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Biomedical subjects

W Serlo

Publications and source records attributed to W Serlo.

At least 37 records · Page 2Linked to original sources
PubMed1996

Accelerated pubertal development in patients with shunted hydrocephalus.

OBJECTIVE: To evaluate pubertal development and peripheral concentrations of gonadotrophins and sex hormones in children with shunted hydrocephalus compared with healthy controls. STUDY DESIGN: 114 patients (52 females, 62 males) and 73 healthy controls (35 females, 38 males) aged 5 to 20 years were analysed for stage of puberty, age at menarche, testicular volume, basal serum follicle stimulating hormone (FSH), luteinising hormone (LH), sex hormone binding globulin (SHBG), testosterone and oestradiol concentrations, and free androgen index. RESULTS: Male gonadal and male and female pubic hair development occurred significantly earlier in the patients than in the controls. The mean age at menarche was significantly lower in the female patients than in their controls (11.7 v 13.2 years; p < 0.001), and lower than it had been for their mothers (v 13.1 years; p < 0.001). Relative testicular volume was higher in the male patients than in their controls (1.2 standard deviation score (SDS) v 0.2 SDS; p < 0.001). The prepubertal patients had higher basal LH (0.13 U/l v 0.08 U/l; p < 0.001) and SHBG (132.3 nmol/l v 109.1 nmol/l; p < 0.01) than the controls. Both the prepubertal and pubertal females had significantly higher basal FSH than their controls (1.57 U/l v 1.03 U/l; p < 0.05, and 4.0 U/l v 2.9 U/l; p < 0.01, respectively). CONCLUSIONS: Hydrocephalic children experience accelerated pubertal maturation, reflected in a younger age at menarche in females and an increased testicular volume in males. This may be because of enhanced gonadotrophin secretion, possibly resulting from unphysiological variations in intracranial pressure.

Adolescent↗
PubMed1996

Long-term outcome of fetal hydrocephaly.

Long-term outcome of 25 fetuses with ventriculomegaly diagnosed before delivery who survived the neonatal period up to school age was examined at 10.1 (standard deviation, 2.6) years of age. Twelve children had normal motor and mental development, seven were severely handicapped, and six showed intermediate outcome. The fetuses with severe handicaps on long-term follow-up had more severe ventricular dilation than the fetuses with good long-term outcomes. Eighteen of the children had surgical treatment, and seven of them had normal long-term development. Thirty percent of surviving fetuses with ventriculomegaly have poor long-term outcomes. In isolated progressive ventriculomegaly, early delivery as soon as fetal lung maturity allows might be reasonable for achievement of better long-term prognosis.

Child↗
PubMed1995

Experiences with flow-regulated shunts (Orbis-Sigma valves) in cases of difficulty in managing hydrocephalus in children.

Due to an increasing number of shunt complications with conventional valves, we performed a study of 80 flow-regulated Orbis-Sigma valves implanted in 47 children who had had repeated complications with conventional valves and 33 children receiving their first shunt. The results were encouraging. During the first 5 years after implantation, the probability of absence of any kind of surgical intervention to the valve system was 57% and the probability satisfactory function of the valve itself was 70%. The most frequent complication was underdrainage of CSF, especially in children under the age of 1 year. No cases of CSF overdrainage occurred in this series. The Orbis-Sigma valve appears especially useful for patients unable to tolerate the anti-siphon device, and for patients over 1 year old receiving their first valve for hydrocephalus of non-tumoral and non-haemorrhagic origin.

Adolescent↗
PubMed1995

Technical report: radiological evaluation of patellar malalignment using a new frame for axial imaging of the patellae.

Axial radiographs were performed on 59 children and adolescent patients with patellar malalignment using the method described by Laurin. A special frame was used to keep the knees in 20 degrees flexion and to maintain standard conditions. Radiological indices were measured before realignment surgery. A statistically significant difference (P < 0.0001) in the lateral patellofemoral angle was observed comparing malaligned and control patellae. Laurin's technique using a special frame provides a method of obtaining standard radiological measurements of patellar malalignment for use in surgical planning.

Adolescent↗
PubMed1995

Slow prepubertal linear growth but early pubertal growth spurt in patients with shunted hydrocephalus.

OBJECTIVE: To evaluate growth and to compare anthropometric measures and the degree of physical maturation in children with shunted hydrocephalus with those in healthy children. METHODS: One hundred fourteen patients (62 male) and 73 healthy subjects (38 male) 5 to 20 years of age were analyzed for growth data and current auxology, stage of puberty, and bone age. RESULTS: Boys with hydrocephalus were shorter than control boys during their first 8 years of age, and no catch-up growth was observed until puberty. Girls with hydrocephalus were of the same size at birth as the control girls, but their linear growth retarded during the first years of life, leading to reduced relative height between the age of 5 to 8 years. The pubertal growth spurt occurred earlier in boys with hydrocephalus (age at midgrowth spurt, 12.1 vs 13.3 years), and a similar trend was seen in girls (10.0 vs 10.7 years). The final height was again reduced, especially in boys. Patients with hydrocephalus were more obese than control subjects, girls more often than boys. Relative bone age was retarded in prepubertal (-0.42 vs 0.32 SD) and accelerated in pubertal patients (0.54 vs -0.19 SD). CONCLUSIONS: Children with hydrocephalus experience slow linear growth in prepuberty, but they have an earlier adolescent growth spurt. Together these factors result in a reduced final height. An increase in relative weight emerges in the preadolescent period, and this phenomenon is accentuated after puberty, leading to an increased prevalence of obesity.

