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Biomedical subjects

R Daum

Publications and source records attributed to R Daum.

At least 19 recordsLinked to original sources
PubMed1992

[Morphometric analysis of the vascular tree of fetal tubular bones in an experimental model].

The area of interest for the longitudinal growth is the distal growth plate. In a postmortem study we were interested in changes of the epiphyseal vascular length density after fracture and surgical therapy of foetal and neonatal femora (25th to 40th post conceptional weeks). We formed three groups of equal size. Group A (25 femora) was the control group. In group B and C we performed fractures in the middle third of the femora, in group C the femora was operated with a plate afterwards. A microangiography of all femora occurred and after plastination transparent slices were produced. In this manner we could study the epiphyseal vessels in the growth plate. Using image analyses we could show that vascular density of the epiphyseal growth plate could be verified only through fracture but not by surgical therapy. The integrity of the distal epiphyseal vascular architecture is the aim after all.

Arteries↗
PubMed1992

Does lateral bending lead to bowing fracture in an infantile lower arm?

In a postmortem study on 50 lower arms of fetuses of the 25th week of gestation and newborn we performed three-point bending experiments to find out the stability of the lower arm after bending to the resulting fracture. Lower arms with intact soft tissue show an elastic behavior when bent from the side until fracture occurs. Applying the loading deflection diagrams we could classify the fractures into three types which differ significantly by means of bending moment, maximal deflection per unit length, and force required.

Biomechanical Phenomena↗
PubMed1991

Rare ovarian tumors in childhood.

Between 1972 and 1990 44 patients with ovarian tumors were treated at the Department of Pediatric Surgery of the University of Heidelberg. 27 patients (61%) suffered from tumor-like lesions: neonatal, pubertal (functional) cysts, and cysts in case of syndromes. 17 genuine tumors were found (39%): 8 germ-cell tumors, 7 cystomas respectively cystadenomas and 2 tumors of the gonadal stroma. Malignancy has been observed only in two cases: 1 malignant teratoma and 1 malignant granulosa-theca-cell tumor. 2 tumor-like lesions were caused by syndromes: Albright-McCune-Sternberg- and Stein-Leventhal syndrome: Treatment of uncommon tumors depends on their size, hormonal activity, on the syndromes with which they are associated, and on the tumor status.

Child↗
PubMed1991

[Familial colonic polyposis and malignant transformation: preventive colectomy in childhood?].

Familial polyposis coli is a classical premalignant disease. Malignancy has been observed as early as the 2nd decade of life. The probability of the development of colorectal cancer rises with age. The problem of prophylactic colectomy in childhood and adolescence is discussed using the example of two sisters whose father died of colorectal cancer at the age of 32.

Adenomatous Polyposis Coli↗
PubMed1991

[The acute abdomen in the neonatal period].

Over a period of 22 years 91 cases of perforation or rupture of the intestinal tract were observed. Necrotising enterocolitis was most frequent (45%) followed by ruptures of congenital atresias of the intestinal tract (32%). In the first 11 years the mortality rate was 50%, in the following second period 25%. Infant birth weight registered in the first period was over 3000 g in 26% of the babies, in the second period in 11.5%. Whereas no child weighing less then 1000 g was admitted to hospital in the first period, 14% of those admitted in the second period did.

Abdomen, Acute↗
PubMed1990

[Tumors of the ribs in children].

We here present a review of ten pediatric patients with rib tumors that were treated in our hospital since 1970: a juvenile bone cyst, an aneurysmal bone cyst, an eosinophilic granuloma, a Ewing sarcoma, a metastasis of a neuroblastoma, an osteochondroma, a hemangiopericytoma, and a callous tumor at the site of a previous single rib fracture. The relative frequency of rib tumors is similar to that of bone tumors in other locations. A biopsy of the affected bone should be the first step of the operative intervention. As demonstrated in a case of eosinophilic granuloma, the indication for subperiosteal rib resection can be defined generously. A completed regrowth of the rib defect can be expected. Even the loss of a complete rib is generally well tolerated, as shown in an infant with an aneurysmal bone cyst, a rare disease in this age group. Malignant tumors of the chest wall, however, require special experience in thoracic surgery and necessitate close interdisciplinary cooperation. Complete primary resection of a malignant rib tumor and its plastic reconstruction is demonstrated in a case of a Ewing sarcoma in childhood. In children and adolescents a vicryl net should generally be used to reconstruct extended chest wall defects reliably and functionally stable.

