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  • 1
    Electronic Resource
    Electronic Resource
    Recommendations for treatment of contralateral inguinal hernias in children (1999)
    Springer
    Hernia 3 (1999), S. 53-56 
    Details
    ISSN: 1248-9204
    Keywords: Contralateral hernia ; Children ; Incidence ; Predisposing disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary It is impossible to determine whether or not a child will develop a contralateral hernia after inguinal hernia repair. There exists no risk score for the occurrence of a contralateral hernia. This well-known fact prompted us to perform the underlying study. In a retrospective trial, we reviewed the files of all children operated on for inguinal hernias in our department from January 1986 until December 1994. During this period, we performed 1721 hernia repairs on 1708 children aged 0–16 years. In 96 (5.6%) of these patients, the indication to operate was a contralateral hernia following previous unilateral repair. Comparison of the ages at the time of primary inguinal repair of those children who developed a contralateral hernia (n=96) and those who did not (n=1612) showed a significantly increased incidence of contralateral hernias if the primary operation was performed before the age of two months (p〈0.0001). Diseases predisposing to hernias were found in 38% of all children (prematurity, dystrophia, ventriculo-peritoneal shunt, ascites, asthma). The authors recommend a contralateral exploration for children under the age of two months if they have any predisposing disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01194602
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  • 2
    Electronic Resource
    Electronic Resource
    Femoral hernia in childhood: evaluation of sonography as a diagnostic aid (1999)
    Springer
    Hernia 3 (1999), S. 19-21 
    Details
    ISSN: 1248-9204
    Keywords: Femoral hernia in childhood ; Sonography ; Operative technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Between 1986 and 1997, 1,970 children up to the age of 15 were operated for inguinal hernia at the University Surgical Clinic of the RWTH Aachen. During this period, we operated on 6 children for femoral hernia (0.3% of the total number of hernia operations). A preceding inguinal hernia appeared to favor femoral hernia in childhood. In our view, preoperative diagnostic examination of children using sonography is an absolute requirement. Our surgical method consisted of closing the hernial orifice using a continuous double-row suture. The success of our surgical approach has been confirmed by non-recurrence of the complaint.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01576735
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  • 3
    Electronic Resource
    Electronic Resource
    Zwerchfellverletzungen – Klassifikation, Diagnostik und Therapie (1997)
    Springer
    Der Chirurg 68 (1997), S. 509-512 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Injuries of the diaphragm ; Classification ; Diagnosis ; Therapy. ; Schlüsselwörter: Zwerchfellverletzungen ; Klassifikation ; Diagnose ; Therapie.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Bei stumpfen thorakalen und abdominalen Verletzungen wird das Zwerchfell in der Diagnostik oft vernachlässigt. Eine Zwerchfellverletzung wird entweder durch direkte oder indirekte Gewalteinwirkung verursacht. Das klinische Beschwerdebild ist sehr variabel und wird besonders bei polytraumatisierten Patienten durch andere Verletzungen maskiert. Zwischen 1987 und 1995 sind 17 Patienten mit Zwerchfellverletzungen behandelt worden. Bei 4 dieser Verletzten lag eine isolierte Ruptur des Diaphragmas vor; bei den übrigen 13 fanden sich zusätzlich Begleitverletzungen. Präoperativ konnte mit folgenden Untersuchungsmethoden die korrekte Diagnose gestellt werden: Sonographie in 12, Röntgenthorax in 6, CT-Abdomen in 2 Fällen, MDP und CT-Thorax in 1 Fall. Während der ersten 2 Tage nach dem Unfalleintritt sind 15 Patienten, einer innerhalb des 1. Jahres und einer erst 23 Jahre später, therapiert worden, 2 Verletzte starben an den Folgen der Begleitverletzungen.
