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  • 1
    Electronic Resource
    Electronic Resource
    Thyroid carcinoma in childhood: Management and follow up of 11 cases (1994)
    Springer
    European journal of pediatrics 153 (1994), S. 17-22 
    Details
    ISSN: 1432-1076
    Keywords: Thyroid carcinoma in childhood ; Thyroid nodules Cervical adenopathy ; Thyroidectomy ; Radio-iodine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Eleven patients under 16 years of age, 5 males and 6 females were diagnosed with thyroid carcinoma in our hospital between 1974 and 1992. Median age at diagnosis was 9.5 years (range: 5.2–15.7 years). The presenting sign was a single thyroid nodule in 5, multiple thyroid nodules in 1, cervical adenopathy in 3, and thyroid nodules in conjunction with cervical adenopathy in 2 patients. Histological diagnosis was papillary carcinoma in 5 cases, follicular carcinoma in 2, mixed papillary-follicular carcinoma in 3, and anaplastic carcinoma in one. Only 4 patients had no extrathyroidal metastases at diagnosis. All but one subjects underwent total thyroidectomy, either one-staged or two-staged. If metastases were present, ablative radio-iodine therapy followed. Two patients died within a few months, one from complications of lung metastases, another from diffuse spread of anaplastic carcinoma. Two patients were lost to follow up; 7 patients have been followed for 9.0–18.0 years. Of these, one patient with initial lung metastases has had six recurrences which were successfully treated each time with radio-iodine although thyroglobulin levels remained elevated; another patient who had an initial subtotal thyroidectomy incurred a relapse 12 years later during pregnancy but is doing well now after more intensive surgery. We propose that children with differentiated thyroid carcinoma should undergo total thyroidectomy and selective lymph node extirpation by a skilled surgeon followed by whole body radio-iodine scan and ablative radio-iodine treatment if necessary. Plasma thyroglobulin can then be used as a tumour marker and suppressive levothyroxine does should be given.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000781
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  • 2
    Electronic Resource
    Electronic Resource
    Thyroid carcinoma in childhood: management and follow up of 11 cases (1994)
    Springer
    European journal of pediatrics 153 (1994), S. 17-22 
    Details
    ISSN: 1432-1076
    Keywords: Key words: Thyroid carcinoma in childhood – Thyroid nodules – Cervical adenopathy – Thyroidectomy – Radio-iodine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Eleven patients under 16 years of age, 5 males and 6 females were diagnosed with thyroid carcinoma in our hospital between 1974 and 1992. Median age at diagnosis was 9.5 years (range: 5.2 – 15.7 years). The presenting sign was a single thyroid nodule in 5, multiple thyroid nodules in 1, cervical adenopathy in 3, and thyroid nodules in conjunction with cervical adenopathy in 2 patients. Histological diagnosis was papillary carcinoma in 5 cases, follicular carcinoma in 2, mixed papillary-follicular carcinoma in 3, and anaplastic carcinoma in one. Only 4 patients had no extrathyroidal metastases at diagnosis. All but one subjects underwent total thyroidectomy, either one-staged or two-staged. If metastases were present, ablative radio-iodine therapy followed. Two patients died within a few months, one from complications of lung metastases, another from diffuse spread of anaplastic carcinoma. Two patients were lost to follow up; 7 patients have been followed for 9.0 – 18.0 years. Of these, one patient with initial lung metastases has had six recurrences which were successfully treated each time with radio-iodine although thyroglobulin levels remained elevated; another patient who had an initial subtotal thyroidectomy incurred a relapse 12 years later during pregnancy but is doing well now after more intensive surgery. We propose that children with differentiated thyroid carcinoma should undergo total thyroidectomy and selective lymph node extirpation by a skilled surgeon followed by whole body radio-iodine scan and ablative radio-iodine treatment if necessary. Plasma thyroglobulin can then be used as a tumour marker and suppressive levothyroxine dose should be given.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02000781
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  • 3
    Electronic Resource
    Electronic Resource
    Patient controlled analgesia (PCA) in paediatric surgery: a prospective study following laparoscopic and open appendicectomy (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 6 (1996), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Patient controlled analgesia (PCA) has not yet gained universal acceptance for the management of postoperative pain in paediatric surgery. In a prospective study we evaluated feasibility and complications of PCA following 90 cases of laparoscopic or open appendicectomy. PCA proved to be a safe and feasible method with few complications (2% of medical complications, no abort of application, 17 technical checks in a total running time of 4125 h). Acceptance by patients was high and children of all age groups worked the system properly. Assessment of application protocols showed, that the consumption of analgesics was significantly reduced following laparoscopic appendicectomy (P 〈 0.05). PCA is a safe and feasible method for the management of postoperative pain in children and PCA recording provides an excellent insight into the consumptional behaviour of patients, enabling staff to evaluate postoperative pain for various procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9592.1996.tb00349.x
