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Biomedical subjects

R Daum

Publications and source records attributed to R Daum.

At least 55 records · Page 3Linked to original sources
PubMed1987

Tumour-induced intraluminal stenoses of the cervical trachea--tumour excision and tracheoplasty.

Three children with stenoses of the cervical trachea caused by tumours are reported on. The first was a 13-year-old girl with a sarcoma of the tracheal wall 20 cm down. We performed partial resection of the trachea and turned a skin flap according to Denecke into the defect. In the second case a capillary haemangioma had caused severe stenosis, requiring resection of the tumour together with the tracheal mucosa. A haemangioma had caused tracheal stenosis in the third case, too; in this child partial tracheal resection and skin flap plasty were performed. The postoperative course was uneventful in all three children. So far, there is no recurrence of the sarcoma 4 1/2 years after operation.

Adolescent↗
PubMed1987

[Ovarian pseudocysts in female newborn infants: prenatal ultrasonic diagnosis and surgical consequences].

During the last year we diagnosed within the scope of preventive medical care of pregnant women in about the 30th pregnancy week, seven foetuses with abdominal cystic tumours by ultrasound examination. Postpartal ultrasound controls of the mature newborn confirmed the findings. After laparotomy we found ovarian pseudocysts with a volume up to 90 ccm. Histologically we could not identify ovarian tissue. In 66% of the cases we found small cysts on the contralateral ovary. Differential diagnosis and the possible complications must be considered. A laparotomy should be performed and only by high steroid serum level a conservative therapy with MPA should be considered. This is the case in premature newborn with an immature endocrine regulation mechanism.

Diagnosis, Differential↗
PubMed1987

[Cantrell's syndrome].

Congenital diaphragmatic hernia is associated with a high mortality, especially when combined with other defects. The unusual repeated combination of the same congenital abnormalities by a number of patients and the fact that during embryonic life these organs develop from the mesoderm implies the existence of a specific syndrome. This article summarises the available clinical data and reports on three cases with Cantrell's syndrome, showing different pattern of congenital defects such as: 1) supraumbilical abdominal wall defects; 2) a defect of the lower sternum; 3) a deficiency of the anterior diaphragm; 4) a defect in the diaphragmatic pericardium; 5) congenital intracardiac defects.

Abdominal Muscles↗
PubMed1987

[Lichen sclerosis et atrophicus as a cause of acquired phimosis--circumcision as a preventive procedure against penis cancer?].

From January to December 1985, circumcision for acquired phimosis was performed at our department in 140 boys with a median age of 4 3/4 years. The histological examination of the prepuce revealed the existence of lichen sclerosus et atrophicus (LSA) in 6 cases, e.g. 4.3% of all circumcisions performed. The striking frequency of this chronic inflammatory epithelial change and the often cited connection between the existence of LSA and the development of penile cancer during adulthood as well as the well-known tendency towards the incidence of recurrent phimosis in LSA patients support the claim for total circumcision in these cases.

Adolescent↗
PubMed1987

[Arterial blood supply of the upper pole of the spleen in main artery occlusion].

Vascular dissections of the splenic-, gastric- and pancreatic region, corrosion specimens of the upper splenic pole and arteriographies of the superior polar artery after trunc lienal artery occlusion in human served as an answer to the question of the arterial supply of the upper lienal pole. The present results point out the importance of the upper polar artery and the existence of intersegmental anastomosis. The latter gain importance in case of trunc splenic artery occlusion. The short gastric vessels are of subordinate value.

Collateral Circulation↗
PubMed1987

[Gastrointestinal perforations in neonatal surgery].

