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Biomedical subjects

P Wurnig

Publications and source records attributed to P Wurnig.

At least 19 recordsLinked to original sources
PubMed1992

BCG osteomyelitis as a rare cause of mediastinal tumor in a one-year-old child.

A one-year-old child with BCG osteomyelitis of the upper spine is reported. The child was admitted because of viral infections of the upper respiratory tract. A lateral x-ray examination of the lung showed what was thought to be a mediastinal tumor. The preoperative diagnostic problems are discussed, because the etiology in our case was unknown until the histological report arrived. The knowledge of the complication, of osteomyelitis after vaccination, is small although the first case was published more than 40 years ago. Since then about 300 cases have been reported in the literature. The disease is seen in the first five years of life in otherwise healthy children. Most cases are localized near the epiphysis of the long bones. A localization in the spine, as described in our case, has been published only three times before. The highest frequency of BCG osteomyelitis is reported in Finland and Sweden with about 40 cases per 1 million vaccinations.

Diagnosis, Differential↗
PubMed1990

Electroresection with a new endotracheally applicable resectoscope.

Besides dilatation, cryotherapy, laser and surgical resection, the technique of endoscopic, endotracheal electroresection provides an alternative in the treatment of endotracheal stenoses. The instrument is similar to the resectoscope used in urology, but additionally equipped with a longer action range and respiration facility. It is insulated at the tip of the shaft. The electroresectoscope was employed on 64 occasions at our institution in three indications: endotracheal diseases, granulomas following tracheostomy; and short subglottic membrane stenoses, partly secondary to long-term intubation. Indications, advantages and drawbacks of the method are discussed.

Anastomosis, Surgical↗
PubMed1990

[Therapy of carotid stenosis in contralateral occlusion of the internal carotid artery].

From January 1985 up to December 1987 sixteen patients with unilateral stenosis of the internal carotid artery (ICA) and concomitant chronic contralateral carotid occlusion underwent surgical correction of the stenosis. 31.2% were asymptomatic, 18.7% had transient ischemic attacks and 50% had suffered a stroke. On the occluded side 31.2% had had a stroke. Angiography showed intracerebral shunting to the occluded side in 43.7%; 56.2% of the patients had concomitant stenoses of intracerebral vessels. Surgical correction consisted of endarterectomy and patch-plasty of the ICA-stenosis in local anesthesia under protection of an intraluminal shunt. There was no mortality and no perioperative stroke. After a mean interval of 32 months life table analysis showed a stroke-free rate of 92% from 6 to 24 months on the operated side and of 84% from 12 to 24 months on the occluded side. We conclude that ICA-endarterectomy in patients with contralateral ICA-occlusion can be done without increased perioperative risk and yields satisfactory long time results.

Arterial Occlusive Diseases↗
PubMed1989

Implantation of a silastic balloon for reduction of radiation injuries of the bowel in two children with neuroblastoma.

Two children with stage IV neuroblastoma died from severe reactions of the bowel due to radio-chemotherapy. This led to the suggestion of protecting the bowel by implantation of a silastic balloon to push the bowel away from the treatment volume. This procedure was tried in two children with stage IV neuroblastoma and resulted in excellent tolerance of the high-dose radiotherapy.

Abdominal Neoplasms↗
PubMed1989

Surgical treatment of bilateral Wilms' tumours with special reference to second operations in metachronous disease.

We report on six patients with bilateral Wilms' tumours (among them one pair of siblings) who underwent surgery within a period of 20 years. Wilms' tumours appeared synchronously in three patients and successively in the other three. Case reports are given for three of the six patients. The tumours have a remarkable multilocular appearance, indicating a multilocular genesis. In this context, the phenomenon of nephroblastomatosis is discussed. In addition to surgical treatment, aggressive conservative therapy should be employed, particularly with metachronous disease and the resulting acquired solitary kidney in these patients.

Child, Preschool↗
PubMed1989

Transient functional obstruction of the colon in neonates: examination of its development by manometry and biopsies.

Between 1975 and 1983, 17 neonates with transient functional obstruction of the colon were studied in our surgical department. Five could be successfully treated conservatively with enemas. In the remaining 12 cases colostomy was necessary. In three cases colostomy was performed too late and the patients died. In the other nine cases rectal biopsies and anorectal manometries were performed repeatedly. In spite of clear radiological signs of colonic obstruction such as in Hirschsprung's disease in each case, and identical clinical signs, true aganglionosis could be excluded. Rectoanal manometry 4 months after colostomy showed that the situation had normalized in five cases, but was still pathological in four cases, as in aganglionosis. Of the rectal biopsies, five showed signs of immaturity of ganglionic cells and three were normal. Rectoanal manometry 12-24 months later showed normal reaction in all cases, and of the five cases with immaturity of the ganglionic cells at 4 months one was still pathologic at 12-24 months. In eight of 12 cases the colostomy was closed without relapse of the obstruction, even on long-term follow up. Aganglionosis of the ultrashort type was excluded. In cases of severe transient functional obstruction of the colon in neonates, in which colostomy is necessary, rectoanal manometry and rectal biopsies should be performed as early as possible. Rectoanal manometry, at least, should be done before closure of the colostomy to avoid relapse of the obstruction from closing it to early: the functional disturbance may persist for several months. The term "small left colon syndrome" should be abandoned in favor of "transient functional obstruction,", as the latter describes the clinical condition far better.