Adolescent↗
PubMed1994

A competitive dual-label time-resolved immunofluorometric assay for simultaneous detection of carbonic anhydrase I and II in cerebrospinal fluid.

Carbonic anhydrase (CA) is functionally an important enzyme in the central nervous system (CNS) where it is involved in the control of acid-base balance and regulation of the production of cerebrospinal fluid (CSF). Isoenzyme II (CAII) is the most widely distributed CA in the CNS being specifically present in CNS glial tissue and therefore it is expected to be leaked to CSF in degenerative CNS diseases. A competitive dual-labeled time-resolved immunofluorometric assay was developed for simultaneous quantification of human CAI (HCA I) and II (HCA II) in CSF. HCA I was measured to determine the blood contamination in the samples. This solid-phase immunoassay is based on competition between europium (Eu3+)- or samarium (Sm3+)-labeled antigen and the sample antigens for polyclonal rabbit antibodies which are attached to microtiter-plate wells precoated with sheep anti-rabbit IgG. The subsequent immunoassay, including the separation of free and bound HCA I and II, requires only one incubation step, after which an enhancement solution dissociates Sm3+ and Eu3+ ions from the labeled HCA I and II, respectively, into a solution where they form highly fluorescent chelates. Spectra of the fluorescent chelates in the microtitration strip wells were run on time-resolved fluorometers equipped with filters for Eu3+ (613 nm) and Sm3+ (643 nm), the fluorescence from each sample being inversely proportional to the concentration of antigens. The detection limit of the HCA II assay was 0.3 micrograms/l and that of the HCA I assay was 5.2 micrograms/l. The intra- and inter-assay imprecisions (C.V.s) were 8.0% and 8.8% for HCA I and 6.3% and 4.8% for HCA II, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Long-term prognosis for children with shunted hydrocephalus.

We reviewed the previous medical history and the social status of all patients of Oulu University Central Hospital who had had in the age range 16-26 years shunted hydrocephalus (HC) during childhood. Of 42 patients selected 7 had died and another 5 had been institutionalized for severe mental handicap. Shunts had been changed a total of 103 times in 29 patients still living. The most common reason for a reoperation was blockage. Half of the patients re-examined showed neurological abnormalities or epilepsy. Both the verbal and the nonverbal IQ of the patients remained weak to average. Even though the patients' medical prognosis was fair, their social maturation did not keep up with their physical abilities. One-third were receiving or had received vocational training, but only a few were working. Up to one-quarter of the patients with shunted HC were at home without any meaningful work activities.

Adolescent↗
PubMed1994

Development of the neurocranium after transsutural fixing by new, resorbable poly-L-lactide miniplates. A comparison to fixing with the common titanium miniplates.

The right coronal sutures of twelve (12) newborn rabbits were fixed with commercially available, self-reinforced poly-L-lactide miniplates, with eight (8) rabbits sham treated with titanium miniplate fixation as reference experiments, in order to demonstrate the possible effects on skull growth. After six (6) months follow-up, both types of plate were detected to have caused a similar asymmetry in the neurocranium. Therefore, in our opinion, fixing across growing sutures, even with the new biodegradable devices, should be avoided.

Animals↗
PubMed1994

Information value of magnetic resonance imaging in shunted hydrocephalus.

OBJECTIVE: To study the role of magnetic resonance imaging (MRI) in evaluating children with shunted hydrocephalus. METHODS: Sixty one asymptomatic children with shunted hydrocephalus or cystic cerebrospinal fluid collections were studied by cranial MRI. The information obtained from the images was classified into three categories: provided (1) a new diagnosis, (2) additional information, or (3) no essential new information. The findings were compared with those of the last follow up computed tomograms. RESULTS: MRI provided a new diagnosis in seven cases (11.5%), and additional information was obtained in 34 (55.7%) cases. In 20 cases (32.8%) no essential new information was obtained. MRI visualised white matter lesions and corpus callosum pathology more often than computed tomograms. CONCLUSIONS: MRI provided new important information in cases of children with shunted hydrocephalus to such an extent that it can be recommended as the primary imaging method for every child with this disorder.

Adolescent↗
PubMed1994

Polyglycolic acid membrane interpositioning for the prevention of skull deformity following experimental craniosynostosis.

