PubMed Health⌕ Search

Biomedical subjects

J Wit

Publications and source records attributed to J Wit.

At least 19 recordsLinked to original sources
PubMed2007

[Emergency ward management of traumatic head injury in children].

BACKGROUND: The controversial situation relating to assessment and management of the traumatic head injury (THI) in children inspired us to study our own patient pool. The aims were to find a significant correlation between skull fracture or clinical symptom and intracranial lesion as well as to determine the importance of each radiological diagnostic method in the initial management of the pediatric THI. PATIENTS AND METHODS: In 1 year 1,637 children had been treated in the emergency room of pediatric surgery with the diagnosis of THI. Age, sex, injury pattern, symptoms, radiological diagnostic methods, diagnosis, and clinical follow-up had been registered. RESULTS: A significant correlation between skull fracture or clinical symptom and the intracranial injury in children could not be found, but risk factors exist. Cranial computed tomography is the imaging method of choice. X-ray, ultrasound, and MRI of the head are reserved for a few indications. CONCLUSION: A management plan for pediatric head and brain injury in the emergency room based on our own and published international results is introduced.

Adolescent↗
PubMed2003

[A rare location for extratruncular vascular malformation].

We report on an undefined tumor of the right ulnar side of the elbow in a 15-year-old boy. The clinical examination showed painful swelling in the area of the ulnar nerve at the right elbow as well as sensory and motor deficits of the right hand corresponding to distribution of the ulnar nerve. Ultrasound examination and magnetic resonance imaging showed a tumor along the nerve. Subsequent surgical therapy included tumor decompression by division of the fascia. The histological examination demonstrated a capillary hemangioma that infiltrated the ulnar nerve.After surgery, oral glucocorticoid therapy with cortisone (5 mg/kg per day) was administered over a period of 4 weeks, alternating between 1 week of therapy and 1 week without medication. The result of this combined therapy was a rapid diminution of the tumor and an almost complete restitution of the neural function.

Adolescent↗
PubMed2002

Rare mesenchymal lesions: Hamartoma of the chest wall and juvenile active ossifying fibroma in siblings.

Mesenchymal hamartomas of the thorax are known as rare dysontogenetic tumorous non-neoplastic lesions. The juvenile active ossifying fibroma (JAOF) also is considered as a benign tumor like lesion of the mesenchymal connective tissue. The authors report the cases of 2 siblings-a 2-year-old girl with a hamartoma of the chest wall and her 4-year-old brother with a JAOF. The girl had bilocular mesenchymal hamartoma in the area of the 8(th) rib diagnosed in the first year of life, which was surgically removed completely. Her brother had been treated for JAOF of the right nasal sinus area diagnosed at the age of 15 months. Both lesions are extremely rare mutations of the local tissue, which occur typically in early childhood and continue benignly after surgical resection, but such a familial occurrence in siblings has not yet been reported. Furthermore, according to the histologic findings, the JAOF also could be seen as a hamartomatous lesion.

Bone Neoplasms↗
PubMed2000

[Is the Bishop-Koop anastomosis in treatment of neonatal ileus still current?].

Fourty-three cases of ileus in newborns are presented. Twenty-seven newborns received a Bishop-Koop anastomosis. In 19 cases, the Bishop-Koop anastomosis was performed primarily and in 8 cases as a second intervention. We consider the Bishop-Koop anastomosis to be a safer procedure than primary end-to-end or end-to-side anastomosis. Only one anastomotic leak occurred in our patients. We prefer the Bishop-Koop anastomosis not only in cases of meconium ileus, but also in other types of intestinal atresia and stenosis, especially for the management of greatly different intestinal diameters. In our experience, this method is also suitable for re-anastomosing a double-barrel anastomosis. The Bishop-Koop procedure minimizes the risks of primary anastomosis without enterostoma, and later extraperitoneal closure of the stoma is easy and safe.

Anastomosis, Surgical↗
PubMed2000

Ultrasonographic late results after surgically treated cryptorchidism.