Biopsy↗
PubMed1989

[Acute abdomen caused by paraduodenal hernia].

Internal hernias are rarely diagnosed. Most of the times they are found at laparotomy when complications and their symptoms (for instance palpable tumour, abdominal pain, vomiting and ileus) require surgical treatment. We present a case of an eleven-year-old boy who was admitted to our hospital because of acute abdominal pain. Appendectomy brought only temporary relief of pain. Subsequent laparotomy yielded the diagnosis of left-sided paraduodenal hernia.

Abdomen, Acute↗
PubMed1987

Treatment of tracheal stenoses by resection in infancy and early childhood.

An inquiry of Austrian paediatric and thoracic surgeons revealed six children aged 4 months to 5 years who had undergone circumferential resection of the trachea for congenital or acquired tracheal stenoses. Clinical data relating to these six Austrian cases are briefly presented. Experience shows that circumferential resection of localized tracheal stenoses can also be recommended for infants and young children.

Child, Preschool↗
PubMed1987

Experience in surgical treatment of pulmonary and bronchial tumours in childhood.

From the patient material of three paediatric surgical centres and the patient material of the paediatric surgical hospitals of Zurich, Switzerland and Leipzig, GDR, 24 cases of lung and bronchial tumours are reported. The aim of this review is to show a spectrum of the cases observed in our region. The most frequent of these very rare tumours was pulmonary blastoma, followed by endobronchial adenoma in its different variants. Since only the latter can be endoscopically diagnosed, endoscopy should be carried out as early as possible when the diagnosis is not clear. Cystic lung disease seems to be particularly frequently associated with pulmonary blastomas. Uncertainties in diagnosis and therapy owing to the rareness of these diseases cause further problems.

Bronchial Neoplasms↗
PubMed1987

Endotracheal and endobronchial tumours in childhood.

Following a review of the literature on the most common types of endobronchial tumours (carcinoid cylindromas and mucoepidermoid tumours), four cases of such bronchial tumours in children are reported. Two of them underwent isolated bronchial resection, whereas one of the others had to undergo bilobectomy in addition and the other, pneumonectomy. The patients remained free of recurrences after a follow-up of 5-20 years. The advantage of circumferential resection and some technical aspects are discussed.

Adenoma↗
PubMed1986

[Chronic constipation in childhood--only crux medici or diagnostic pitfall?].

Severe chronic constipation in children is always a burden to the whole family. The typical steps of investigation such conditions are demonstrated. The most common forms of organic causes for chronic constipation are explained by examples; it is important to know them in order to avoid misdiagnosis. Step-by-step-examination is important to find out all organic possibilities.

Adolescent↗
PubMed1986

The significance of tracheal stenosis in esophageal atresia.

The significance of tracheal stenosis in children operated upon for esophageal atresia is described. Stenosis is caused mainly by tracheal compression by the innominate artery leading to tracheal malacia. Following esophageal repair tracheal compression is increased causing life-threatening asphyctic attacks during feeding. After establishment of diagnosis urgent surgery by means of truncopexy is indicated. The incidence of this complication is about 1 in 20 according to our figures and 1 in 40 according to Filler (Filler et al. 1976).

Esophageal Atresia↗
PubMed1986

Circulating committed and pluripotent haemopoietic progenitor cells, in infants.

Circulating CFU-GM, BFU-E and CFU-MIX were assayed in 21 infants aged between 1 day and 44 weeks. Compared to 15 adults, progenitor cells of all types were increased until 10 weeks following birth and approached the respective ranges of adults thereafter. The mean increases of progenitor cells in infants aged between 1 day and 10 weeks were 26-fold for CFU-GM, 7-fold for BFU-E and 5-fold for CFU-MIX. Our results demonstrate that not only committed progenitor cells (CFU-GM, BFU-E), but also early progenitor cells with the capacity for self-renewal (CFU-MIX), are increased in early infancy. These data further support the hypothesis that high levels of blood progenitor cells in very early stages of life reflect the colonization process of developing bone marrow by circulating progenitor cells and demonstrate the terminal phase of this process during the first 10 weeks after birth.

Adult↗
PubMed1985

Morphological findings in peptic esophageal stenosis with Barrett's ulcer in children.

The morphological findings in three resected specimens of Barrett's ulcer in children are discussed. Nearly identical morphologic changes are found in all cases, even in adults. This pathologic condition is understood as the third or fourth stage of reflux esophagitis. Perforation or even malignant degeneration is described in these cases. Therefore mainly all therapeutic aims must be to prevent these stages.

Barrett Esophagus↗
PubMed1984

Peripheral blood mononuclear cells of splenectomized patients are unable to differentiate into immunoglobulin-secreting cells after pokeweed mitogen stimulation.

The function of B cells from the peripheral blood of splenectomized patients has been investigated at the cellular level. The peripheral blood of these patients contained normal numbers of mononuclear cells (MNC) spontaneously secreting IgG and IgM, but an increased amount of IgA-secreting cells. In contrast to MNC isolated from healthy controls, the patients' peripheral blood MNC were unable to differentiate into immunoglobulin-secreting cells in a pokeweed mitogen-driven culture system. Proliferation in response to pokeweed mitogen, however, was significantly higher with patient MNC as compared to control MNC.

Adolescent↗