    Notes: Summary. Diagnosis of diaphragmatic rupture is often missed after blunt thoracic and abdominal injuries. Rupture of the diaphragm is caused either by direct or indirect violence. The clinical manifestations are unpredictable and of infinite variety, and, especially in massively traumatized patients, masked by other injuries. Between 1987 and 1995, 17 patients were treated for traumatic injury of the diaphragm. Four of 17 patients sustained isolated diaphragmatic rupture; in 13 the rupture was combined with other injuries. Preoperatively the following diagnostic procedures were performed: ultrasonography in 12 patients, chest X-ray in 6, computed tomography of the abdomen in 2, water soluble enema into the stomach in 1, and computed tomography of the thorax in 1 patient. Therapy of diaphragmatic injury was performed in 15 patients within 2 days, in one within 1 year and in one 23 years after the accident. Two patients died due to accompanying injuries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050221
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  • 4
    Electronic Resource
    Electronic Resource
    Hyperbilirubinemia associated with a cystic abdominal mass in a 6-week-old girl: case report (1998)
    Springer
    Pediatric surgery international 14 (1998), S. 224-226 
    Details
    ISSN: 1437-9813
    Keywords: Key words Cystic abdominal mass ; Diagnostic ; Ultrasound ; Laparoscopy ; Gastric duplication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abdominal cysts in girls are frequently observed by abdominal ultrasound (US) and are usually ovarian. In this case a cystic structure located in the right abdomen was seen in a female newborn without symptoms and was initially described as a possible ovarian cyst. Frequent US examinations showed an increase in volume and diameter, and temporary, recurring episodes of hyperbilirubinemia were observed. The US scans showed no relationship to the biliary tree. During a diagnostic laparoscopy, a cystic structure attached to the pyloric region was seen. A laparotomy revealed a cystic duplication of the stomach, which could be resected completely. The finding is discussed emphasizing the importance of clinical findings and diagnostic methods in the diagnosis and management of abdominal cystic masses in females.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050708
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  • 5
    Electronic Resource
    Electronic Resource
    Short-term absorbable material for diaphragmatic replacement (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 19-22 
    Details
    ISSN: 1437-9813
    Keywords: Key words Diaphragmatic replacement ; Absorbable material ; Experimental study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate absorbable materials for use for replacement of the diaphragm, we implanted materials in experimentally-created diaphragmatic defects in pigs. As a short-term absorbable material, bovine serosa (BS) was used. Its absorption was complete after 4–6 weeks. In a control group, the defect was repaired with a continuous running polypropylene suture. In two other groups the defect was closed with lyophilized dura (LD) and a modified transverse abdominal muscle flap according to Hecker, respectively. Physical studies (load capacity and elasticity) and histologic investigations were performed in one-half of the animals of each group after 3 and 6 months, respectively. Considering their physical properties, it could be shown that all materials tested are suitable for replacement of the diaphragm, but that BS best resembled native diaphragm. We conclude that short-term absorbable BS is suitable for replacement of the diaphragm in pigs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050005
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  • 6
    Electronic Resource
    Electronic Resource
    Inflammatory pseudotumor of the diaphragm (1999)
    Springer
    Pediatric surgery international 15 (1999), S. 387-390 
    Details
    ISSN: 1437-9813
    Keywords: Key words Inflammatory pseudotumor ; Diaphragm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 5-year-old-boy presented with a right pleural effusion and fever. A tumorous mass was located between the right lung and the liver. The boy underwent a right thoracotomy with excision of the tumor and the adherent parts of the right hemidiaphragm. Histology and immunohistochemistry showed an inflammatory pseudotumor of the diaphragm. This is the first reported case of an inflammatory pseudotumor in this location. A brief review of the heterogeneous theories about the pathogenesis and the different therapeutic regimens for this rare neoplastic entity are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050607
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  • 7
    Electronic Resource
    Electronic Resource
    Infantile hypertrophic pyloric stenosis: myopathic type (1990)
    Springer
    Acta neuropathologica 80 (1990), S. 295-306 
    Details
    ISSN: 1432-0533
    Keywords: Pyloric stenosis ; Smooth muscle ; Myenteric plexus ; Visceral myopathy ; Neuropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Smooth muscle cell biopsies obtained at pyloromyotomy from 37 children with infantile hypertrophic pyloric stenosis (IHPS) were studied by light and electron microscopy and compared with 6 autopsy control cases without any clinical evidence of this disorder. In cases with IHPS an apparently irregular increase in the number of smooth muscle cells by mitosis was accompanied by an increase of the endoplasmic reticulum, proliferation of mitochondria and regressive changes, such as shrinkage, swelling, necrosis and apoptosis of smooth muscle cells. Other alterations, seen in some but not all cases consisted of large numbers of unusual dense granules some of which were clearly associated with actin filaments and, therefore, regarded as derivatives of the normally occurring dense bodies. Furthermore, intermyofibrillar and subsarcolemmal glycogen accumulations, various nuclear abnormalities and pleomorphic membranous cytoplasmic or nuclear bodies occurred. While smooth muscle cell abnormalities predominated in some cases of IHPS, in others there were more severe axonal changes in the myenteric plexus. It is suggested, therefore, that a primarily myogenic type of IHPS can be distinguished from a predominantly neurogenic type.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00294648