Bone Cysts↗
PubMed1990

[Life style and quality of life of children and adolescents following malignant tumor disease].

Psychosocial support after the diagnosis of childhood cancer is absolutely necessary to help not only the patients but also the parents, family members, and friends to deal effectively with the emotion and social problems arising from the disease. Psychological support for the whole family, rooming-in facilities on the ward, parent-self-help-groups, social and financial helps reduce problems which flow from such a diagnosis and may develop a positive coping strategy. Experiences over a long period of psychosocial aftercare in the University Hospital of Heidelberg are analyzed and some scientific data of this model are reported.

Adaptation, Psychological↗
PubMed1989

Motility malfunction of the gastrointestinal tract by rare diseases--fibrosis of the intestinal wall.

We report on two children who were admitted with chronic ileus without mechanical obstruction. In the 4-month-old female newborn, high-dose radiation was applied after extirpation of a sympathicoblastoma. Within a few years a metaplasia of the muscle coat of the small intestine developed with a resulting malabsorption syndrome. Although the damaged part of the intestine was resected, the process progressed and the child died. In the second case, a chronic ileus developed at the age of 10 years as a result of fibrosis of the intestinal tract. Repeated laparotomies were performed, and no mechanical obstruction could be found. The most probable diagnosis is a form of scleroderma affecting mainly the alimentary tract without any skin involvement. The patient died in a severe cachexia.

Child↗
PubMed1989

Three years' experience with large ovarian cysts diagnosed in utero.

Thirteen fetuses with abdominal cystic tumors were diagnosed by routine prenatal ultrasonography between the 28th and 36th week of gestation. Postnatal ultrasonography of the full-term newborns confirmed the findings. Laparotomies were performed in all cases except one. Patients who were operated on had large ovarian pseudocysts with volumes between 24 and 120 cc. In seven patients (54%), the cysts arose from the left ovary; this included four cases in which the postnatal ultrasound was interpreted as showing the cysts in the right abdomen. Very thin cystic walls threatening perforation were found in 91%. In 33%, we found salpingotorsion on the affected side. Small contralateral ovarian cysts were found in 66% of the patients. One infant required resection of 30 cm of necrotic jejunum because adhesions to the cyst had caused bowel volvulus. Histology of the cysts showed hemorrhage and calcifications, but ovarian stroma was absent in all but one patient. Serum estradiol-17 beta, progesterone follicle-stimulating hormone, and luteinizing hormone were normal in all cases, and similar levels were found in the cyst fluid. These results show that large abdominal cystic masses in full-term infant girls with normal gonadotrophin levels and normal serum estradiol-17 beta and progesterone levels are very likely to require surgery; this is in contrast to preterm neonates with elevated gonadotrophins who can be treated with medroxyprogesterone acetate in the absence of clinical signs necessitating surgery.

Female↗
PubMed1989

Wilms--a man, a syndrome.

A biography is presented in commemoration of the 70th anniversary of the death of Max Wilms, whose name is almost exclusively known in association with the mixed tissue tumours of the kidney. Describing his curriculum vitae, we intended to place particular emphasis on the significance of his surgical work at the University of Heidelberg.

Child↗
PubMed1989

[Diagnosis and therapy of chronic rupture of the fibular ligament in children].

74 children with ruptures of lateral ligaments of the ankle were treated surgically between 1979 to 1986. In ten cases we found chronical ligament changes. In these cases periostal flap modified after Kuner was performed. The follow up of our patients showed good results in all, thus we could show that the periostal flap was effective. As the functional conservative ligament rupture therapy increases the periostal flap plastic in the case of children with chronical ligament changes is indicated.

Ankle Injuries↗
PubMed1989

[Severe injuries of the cervical spine in childhood, an interdisciplinary consideration].

