[Trauma-induced diabetes insipidus].
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Adolescent↗
Biomedical subjects
J Kühr
Publications and source records attributed to J Kühr.
[The appendix stump insufficiency. Clinical appearance forms and treatment].
Early manifestation of insufficiency of the appendiceal stump appearing as a diffuse peritonitis with a septicemic general state has led to the death of 6 of 10 patients treated here. One has to suppose that these complications have additional unknown causes. Insufficiency of the stump, with or without necrosis of the cecum, can only be discovered with active procedures and than treated in the appropriate way. Each of these patients has been lost when there has been no courage for reintervention or even an excuse for providing intensive medical treatment with respiration aid and hemodialysis. As a rule, the fecal fistula appears during postoperative days 5-8 without diffuse peritonitis and should be treated in a conservative way; spontaneous fading away should be expected and operative occlusion should not be started before a 3 month interval.
Appendectomy↗
[Surgical management of liver trauma (author's transl)].
Surgical management and follow up of 85 patients with liver trauma are reported. 20 patients had only liver trauma, all others were polytraumatised. Letality was 20% in patients with sole liver trauma, the overall letality was 43%. In most cases death resulted from prolonged circulatory shock. Most of the other casualities resulted from septical complications of biliary peritonitis. Prognosis was mainly correlated with the interval between trauma and surgical treatment as well as with the amount of blood lost. The main features of the operative technic were access to the liver through a subcostal and sometimes transdiaphragmal incision, temporary tamponade of the bleeding source, compression of the hepatoduodenal ligament, of the vena cava (intrapericardial) to minimize blood loss. Instead of hemihepatectomy, resection of liver tissue was limited to the smallest amount possible, and followed by extensive drainage.
Abdominal Injuries↗
[Corrosive lesions of the upper intestinal tract in gastrectomized patients (author's transl)].
Lesions of the upper gastrointestinal tract caused by acid or alkaline solutions are generally limited to the esophagus and the stomach, because of physiological blocking mechanisms. In patients partially gastrectomized noxious solutions however can enter into lower parts of the gastrointestinal tract and cause severe lesions. Among 74 patients observed with corrosive lesions of the gastrointestinal tract two had undergone partial gastrectomy (Billroth II) previously. In these 2 patients very severe lesions of the intestinal mucosa were initiated; one of these patients died in spite of two resections of parts of the small intestine after massive gastrointestinal hemorrhage. These additional complications have to be foreseen in gastrectomized patients with corrosive lesions of the gastrointestinal tract.
Adult↗
[The radiological appearances of caustic burns in the upper intestinal tract (author's transl)].
Seventy-three caustic burns of the upper gastrointestinal tract were divided into early and late effects; the radiological findings were analysed and, as far as possible, compared with the endoscopic results. The central role of radiology proved to be indisputable, particularly for the demonstration of a perforation, for the control of treatment by drugs or dilatation and before surgery. Endoscopy is of particular value in the diagnosis of caustic burns if the radiological findings are negative, for following treatment and for clarifying atypical late changes in order to exclude malignant degeneration.
Adolescent↗
[Endoscopic features of the incipient late stage of acid-induced corrosive burn of the stomach (author's transl)].
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Adolescent↗
[Characteristics of a target population for preventing house-dust mite allergy in toddlers].
AIM: To evaluate a recruitment strategy to identify high risk toddlers for a programme of prevention of allergy. For screening, parents were asked to participate in our study by information form and screening questionnaire on the occasion of routine check-up visits of toddlers scheduled between 20 and 48 months of age in four paediatric practices. As a next step, readiness of parents for implementation of preventive measures was confirmed. METHOD: Inclusion criteria were age between 20 and 48 months and a positive atopic family history (evaluated by 5 questions regarding asthma, allergic rhino-conjunctivitis and atopic dermatitis) of parents or siblings. This was confirmed by sensitization to an environmental allergen (skin prick test (SPT)) in at least one parent. If these inclusion criteria were fulfilled, the toddlers were randomly allocated to the intervention and control group of the prevention programme. RESULTS: 111 of 175 screening questionnaires (63.4 %) were returned. In 76.6 % (n = 85) of these 111 questionnaires a positive atopic family history (mother, father, sibling) was noted. All inclusion criteria were fulfilled by only 43 toddlers (age: median 33.6 months, 5-95 % quantile: 21.6-48 months). Based on the positive screening questionnaire, history of atopy was confirmed by positive SPT in 70.0 % of fathers and 77.8 % of mothers. Despite a negative screening questionnaire, history of atopy was detected by a positive SPT in 11.1 % of mothers and 47.4 % of fathers. Detection of specific IgE against house-dust mite in 9 of 18 serum samples revealed the risk for allergy of the toddlers. A re-evaluation after three months showed that all the elements of the prevention programme as well as the recommendations for the control group had been almost completely accepted by all the families concerned practically without any reservations. CONCLUSION: The recruitment of toddlers with high risk for developing allergy turned out well and could be validated. The prevention programme was readily accepted by the families and thus can be used for a larger study.
Antigens, Dermatophagoides↗
[Respiratory symptoms in children with low birth weight with or without perinatal respiratory insufficiency].
We recorded prevalence of respiratory symptoms in 104 school children aged eight years (+/- 0.4 years) who were born with a weight below 2500 grams. Perinatal respiratory insufficiency (PRI) was observed in 18 children. Validation by medical records in 14 cases demonstrated that 7 children had been oxygen dependent over 1-5 days after birth, the other 7 children had required mechanical ventilation from 2 days up to 4 month. Children with a history of PRI did not suffer more frequently from "cough after exercise" (17%), "wheezing" (50%) or "frequent cough" (11%) than healthy children of low birthweight. Corresponding values were 26%, 38%, and 18% respectively. Multiple logistic regression analyses confirmed these observations. In children with a low birthweight PRI is not associated with respiratory symptoms at school age.
Anthropometry↗