Search PubMed⌕ Search

Biomedical subjects

S Wirth

Publications and source records attributed to S Wirth.

At least 91 records · Page 5Linked to original sources
PubMed1990

Cellular cytotoxicity against autologous hepatocytes in children with different forms of chronic hepatitis B.

Cell-mediated immune reactions play the most important role in the pathogenesis of chronic viral and auto-immune hepatitis. Cellular cytotoxicity (CC) of peripheral blood lymphocytes against autologous hepatocytes isolated from liver biopsies was studied in 29 children with different types of hepatitis B surface antigen (HBsAg)-positive hepatitis. Children with chronic hepatitis B showed higher cytotoxicity than control patients. However, a correlation of cytotoxicity to serum amino-transferases, HBeAg-/Anti-HBe-status, and hepatitis B virus DNA in serum could not be found. Children with a higher percentage of hepatitis B core antigen (HBcAg) expression in their liver tissue presented lower CC values, and vice versa. This supports the hypothesis that virus elimination occurs via T-cell attack against HBcAg expressing hepatocytes. Furthermore, children with a longer duration of chronic hepatitis B had considerably higher cytotoxicity values. Possibly, CC plays a role in perpetuating liver damage after infection with hepatitis B virus.

Adolescent↗
PubMed1990

Diagnostic significance of epithelioid granulomas in Crohn's disease in children. Multicenter Paediatric Crohn's Disease Study Group.

Out of 528 children with Crohn's disease in a Multicenter Paediatric Crohn's Disease Study Group, 37 cases had epithelioid granulomas but did not fulfill defined radiographic criteria of the disease. Follow-up studies including clinical, biochemical, radiological, endoscopic, and histological investigations were done in these patients. Initially, all patients showed clinical symptoms and 27 of them had biochemical signs of chronic inflammation. After a mean follow-up of 3 years, all 37 children treated for Crohn's disease got a complete upper gastrointestinal series with small bowel followthrough and 8 children in addition had barium enemas. Colonoscopies were done in 23 patients. Radiographic examination revealed Crohn's disease in 14 and endoscopy additionally confirmed Crohn's disease in 8 further cases. One child was diagnosed as having chronic granulomatous disease. Thirteen children still remained unclassified after these follow-up studies including radiographs and endoscopy. An interval of 3 years may in some cases be too short to express the complete radiographic pattern of Crohn's disease. Our studies demonstrate that in addition to initial radiological, endoscopic, and histological investigations, a thorough follow-up is necessary in early diagnosed patients. In these children, epithelioid granulomas are of high diagnostic validity preceding radiological changes of Crohn's disease often for years.

Adolescent↗
PubMed1990

Defective jejunal brush border membrane sodium/proton exchange in association with lethal familial protracted diarrhoea.

The spectrum of clinical disease associated with specific defects in jejunal brush border membrane sodium/proton exchange is poorly defined and only two patients have been described so far. Jejunal brush border membrane transport studies were performed in a boy who presented with lethal familial protracted diarrhoea in the first few days of life. Using jejunal brush border membrane vesicles prepared from conventional jejunal biopsy specimens, initial sodium uptake under H+ gradient conditions was found to be only 6% of the mean control value. In contrast, sodium stimulated glucose uptake was normal. Our data confirm the importance of a congenital defect in this exchanger as a cause of severe sodium-losing diarrhoea and extend the spectrum of disorders characterised by a specific defect in brush border membrane Na+/H+ exchange to include some forms of lethal familial protracted diarrhoea.

Biological Transport, Active↗
PubMed1990

[Hepatitis A, B, CMV, EBV and HIV infections in premature and term newborn infants following polytransfusion].

306 children who received polytransfusion or exchange transfusion between 1979 and 1983 and 104 age-matched controls were re-examined at a median age of 2.9 years for hepatitis A and B, CMV, EBV, and HIV infections. This retrospective study revealed no differences between transfused children and controls. HBsAg and anti-HIV were not detected. Two children were suspected of having hepatitis C. In both groups the incidence of positive CMV and EBV serologies was significantly increased in children from Mediterranean countries. Red cell concentrates were less frequently associated with CMV infection. These results confirm the exclusive recruitment of volunteer donors from a "healthy", mainly rural population and support the preferred use of red cell concentrates in paediatric patients.

Antibodies, Viral↗
PubMed1990

[Congenital intracranial teratoma with exophthalmos].

We report the rare case of a term newborn with an excessively large congenital, intracranial teratoma expanding into the right orbita and maxilla. The main symptoms were a total unilateral exophthalmos, a tumorous mass in the right cheek, macrocephaly with wide sutures, and a bulging fontanel. The diagnosis was confirmed by sonography, computed tomography and an exploratory excision from the retromaxillary region.

Brain↗
PubMed1987

[Treatment of congenital varicella with acyclovir].

We describe three newborns who developed varicella six hours, five or eight days after delivery. Because of the high lethality rate of congenital varicella treatment with acyclovir appeared to be indicated. Acyclovir was administered intravenously in a dosage of 3 X 5, 3 X 7.5, and 3 X 10 mg/kg/day for three to five days. All patients showed prompt clinical improvement and the skin lesions disappeared. Side effects were not observed. Dependent on the dosage radioimmunological determination of acyclovir serum levels revealed basic values between less than 0.34 to 13.9 mumol/l; peak levels ranged from 14.0 to 70.2 mumol/l. Our preliminary results demonstrate that acyclovir can be successfully used to treat congenital varicella. A dosage of at least 3 X 7.5 mg/kg/day is recommended.

