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Biomedical subjects

H B Eckstein

Publications and source records attributed to H B Eckstein.

At least 19 recordsLinked to original sources
PubMed1985

Congenital diaphragmatic hernia: a 20 year experience.

The records of 253 children with congenital diaphragmatic hernia admitted to The Hospital for Sick Children, Great Ormond Street, between 1961 and 1980 were analysed. The overall mortality of 37 per cent is greater than that reported in the preceding 13 years from the same institution, and showed no improvement over the 20 years. While there was no significant increase in the number of admissions over the study period, the proportion of children who underwent surgery within the first 6 h of life steadily increased from 13 per cent in the first five years to 39 per cent in the last five years. The mortality of this group (65 per cent) did not improve over the study period and this would account for the lack of improvement in the overall survival figures. However, analysis of birth weights, onset and severity of signs and lung weights indicates that the increasing number of early admissions was due to speedier transfer rather than to referral of more severely affected children in the later years.

Child↗
PubMed1984

Epididymal abnormalities associated with maldescent of the testis.

A prospective series of 118 consecutive patients admitted for exploration of the groin is reviewed. Seven patients were excluded from the study; the remaining 111 patients had among them a total of 132 maldescended testes. These were classified as either truly undescended testes associated with a complete hernial sac, undescended testes with no hernial sac, or ectopic testes. All testes were examined at operation and the incidence of associated epididymal abnormalities was noted. Four main types of epididymal abnormality are described and a classification is suggested. These abnormalities may contribute to impaired fertility despite orchidopexy, particularly in the group of patients with truly undescended testes associated with a hernial sac where the incidence of epididymal abnormalities was high (75%) compared with an incidence of 20% in the other two groups.

Adolescent↗
PubMed1984

Ileal conduit urinary diversion in children. A long term follow-up.

In recent years ileal conduit diversion for children with neuropathic bladders secondary to myelomeningocele has been performed less frequently than previously, mainly because of reports of long term upper tract deterioration in these patients. The results of this series of 144 ileal conduit urinary diversions show that in the 85 children diverted for more than ten years, there has been improvement or preservation of their upper tracts in 80%. This compares favourably with the results of a recently reported series of colonic conduit diversions and consequently we feel that there is still a place for ileal conduit diversion in this group of patients. The early and late complications are described and means of minimising these are discussed.

Adolescent↗
PubMed1983

Intussusception in infancy and childhood. A 13-year review of 75 patients.

Our experience of intussusception in 75 patients has been reviewed. The average duration of symptoms from onset to diagnosis was 40 hours. Barium enema was performed in 34 patients and in only six was the intussusception reduced successfully by hydrostatic pressure. Seventy-one laparotomies were performed with no mortality. Resection was carried out in seven patients for gangrenous bowel or presence of a leading point. The main complication was that of wound infection which occurred in eight patients. Incidental appendicectomy was safe and did not increase the complication rate.

Age Factors↗
PubMed1982

Cranio-spinal fasciitis in infancy.

Two infants with very large, rapidly growing vascular tumours of the back are presented, one in the occipital region and one in region of the lumbo sacral spine. In both, malignant soft tissue tumours were diagnosed on clinical grounds. Histological examination of both tumours showed them to be benign and the difficulty of histopathological assessment is discussed. Both tumours were totally excised, with difficulty, and the follow-up studies confirm the benign nature of the tumours.

Carotid Arteries↗
PubMed1982

Congenital hypertrophic pyloric stenosis--a 20-year review of 282 surgically treated infants.

A series of 282 children subjected to pyloromyotomy for congenital hypertrophic pyloric stenosis seen in the years 1961--1980 is presented. The various features relating to presentation, diagnosis and treatment are compared and contrasted in those treated in the first decade, 1961--1970 (series A) with those treated in the second decade, 1971--1980 (series B). It is noteworthy that there was an increased demand for radiological investigation in the second decade, and the fact that the number of patients diagnosed by radiological means only has doubled (from 9% to 19%) in the two series is probably a reflection of medical training and attitude. There was a marked decrease in the amount of post-operative vomiting during the second decade of this study and there was a slight tendency to earlier discharge from hospital in the latter years. The series confirms that congenital hypertrophic pyloric stenosis treated by pyloromyotomy has no mortality and only a minimal morbidity.

