6 cases were observed during the course of tumors, 4 cases were secondary to bilateral renal stones (or unilateral in a single kidney), 3 cases were observed before surgical correction of latent or well tolerated congenital uropathy, and 9 cases occurred immediately after an operation (including 8 after antireflux surgery). Emergency treatment of obstructive anuria is based on urinary diversion, ideally by percutaneous nephrostomy under ultrasonic control. However, prevention is the best treatment of anuria: treatment of urinary tract infections resulting in renal stones, ultrasonographic monitoring for chronic proximal urinary tract dilatation in tumors: rigorous atraumatic operative technique avoiding oedema.

Adolescent↗
PubMed1990

[Failures observed after repair of the pyeloureteric junction in children based on a series of thirteen cases].

We report a series of 13 infants with failed surgery for pyeloureteric junction (PUJ) obstruction. Failure was defined as the necessity for further surgery, either refashioning of the anastomosis or nephrectomy. These infants were part of a series of 306 with 322 PUJ. Of the 258 surgically treated infants, 232 (90%) had a post operative course without complication or need for reoperation. The failure rate was significantly higher in infants operated before the age of 4 months (8/65: 12.3%) when compared with those over 4 months of age (5/193: 2.59%). The use of postoperative drainage via a nephrostomy significantly reduced the percentage of early complications (e.g. fistula) but did not affect the final failure rate. The severity of the obstruction at presentation correlated with a bad outcome after reoperation. Of the cases which resulted in failure after reoperation (7/258: 2.7%) all occurred in cases of severe obstruction with parenchymal damage. While the failure of surgery is often evident early (persistant fistula, urinoma, non-functioning kidney on IVP) this may only become obvious some years later. Reoperations were successful in half the cases irrespective of the time between the initial operation and the reoperation. Long term follow-up of all infants operated for PUJ obstruction is recommended.

Adolescent↗
PubMed1989

Beckwith-wiedemann syndrome and neural crest tumors. A report of two cases.

We report 2 cases of thoracic neural crest tumors complicating the course in patients with Beckwith-Wiedemann syndrome (BWS). In the first patient, a thoracic neuroblastoma was fortuitously discovered at age 3 months on a chest film prior to a partial glossectomy. In the follow-up left nephroblastoma and a right kidney simple cyst appeared. In the second patient, a thoracic tumor which proved to be a mature ganglioneuroma was discovered at age 4 years on a follow up spinal radiograph. Although less frequent than nephroblastoma and/or adrenal tumors, the occurrence of thoracic neuroblastoma in BWS suggests that periodic chest radiograph and assays of HVA, VMA and Dopamine should be included in the follow-up protocol.

Beckwith-Wiedemann Syndrome↗
PubMed1989

[Failures observed after repair of the pyeloureteral junction in children. Apropos of 13 cases].

We report a series of 13 infants with failed surgery for pyeloureteral junction (PUJ) obstruction. Failure was defined as the necessity for further surgery, either re-fashioning of the anastomosis or nephrectomy. These infants were part of a series of 306 with 322 PUJ. Of the 258 surgically treated, 232 (90%) had a post operative course without complication or need for reoperation. The failure rate was significantly higher in infants operated before the age of 4 months (8/65: 12.3%) when compared with those over 4 months of age (5/193: 2.59%). The use of postoperative drainage via a nephrostomy significantly reduced the percentage of early complications (e.g. fistula) but did not affect the final failure rate. The severity of the obstruction at presentation correlated with a bad outcome after reoperation. Of the cases which resulted in failure after reoperation (7/258: 2.7%) all occurred in cases of severe obstruction with parenchymal damage. While the failure of surgery is often evident early (persistent fistula, urinoma, non functioning kidney on IVP) this may only become obvious some years later. Reoperations were successful in half of the cases irrespective of the time between the initial operation and the reoperation. Long term follow up of all infants operated for PUJ obstruction is recommended.

Adolescent↗
PubMed1989

[Urethral fistula following reconstructive surgery of hypospadias. Apropos of 34 cases].

Thirty-four children, ten of them coming from another Surgical Center, underwent repair for urethral fistula after hypospadias reconstructive surgery, over a period of three years (1985-1987). After the first operation, there was no recurrence in 59% (20 cases). Currently, all fistulas have been closed, except in 3 cases. Closure by direct suture was used in 30 cases (88%). The best results were observed with suture in three planes and without diversion, on an outpatient basis (91% of success for 12 cases). The Leveuf method is a safe operation for complex penile fistulas after repeated surgery.

Adolescent↗
PubMed1989

[Postoperative recurrence of esophago-tracheal fistula. Significance of peroperative catheterization of the fistula with tracheoscopy. Apropos of 10 cases].

Ten children with recurrent tracheo-oesophageal fistula have been treated over 13 years (1976-1988). Five patients were referred from other centers. The original pathology was oesophageal atresia in eight and two patients had a tracheo-oesophageal fistula alone. Barium swallow demonstrated the recurrent fistula in only five of eight cases. In fact, the key examination is tracheoscopy providing that catheterisation of the fistula. The position of the catheter is verified radiologically. The difficulties of surgery in recurrent fistula are linked to the problem of locating the level of the fistula peroperatively. Without catheterisation of the fistula, there were one failure out of three cases (one dead). By contrast, in the seven cases where the fistula was catheterised, a successful outcome was always obtained. The failure of surgery for recurrent tracheo-oesophageal fistula is not linked to a technical problem of closure of the fistulous tract but to failure to localize the fistula adequately.

Adolescent↗
PubMed1988

[Ureteropelvic junction syndromes: antenatal diagnosis].

Seventy-four hydronephrosis by uretero-pelvic obstruction, discovered by antenatal real-time ultrasound, have been managed on sixty-one children. Three groups, with a specific management, are distinguished. The minimal forms have been only watched over (15 cases). The average forms have been operated (49 cases); considering the results (3 immediate complications and 2 early stenoses), it seems better to wait for 4 months to operate and to place a drain in renal cavities. In major forms (silent kidney on IVP), the diagnosis and therapeutic management use the percutaneous nephrostomy (10 cases). The interest of antenatal diagnosis of uretero-pelvic obstructions is to allow to operate, not only before the renal deterioration emphasizes, but principally before septic complications.

Age Factors↗
PubMed1987

[Polycystic renal dysplasia in children].

Ultrasonography has profoundly modified the diagnostic conditions of polycystic renal dysplasia in children. Non-palpable forms, which were previously most frequently missed, can now be detected during the antenatal period. In infants, ultrasonography generally provides a definite diagnosis, which can be confirmed by aspiration-opacification of the cysts. On the basis of a series of 40 cases and a review of the literature, the authors discuss the therapeutic implications of these new data. Surgery remains essential in cases of palpable polycystic renal dysplasia, especially when it is complicated. However, in the sub-clinical forms, as the risks of malignant degeneration and the incidence of post-operative complications are minimal in the one case and undefinable in the other, surgical excision is possible but not essential.

Child↗
PubMed1987

[Partial splenectomy for epidermoid cysts of the spleen in children. Apropos of 3 cases].

Three cases of epidermoid cyst of the spleen treated by partial splenectomy are reported on children. The diagnosis rests now on the ultrasonography. The operative indication is systematic because of the risks of complication. The polar localisation of the cysts permits one to make a conservative surgery. The partial splenectomy is a technique of choice in this benign tumoral pathology. Postoperative digital intravenous subtraction angiography demonstrated the good vascularization of the remaining part of the spleen.

Adolescent↗