Acyclovir↗
PubMed1985

Congenital renal arteriovenous malformation (aneurysmal type) in childhood.

We report on a 9-year-old boy with a congenital renal arteriovenous fistula of the aneurysmal type, a form previously not observed in childhood. The clinical picture was unusual with severe arterial hypertension, excessive polyuria and decreased levels of serum sodium and chloride as main signs. Clinical and biochemical findings normalised after nephrectomy of the kidney involved.

Arteriovenous Malformations↗
PubMed1983

Radioimmunological determination of somatomedin B in healthy children and in children with growth disturbances.

Serum somatomedin B levels were determined by radioimmunoassay in 209 healthy boys and girls from one month to 16 years of age. Low values were found up to the second year life. In the first year the mean level was 13.8 mg/l in girls and 11.5 mg/l in boys. In older children the values increased to levels between 13 and 22 mg/l in boys and between 13 and 18.5 mg/l in girls. They were independent of the stage of pubertal development. Somatomedin B levels were normal in 71 children with constitutional growth delay, primordial dwarfism, familial dwarfism and other forms of growth disturbance. The mean levels were between 12.1 and 14.4 mg/l. Values below 6 mg/l were present only in children with hGH deficiency. In these patients we could find an increase of the mean level from 4.3 mg/l without therapy to 9.4 mg/l under treatment. Thus the determination of somatomedin B seems to be useful for the diagnosis of hGH deficiency.

Adolescent↗
PubMedDate not supplied

[Clinical importance of hepatitis B virus DNA detection in serum of children with chronic hepatitis B].

206 sera from 172 children with chronic hepatitis B infection were tested for HBV DNA by dot blot hybridization. 111 were positive and 95 negative for HBV DNA. 103 (78.6%) of the positive patients had HBeAg and 5 (7.7%) anti-HBe. In 60 (92.3%) of the anti-HBe positive sera no HBV DNA could be detected. Children with elevated liver enzymes had HBV DNA in 80.1%, whereas in 71.6% of the chronic HBsAg carriers with normal liver enzymes no HBV DNA was found. In 87 of the 95 dot blot negative patients polymerase chain reaction was performed. 73 (83.9%) children of this group were HBV DNA positive. All HBeAg positive patients and those with elevated aminotransferases had HBV DNA in their serum. 56 anti-HBe-positive HBsAg carriers were also positive; 14 were negative for HBV DNA. Our results demonstrate that viral sequences can be found in all HBeAg positive and in most of the anti-HBe positive children. Patients with ongoing virus replication have to be considered infectious and recommendation for vaccination of close relatives of these patients must be stressed.

Adolescent↗
PubMedDate not supplied

[Parenteral nutrition in treatment of short stature in adolescents with Crohn disease].

Growth retardation and delayed puberty occur in 20-35% of children and adolescents with Crohn's disease. Alternate day corticosteroid treatment, use of azathioprine, enteral or parenteral hyperalimentation and surgery have been advocated to reverse growth failure. Because of nonacceptance of elemental diet 7 patients with Crohn's disease and growth retardation received parenteral nutrition for 2-3 months (maximal for more than 30 months in one patient). All of them exhibited a mean weight gain of 10 kg and a mean increase of their height velocity from 2.4 to 7.1 cm/year. Main problems were bacterial infections and dislocations of the central lines. Surgery was performed in 3 adolescents immediately after parenteral nutrition. One patient showed a catch-up growth during a 30-months nocturnal home parenteral nutrition at a biological age of 21 years. Parenteral nutrition is an effective regimen to manage growth failure in children with Crohn's disease, but has to be performed for larger periods in individual cases.

Adolescent↗
PubMedDate not supplied

[Kawasaki syndrome with acute gallbladder hydrops--case report and review of the literature].

We describe a 2 3/4-year-old boy with Kawasaki disease associated with the rare complication of acute hydrops of the gallbladder. Because of the severe abdominal symptoms cholecystectomy was performed. A review of the literature shows that about half of the patients had been operated upon. Therefore conservative treatment may provide complete improvement. Ultrasonography is not only very helpful in the diagnosis but also in follow-up.

Child, Preschool↗
PubMedDate not supplied

Alpha-interferon treatment in HBeAg positive children with chronic hepatitis B and associated hepatitis D.

The main problem of children with HBeAg positive hepatitis B and associated hepatitis D is progression to liver cirrhosis with decompensation of liver function and need for liver replacement therapy within 15-20 years after infection. To determine whether interferon-alpha (IFN-alpha) therapy has a positive effect on HBV replication and inflammatory activity, we evaluated clinical and serological data of 8 children treated with IFN-alpha and 6 historic control patients without treatment. 4 of the nontreated patients seroconverted from HBeAg to anti-HBe between 7 to 17 years after initial diagnosis and showed decreased inflammatory activity in the liver. In the treatment group, the rate of seroconversion to anti-HBe (3 early, 2 late seroconverters) corresponded well to former trial results obtained in patients exclusively infected by HBV. Serum aminotransferase levels decreased or normalized in seroconverted children. In chronic HBV infection with associated hepatitis D (HDV) infection--compared to the spontaneous course of the disease--IFN-alpha therapy reduced inflammatory activity by earlier seroconversion to anti-HBe in responding patients. Moreover, viral replication and infectivity of hepatitis B was markedly reduced, but no effect on replication of HDV could be documented. Although long-term effects cannot be exactly estimated, at present IFN-alpha remains the only available treatment for HBeAg and anti-HDV positive children and seems to be of benefit for responding patients.

Adolescent↗