From 1970 until 1987 we treated 69 newborns with gastro-intestinal perforations. Immediate measures in form of laparotomy were undoubtedly necessary. Regarding our casuistic the authors present the clinical findings, necessary preoperative diagnostic measures and intra-operative and postoperative treatment. The localisation and the origin of the perforation are pointed out. The most frequent localisation was the small bowel (58%), followed by the colon (35%). Etiologically we found extensive NEC, atresias, meconium ileus and Hirschsprung's disease. In 4 cases iatrogenic rectum perforations, in 3 cases spontaneous gastric and duodenal perforations and twice an appendicular perforation were seen. Our operative procedure depends on the localisation, the degree of peritonitis, on intestinal necrosis and trophic alterations of the gut following ileus. In spite of intensive care, the mortality rate is still very high indicated with 33%. Furthermore more than half premature newborns died (18 out of 33). Based on these facts we propose quick diagnostic measures, interdisciplinary cooperation, an emergency operation followed by intensive care to ameliorate the results. Nevertheless we must keep in mind that newborns, who some years ago were condemned to die, nowadays can be operated, thus changing the mortality of gastro-intestinal perforations.

Colonic Diseases↗
PubMed1987

[Intestinal invagination. Analysis of case reports in the last 45 years].

The retrospective study analyses 219 children with intussusception, who were treated in the Dpt. of Pediatric Surgery, university of Heidelberg between 1942 and 1986. The patients were divided into three groups. The mortality of the first group (1942-1966) was 20%. Since 1966, however, no patient with intussusception was lost. Recent diagnosis advances with ultrasonography allowed early diagnosis and at the same time the complication rate dropped from 34 (group 2, 1967-1981) to 11% (group 3, 1981-1986). Simultaneously the intestinal resection rate was reduced. The developments in diagnosis and therapy during the last 45 years, based on the analyses of the three groups, are discussed in detail with the literature.

Child, Preschool↗
PubMed1987

[Disorders of vascularization in para-epiphyseal groove humeral fractures and their clinical significance for the growing skeleton].

We analysed retrospectively 50 humerus fractures in the vicinity of elbow joint and 40 fractures of the proximal humerus with respect to possible injuries of the vessel pattern of the epiphyseal plate. The normal vessel pattern of the epiphyseal plate was examined postmortem on 8 foetus and newborns up to 6 months. We plastinated the affected regions and could compare symmetry of the vessel pattern in the epiphyseal plates as well as therapeutic consequences, especially after injuries of the elbow joint. Vascular disturbances in the case of young children, i.e. by fractures of the lateral oder medial condyle are undoubtedly seen. A fish-tail deformity can be a complication. By older children with mature epiphyseal plate we could not register any complications. In such cases we are interested in restoring the joint stability by refixation.

Arteries↗
PubMed1986

[Peculiarities of juvenile vertebral fractures and dislocations of the cervical vertebrae].

In addition to diagnostic and therapeutic problems of the bony spine injuries in childhood, questions of the participation of the growth plate arise and indicate the following treatment. In the last decade we treated 23 spine injuries, resulting after fall from height. Most of the cases showed single to multiple compression fractures of the anterior spine followed in a descending frequence by the lateral compression fractures, the disconnection ot the epiphyseal plate of the axis and the actual luxation fractures with injury of the stratum germinativum. In contrast to the prognostic favourable impression fractures with a spontaneous correction, luxation fractures with or without paraplegia must be repositionned and stabilized.

Cervical Vertebrae↗
PubMed1986

[Delivery planning and interdisciplinary management of large coccygeal teratomas].

Prenatal sonographic screening and a growing experience of examiners with regard to possible congenital malformations such as large coccygeal teratomas have induced the request for an early interdisciplinary consultation between obstetrician, human geneticist, paediatric surgeon, neonatologist and psychologist. It should aim at a careful information and counselling of the parents with regard to the mode of delivery and possibilities of operative management. The prerequisites for far sighted planning and performance of delivery are demonstrated by the example of large coccygeal teratomas. The availability of equipment, facilities and manpower at the time of delivery guarantees a course of delivery at reduced risk and is, together with the psychological guidance of the parents, a basic element of optimal care for the newborn.

Coccyx↗
PubMed1985

[Cystic duplications of the cervical esophagus].

Cystic duplications in the cervical region are very rare. In most cases compression of the trachea leads to severe symptoms of respiration. Two cases of cystic duplication are described - a nine months old child and a newborn baby. In the first case the cyst was localized on the right side of the thyroid. Extirpation could be done without any complications. The operation on the second case was difficult. The tumor was localized between oesophagus and trachea rotating the larynx.

