Search Results - (Author, Cooperation:J. Troeger)

2015-11-13

Nature Publishing Group (NPG)

0028-0836

1476-4687

Biology

Chemistry and Pharmacology

Medicine

Natural Sciences in General

Physics

Animals ; Antineoplastic Agents, Alkylating/pharmacology/therapeutic use ; Apoptosis/drug effects ; Cell Lineage ; Cell Proliferation/drug effects ; Cell Tracking ; Cyclophosphamide/pharmacology/therapeutic use ; Disease Models, Animal ; Disease Progression ; *Drug Resistance, Neoplasm/drug effects/genetics ; *Epithelial-Mesenchymal Transition/drug effects/genetics ; Female ; Lung Neoplasms/drug therapy/genetics/*pathology/*secondary ; Male ; Mammary Neoplasms, Experimental/*drug therapy/genetics/*pathology ; Mice ; MicroRNAs/genetics ; Neoplasm Metastasis/drug therapy/genetics/*pathology ; Reproducibility of Results

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract This study was intended to determine the level of the conus medullaris in normal babies. We examined 114 healthy infants using high resolution ultrasound which identified the spinal cord and the tip of the conus medullaris. This method provided a good analysis of the level of the conus medullaris so that we could assess the rate of ascent to L1/2. The range of the conus level for all children was at TH12/L1 interspace to L4.78% of babies aged between the 30th and 39th postmenstrual week had the tip of the conus medullaris between L2 and L4. 84% of babies aged between the 40th and 63rd postmenstrual week had their conus level between TH12/L1 and L1/2 interspace. In one girl aged 53 weeks the tip was found at L4. Ultrasound is a reliable method to observe the development of the conus level in young infants and to identify a tethered cord.

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1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract In a multicenter trial we retrospectively evaluated the clinical and sonographic data of 49 neonatal ovarian cysts, 44 of which were detected prenatally and 5 on the first day after delivery. Of the 44 prenatally detected cysts 39 were purely cystic, 5 echogenic or had a mixed pattern. In 20 patients the cystic appearance changed during delivery from purely cystic to a mixed pattern being independent on the size of the cyst. 26 of the 44 cysts were treated surgically. Salpingotorsion was found in 8 and was independent on the size of the cyst. In 15 a salpingo-oophorectomy or oophorectomy was performed, in 11 the ovary was saved. 23 patients were followed sonographically: 15 cysts showed complete resolution within 14 months without correlation to the sonographic pattern. The volume of these cysts varied between 5 and 71 ml. Neonatal ovarian cysts disappear spontaneously frequently and rarely cause severe symptoms. The authors recommend follow-up by ultrasound as the primary modality. Surgical intervention is recommended only if the cyst is space-occupying and percutaneous puncture can not be performed or in the case of emergency.

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract In order to evaluate the sensitivity of ultrasound to intraperitoneal fluid, such as ascites or blood, an experimental study was performed in the pig. Various amounts of fluid were injected into the peritoneal cavity to investigate distribution and diagnostic criteria in different positions. As little as 10 ml of fluid was visualized around the urinary bladder in an upright position. In the supine position, 20 ml could be detected around the bladder and 30 ml around the liver. The injection of at least 60 ml resulted in a pattern of free-floating bowel loops. The sonographic findings of fluid distribution were correlated to radiological studies. As different amounts of fluid produce characteristic sonographic patterns, an approximate estimation of the intraperitoneal fluid volume can be made.

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract As part of a multicenter surfactant rescue study, the chest X-rays of 239 preterm and term infants were analyzed. To study the influence of surfactant administration on radiographic appearance, 130 patients with a clinical and radiological diagnosis of typical respiratory distress syndrome were selected, in whom adequate chest x-rays before and within 48 h after treatment were available. Median gestational age was 30 weeks (range 25–38 weeks), median birth weight was 1335 g (range 625–3450). The time of surfactant application ranged between 90 min and 24 h after birth (median 6 h). The most common finding after surfactant administration was uniform (n=47) or disproportionate (n=46) improvement of pulmonary aeration, which showed a significant correlation to posttreatment reduction of oxygen requirement (p〈0.001). Asymmetric clearance was more often localized on the right side and usually disappeared within two to five days. Only in 13 patients no change of ventilation was found. Development of interstitial emphysema (n=24, including three patients with pneumothorax) after surfactant treatment was an unfavourable prognostic sign. 54% of these patients (13 of 24) died within the first month of life, compared to 8% (7 of 93) in the group of patients with initial improvement of ventilation.