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  • 8
    Electronic Resource
    Electronic Resource
    Diaphragm replacement: An experimental animal study (1997)
    Springer
    Hernia 1 (1997), S. 123-127 
    Details
    ISSN: 1248-9204
    Keywords: Diaphragm replacement ; Absorbable material ; Electromyography ; Physical and histologic examination ; Animal study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We performed an open experimental study for evaluation of rapidly absorbable material of bovine serosa for diaphragm replacement. A total of 100 Sprague-Dawley rats were randomly assigned to five groups of equal size. In the control group (n=20) incision of the diaphragm was followed by primary suture. The animals of the four other groups underwent partial resection of the left hemidiaphragm. The defects were repaired by lyophilized dura, polytetrafluorethylene (PTFE), autologous transversus muscle or rapidly absorbable bovine serosa. We performed electromyography (EMG) and postmortem physical examinations of elasticity and load capacity of the different materials as well as histologic examinations after three and six months. A total of 89 animals survived and were subject to the analysis. There were no differences between the groups concerning growth and weight gain. The EMG showed normal function for the absorbable material and the transversus muscle. Only scanty physiologic waves were registered in the PTFE group. Load capacity measurements showed the lowest value of 4.71 N for the native diaphragm; all other materials had much higher values (17.66 N – 51.99 N) with a peak load capacity in the PTFE group. Measurements of elasticity displayed similar results. The native diaphragm had the lowest value (1516 N/m); much higher values were found in all the other materials tested (3905 N/m – 7654 N/m) with again peak values for PTFE. The differences of all materials compared to native diaphragm were statistically significant (p〈0.05). The histologic examinations revealed strong foreign body reactions in the dura and PTFE groups. The absorbable bovine serosa had vanished three months postoperatively. Short-term absorbable bovine serosa tested successfully as a partial replacement of the diaphragm in this experimental study on rats. There may be additional indications for this material if a temperary replacement is intended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02426416
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  • 9
    Electronic Resource
    Electronic Resource
    Hirschsprung disease: Paternal transmission to a son (1993)
    Springer
    European journal of pediatrics 152 (1993), S. 467-468 
    Details
    ISSN: 1432-1076
    Keywords: Hirschsprung disease ; Familial occurrence ; Genetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hirschsprung disease (HD) is genetically heterogeneous with approximately 4% familial occurrence. The recurrence risk is higher in patients with severe involvement. We describe the transmission of histotopochemically proven HD from a father with long aganglionic segment disease to a son with ultrashort segment disease. This observation suggests that the length of involvement in HD is related to the variable expression of the gene defect. It also suggests autosomal dominant inheritance of HD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01955050
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  • 10
    Electronic Resource
    Electronic Resource
    Inzidenz von kontralateralen Leistenhernien im Säuglings- und Kindesalter (1997)
    Springer
    Langenbeck's archives of surgery 382 (1997), S. 252-256 
    Details
    ISSN: 1435-2451
    Keywords: Key words Contralateral hernia ; Childhood ; Incidence ; Indication for simultan operation ; Schlüsselwörter Kontralaterale Hernie ; Kindheit ; Inzidenz ; Indikation zur Simultanoperation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Inzidenz von Leistenhernien im Kindesalter beträgt 1 – 2%, bei Frühgeborenen steigt sie bis auf 30% an. In 9,5% der Fälle ist nach unilateraler Hernienversorgung mit der Ausbildung einer kontralateralen Hernie zu rechnen. Bei den eigenen Patienten bildete sich bei 96 Kindern (5,6%) eine kontralaterale Hernie aus. Signifikante Unterschiede bestanden hinsichtlich des Geschlechts. Jungen sind häufiger von der Ausbildung einer kontralateralen Hernie betroffen als Mädchen. War eine Hernie in den ersten 2 Lebensmonaten aufgetreten, so mußte im späteren Leben hochsignifikant mit dem Auftreten einer kontralateralen Hernie gerechnet werden (p〉0,0001). Diese tritt in 84,9% der Fälle innerhalb der beiden ersten postoperativen Jahre auf. Daher halten wir die routinemäßige Simultanoperation der kontralateralen Seite bei Kindern 〈2 Monaten für indiziert.
    Notes: Abstract Inguinal hernia is a frequent surgical disease during infancy, occuring in 1 to 2% of all mature newborns and rise up to 30% of all premature babies. In 9.5% a contralateral hernia is found after unilateral operation. In our own patients this rate was 5.6%. The development of a contralateral hernia was significantly more often found in boys than in girls. If the hernia occured during the first two months of life, a contralateral hernia developed later highly significant (p〉0.0001). Within the first two postoperative years the second hernia arose in 84.9%. We recommended to routinely operation for a contralateral hernia in all children younger than two months.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00008051
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