[pathology of the umbilical cord in relation to gestational age:. Findings in 4,267 fetal and neonatal autopsies]. / Pathologie der Nabelschnur in Abhängigkeit vom Gestationsalter. Befunde bei 4267 fetalen und neonatalen Autopsien.

UNLABELLED: The umbilical cord is the "foetal lifeline". Pathological changes of the umbilical cord may strongly threat foetal life. Otherwise there are many morphological abnormalities without any influence on foetal well-being. There is poor knowledge about many special pathologic-anatomical features of the cord. AIMS: Our aim was to study the incidence and relevance of pathological changes of the umbilical cord, including so-called "cord accidents", in our large autopsy series. METHODS: Our study is a review of 4267 cases, including 1301 aborted foetuses and 2966 stillborns and lifeborns less than 7 days of age, autopsied from 1971 to 1996 in our department. RESULTS: Of 1301 aborted foetuses, 94 (7.2%) had abnormalities of the umbilical cord. Most of them (about 59%) showed torsion, stricture or "Thin-cord-Syndrome". Other important lesions of the cord in aborted foetuses are omphaloceles and constrictions of the cord secondary to Streeter bands. Most of all changes of the cord found in aborted foetuses were lethal factors. Of 2966 stillborn and lifeborn children, which died before day 7 of life, 456 (15.4%) had abnormal findings in relation to umbilical cord. 228 children showed umbilical cord accidents (i.e. true knots, cord prolapse, cord entanglement). Likewise in 228 children, we found especially changes of cord vessels like singular umbilical artery and others, cord oedema, insertion anomalies and other changes. This findings often represent no lethal factors. CONCLUSIONS: Torsion, stricture, and the complex of the thin umbilical cord play the most important role especially in abortion, but is also the most important cause of death of the older foetus in relation to true umbilical cord pathology.

[Nasal encephalocele as a cause of recurrent bacterial meningitis]. / Nasale Enzephalozele als Ursache einer rezidivierenden bakteriellen Meningitis.

Nasal encephaloceles are rare inborn malformations of the central nervous system. We report on a 30 months old boy with recurrent bacterial meningitis where a nasal encephalocele was diagnosed. We describe diagnostic procedures and the development and treatment of this interesting disease. The nasal encephalocele was successfully removed surgically.

[Histological findings of the small intestinal mucosa in rotavirus infections in infants and young children]. / Histologische Befunde der Dünndarmschleimhaut bei Rotavirusinfektionen im Säuglings- und Kleinkindalter.

In a prospective study we performed small intestinal mucosal biopsies in 40 children with acute rotavirus diarrhoea. Biopsies were taken from these children between the 2nd to 10th day of acute phase. The children were at an age of less than 18 month. 95% of the patients had normal histological findings of the small intestinal mucosa. Only 2 children (5%) had well defined injuries of intestinal mucosa. Correlations were not found between clinical findings, morphological results and therapy. In one child with gastroenteritis and meningitis rotaviruses were found in cerebrospinal fluid. In 31.25% of all children rotavirus infection was acquired by a nosocomial infection. The treatment of rotavirus infection is symptomatic. Usually intestinal mucosal biopsy as a routine diagnostic method isn't recommended and it should be used only in intractable courses.

[An extragonadal retroperitoneal endodermal sinus tumor--results of treatment and treatment sequelae in a 3-year-old boy]. / Ein extragonadaler retroperitonealer Endodermal-Sinus-Tumor--Behandlungsergebnisse und Behandlungsfolgen bei einem 3 Jahre alten Knaben.

A case of an extragonadal endodermal sinus tumour in a three-year old boy is presented. Complete resection of the retroperitoneal tumour was possible after initial chemotherapy. Combined radio-chemotherapy after tumour removal led to complete remission now lasting for more than 5 years. There was unilateral renal atrophy and diverticulum of the stomach as treatment related complications. The favourable prognosis of this tumour due to intensified treatment is discussed in relation to treatment sequelae. The interdisciplinary approach in treatment of cancer in children is emphasized.

[The problem of double abnormalities]. / Zur Problematik von Doppelmissbildungen.

Twin monsters are rare obstetrical events. The article reports on the course and the termination of pregnancy of a fetus with epignathus (non separated asymmetrical twin monster) and a fetus with thoracopagus (non separated symmetrical twin monster). In this connection the importance of an early prenatal diagnosis is discussed.

[Morphology of prune belly syndrome]. / Beitrag zur Morphologie des Bauchdeckenaplasiesyndroms.

Presenting a case of our own, the different forms and their severity of the prune-belly-syndrome are discussed. Considerations about the pathogenesis let us accept a common superordinate disturbance in the differentiation of myotoma and urinary system.