BACKGROUND: Because uncorrected cryptorchidism is accompanied by the high risk of later disturbed testicular function and cancer, early surgery in the second year of life is recommended. OBJECTIVE: To evaluate testicular morphology, the sonomorphologic testicular long-term outcome and additional complications, as well as possible differences depending on varying ages at surgery. MATERIALS AND METHODS: Seventy-five previously maldescended testes in 68 boys were studied with US, 2-11 years after intrascrotal orchidopexy. Nineteen had been operated on in the first or second year of life, while the other 49 boys underwent surgery at a later age (up to 7 years). Each examination utilised conventional B-mode and colour Doppler (7-MHz linear ART probe, Acuson XP 128) to examine the scrotal and inguinal regions on both sides; testicular volume and perfusion were assessed. Ultrasound changes in testicular volume, architecture and Doppler flow rates were regarded as the most valid indirect indices of testicular damage. Histopathological correlation was not obtained, for ethical reasons, in any of the probands. RESULTS: Thirty-five of the surgically fixed testes were normal with regard to position, volume, structure and perfusion. The other 40 (53%) showed abnormalities of one or more of these parameters without any correlation with the patient's age at surgery or the time interval between surgery and US. Additional relevant findings, which were also found on the non-operated side, were: microlithiasis (n = 6), inguinally retained testis (n = 6), hydrocoele (n = 5), hydatid (n = 5) and varicocoele (n = 1). CONCLUSIONS: Ultrasound, including colour Doppler, enables an exact morphological analysis of the late results after surgically corrected cryptorchidism. The spectrum of findings does not show any correlation with the time of surgery. Thus, the value of even early surgery has to be questioned. Pre-existent primary damage (dysplasia) seems more important for long-term outcome of the testis. Additionally, US was of high value in demonstrating additional unexpected anomalies, the majority of which needed sonographic follow-up or even surgery.

Child↗
PubMed2000

Growth and neurodevelopmental outcome of very low birthweight infants with necrotizing enterocolitis.

UNLABELLED: The aim of the study was to assess the effect of necrotizing enterocolitis (NEC) on neurodevelopmental outcome and growth. Neurodevelopmental outcome of 20 out of 22 suriviving very low birthweight infants (VLBW) diagnosed with NEC between 1992 and 1996 was compared with 40 control infants matched for gestational age and year of admission. Follow-up studies were performed at 12 and 20 mo of corrected age. The German revision of the Griffiths' scales was used for development assessment. Neurodevelopment was significantly delayed in infants with NEC at 12 mo (median general developmental quotient: 90.0 vs 97.8; p = 0.04) and 20 mo (86.4 vs 97.7; p = 0.004) of age. Somatic growth did not differ between infants with and without NEC. Fifty-five percent of infants suffering from NEC but only 22.5% of the infants without NEC were severely retarded (developmental quotient < -2 SD of a control group of healthy newborns) at 20 mo of corrected age. CONCLUSION: Preterm infants developing NEC are at risk for neurodevelopmental impairment and need close neurodevelopmental follow-up for the first years of life.

Developmental Disabilities↗
PubMed1999

Validity of height velocity as a diagnostic criterion for idiopathic growth hormone deficiency and Turner syndrome.

A deflecting growth curve over several years is sometimes the only indication for the possible presence of a growth disorder. In this study we looked at the potential diagnostic role of long-term downward deflection of the growth curve. It reports on the diagnostic validity of height velocity over 1, 2 or 3 years for isolated idiopathic growth hormone deficiency and for Turner syndrome in prepubertal children with a height that is still above -2.5 standard deviation scores (SDS). 1-year height velocity was found to have no diagnostic value because of an almost complete overlap of height velocity distributions with normal prepubertal children. However, height velocity over 3 years was found to have an acceptable validity in children 5-12 years old. In this age range a change in height SDS of -0.75 can be used as a valid criterion for further examination of karyotype and GH secretion capacity even if there are no other clear signs of a particular growth disorder.

Body Height↗
PubMed1998

Multisystem organ failure and capillary leak syndrome in severe necrotizing enterocolitis of very low birth weight infants.

BACKGROUND: Classification systems for necrotizing enterocolitis (NEC) in preterm infants have been developed to define severity grades relevant for treatment and prognosis. Multisystem organ failure (MSOF) and capillary leak syndrome (CLS) also have prognostic value in these patients. The aim of this retrospective study was to investigate the incidence and predictive value of MSOF and CLS according to the classification criteria. METHODS: The records of 1,022 very low birth weight infants admitted from 1982 to 1996 were reviewed for diagnosis of NEC stage IIA or higher (classification of Walsh and Kliegman). Among those patients (n = 50) the incidence of MSOF and CLS was determined, separately for surgical or conservative treatment. RESULTS: Twelve patients were assigned to stage II, 22 to stage IIIa, and 16 to stage IIIb; 31 infants underwent operation. Mortality rate was not influenced by the grade. In eight patients only gastrointestinal symptoms were found, whereas in 23 patients, up to three organ systems and in 19 patients, four or more organ systems were affected. Mortality depended on the number of involved organ systems. CLS occurred postoperatively in 10 of the 31 infants; eight of them died. CONCLUSION: The prognostic values of MSOF and CLS are higher than that of classification criteria in NEC of VLBW infants.

Capillary Leak Syndrome↗
PubMed1998

[Value of ultrasound in diagnosis of appendicitis in childhood].

Ultrasonography has been shown to be valuable in diagnosis of appendicitis in children. For the management of cases where clinical and ultrasonography findings lead to different results, we evaluated standard therapeutical concepts which have been proved to be reliable in our clinic.