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract The current nonoperative management of ileocolic intussusception includes hydrostatic and pneumatic reduction, both performed under fluoroscopic monitoring. Recently, a new technique — ultrasoundguided reduction — replaced the conventional approach in our institution. Over a 20-month period, 46 intussusceptions were diagnosed sonographically in 40 patients. In all cases, reduction was attempted under ultrasound guidance by means of a normal saline enema. In 42 cases (91%) reduction was successful and only four patients had to be operated (two resections, two manual reductions). Complications did not occur. this technique permits distinct visualization of the entire process, providing a clear and detailed echogram of the fluid-filled large and small intestine. We established the following definite criteria of reduction: disappearance of the target, demonstration of the ileocecal valve, visualization of the fluid reflux, and fluid filling of small bowel loops. The presented technique for the reduction of intussusception without radiation exposure is reliable and safe, and appears to be one of the most promising methods for the nonoperative treatment of ileocolic intussusception.

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract A donut-shaped intestinal structure in the lower right abdomen, observed during abdominal ultrasound investigation following nonoperative intussusception reduction, may create a diagnostic problem concerning differentiation from a residual or recurrent intussusception or underlying small bowel disease. In 30 cases of ileocolic intussusception an abdominal ultrasound examination was performed after reduction, the success of which was proven by radiological and clinical criteria. More than half of the examinations showed an aperistaltic “donut” in the ileocecal region which was similar to the target sign commonly seen in intussusception. Differentiation was possible according to the following two criteria: first, the diameter of the donut was smaller than that of the original target sign seen in these patients. Second, the donut consisted of a broad hypoechoic rim and an echogenic center, whereas the target was normally composed of multiple concentric rings. One third of the patients showed localized thickening of the walls of the distal ileal loops which did not cause diagnostic problems. All of the suspicious intestinal structures disappeared within the first 5 days following reduction. It is our opinion that the post-reduction donut correlates with significant edema of the ileocecal valve and does not represent a mechanical lead point or persisting residual intussusception.

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1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Abstract Over the period of one year, the hips of 92 preterm neonates were examined by ultrasound. Using the Graf classification only 7% showed an angle alpha between 50 and 60 degrees, which is characteristic of type IIa hips. In all other cases the angle alpha was above 60 degrees (type I). Sonographically there were no pathological cases (type IIg or worse). A reason for the relatively low number of type IIa hips could be that the short osseous acetabular rim and the broad cartilagenous Y-joint in this age group result in a “false” increase of the angle alpha.

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Springer Online Journal Archives 1860-2000

Medicine

Electronic Resource

1432-1998

Kidney diseases ; Sonography ; Urography ; Comparative study

Springer Online Journal Archives 1860-2000

Medicine

Abstract Renal sonograms of 260 children were compared with the corresponding excretory urograms. Since each kidney was evaluated separately 520 sonographic and urographic findings could be compared. The study is based on single investigations only, serial investigations were not included. 326 kidneys could be classified as being normal, primarily on the basis of the urogram. By sonography only 10 out of these 326 were misinterpretated as being pathological, 2 by urography. 194 kidneys could be classified as being pathological either by urography or — if necessary — by other methods. In 16 out of these 194 no evidence for a pathological process could be found in the sonogram (7 cases of destructive pyelonephritis, 3 cases of double kidneys, 2 cases of slight obstruction of urine flow, 2 cases of small kidneys, 2 cases of ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureterolith, 1 case of ureteral bud). In 2 cases pathological alterations of the kidney were found by both methods, however, the diagnosis differed. Nonfunctioning kidneys were found in 15 cases. In all of these the sonogram provided important complementary information. Our results show 1) that by a systematic application of sonography the early diagnosis of urinary tract malformations can be improved 2) that renal sonography provides the basis for a stricter application of excretory urography and 3) that by the combination of both methods the diagnosis of renal diseases can be improved.

Electronic Resource

1432-1440

Vesico-renal reflux ; Renal parenchymal scar ; Urinary tract infection ; Asymptomatic bacteriuria ; Uroepithelial cell ; Vesico-renaler Reflux ; Nierenparenchymnarbe ; Harnwegsinfektion ; Asymptomatische Bakteriurie ; Uroepithelzelle

Springer Online Journal Archives 1860-2000

Medicine

Zusammenfassung 62 Patienten (14 Knaben, 48 Mädchen), bei denen an insgesamt 85 Niereneinheiten ein vesico-renaler Reflux (Grad 2–4) erfolgreich operiert worden war, wurden im Durchschnitt 9,3 Jahre postoperativ auf das Auftreten von Harnwegsinfektionen (HWI) und von neuen Nierenparenchymnarben (NN) verfolgt. Bei den männlichen Patienten traten postoperativ bis auf einen Knaben keine HWI bzw. NN auf. Ähnliches galt auch für etwa 45% der Mädchen. Beide Gruppen von Patienten wiesen vor Operation hohe Refluxgrade auf. Bei den übrigen Mädchen, deren präoperative Reflux-Grade im Durchschnitt relativ niedrig lagen, traten jedoch postoperativ über Jahre noch HWI auf. NN entwickelten sich vorwiegend in dieser Zeit. Untersuchungen der Fähigkeit von Uroepithelzellen (UEZ), das Bakterienwachstum zu hemmen, zeigten, daß die UEZ dieser Patienten das Bakterienwachstum nicht supprimieren konnten. Somit entsprachen diese Mädchen bezüglich ihrer UEZ-Funktion Patientinnen mit asymptomatischer Bakteriurie. HWI und NN bei Reflux scheinen somit durch unterschiedliche Ursachen ausgelöst zu werden.