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  • 4
    Electronic Resource
    Electronic Resource
    A computerised vector manometry study of the so-called ectopic anus (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 8-14 
    Details
    ISSN: 1437-9813
    Keywords: Key words Ectopic anus ; Anorectal malformation ; Anorectal manometry ; Eight-channel profilometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There are several totally different definitions of the so-called ectopic anus. To determine whether computerized eight-channel manometry helps to define the entity of the ectopic anus, ten patients (nine females) were operated upon for an ectopic anus by the anal transposition technique (perineal pull-through procedure). Besides the software-supported manometric data, the qualitative imaging analysis was of interest. We calculated the factor by which the pressure of the three ventrally-located segments was lower than the mean segmental pressure at this part of the anal canal. The results were compared to standard age-related values established in a former study in 100 children. Besides pre- and postoperative manometry, barium roentgenograms were obtained. The anal-canal length at rest in the ectopic anus was significantly (P 〈 0.0001) longer. The segmental asymmetry index in the lower anal canal (LAC) was increased, but not significantly. The pressure in the ventral segments of the LAC was significantly (P 〈 0.0001) decreased and was less than one-half of the mean segmental pressure in this zone. We found a significant correlation between the degree of anterior displacement and the factor by which the ventrally-located pressure values were decreased. Postoperatively, this factor increased significantly. From a functional point of view, the definition of the ectopic anus includes a deficient high-pressure zone ventrally in the LAC. The LAC seems to run out or nearly out of the ventral sphincteric issue to end ectopically on the perineal surface.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050003
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  • 5
    Electronic Resource
    Electronic Resource
    Proliferation, zonal maturation, and steroid production of fetal adrenal transplants in adrenalectomized rats (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 293-296 
    Details
    ISSN: 1437-9813
    Keywords: Key words Fetal transplantation ; Proliferation ; Adrenal glands ; Addisonian crisis ; Rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The present study investigated the histologic maturation, proliferative capacity, and steroid production of fetal adrenal transplants (Tx) in adrenalectomized rats. A pair of fetal adrenal glands (18–20 days of gestation) was transplanted into the omentum of syngeneic Lewis rats (n=45). Four weeks later, in 5 animals the grafts were excised for morphologic evaluation. Proliferation was investigated by immunohistochemical staining for KI-67 protein and quantified by the proliferation index (PI = positive cells/100 counts). All other hosts (Tx; n = 40) underwent bilateral adrenalectomy (AE) to induce Addisonian crisis. Postoperatively, survival and concentrations of potassium, sodium, aldosterone, and corticosterone were recorded for 6 months. These data were compared to controls (C = only AE; n = 30) and a sham group (S; n = 10). At the end of the study period all surviving hosts were killed for histologic examination of grafts. At 4 weeks post-Tx the adrenal grafts demonstrated a distinct zona glomerulosa and frequent proliferation with a PI of 0.084, comparable to normal control (0.092). Following AE survival was significantly prolonged in Tx (86% vs 12% of C, P 〈 0.05). Control animals developed severe hyponatremia and hyperkalemia, whereas in Tx only transient signs of Addisonian crisis were recorded. Levels of aldosterone dropped within 7 days in the Tx and C groups, but returned to normal for Tx within 8 weeks. Corticosterone levels of Tx animals fell to 25% within week, but steadily increased to 70% by the end of the study. At 6 months, grafts revealed a mature adrenocortical structure with little proliferative activity, which was comparable to controls. In a syngeneic rat model fetal adrenal transplants thus mature and proliferate to provide sufficient steroid production for adrenalectomized hosts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050747
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  • 6
    Electronic Resource
    Electronic Resource
    Fetal adrenal transplants respond to ACTH and prevent addisonian crisis in adrenalectomized rats (1998)
    Springer
    Pediatric surgery international 13 (1998), S. 271-273 
    Details
    ISSN: 1437-9813
    Keywords: Key words Fetal transplantation ; Adrenals ; Addisonian crises ; Rat ; Adrenocorticotropic hormone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The present study investigates whether fetal adrenal transplants into the omentum of adrenalectomized rats will be integrated into the recipient's endocrine system to provide competent adrenocortical function. The results demonstrate that fetal adrenals graft with a rich vascular supply, mature histologically, and produce increasing levels of corticosterone. When bilateral adrenalectomy is performed in the recipient, survival is prolonged and addisonian crisis can be prevented. Moreover, adrenocorticotrophic hormone levels decrease with increasing levels of corticosterone, indicating that the fetal grafts are integrated into the physiological pituitary-adrenocortical feedback system.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050314