Since 1976 in the department of pediatric surgery in Heidelberg we treated five fractures of the cervical spine with luxation, three patients demonstrated a high spinal lesion with tetraplegia. During the past five years eight subluxations were hospitalised. In this paper we relate the various injury mechanisms and fracture forms; especially the typical lesions of the altanto-axial region are discussed. The importance of modern imaging techniques, including NMR, as well as the age- and situation-dependent therapy are detailed. Based on a case report on a four year old boy with upper cervical spine lesion and tetraplegia medical nursing and logistic problems are discussed. Incentives of intensive care albeit limited, in pediatric surgical and pediatric anaesthesiological departments, not specialised in the management of tetraplegia, are pointed out.

Cervical Vertebrae↗
PubMed1988

[Disorders of vascularization following fracture of the ankle joint in children].

In the Department of Paediatric Surgery of the University of the Heidelberg, 64 children were admitted during five years to the hospital after an ankle fracture. 12 children showed a typical fracture of the growth plate (v. Laer). All 12 were not older than 12 years. The problem of this typical form of fracture is that even careful accurate treatment may be followed by growth problems of the tibial malleolus. A microangiographic postmortem study using plastinated shetts (v. Hagens) showed a normal distribution of vascularity of the ankle joint. The vascular damage after fracture and the damage of the local vascularity in the area at the growth plate after surgical treatment are comparable.

Ankle Injuries↗
PubMed1988

[Surgical protocol and intraoperative considerations in interventions on the testis].

The surgical treatment of incompletely descended of the testes depends on the type of the undescended testis, the age of the patient, and the time of treatment. In a few years' time new techniques of autotransplantation may solve the problem of repositioning the testes in the scrotum. Exact knowledge of possible malformation of the testes and epididymis is essential for the paediatric surgeon. Torsion of one testicle with possible autoimmune impact involving the healthy testicle requires immediate exploratory surgery and treatment according to age. Paediatric carcinoma of the testes is rather rare, whereas treatment and prognosis vary with the histological type. Accurate classification and cooperation with a centre for paediatric oncology are essential.

Adolescent↗
PubMed1988

[Follicular ileitis (Golden syndrome). Apropos of 2 cases].

We report on two cases with the seldom diagnosis of papillary lymphoid hyperplasia. In both cases the children were boys in the primary school age. The admission was performed due to rectal bleeding, abdominal colics and vomiting. Intraoperatively we found papillary changes in the terminal ileum. Suggestions to intra-operative management and literature comparison are given in this study.

Child↗
PubMed1987

Tumour-induced intraluminal stenoses of the cervical trachea--tumour excision and tracheoplasty.

Three children with stenoses of the cervical trachea caused by tumours are reported on. The first was a 13-year-old girl with a sarcoma of the tracheal wall 20 cm down. We performed partial resection of the trachea and turned a skin flap according to Denecke into the defect. In the second case a capillary haemangioma had caused severe stenosis, requiring resection of the tumour together with the tracheal mucosa. A haemangioma had caused tracheal stenosis in the third case, too; in this child partial tracheal resection and skin flap plasty were performed. The postoperative course was uneventful in all three children. So far, there is no recurrence of the sarcoma 4 1/2 years after operation.

Adolescent↗
PubMed1987

[Ovarian pseudocysts in female newborn infants: prenatal ultrasonic diagnosis and surgical consequences].

During the last year we diagnosed within the scope of preventive medical care of pregnant women in about the 30th pregnancy week, seven foetuses with abdominal cystic tumours by ultrasound examination. Postpartal ultrasound controls of the mature newborn confirmed the findings. After laparotomy we found ovarian pseudocysts with a volume up to 90 ccm. Histologically we could not identify ovarian tissue. In 66% of the cases we found small cysts on the contralateral ovary. Differential diagnosis and the possible complications must be considered. A laparotomy should be performed and only by high steroid serum level a conservative therapy with MPA should be considered. This is the case in premature newborn with an immature endocrine regulation mechanism.

Diagnosis, Differential↗