[Economic growth with zero population growth and with declining population].
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Demography↗
Biomedical subjects
R Kurz
Publications and source records attributed to R Kurz.
[Parenteral amino acid substitution in surgically treated newborn infants].
9 newborns received a standardized parenteral nutrition following abdominal major surgery. The composition of the amino acid solution used followed the requirements of newborns as well as their postoperative metabolism. The favorable course, the effective control of the catabolism and the lack of significant imbalances of the amino acid patterns indicate that the composition of the amino acid solution was appropriate. Augmentation of the amino acid dosage up to 2 g/kg B.W. at the end of the first postoperative week resulted in a relatively high load of nitrogen and acidosis. Therefore the usually demanded supply of 120-200 non-protein-calories (kcal) for 1 g nitrogen turns out to be too low. Though the relative over-load of amino acids is used for energy utilisation, it stresses, however, the metabolism.
Abdomen↗
[The chronically altered appendix in children. Cooperative work of the Austrian Society for Pediatric Surgery].
In this multicentric study the anamnestic data and parents questionaires of 2-29 children were evaluated, whose appendix vermiformis at the time of operation showed no signs of inflammation. 31,1% macroscopically showed cicatrisation or fasciation, in 13,7% other enteral or gynaecological (1%) findings were present. In 1194 of the cases of patho-histological examination of the appendix had been made of which 36.4% were negative, 37.7% showed cicatrisation, 15,0% oxyuriasis and 10,4% coproliths. In the discussion of the significance of the chronically altered non-inflamed appendix we compared patients with and without macroscopical or microscopical alterations. We came to the conclusion that the probability-index as to sex, duration of symptoms, complexity of symptoms, incidence of postoperative well-being, proved the chronically altered appendix not to be an illness per se, but the result of spontaneously arrested inflammation. Since the rate of children admitted with a perforated appendix is high (15-20%) in comparison with the rate of complications after removal of non-inflamed appendices (2,9%), we believe that according to the diagnostical problems the principle can be maintained: in dubio pro operatione.
Adolescent↗
[Treatment of Wilms' tumor (author's transl)].
Uniform treatment based on the therapeutic approach of the 1st and 2nd US National Wilms' Tumor Study was decided on in March 1976 by paediatricians, surgeons, urologists and radiotherapists in Austria. Wilms' tumour was diagnosed in 34 children between 1 january 1976 an 29 february 1980 (stage I: n = 11, stage II: n = 8, stage III: n = 8, stage IV: n = 7). Parents of two children refused treatments; both children have since died of metastases. Of the remaining 32 children 29 (90.6%) are alive, 10 for more than 4, 15 for more than 3 and 19 for more than 2 years after diagnosis. 21 children are without need of treatment. Three children have died, one due to postoperative complications, one due to haemorrhagic chickenpox, but free of tumour, and one after insufficient treatment. Two of the five children with a recurrence between 2 1/4 to 15 months after diagnosis had been treated inadequately in the initial phase. The tumour free survival rate in 74.2%. Two children with early occurring or recurrent lung metastases have survived for 53 1/2 and 54 months up to now.
Age Factors↗
[Present and future of oral pertussis vaccination].
Parenteral immunization against whooping cough shows some disadvantages which led to proposals to curtail pertussis vaccination in some countries. As a result a striking rise in pertussis morbidity in these regions was noted, so vaccination against whooping cough is still indicated. We developed an oral vaccine for the neonate to achieve a protective immunity at a time when it is especially needed and to avoid side-reactions. Oral vaccine was given to more than 15,000 newborns, vaccination results of the last 3 years are reported.
Administration, Oral↗
[Delayed splenic rupture and fat embolism in childhood (author's transl)].
The authors present the history of a seven-year-old male child suffering from delayed splenic rupture and fat embolism syndrome simultaneously. The conservative treatment of splenic ruptures as well as incidence and early diagnosis of fat embolism syndrome in childhood will be discussed.
Accidents, Traffic↗
[Laryngo-tracheo-oesophageal cleft and G-syndrome--interposition of a flap from the sternocleidomastoid muscle (author's transl)].
A 7-month-old dystrophic infant weighing 3.8 kg was investigated endoscopically in relation to recurrent pneumonia. A tracheo-esophageal cleft was demonstrated. The situation was complicated by the coexistence of achalasia of the cardia. There was also hypertelorism and malformation of the urinary tract, so that this would appear to be a case of the G-Syndrome. A Heller's operation with fundoplication and gastrostomy was performed and only after this was the tracheooesophageal cleft closed. A flap of sternomastoid muscle was interposed between the trachea and oesophagus. Stenosis was treated by dilatation.
Abnormalities, Multiple↗
[Problems of Hodgkin's disease in childhood].
Many publications about treatment results of Hodgkin's disease in adults give a rather optimistic outlook. Our experience with the treatment results of 10 children between 1970 and 1980 is rather disappointing due to late side effects of the combined treatment modalities. These complications of therapy and guidelines form the management of various stages of Hodgkin's disease are discussed.
Child↗
Effect of manual lymphdrainage massage on blood components and urinary neurohormones in chronic lymphedema.