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  • 7
    Electronic Resource
    Electronic Resource
    Organ-specific distribution of major histocompatibility antigens in rats (2000)
    Springer
    Pediatric surgery international 16 (2000), S. 285-292 
    Details
    ISSN: 1437-9813
    Keywords: Key words Major histocompatibility complex (MHC) ; Rat ; Immunohistochemistry ; Distribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The present study systematically investigated the expression and distribution of the major histocompatibility complex (MHC) classes I and II in the rat. About 150 native tissue probes from eight adult Lewis rats were taken, representative for most organs, tissues, and the vascular system. MHC expression was analyzed by two monoclonal antibodies (mAb) generated against the non-polymorphic determinants of rat MHC class I (Ox-18) and class II (Ox-6). Immunoreactivities were compared to those of different endothelial (HIS52, TLD-3A12, Ox-43, REHA-1 antigen), histiocytic (ED1, ED2), B-cell (RLN-9D3), and T-cell (MRC Ox-52) markers. A nonspecific mAb (MR12/53) served as a negative control. Pretested concentrations on various tissues and the alkaline phosphatase-anti-alkaline phosphatase technique allowed semiquantitative evaluation of serial cryostat tissue sections. MHC class I expression was detected on most immunocompetent cells. Endothelial cells were stained heterogeneously along the vascular system and the organ-specific microcirculation. Furthermore, some organs showed staining of parenchymal cells. MHC class II was found on all immunocompetent cells positive for the B-cell marker and about 15% of cells positive for the histiocytic markers. Besides the well-known expression of MHC class II in the outer zone of the renal proximal tubule, further organ-specific cell forms were found positive. In conclusion, the present study outlines tissue-specific distribution of MHC I/II and implies that each organ carries a variable immunologic burden that needs to be considered for any transplantation model.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003830050746
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  • 8
    Electronic Resource
    Electronic Resource
    Colostomien im Säuglings- und Kindesalter (1968)
    Springer
    Langenbeck's archives of surgery 321 (1968), S. 171-184 
    Details
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zusammenfassung In den Jahren 1946 bis 1967 wurde an der Chirurgischen Klinik der Universität Heidelberg bei 89 Kindern (55 Knaben, 34 Mädchen) ein Anus praeternaturalis angelegt. Häufigste Operationsindikation als Grundkrankheit war die Hirschsprungsche Erkrankung mit 39,3% und die Anal- und Rectumatresie mit 33,7%. 80,9% der Kinder befanden sich im Säuglingsalter, 64,0% im 1. Lebensmonat und 44,9% sogar noch innerhalb der 1. Lebenswoche. Die Lokalisation des Anus praeter hängt von der Grundkrankheit und von der beabsichtigten Art der Rückverlagerung ab. In unserem Krankengut war 45mal das Sigma, 24mal das Transversum, 2mal das Ascendens, 17mal das Coecum und 1mal das Ileum verwandt worden. Komplikationen beobachteten wir in 49,4%, sie waren größten Teils harmloser Natur und bedurften keiner Therapie. Allgemeiner Art waren es vor allem Enteritiden; lokaler Art neben leichten Hautrötungen und Erosionen Prolaps, Stenosen, Wundinfekte und Fisteln. Die Letalität als direkte Folge der Operation betrug 1,1%. Als zweckmäßigste Operationsmethode wird die modifizierte Technik vonNixon empfohlen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01439975
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  • 9
    Electronic Resource
    Electronic Resource
    Rundgespräch (1970)
    Springer
    Langenbeck's archives of surgery 327 (1970), S. 1137-1144 
    Details
    ISSN: 1435-2451
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01259205
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  • 10
    Electronic Resource
    Electronic Resource
    100. Zur Wahl des Operationsverfahrens beim Megacolon congenitum Hirschsprung aufgrund von Spätergebnissen (1980)
    Springer
    Langenbeck's archives of surgery 352 (1980), S. 339-341 
    Details
    ISSN: 1435-2451
    Keywords: Hirschsprung's disease ; Late complications ; Megacolon congenitum Hirschsprung ; Spätkomplikationen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die gravierendsten Spätkomplikationen des operierten Megacolon sind erneute Obstipation, Enkopresis, Diarrhoe sowie Enuresis. Die Wertung der üblichen Standardoperationen nach Swenson, Duhamel, Rehbein und Soave wird anhand dieser Spätkomplikationen bei rund 6000 Megacolonfällen aus der Literatur quantitativ vorgenommen. Die Operationsmethode nach Rehbein hat hierbei die wenigsten Komplikationen und ist unter diesem Gesichtspunkt als das empfehlenswerteste Verfahren der Megacolonchirurgie anzusehen.
    Notes: Summary The most common late complications after operation for Hirschsprung's disease are constipation, fecal soiling, diarrhea, and enuresis. A follow-up in the literature of about 6000 cases of congenital megacolon operated on according to the procedures of Swenson, Duhamel, Rehbein, and Soave gives the lowest rate of late complications with the Rehbem operation, the method which is therefore recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01292061
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