Timing of osteosynthesis of fractures in children changes the outcome.

Purpose: The search for optimal treatment strategies for fractures in children that require osteosynthesis is controversial and is still being debated. A major factor that has been under discussion is the impact of the timing of surgery: the time delay between the trauma and the operation, as well as the duration of the surgical procedure, and the time of day that the operation is performed are potential factors that might influence the outcome. Therefore, the aim of our study was to investigate the influence of these factors on the outcome after osteosynthesis of diverse fractures of the extremities in children.

Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation?

Introduction:  The treatment of the displaced fracture of the lateral condyle of the distal humerus in children aims not only to avoid nonunion, malalignment, and impairment of the range of motion of the elbow but also to prevent delayed healing and the development of any prearthrotic deformity. To date there is no agreement on what kind of osteosynthesis should be used. So far, the screw fixation and Kirschner wire fixation have both been applied.

Ambulatory or inpatient management of mild TBI in children: a post-concussion analysis.

Background: Diagnosis and treatment of children with mild traumatic brain injury (mTBI) remain a challenge since initial signs and symptoms do not always indicate the severity of the trauma. Therefore, guidelines regarding the decision upon imaging methods and ambulatory or hospitalized treatment are needed. The goal of our study was to investigate if the standard that was allied from the PECARN rules and is applied in this study can ensure that patients with clinically important brain injury are recognized and leads to outcomes with a low complication rate, a high patient satisfaction and minimal post-concussion syndrome incidence.

Platelet Derived Growth Factor Has a Role in Pressure Induced Bladder Smooth Muscle Cell Hyperplasia and Acts in a Paracrine Way.

Purpose: Bladder outlet obstruction is a finding in many urological disorders, leading to bladder wall hyperplasia. We investigated platelet derived growth factor and its receptor in human bladder smooth muscle cells and urothelial cells exposed to hydrostatic pressure or PDGF in vitro.

Materials And Methods: Bladder smooth muscle cells and urothelial cells were exposed to elevated hydrostatic pressure for 1 hour.

Multiply trauma in children: pulmonary contusion does not necessarily lead to a worsening of the treatment success.

Aim: The aim of the study is to evaluate the impact of pulmonary contusion on the overall outcome in children with multiply injury.

Patients And Methods: Retrospective review of 123 multiply injured children during a 10-year period (January 2000 to February 2010) who were admitted to the intensive care unit of a university affiliated, tertiary care pediatric trauma center. The diagnosis of pulmonary contusion (case group) was defined by the clinical context and the results of chest X-ray and blood gas analysis.

Long-term results of endoscopic treatment of vesicoureteral reflux in children: comparison of different bulking agents.

Objective: To determine the long-term effect in children of endoscopic treatment of vesicoureteral reflux (VUR) using different bulking agents. VUR status, recurrence of urinary tract infection (UTI), and recurrence of febrile UTI were evaluated as endpoints.

Methods: From 1993 to 2005, we injected 229 refluxive ureters (VUR grade II-IV) in 135 children.

The treatment of supracondylar humeral fractures with elastic stable intramedullary nailing (ESIN) in children.

Background: Supracondylar humeral fractures are the most common elbow fractures in children. In case of displacement and instability, the standard procedure is closed reduction and percutaneous Kirschner wire fixation. As Kirschner wire fixation requires postoperative cast immobilization, does not allow early mobilization, and is associated with the risk of damage of the ulnar nerve, innovative techniques should be evaluated.

[Screw osteosynthesis of proximal femur fractures in children].

Objective: Optimal reposition and stable fixation of M/1 and M/2 fractures are necessary. Careful operation and urgent surgery prevent complications.

Indications: M/1 and M/2 fractures of the proximal femur in children > 4 years.

Acquired heart block: a possible complication of patent ductus arteriosus in a preterm infant.

A large patent ductus arteriosus (PDA) is a frequently encountered clinical problem in extremely low birth weight (ELBW) infants. It leads to an increased pulmonary blood flow and in a decreased or reversed diastolic flow in the systemic circulation, resulting in complications. Here we report a possible complication of PDA not previously published.

Cajal-like cells in the upper urinary tract: comparative study in various species.

The interstitial cells of Cajal (ICC) play an important role in the control of gut motility. The recognition that the ICC cell membrane harbors the c-kit receptor (CD117) sparked rapid advancement in ICC research on the gut and certain pathologies using immunochemical and molecular methods. The question arises whether ICC exist in the upper urinary tract (UUT) and trigger motility.

Cajal-like cells in the human upper urinary tract.

Purpose: Interstitial cells of Cajal (ICCs) have an important role in the regulation of gut motility as they are responsible for the slow wave activity of smooth muscle. It is still unknown if ICCs also occur in the human upper urinary tract. Since these cells express and are marked by the c-kit receptor CD117, we investigated its occurrence and distribution along the human upper urinary tract.

[Minimally invasive funnel chest correction: initial experiences and critical evaluation of this fascinating technique].

The discussion about the surgical correction of funnel chest deformities enjoys a great renaissance since D. Nuss presented a new, minimal invasive technique. Although his method has gained wide acceptance among patients and pediatric surgeon the question arises, whether it can be considered as the Golden Standard' already.

Perforation of a central venous catheter into the pelvis of the kidney: a rare complication.

Most adverse events related to central venous catheter (CVC) use in severely ill neonates who require total parenteral nutrition (TPN) are caused by malposition of the tip of the catheter, followed by complications such as infection, sepsis, thrombosis or, rarely, perforation of the vessel. Malpositioned tip of a CVC into the renal vein followed by thrombosis is well known. We report two cases of perforation of a CVC into the renal pelvis.