Diagnosis, Differential↗
PubMed1985

[Delayed diagnosis in right sided congenital diaphragmatic hernia].

Report on two cases with delayed diagnosis of congenital diaphragmatic hernia. The cause of partial and total opacity of the right chest was recognised only after thoracotomy which followed misdirected diagnostic procedures such as tomography, bronchoscopy and repeated punctures of the pleural cavity. In both cases a transdiaphragmatic liver prolapse with signs of transthoracic liver punctures was found. The diagnostic importance of sonography and if necessary, computed tomography and liver scintigraphy in infancy and childhood, is emphasised.

Diagnostic Errors↗
PubMed1984

Value of antigen quantitation in Haemophilus influenzae type b meningitis.

We studied Haemophilus influenzae type b meningitis in 68 patients to evaluate whether quantitative determination of PRP in body fluids obtained at admission or measurement of the duration of its presence helped identify patients at risk for complications. Geometric mean admission PRP concentrations in CSF, blood, and urine increased with severity of disease, but individual values varied greatly. Measurements of the duration of antigenemia and antigenuria also varied widely and were best predicted by the admission or peak PRP concentration. The mean duration of both antigenemia and antigenuria increased with severity of disease. In contrast, the elimination half-life of PRP did not differ significantly with severity of hospital course, peak PRP concentration in blood or urine, or patient age. Clearance from CSF could not be accurately assessed, but PRP was detectable in only six of 41 patients in whom spinal fluid was obtained after the eighth day of hospitalization; all had complicated courses. Although latex particle agglutination assay is a valuable aid in rapid diagnosis of invasive Hib infections, the predictive value of antigen quantitation at admission and the determination of its duration in body fluids is limited by the wide range of observed values.

Agglutination Tests↗
PubMed1984

[Tumors of the adrenal gland in childhood. Report of 38 patients].

During the past 17 years at the Department für Pediatric Surgery, University of Heidelberg, 38 children aged 1.6 to 14 years were adrenalectomized (unilateral 3.3, bilateral 5). Individual diagnoses were: neuroblastoma 23; pheochromocytoma 5; adrenocortical carcinoma 8; adrenocortical adenoma 4; bilateral nodular hyperplasia 2 cases. Patients with histologically benign lesions are alive and without recurrence more than 5 years after surgery, except one patient who developed Nelson's tumor after bilateral adrenalectomy for Cushing's disease. Of the patients with malignant adrenal tumors 21 died within 18 months after therapy was started, a 7 years old girl with an adrenal carcinoma died after a period of 3.6 years of combined treatment. In most cases of adrenocortical tumors virilization was the prominent feature.

Adenoma↗
PubMed1984

Paediatric surgical principles in the management of children with intersex.

Two children, one with dysgenesis of the gonads and chromosomes 46XY and one with true hermaphroditism, are described. The principles of therapy with special reference to the operative correction of the external genitalia are discussed. One child was made a male and the other a female. The diagnostic procedure, heredity, hormonal status, chromosome analysis, histology of the gonads, radiological investigations, and skeletal age will partly determine the future sex, as will the decision of the parents and sociological aspects. The sex must be determined as early as possible. In girls, operative corrections should be performed at the time when their own oestrogen and gestagen production is starting. In boys enlargement of a micropenis can be produced by careful administration of testosterone.

Adrenal Hyperplasia, Congenital↗
PubMed1983

[Mediastinal tumors in childhood].

The article reports on 41 mediastinal tumours in childhood treated from 1967 - 1978 on an inpatient basis. The distributory patterns show that 31.7% of the tumours had their origin in adjacent organs; 24.4% (10) were autochthonous tumours. 16 tumours were located in the posterior mediastinum (11 of which were malignant), 9 in the median mediastinum (7 of which malignant) and 16 in the anterior mediastinum (including 4 malignant ones). Of the primarily malignant tumours, 85% were lymphomas or tumours of neurogenic origin. The lethality of the malignant tumours was 52%. The article deals briefly with the symptomatology, localisation and diagnosis. As far as histology is concerned, a comparison with the mediastinal tumours in adults reveals considerable differences.

Age Factors↗