Female↗
PubMed1982

Pelviureteric obstruction in infancy and childhood. A review of 117 patients.

A series of 135 kidneys with pelviureteric obstruction in 117 children is reviewed (a 16% incidence of bilateral obstruction). The majority (89%) of pyeloplasties or other reconstructive procedures were performed via an anterior transperitoneal approach which afforded excellent surgical exposure with a low (4%) incidence of related post-operative complications. Extra-renal drainage alone was preferred to nephrostomy in the majority of patients. Children presenting with bilateral hydronephrosis were managed by a single, simultaneous bilateral procedure rather than by 2 operations. The total nephrectomy rate of 5% compares favourably with the results reported by authors who favour an extraperitoneal approach and routine nephrostomy drainage.

Child↗
PubMed1981

Renal scintigraphy: quantitative assessment of upper urinary tract dilatation in children.

A standard method of Tc-DTPA renal scintigraphy has been used to examine 426 dilated upper urinary tracts in children aged 2 days-16 yr. The method provides an accurate estimate of individual kidney function and defines the extent of dilatation. Renogram analysis and frusemide-induced diuresis have been applied in an attempt to distinguish between the obstructed upper tract and the dilated upper tract without obstruction. In 304 upper tracts, obstruction was predicted with an overall sensitivity of 0.87. The sensitivity for diagnosis of pelviureteric junction obstruction was 0.93. The value of scintigraphy in excluding significant obstruction and in follow-up studies is emphasized. This is a noninvasive, low-radiation investigation which plays an important role in the assessment of obstructive uropathy in childhood and represents a major advance in diagnostic facilities.

Adolescent↗
PubMed1981

Surgical correction of torsion of the penis.

Torsion of the penis is a rare anomaly, believed to be due to abnormal skin attachment and not to any structural abnormality of the corpora. The rotation is usually to the left in a counter-clockwise fashion. The urethral meatus is placed in a oblique position and the median raphe makes a spiral curve from the base of the penis towards the meatus. Three boys with congenital torsion of the penis are reported. A corrective operative for this condition is described. Penile torsion was first described by Verneuil in 1857, but in the past no operative correction was recommended, since attempts to move the skin around were believed not to correct the spiral alignment of the corpora cavernosa.

Child↗
PubMed1980

Colonic stricture following necrotizing enterocolitis.

There has been a steady increase in the incidence of necrotizing enterocolitis (N.E.C.). Early diagnosis and prompt surgical intervention have improved the mortality considerably (8). With the increasing number of survivors, late complications are more frequently encountered. Three neonates who had developed strictures of the colon 3, 4 and 6 weeks respectively, after the onset of the acute episode of N.E.C. are reported and showed interesting features, an extensive long stricture and a tight short stricture which simulates a colonic atresia.

Colonic Diseases↗
PubMed1979

Postoperative death in paediatric urology.

In the combined experience of two paediatric urologists over a 25 year period only 4 fatalities relating directly to the surgical procedure could be identified. Two other deaths are presented and retrospectively most of the fatalities could have been avoided by present day management but not at the time they occured. Operative mortality in relation to paediatric urology is discussed fully and it is suggested that death related to the immediate surgery should be fully avoidable in relation to paediatric urology. Death from renal failure is a different problem and is unrelated to this paper.

Child, Preschool↗
PubMed1979

Intermittent Catheterisation of the bladder in patients with neuropathic incontinence of urine.

60 patients with neuropathic bladder are presented in whom intermittent catheterisation was attempted as a form of therapy for incontinence over an 18 months period. The treatment was successful in 70% of the patients who presented essentially in an unselected group. It is recommended that this type of treatment is eminently satisfactory for many forms of neuropathic incontinence of urine and patients should be screened and selected for their suitability for such treatment.

Adolescent↗
PubMed1978

Hydronephrosis secondary to ureteropelvic obstruction in children: a review of 14 years of experience.

The clinical presentation and surgical management of 88 children and infants with hydronephrosis secondary to ureteropelvic obstruction are reported. The importance of recognizing associated anomalies of the genitourinary tract is stressed and the advantages of an anterior transperitoneal surgical approach are discussed. The operative technique and drainage procedure varied according to the nature and severity of the abnormality but the dismembered pyeloplasty with extrarenal drainage is favored.

Child↗