The interpositioning of various materials to complete suturectomy for the treatment of craniosynostosis has been used by many surgeons to prevent early postoperative reunion. Clear scientific proof for this procedure has not yet been obtained with any material, however. A previously described model of experimental craniosynostosis was employed to examine the effects of an interpositioned biodegradable polyglycolic acid (PGA) membrane on the growing skull of 14 newborn rabbits. Additional 11 newborn rabbits served as controls, as on their skulls only unilateral resection of the coronal suture was performed (experimental craniosynostosis). The skulls were examined for shape and histology up to 6 months of age. The 11 rabbits in the control group developed a unilateral deformity on their calvaria as demonstrated by dry-skull osteometry. The 14 rabbit skulls having the interpositioning of a PGA membrane done into the resection site at the time of unilateral suturectomy were found to have grown in a remarkably symmetrical fashion. The interpositioning of a PGA membrane therefore seems to prevent the formation of a skull deformity during growth as compared with early suturectomy alone.

Animals↗
PubMed1993

Arthroscopy of the acute traumatic knee in children. Prospective study of 138 cases.

We performed diagnostic arthroscopy for acute knee trauma in 138 children and adolescents aged 13 (1-15) years. The compatibility between the clinical examination and the arthroscopic findings was 59 percent. Ligament injuries were found in 32 cases, 14 of which had rupture of the anterior cruciate ligament. The compatibility in the case of ligament injuries was 31 percent. 48 patients had dislocation of the patella, and a displaced osteochondral fragment was seen in 19, 14 of which were radiographically silent. In 37 cases of distortion of the knee a correct diagnosis would have been missed unless arthroscopy had been performed. Arthroscopy is therefore indicated in children with severe distortion of the knee, hemarthrosis and with dislocation of the patella.

Adolescent↗
PubMed1992

A new method for the creation and measurement of experimental craniosynostosis.

Craniosynostosis is described as a condition in which the premature closure of one or more cranial sutures is exposed as a skull deformity alone or accompanied by neurological disturbances. According to previous research it seemed possible to create an experimental model for investigating the disease by simply resecting a suture in a newborn rabbit. We resected 16 coronal sutures in 16 newborn rabbits and had the skulls investigated for shape and histology up to 6 months of age. A clear deformity at the cranial vault could be detected. The fused site of the suturectomy later on presented a suture-like structure which was macroscopically distinct from a normal skull suture. The procedure is thus established, first, for investigating procedures for treating craniosynostosis in the growing skull, and, secondly, for studying the pathophysiology of craniosynostosis.

Animals↗
PubMed1992

Craniofacial growth in shunt-treated hydrocephalics: a four-year roentgenocephalometric follow-up study.

The craniofacial growth of 24 shunt-treated hydrocephalics aged 5-15 years was evaluated over a 4-year period, by comparing changes in linear and angular cephalometric variables with those of an age- and sex-matched control group. The main findings were increased calvarial thickness, increased cranial base flexure, superior displacement of the sella, and a tendency for the gonial angle to remain more obtuse in the shunt-treated patients. As craniofacial growth in the latter differed only slightly from that observed in the controls, the deviations in facial morphology observed in a previous cross-sectional study of shunt-treated hydrocephalics can be taken to represent a long-term effect of the shunt treatment.

Adolescent↗
PubMed1992

Polylactide and polyglycolic acid-reinforced coralline hydroxy-apatite for the reconstruction of cranial bone defects in the rabbit.

The possibility of using coralline hydroxy-apatite in combination with polylactide and polyglcycolic acid instead of a bone graft in the skull region is examinated. Coralline hydroxy-apatite blocks strengthened with a membrane made of a combination of polylactide and polyglycolic acid were inserted into bony defects created in 12 rabbit skulls. The blocks were observed during a follow-up of 12 months. They became fixed to the surrounding bone and no adverse effects or harmful reactions in the nearby tissues could be detected.

Animals↗
PubMed1992

ENG findings of shunt-treated hydrocephalus in children.

Thirty-eight hydrocephalic children (mean age 11.5 years; range 5.1-17.9) were examined on average 7.9 years after initial shunting. The etiology of the hydrocephalus was divided into 5 groups: perinatal intraventricular hemorrhage 14, congenital obstructive hydrocephalus 14, central nervous system infections 4, intracranial cysts 3, and intracranial anomalies 3 children. Electronystagmographic (ENG) examination included recording of spontaneous and positional nystagmus, the pendular eye tracking test, saccadic eye movements, optokinetic and caloric reactions. Only 5 children (13%) had a normal ENG. Thirty-one children (82%) had ENG pathology of the central type and 12 (44%) of the 27 successfully studied had pathological caloric reactions. Ten children (26%) had a combination of both central and vestibular pathology. There was no statistical difference between the boys and the girls or between different etiological groups. The high prevalence of vestibular pathology among these hydrocephalic children may be relevant to their impaired motor performance, because only 7 (18%) of the children studied exhibited normal motor performance in the neurological tests.

Adolescent↗