Summary 62 patients (14 boys, 48 girls) representing 85 refluxive renal units (Grade 2–4) were investigated after successful operation for the development of further urinary tract infections (UTI) and renal scars (RS). The mean follow-up was 9.3 years. With the exception of one boy, none of the male patients developed any UTI or new RS. A similar result was obtained for about 45% of the girls. These two groups of patients presented with high-grade reflux before surgery. The remaining female patients (about 55%), however, presenting with lower-grade reflux before surgical treatment, developed further UTI as well as new RS despite surgical correction of their reflux. Investigations on the capacity of uroepithelial cells (UEC) to suppress bacterial growth revealed a deficient antibacterial effect of UEC in these patients. Such an UEC defect has also been shown in patients with asymptomatic bacteriuria. In conclusion, different reasons seem to be responsible for recurrent UTI and the development of RS in patients with reflux.

Electronic Resource

1433-0431

Key words Osteomyelitis • Radiography • Sonography • Radionuclide imaging • MRI ; Schlüsselwörter Osteomyelitis • Röntgen • Sonographie • Szintigraphie • Magnetresonanztomographie

Springer Online Journal Archives 1860-2000

Medicine

Zusammenfassung Da bei akuter Osteomyelitis im Kindesalter ein früher Behandlungsbeginn zur Vermeidung von Spätschäden wichtig ist, muß die Diagnose so rasch wie möglich gestellt werden, wobei den bildgebenden Verfahren eine wesentliche Rolle zukommt. Eine sinnvolle Bildgebung bei klinischem Verdacht auf akute Osteomyelitis im Kindesalter beginnt mit dem Röntgenbild zum Ausschluß anderer Differentialdiagnosen und der Sonographie zum evtl. Nachweis punktierbarer subperiostaler Abszesse oder Gelenkergüsse, aus denen der Erregernachweis unmittelbar möglich wäre. Falls mit Röntgenbild und Sonographie kein pathologischer Befund zu erheben ist, sollte je nach klinischer Lokalisierbarkeit des Befundes und nach Lokalisation des vermuteten Entzündungsherdes eine Magnetresonanztomographie oder ein Szintigramm angeschlossen werden. Erstere hat Vorteile in der exakten anatomischen Darstellung und ist daher auch präoperativ wichtig, letzterem ist wegen der möglichen Beurteilbarkeit des gesamten Skelettes der Vorzug zu geben bei unklarem Lokalbefund oder bei multilokulären Prozessen. In seltenen Fällen kommt die Leukozytenszintigraphie zum Einsatz. Die Galliumszintigraphie hingegen sollte im Kindesalter wegen der höheren Strahlenbelastung möglichst vermieden werden. Die einzelnen Untersuchungsverfahren werden im Folgenden dargestellt und kritisch einander gegenübergestellt.

Summary In acute osteomyelitis of childhood a rapid diagnosis and initiation of antibiotic therapy is necessary in order to prevent late sequelae. Thus, diagnostic imaging plays a crucial role. If acute osteomyelitis is suspected in a child, imaging starts with conventional radiography in order to exclude other differential diagnoses. This is followed by sonography for the purpose of diagnosing a subperiosteal abscess or joint fluid from which the causative organism could be isolated. If the diagnosis is unclear, the next step should be either MRI or 99m Tc-MDP bone scan, depending on the possibility of clinical localization and the site of the suspected lesion. MRI is superior to bone scan in depicting the exact anatomy, which is extremely important in spinal osteomyelitis and preoperatively. The bone scan can show the whole skeleton in one examination and should be favored if there is no definite localization or in suspected multifocal osteomyelitis. Rarely scintigraphy with labeled white blood cells is indicated. The 67 Ga scan, however, should not be used in children because of the high level of radiation exposure. The different imaging modalities are described in detail and an imaging diagnostic workup is outlined.

Electronic Resource

1433-0474

Springer Online Journal Archives 1860-2000

Medicine

Skelettfehlbildungen und Herzfehler sind Leitsymptome des autosomal dominant erblichen Holt-Oram-Syndroms. Bei vollständiger Penetranz kann der Ausprägungsgrad der klinischen Symptome innerhalb einer Familie jedoch sehr unterschiedlich sein und zu diagnostischen Schwierigkeiten führen. Anhand von 13 eigenen Patienten mit Holt-Oram-Syndrom im Alter 1–35 Jahren wird das klinische Spektrum dargestellt. Es reicht von - meist asymmetrischen - Phokomelien der oberen Extremität bis zu isolierten Thenarhypoplasie als Minimalsymptom der Erkrankung. Eltern eines scheinbar sporadischen Falles sollten gezielt daraufhin untersucht werden, um das Wiederholungsrisiko für weitere Kinder bestimmen zu können.

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