[Doppler ultrasound studies of long-term follow-up of children with hemolytic-uremic syndrome]. / Dopplersonographische Untersuchungen im Langzeitverlauf von Kindern mit hämolytisch-urämischem Syndrom.

AIM: In the present study, we compared the diagnostic value of Doppler sonography with "B-Imaging" in the acute and chronical period of the HUS in children. METHOD: For this, we analysed the Doppler sonographic measurement (Acuson-128) from 3 patients in the acute stage of the disease and 14 patients after approximately 5 years. All patients examined in the chronic stage of the disease had been treated by peritoneal dialysis in the acute stage. As a control, the Doppler sonographic analysis of the A. renalis was performed in 25 healthy children. RESULTS: During the acute phase of the HUS, we found a significant increase in both the resistive index (RI) and the pulsatility index (PI). In addition, the diastolic current in the A. renalis was decreased or the blood flow was reversed. The kidney volume as well as the echo was increased in all cases. A recovery of the kidney observed as beginning diuresis coincided with a return to normal parameters in the Doppler sonographic measurement. In patients examined after 5 years, both the RI and the PI value was significantly (p < 0.01) different from the control group. These parameters correlate with the effective renal plasma flow, but not with the glomerular filtration rate. CONCLUSION: We conclude that in the acute stage of the HUS either "B-Imaging" or duplex sonography yield pathological parameter values. For the observation of the renal symptoms during the chronic phase of the disease, duplex sonography is clearly superior.

[Obstructive uropathies in early childhood--surgical intervention as renal protection]. / Obstruktive Uropathien im frühen Kindesalter--Der operative Eingriff als renale Protektion.

Anomalies in the urinary tract can be noticed early by prenatal sonography. In the case of obstruction, a decompressive procedure can follow immediately after birth. Long-term results of renal function in cases of pyeloureteral obstructions after 6-10 years make it clear that results are better the earlier pyelon resection is performed. In cases of obstructive megaureter, operative procedures are indicated for severe disturbances of ureteral transport. Progressive renal and ureteral wall destruction is promoted by performing operations too late.

[Polyuria and polydipsia in acute fatty liver of pregnancy. Discussion based on a case]. / Polyuro-polydipsie et stéatose hépatique aiguë gravidique. Discussion à propos d'un cas.

We report the case of a 25-year-old nullipara in whom polyuria and polydipsia occurred 8 weeks before the first symptoms of acute fatty liver of pregnancy and disappeared a few days after delivery. This time course suggests that polyuria and polydipsia were closely related to acute fatty liver of pregnancy. Thus, this diagnosis should be envisaged in any woman with normal blood levels of glucose and calcium, and complaining of polyuria and polydipsia in the third trimester of pregnancy.

[Operative therapy of a refluxing double ureter in childhood]. / Zur operativen Therapie des refluierenden Ureter duplex im Kindesalter.

Surgical methods for repairing the bilateral vesico-ureteral reflux have to be adapted to the pathomorphological and pathodynamic variety of refluxing ureters. Ureteroureterostomy can be performed in the cranial section of the ureter in order to check the local situation of the kidney and its macroscopic structure. But the distal localisation of the uretero-ureteral anastomosis proves to be favourable too. The operation according to Politano-Leadbetter is the method of choice to correct the reflux. It is only in therapy-resistent pyuria with decompensation of the kidneys that temporary supravesical urine-derivation has turned out to be an advantage because the possibility of organ-conservation by surgery later is still preserved.

[Trophoblastic pseudotumour of the uterus (author's transl)]. / Pseudotumeur trophoblastique de l'utérus.

When perforation of the uterus occurred while a therapeutic termination of pregnancy was being carried out in a 25-year-old woman it was shown that the monomorphic trophoblastic pseudotumour was invading the myometrium. It was not secreting HCG when it was diagnosed and it had not recurred 19 months after the diagnosis and hysterectomy.

[The oral glucose tolerance test during normal pregnancy (author's transl)]. / L'épreuve d'hyperglycémie provoquée par voie orale au cours de la grossesse normale.

Physiological changes in carbohydrate tolerance were studied between the beginning and end of pregnancy. Amongst 145 oral glucose tolerance tests performed between the 9th and 40th weeks, results indicated that carbohydrate tolerance evolved throughout pregnancy. The first 24 weeks were characterised by a change in the shape of the glucose tolerance curve, in the form of horizontalisation of the terminal part, but with no increase in early blood glucose figures. It was only after the 24th week that mean blood glucose levels were seen to be increased. The interpretation of glucose tolerance tests during pregnancy should take these physiological changes into account. Critical values, above which diabetes must be suspected, are different at the beginning and end of pregnancy. The critical point would appear to be around the 24th week.

[Fetal maternal anti-HLA sensitization. Its relationship with the pathology of pregnancy and/or the neonate (author's transl)]. / Immunisation foeto-maternelle anti-HLA et pathologie gravidique et/ou néo-natale.

The frequency of maternal anti HLA sensitization was studied in 1401 normal and pathological pregnancies. The analysis of the obstetrical history showed in patients with sensitization, a stabilical highs indications of preceding abortion and premature labors and of actual anemies and premature labors. The signification of such, an association remains to be found.