In an earlier paper we have shown that manual lymph drainage massage of edematous limbs can result in the excretion of up to 1 liter urine derived from reabsorption and transport from the interstitial fluid, simultaneously with significant changes in the excretion of urinary neurohormones. These findings indicated that histamine and serotonin were released from the edematous tissue and that circulation improved through increased output of adrenaline and noradrenaline. The results achieved led us to assume that similar changes may have occurred in the blood during treatment, and induced us to study the effect of manual lymphdrainage on various blood constituents and urinary neurohormones.
Adolescent↗
[Investigation of postoperative suppression of cellular immunity in infants and children by DNCB skin test (author's transl)].
The DNCB-responsiveness of operated infants and children by skin sensitization indicates a transient depression of the entire reactions of delayed immunity following major surgery. There is a strong connection between this immunosuppression and the risks of postoperative infections. Age and preoperative clinical stage of children as well as the extent of the operation determine the grade of the immunosuppression.
Adolescent↗
[Thrombopoiesis and blood coagulation in pediatric patients with septicemia (author's transl)].
45 infants and children with thrombocytopenia and septicemia were studied. Many parameters of blood coagulation, the platelet diameters and the megakaryocytes of the bone marrow (Feulgen stained cytophotometry and maturity of the megakaryocytes) were examined. 15 patients had a consumption coagulopathy and 30 were classified as having an isolated septic thrombocytopenia. In both groups the number of the megakaryocytes of the bone marrow smears were normal. 81% of the megakaryocytes were mature. The patient group with isolated septic thrombocytopenia had significantly greater ploidy values of the megakaryocytes than a control group. In both groups the diameters of the platelets were also significantly greater than in an age matched control group of children with a normal platelet count. These results allow the conclusion that the thrombocytopenia in pediatric patients with septicemia is not caused by a diminished production of platelets.
Blood Coagulation↗
[Coxitis fugax (author's transl)].
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Adolescent↗
[Paradoxical ventilatory response of babies to pure oxygen (author's transl)].
In order to determine indicators for the risk of SIDS (sudden infant death syndrome) the respiratory responses of babies (age 1 to 5 months) during sleep to various gas mixtures was examined. Using a face mask combined with a pneumotachograph in all cases a marked increase of the ventilation was found, when the babies were exposed to pure oxygen. Furthermore, the response of the babies to the exposure to mild hypoxia was tested. In 24 out of 36 babies a ventilatory depression was observed which sometimes was coupled with periodic or arrhythmic ventilation. These paradox reactions--depression by mild hypoxia and stimulation by hyperoxia--might be related to a possible circulus vitiosus in the pathogenesis of SIDS.
Carbon Dioxide↗
[Changes in cellular and humoral immunity in the postoperative period (author's transl)].
The decrease of E-rosettes forming lymphocytes in infants and children after surgery indicates a temporary deficiency of the cellular immune-defence, which depends on the age of the patients and the duration of the procedure. It finds its most marked expression in newborns and infants respectively, after major abdominal surgery. Children suffering from pre-operative complications like shock, ileus or infection have lower initial values and get post-operative infections more frequently. The humoral immune-defence is not impaired, the IgM-concentrations even show a significant post-operative increase.
Age Factors↗
[Erythrocyte density distribution disorders in infants with respiratory regulation disorders].
The frequency distribution of the density of erythrocytes was investigated in 22 babies by using the method of Danon and Marikovsky. This investigation seems to be a very suitable method for identifying minimal alterations in the oxygen transport system. In all 22 babies typical S-like density distribution curves were observed similar to those of adults. Eight of the babies with clinically demonstrable disorders in respiration control (ARS) were taken as one group. In comparison with the control group (14 babies) it could be shown that the erythrocytes of the ARS-babies had a lower density than the erythrocytes of normal babies. This difference proved to be statistically significant. No difference between control group and ARS-group could be shown with respect to the distribution of size of the erythrocytes, the mean cell hemoglobin concentration (MCHC), and the mean cell volume (MCV). We assume that the deviation in density distribution of erythrocytes from normal in the ARS-group may be attributed to biochemical changes provoked by the chronical hypoxia. It can be stated that, independent of the interpretation of this phenomenon, a new additional factor could be found for the identification of risks for ARS and possibly for the sudden infant death syndrome (SIDS).
Apnea↗
[Tetanus prophylaxis in the child. Conclusions from tetanus antibody determinations].
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Adolescent↗
[Septicemia in the operated newborn (author's transl)].
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Age Factors↗
[Tetanus antibody determinations in children (author's transl)].
Tetanus antibody determinations in 109 children aged 1 1/2 to 15 1/2 years showed that 98.2% had a sufficiently protective tetanus antitoxin titre. There were no significant differences between completely and incompletely first immunised children. Increased titres of up to 25 IU/ml serum were found shortly after multiple boostering. According to the observed titres boostering after trauma is at the earliest necessary after 5 years in complete or incomplete primary immunisation or after the last boostering. Passive immunisation is only indicated in the traumatised non-immunised and in patients with wounds of larger standing who have not been immunised for more than 5 years.
Adolescent↗