Acute Disease↗
PubMed1998

[Pro and contra laparoscopic appendectomy in childhood].

The question should be cleared, if and to what extent the indication for appendectomy has changed since the beginning of the minimal invasive surgery in childhood. At first we had the chance to compare two patient groups in the different locations of the clinic for paediatric surgery in the Humboldt-University before their consolidation, because the indication for laparoscopic appendectomy was differently decided. The analysis of these two patient collectives (more than 50 children each) showed, beside the well known different preoperative parameters (age, sex allotment and anamnesis) the distinct indications finding for the minimal invasive procedure. In one group even the acute inflammatory appendicitis was excluded from the laparoscopic technique, in the other group only the sonographic proved perityphlitic abscess was excluded. In this group--corresponding to the more generous indication--there were more wound healing complications after phlegmonous and gangrenous appendicitis--even a little more (0.4%) than in a compared conventional operated collective. Cause of this reason the indication for the laparoscopic technique was defined more rigid (excluding the acute inflammatory disease), to get a high quality standard. The following 350 children after having appendektomy were analysed in the from now on merget locations under special consideration of postoperative complications. Including 54 laparoscopic procedures we saw significant less complications and registered a better average outcome including living quality criteria.

Adolescent↗
PubMed1996

Neuroectodermal cyst may be a rare differential diagnosis of fetal sacrococcygeal teratoma: first case report of a prenatally observed neuroectodermal cyst.

In spite of the fact that most anomalies can be accurately diagnosed prenatally, one may be confronted with an extremely rare fetal abnormality that has never been described before. We report a case of a neuroectodermal cyst arising from the posterior neuropore. After 21 weeks of gestation a fetal anechoic intra- and extra-abdominal tumor was detected. The mass grew to 75 x 41 x 33 mm at 35 weeks. Initially it was believed to be a sacrococcygeal teratoma. Serial scans and Doppler ultrasound examinations were performed, which demonstrated fetal well-being. Color Doppler imaging failed to demonstrate increased tumoral perfusion. After elective Cesarean section, the tumor was excised. The postoperative course was complicated by recurrent infections of the urinary tract due to neurological damage to the bladder. There was also impaired function of the anal sphincter. The histological finding of a monolayer of neuroepithelial cells and melanocytes led to the diagnosis of a neuroectodermal cyst.

Adult↗
PubMed1994

Traumatic versus perinatally acquired dysarthria: assessment by means of speech-like maximum performance tasks.

The performance of two children with traumatic spastic dysarthria, aged 10 and 14 years, on maximum performance tasks was compared with that of two closely matched children with perinatal spastic dysarthria, and reference groups of five children with perinatal spastic dysarthria and five control children with normal speech. Results showed that performance of the perinatal spastic children on all three tasks was poorer than that of their peers with normal speech. In contrast, the traumatic spastic children performed within the normal limits on maximum sound prolongation and fundamental frequency range, but their maximum repetition rate was extremely slow. The overall low performance of the perinatal spastic children could be the result of inadequate motor development in addition to the neurological impairment. The traumatic spastic children--with a normal developmental history--compensated for their impairment by slowing down their speech rate. Therapeutic implications are suggested.

Adolescent↗
PubMed1993

Maximum performance tests in children with developmental spastic dysarthria.

Three noninvasive Maximum Performance Tasks (MPT)--Maximum Sound Prolongation (MSP), Fundamental Frequency Range (FFR), and Maximum Repetition Rate (MRR)--were administered to 11 children with spastic dysarthria due to cerebral palsy and to 11 control children with normal speech in order to determine the value of the tasks for differentiating between these groups of children. From the acoustic measurements, nine parameters were calculated, and in seven of them highly significant group differences were found. By adding the unweighted z-scores of four parameters (maximum sound prolongation, syllable duration, fundamental frequency range, inter-utterance variability of syllable duration), a composite z-score was constructed with nonoverlapping distributions for both groups. The authors conclude that maximum performance tasks, despite the large intrasubject and intersubject variability in both normal and pathological speakers, are powerful tools for detecting spastic dysarthria.

Age Factors↗
PubMed1990

Experimental studies on caustic burns of the stomach by aggressive chemicals.

The treatment of caustic burns of the stomach in childhood by acids, alkalis and especially soldering fluids has remained without any clear concept so far. Surgical treatment consists of therapy of acute complications or late sequelae. Early endoscopy enables one to decide between conservative treatment and early laparotomy. Animal experiments were performed in albino rats for the development of a therapeutic concept. Because of its amphoteric and aggressive nature, soldering fluid zinc dissolved in 33-50 M saline) was used as the caustic substance. Clear demarcation and tissue changes can be recognized after 6-8 h, at the earliest. Laparotomy aiming at protective plication or atypical gastric resection should be performed at that time, if endoscopy reveals a third-degree caustic burn of the stomach.

Animals↗