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Biomedical subjects

W C Hecker

Publications and source records attributed to W C Hecker.

At least 91 records · Page 5Linked to original sources
PubMed1980

[Thyroid carcinoma in children (author's transl)].

In about 50% the thyroid carcinoma in childhood presents regional lymphnode metastases as leading symptom. The "cold nodule" is the typical scintigrafic equivalent of thyroid cancer in infants. Papillary carcinoma is the predominating histologic type (80%) with a good prognosis. Radical removal of the thyroid lobe with the primary lesion and subtotal resection of the opposite lobe, combined with selective neck dissection if necessary seems to improve the results. Scintigrafic control postoperatively detects malignant remnant tissue for 131-iodine-treatment, finally TSH-suppressive hormone administration is followed. In our own cases the survical rate in 25 children was at least more than 90%.

Carcinoma, Papillary↗
PubMed1980

[Pediatric problems arising from surgery of the pancreas in childhood (author's transl)].

The annular pancreas which is responsible for one third of the cases of duodenal obstruction plays a central role in pancreatic malformations. Therapy of choice is a duodeno-duodenostomy. Prognosis is deteriorated by frequent premature delivery, Down's syndrome and associated malformations. Among pancreatic tumors the congenital pancreatic cyst, the cysto-papillary adenoma and the insulinoma are particularly considered the latter in connection with the discussion of hyperinsulinism which also nesidioblastosis is associated. Pancreatic tumors to require surgical therapy and a subtotal excision of the pancreas is frequently necessary in nesidioblastosis. Besides pancreatitis which is diagnosed in Germany also pancreatic rupture with subsequent posttraumatic pancreatitis leading to pancreatic pseudocysts is discussed. There are no deaths after isolated pancreatic trauma or surgery of pancreatic pseudocysts.

Adenoma, Islet Cell↗
PubMed1980

Precocious puberty in a boy with HcG-producing hepatoma. Case report.

This paper deals with a three-year-old male patient with sexual precocity due to a gonadotropin-producing hepatoma. Maximum levels of serum-gonadotropins were 340 muULH/ml, 430 muUHCG/ml, but only 1.4 muUFSH/ml. The level of plasma testosterone was 985 ng/dl, and of plasma delta 4-androstenedione 109 ng/dl. Gonadotropin in serum reacted like choriongonadotropin but unlike pituitary luteinizing hormone when compared in dilution tests by radioimmunoassay. Gonadotropin and androgen levels returned to normal after removal of the tumour. Histopathology showed a carcinomatous hepatoblastoma of the epithelial type with immunohistological evidence of beta-HCG production.

Carcinoma, Hepatocellular↗
PubMed1979

[Neuroblastoma in children. Clinical staging and management (author's transl)].

Sixty-four children with neuroblastoma stage I to III c are presented. The coordinated management utilizing surgical excision, irradiation (2--5.000 rad) in stage II and III and multiagent chemotherapy is described. Favorable sites were abdomen (30) and thorax (22). In ten cases the primary site was unknown. The prognosis is influenced by several factors: Patients under 1 year of age without evidence of bone or bone marrow metastases have a favorable outcome (13/15). Nearly all patients with lesions of bone or generalized tumor in bone and/or bone marrow (stage III b and III c) failed to attain long term disease free survival despite combination chemotherapy and the use of radiation therapy (33/34). No relation between histological or biochemical characteristics and prognosis could be found. Biochemical determinations however are useful as an index of response to treatment. Prognosis was independent from sex. A review of the literature and on attempt to improve the therapeutic efficancy in stage III are reported.

Abdominal Neoplasms↗
PubMed1979

General survey of the causes of death in patients who died postoperatively in pediatric surgery.

