Biomedical subjects

R Korinthenberg

Publications and source records attributed to R Korinthenberg.

98 records · Page 6Linked to original sources

PubMedDate not supplied

[Intrathecal production of neopterin in meningitis in childhood].

A major activator of antigen presenting cells (APC) is gamma interferon a product of activated T-lymphocytes. CNS is not well studied and represents a unique system with respect to the immune reactions. Neopterin is an indirect marker of gamma interferon deliberation and may give some new information on the role of APC in CNS. Neopterin in serum and cerebrospinal fluid (CSF) was determined by specific RIA in children who were lumbar punctured to exclude meningitis. Neopterin was found in various concentrations in serum and CSF of all patients (n = 47). Bacterial meningitis (group 3) was diagnosed in 12 and aseptic meningitis in 18 children (group 2). CSF was drawn in 17 children with febrile convulsions (group 1). Elevated serum neopterin in childhood was only reported in children with an atypical PKU, while data on CSF neopterin were published only in a few cases of adults with CNS involvement. The results show that the APC is stimulated rapidly in childhood similar as in adults following severe viral or bacterial infections. Furthermore neopterin in CSF is not only explained by alteration of the blood-brain barrier but also it may reflect local intrathecal response with activation of accessory cells (APC) in the CNS itself. Between the stimulation of the cellular immune system indicated by increased levels of neopterin and the severity of the disease seems to be a positive correlation.

Antigen-Presenting Cells↗

PubMedDate not supplied

[Spinal cord tumors in childhood--experience with 31 patients].

Spinal tumors are rare diseases of childhood. The initial symptoms are often very uncharacteristic and the diagnosis is delayed for a long time. From 1970-1983 31 children with intraspinal tumors were seen. The location of these tumors was 7 times intramedullar, 13 times extramedullar-intradural and 11 times extradural. History, findings and treatment of these patients are reported and compared with the available literature. Despite the well known diagnostic problems, early diagnosis and treatment are of the greatest importance for the prognosis.

Adolescent↗

PubMedDate not supplied

[Extraneural medulloblastoma metastasis following non-operated medulloblastoma].

We present a case of a 3 8/12 years old boy with histologically proved medulloblastoma. Preoperatively a tumor of the parotid gland was diagnosed, exstirpated and interpreted as a metastasis of medulloblastoma. Therefore the opinion seems to be questionable, that extracranial metastases of medulloblastomas only occur after injury of the dura mater (operation, shunt).

Cerebellar Neoplasms↗

PubMedDate not supplied

[Prognosis of surviving children with neurologic complications in the intensive phase of leukemia treatment].

32 children survived neurological complications during the treatment of ALL, AML or NHL (intracranial bleeding, convulsions, infections, severe neuropathy, severe EEG-slowing). Neurological, electroencephalographic and psychological examinations were performed 6 months to 6 years after the end of maintenance therapy. Findings were normal or borderline in about 70% of the patients. 20% presented with neurological signs, due to localised cerebral or peripheral lesions. However, these generally did not interfere to high degree with the daily living skills. The frequencies of school problems and of abnormal psychological findings were similar to these found in ALL patients without neurological complications.

Brain Damage, Chronic↗

PubMedDate not supplied

[Severe neuropathy after chemo- and radiotherapy of Ewing sarcoma].

A 15 year old patient presenting with a lumbar Ewing's Sarcoma was treated according to the EICESS-92 pilot study (EVAIA branch). Local therapy consisted of definitive irradiation given simultaneously to chemotherapy courses 5 to 7. Close to the end of treatment the patient developed progressive peripheral neurologic deficits. Such combined toxic treatment side effects are unique and unforeseen in the study protocol.

Adolescent↗

PubMedDate not supplied

Severe hepatotoxicity during valproate therapy: an update and report of eight new fatalities.

Since our last report on valproate (VPA)-related hepatotoxicity in 1988, 8 other children have died of VPA-associated liver failure in Germany and Switzerland. We compared the clinical course of these children with that of 6 children with a reversible outcome of severe hepatotoxicity related to VPA. Thirty-five percent of patients with fatal liver failure were normally developed, 23.5% were receiving VPA monotherapy, and 35.3% were aged < or = 2 years. The initial clinical symptoms of VPA-related hepatotoxicity were nausea, vomiting, apathy or coma, and increasing seizures in more than 50% of patients, in combination with febrile infections at onset of symptoms. As compared with the series of German patients reported in 1988, one third of the fatalities occurred after the first 6 months of therapy as compared with 6% in the 1988 series. Clinical symptoms and laboratory findings were the same in patients with reversible and with fatal outcome. Early or immediate withdrawal of VPA after the first signs of VPA-associated hepatotoxicity may be responsible for the increased number of children who recovered after VPA-related severe liver failure. The pathogenesis of liver failure during VPA treatment remains unknown; metabolic defects and cofactors such as polypharmacy or infections have become increasingly likely to contribute by depleting intracellular CoA. Worldwide, 132 patients have died of VPA-associated liver failure and/or pancreatitis. Because a group at risk for fatalities with VPA cannot be defined precisely, patients treated with VPA and their families must be made well aware of the clinical symptoms of hepatotoxicity such as apathy, vomiting, or increased seizure frequency, especially in the presence of febrile infections. Laboratory tests and clinical controls during the first 6 months of therapy should not be neglected.

Adult↗

PubMedDate not supplied

Ventriculomegaly diagnosed by prenatal ultrasound and mental development of the children.

During the last 8 years in our department, fetal ventriculomegaly was diagnosed by prenatal ultrasound in 105 cases. Ventriculomegaly was detected at 25+/-6 weeks of gestation. In 96 of 105 cases follow-up examinations have been performed both during pregnancy and after delivery. In 47 cases termination of pregnancy, late spontaneous abortion or intrauterine death occurred. 49 cases resulted in live births. Of these, 28 children could be followed up to the age of 36 months, a few children even longer. Myelomeningocele was the most frequent cause of ventriculomegaly (17 cases = 61%). Insertion of ventricular shunt systems was performed in 26 children at a median of 21 days of life. Analysis of postnatal development was performed by the Kaufmann Assessment Battery for Children, or the Munich Functional Development Test. Correlation analysis was performed between parameters of prenatal findings and postnatal development. It could be shown that results of single prenatal ultrasound examinations did not correlate with postnatal development whereas progression of ventriculomegaly was negatively correlated with mental development.

Cerebral Ventricles↗

PubMedDate not supplied

Treatment of cerebral palsy with botulinum toxin A: functional benefit and reduction of disability. Three case reports.

Three patients with cerebral palsy are described suffering, respectively, of pes equinus, spasm of the m. teres major and flexion spasm of the hand, who were treated with botulinum toxin A. These patients demonstrate not only the local reduction of the muscular hyperactivity following treatment with botulinum toxin A but also the potential functional benefit resulting from such a treatment. Thus, local intramuscular injection of botulinum toxin A in children with cerebral palsy should be considered as part of a multidisciplinary treatment concept, since reduction of the disability and the functional improvements could have high impact on daily living activities.

Activities of Daily Living↗