Idiopathic spontaneous pneumomediastinum: an uncommon emergency in children.

Spontaneous pneumomediastinum (SPM) occurs rarely in children. The diagnosis is based on physical examination and chest radiography. Conservative therapy usually leads to recovery. However, SPM in association with severe hypoxia, tachycardia, metabolic acidosis, and high ventilation pressures indicates clinically significant tension in the mediastinum. A collar mediastinotomy is the treatment of choice in these circumstances.

Importance of F18-fluorodeoxy-D-2-glucose positron emission tomography (FDG-PET) for staging and therapy control of Hodgkin's lymphoma in childhood and adolescence - consequences for the GPOH-HD 2003 protocol.

The prognosis for children and adolescents with Hodgkin's lymphoma is excellent. However, many patients will show secondary malignancies 15-30 years after the initial diagnosis, which appears to be connected with the intensity of treatment during primary disease. In the GPOH-HD 95 trial, the indication for radiotherapy was limited to patients who did not show a complete remission after chemotherapy, as determined radiographically. In the future protocol, the indication for radiotherapy in patients with early-stage Hodgkin's lymphoma should be further refined by using FDG-PET for evaluating the response to chemotherapy. Furthermore, in patients at an advanced stage of the disease, it should be determined if sequential FDG-PET research during chemotherapy can separate patients into subgroups with an excellent or a poor prognosis. This article gives a review of the current literature on FDG-PET in patients with Hodgkin's lymphoma and outlines the consequences for future protocols.

Wilms' tumour metastasis to the testis: long-term survival.

We report the case of a 3-year-old boy with a Wilms' tumour of unfavourable histology with metastatic spread to the right testis. Orchiectomy and chemotherapy led to disease-free survival for more than 8 years.

[Monstrous venous hemangioma of the retroperitoneum: problems of diagnosis]. / Monströses venöses Hämangiom des Retroperitoneums--Probleme der Diagnostik.

The venal haemangioma is defined as a benign tumor consisting of veinlike vessels. The preoperative diagnosis and its inherent problems are illustrated using a coincidentally diagnosed monstrous haemangioma tumor of the retroperitonial space in a twenty year old patient. With respect to our patient, X-ray, computer tomography and angiography all failed as diagnostic tools. Only the use of Doppler sonographic flow signals suggested the presence of a haemangioma. The morphology, prognosis and clinical significance of blood vessel tumors are multifaceted. The most important differential diagnoses to the venous haemangioma are the cavernous and the capilliary haemangioma. The venous haemangioma distinguishes itself through the presence of blood vessel walls. Haemangiomas are common benign tumors. In the presence of highly developed muscular components, there exists a transition to angiomyomas and to leiomyomas. Venal haemangiomas are extremely rare in the demonstrated localisation of the retroperitoneal space. Here they can grow to monstrous preportions whilst remaining undetected. Thus the patient is under the potential danger of bleeding to death through trivial injuries. The therapy of choice remains total surgical excision. In situations of unclear clinical results with respect to preoperative diagnosis especially amongst young adults, one should at least consider the possibility of a haemangioma as the root of the problem.

[Monstrous venous hemangioma of the retroperitoneum. Problems in diagnosis]. / Monströses venöses Hämangiom des Retroperitoneums. Probleme der Diagnostik.

The venous haemangioma is defined as a benign tumor consisting of vein-like vessels. The preoperative diagnosis and its inherent problems are illustrated by a coincidentally diagnosed monstrous haemangioma of the retroperitoneal space in a twenty year old patient. With respect to our patient, X-ray, computed tomography and angiography all failed as diagnostic tools. Only the use of Doppler-sonographic flow signals suggested the presence of an haemangioma. The morphology, prognosis and clinical significance of blood vessel tumors are manifold. The most important differential diagnoses of venous haemangioma are the cavernous and the capilliary haemangioma. The venous haemangioma distinguishes itself through the presence of blood vessel walls. Haemangiomas are common benign tumors. They can grow to monstrous proportions whilst remaining undetected. Thus the patient is endangered of bleeding to death because of trivial injuries. The therapy of choice consists in total surgical excision. In unclear clinical situations with respect to preoperative diagnosis especially amongst young adults, the diagnosis of an hemangioma should be taken into amount.

[Stress X-ray of the ankle joint: a cost-benefit analysis]. / Gehaltene Sprunggelenksaufnahmen: eine Kosten-Nutzen-Analyse.

Over an 18-month period findings of stress X-ray of the ankle and medical records of 112 cases were analyzed retrospectively as to indications, results and therapeutic consequences. The analysis showed that critical setting of indications can reduce the frequency of stress X-ray of the ankle and thus lower the total costs. The introduction of guidelines could be advantageous at medical training institutions.

[Increase in the incidence of leukemia in the area of a former hazardous waste site]. / Erhöhung der Leukämieinzidenz in der Nähe einer ehemaligen Sondermülldeponie.

An incidence study, completed in 1990, revealed a significantly increased incidence of leukaemias in the near vicinity of a hazardous waste dump. Linear regression of community incidence rates with community distance to the hazardous waste site showed negative coefficients for leukaemias and malignant lymphoma.