Biomedical subjects
Publications and source records attributed to U Willi.
Radionuclide voiding cystography is a sensitive and accurate method for diagnosing vesicoureteric reflux. This method allows for continuous monitoring of bladder filling and emptying, permits detection of reflux at any time during the study, and evaluates its dynamics. Since it results in very low amounts of radiation to the patient, it is an ideal method for the diagnosis and follow-up of children with reflux.
In blunt abdominal trauma in childhood, sonography should be the primary method for diagnostic imaging. This simple and non-invasive investigation can be readily performed even in cases with severe traumatic organ lesions. In cases not requiring immediate surgery the method can be used for monitoring and follow-up. Other diagnostic procedures such as IVP, CT, abdominal plain x-ray, angiography, scintigraphy do not become superfluous but should be used according to the clinical and sonographic findings.
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Following a stay of a few months in Africa, a 9 year old boy developed gross hematuria, dysuria and pollakisuria. Two urine cultures remained sterile, the intravenous urography was normal. Therefore a tropical disease was looked for. Eggs of Schistosoma mansoni in the urine sediment, a significant level of schistosomal antibodies, and blood eosinophilia proved our suspected diagnosis of schistosomiasis to be correct. An ultrasonic examination of the urinary tract showed a thickened bladder wall. Very unusual in this case is the primary infection of the bladder with Schistosoma mansoni which normally affects the intestine.
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Fractures of the transverse processes of the lumbar vertebrae may be difficult to identify radiographically because they are often obscured by gas and feces. With unilateral fractures, there is often scoliosis convex to the side of the fractures. We propose that this may be due to the ineffective action of the ipsilateral quadratus lumborum muscle which inserts into the transverse processes. The unopposed action of the contralateral quadratus lumborum results in scoliosis convex to the side of the fracture(s). Awareness of this cause of scoliosis can help in differentiating it from scoliosis caused by other painful abdominal processes, and may aid in recognition of the fracture(s).
Common duct cysts are a rare entity. The combination of cystic alterations of the entire bile duct system is less known. Etiology, classification, and Roentgen signs are described in a case presentation with common duct cyst and marked ectasia of the intrahepatic bile ducts.
1975-87 there were 15 infants in the Childrens University Hospital of Zürich, cared for a brain tumor. In 3 cases the first symptoms were already present by birth. In our cases epileptic convulsions were the most common first manifestation of the tumor (40%). In most cases neither clinical symptoms nor EEG changes helped to localize the tumor. In one third of the cases the tumor was manifested with symptoms of increased intracranial pressure. In 11 children (73%) the tumor was localized supratentorially, in 3 cases in the cerebellum, in one case in the brainstem. 13 children were operated, without perioperative mortality. In 10 cases the tumor was radically extirpated, in 3 cases only a subtotal excision of the tumor was possible.
A case of a cervical lymph node abscess in a child is reported from which a pure culture of C. ochracea was isolated. This is the first reported case of such an infection due to this organism. The patient, who was not leukopenic and did not receive antibiotics, was cured following excision.
Veno-occlusive disease (VOD) of the liver was diagnosed in 8 patients with Wilms' tumour and peliosis hepatis (PH) in one. Fever of obscure origin, vague abdominal pain, hepatomegaly or hepatosplenomegaly, severe anaemia or sudden, unexplained drop in haemoglobin, thrombocytopenia, increasing serum transaminase levels, jaundice and ascites recorded within the first weeks or months of tumour diagnosis should arise suspicion of non-metastatic vascular hepatopathy. General or focal decreased accumulation of isotope at liver scintigraphy belong to the early radiologic findings. Sonography and CT may show a generalized irregular echogenicity or attenuation but no unequivocal metastases. One patient with PH had multiple low attenuating foci in both liver lobes and angiographically abnormal pooling of contrast medium in the liver. It is important to recognize these conditions as alternatives to suspected liver metastases, which as a rule develop much later yet on occasions may have very similar radiologic appearances. Therefore the relation in time between tumour diagnosis, initial operation and development of obscure hepatic manifestations is of critical significance for the recognition of VOD or PH. In these patients chemotherapy and irradiation must be discontinued without delay. If the disorders are adequately treated the prognosis may be considered fair.
The purpose of this article is to determine allergic rhinitis and age as potential risk factors for the development of orbital complications of acute rhinosinusitis in children. One hundred two children presenting with orbital swelling were investigated by computed tomography (CT) of the paranasal sinuses and the orbit as well as for underlying allergic rhinitis. Sixty (58.8%) patients had orbital complications of clinical and radiological acute rhinosinusitis. They were grouped accordingly: preseptal cellulitis (n = 24), periostitis (n = 10), and subperiosteal abscess (n = 26). No abscess within the orbit or cavernous sinus thrombosis was found. Thirty-four (56.7%) of the 60 patients underwent allergy investigation. Allergic rhinitis was found in 9 (64.3%) of 14 children with preseptal cellulitis, in 1 (25%) out of 4 children with periostitis, and in 13 (76.5%) out of 17 children with subperiosteal abscess. The prevalence of allergic rhinitis was significantly higher in patients presenting in pollen season from February to August (17:4) than in patients presenting in the period between September and January (6:7). Thus, allergic rhinitis may be a cofactor in the pathogenesis of orbital complications of acute rhinosinusitis. According to our study population, age only influences the type of orbital complication of acute rhinosinusitis in the sense that older children are more likely to develop subperiosteal abscess, whereas younger children develop preseptal cellulitis.