The study is based on 427 patients who died between 1949 and 1976 and who were subjected to a post mortem examination. The years 1949 to 1969 (Group A) and the years 1970 to 1976 (Group B) were compared. Following important results were discovered: The underlying disease as a cause of postoperative death was reduced from 18.5% in Group A to 13.3% in Group B. Postoperative deaths secondary to associated malformations increased from 2.5% to 6.1%. Postoperative deaths due to a wrong diagnosis remained constant at 3%. Deaths due to wrong medical treatment decreased from 18% to 5.1%. Deaths due to postoperative infection increased from 17% to 46.2%. The explanation for this change is that modern intensive care keeps many patients alive who formerly died before the onset of infection. Deaths secondary to postoperative shock remained practically constant at 3% and 4% respectively. Deaths due to postoperative pneumonia decreased from 31% in Group A to 13.3% in Group B. The therapy for pneumonia has therefore markedly improved. The largest number of postoperative deaths was found in newborn infants. However, their part in the total numbers of postoperative deaths is definitely becoming smaller. Amongst the newborn infants there was the highest number of postoperative deaths caused by infections.

Child↗
PubMed1977

[Funnel chest and pigeon breast (author's transl)].

The dominant heredity of funnel chest formation is considered proved. The incidence of funnel chest is about 0.05% of the population, with the emphasis on boys. In very many cases deformities of the anterior chest wall are associated with other deformities. All patients with pigeon breast or funnel chest suffer considerably psychically under their deformity. This is the main indication for operation. The best age for operation is from the 2nd to 6th years of life. Conservative methods of treatment are never successful. Of the present day operative techniques, the stabilizing--by implantation of metal clips--are opposed to the nonstabilizing operative procedures. Both achieve equally good and completely satisfactory results in 85% of cases.

Abnormalities, Multiple↗
PubMed1977

[Problems of enterectomy for diffuse peritonitis in children (author's transl)].

An analysis was made of the author's own patients with diffuse perforative peritonitis (without appendicitis) in childhood. Most patients had a perforated enterocolitis. Treatment of choice: Resectioning the perforated areas of the intestine or Resectioning the intestine just before the perforation; anastomosis in the septic area should not be carried out, instead an enterostomy with two lumina should be performed; intensive therapy; therapy for sepsis with exchange transfusion. The reanastomazation should take place only after the patient has fully recovered; definite criteria for evaluation, when this is the case, were presented. The mortality rate for the author's cases was 46%; statistics taken from international literature indicate a mortality rate of 65%.

Adolescent↗
PubMed1977

[Results of inadequate aftercare following surgical correction of proctatresia (author's transl)].

For deep proctatresia, postoperative aftercare consisting of adequate, long-term bougienage is important. On the basis of 10 cases, it was shown that inadequate postoperative bougienage for proctatresia leads to formation of a megacolon and to overflow incontinence. The incontinence can then only be controlled by carrying out a proctectomy and a sigmoidectomy together with surgical formation of the gracilis. This proved to be satisfactory for all 10 cases presented.

Anal Canal↗
PubMed1976

Solitary hepatic hemangioma in a newborn infant complicated by cardiac failure, consumption coagulopathy, microangiopathic hemolytic anemia, and obstructive jaundice. Case report and review of the literature.

A newborn infant with a large hepatic hemangioma developed congestive heart failure, consumption coagulopathy, microangiopathic hemolytic anemia, and obstructive jaundice. The patient was mildly heparinized (250 units per kg and day) and underwent successful resection of the tumor without lobectomy at the age of 3 days. Blood volume increased from 93.9 ml/kg at the age of 5 h to 124.2 ml/kg prior to surgery. Red-cell mass simultaneously decreased from 53.8 to 39.4 ml/kg. The increase of blood volume is explained by congestive heart failure, the decrease of red-cell mass by intravascular coagulation within the tumor resulting in formation of thrombi and microangiopathic hemolytic anemia. A review of the literature on infants with symptoms caused by an intrahepatic hemangioma during the first month of life confirms that surgical intervention is the treatment of choice for infants with giant solitary hemangioma of the liver.

Anemia, Hemolytic↗