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Biomedical subjects

B Stöver

Publications and source records attributed to B Stöver.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Radiologic differential diagnosis of inflammatory round pulmonary infiltrates in immunocompromised patients. A prospective study using CT and MRT].

In a prospective study we examined the diagnostic ranking of CT and MR in 52 immunocompromised patients with nodular pulmonary lesions and clinical suspicion of invasive pulmonary aspergillosis (IPA). For early diagnosis of IPA (clinical symptoms having existed for less than 10 days) the CT halo sign proved highly sensitive and specific. MRT showed at this time a comparatively high sensitivity but only low specificity that could not be improved upon after Gd-DTPA. At a later stage of the aspergillosis infection (clinical symptoms manifested for more than 10 days) MR identified aspergillus-specific lesions with on-target characteristics (marked enhancement of margins after Gd-DTPA) or the so-called "reverse" target phenomenon (T2-weighted sequences). Such lesions were never seen in the early stage of the disease in patients with nodular pulmonary lesions of different aetiology (pseudomonal or staphylococcal pneumonia).

Adult↗
PubMed1994

[Early changes in the hip joint following epiphysiolysis of the femoral head. Results of an MRT study].

With the aim of detecting patients at risk of developing coxarthritis, 34 patients were investigated prospectively by MRI 6-14 years after epiphysiolysis for slipped capital femoral head. In particular, cartilage changes were analysed by gradient-echo sequences. In 40% of the hip joints investigated cartilaginous lesions were present, detectable as irregularity and flattening of contour and more rarely as changes in signal intensity. In contrast, only 18% of the radiographs available revealed any pathology. When pelvic X-rays are normal or reveal slight sclerosis, cartilaginous lesions on MRI are considered early signs of coxarthrosis. This combination was seen especially often in patients with a primarily high angle of dislocation and in those who needed treatment by reposition or osteotomy. Only in 8 of the 17 hip joints showing sclerosis on conventional radiograms, sclerosis was also diagnosed by MRI, possibly because of partial volume and susceptibility effects at high field strength. Even with limited spatial resolution, cartilage examination is warranted in young patients in whom early osteoarthritis can be expected.

Adult↗
PubMed1993

Correlation of ultrasound and renal scintigraphy in children with unilateral hydronephrosis in primary workup.

Ultrasound accurately detects hydronephrosis in infants and children, while nuclear medicine techniques quantify relative renal function in addition to characterizing the urodynamic relevance of hydronephrosis. This prospective study was undertaken to examine the relationship between ultrasound morphological findings and relative renal function, quantified with dynamic 99mtechnetium mercaptotriacetylglycine imaging, in the initial diagnostic workup of children with unilateral hydronephrosis. The ultrasound grade of hydronephrosis and relative renal function ipsilateral to the hydronephrosis were inversely related, indicating that with more severe hydronephrosis ultrasound fails to estimate the potential reduction of relative kidney function. Because renal function is not necessarily affected by hydronephrosis, renal scintigraphy is indicated to assess the functional status of hydronephrotic kidneys.

Child↗
PubMed1993

Development of late congenital hip dysplasia: significance of ultrasound screening.

Ultrasound for detecting congenital hip dysplasia was performed in 5970 infants, 2121 of whom were reinvestigated. Of those reinvestigated 726 belonged to the screened group not at risk examined as newborns, 70 were infants at risk first investigated as newborns and 363 were infants at risk first examined after the newborn period; the remainder were infants not at risk first investigated after the newborn period. Pathological findings were obtained in 7.7% of the entire group, in 3.9% of children at no risk, and in 5% of patients at risk. Deterioration of Graf's classification of types was seen in 3.2%. 13 children, 3 of the screened group and 10 of the nonscreened group developed hip dysplasia. None of them would have been missed since they were borderline type IIA on at least one side, which warranted mandatory follow-up.

Age Factors↗
PubMed1993

Efficacy and safety of growth hormone treatment in short children with renal allografts: three year experience. Members of the German Study Group for Growth Hormone Treatment in Children with Renal Allografts.

The majority of children with renal allografts have diminished growth and reduced final height. Impaired allograft function and glucocorticoid treatment are the main contributing factors. Since recombinant human growth hormone (rhGH) treatment was able to counteract the growth depressing effects of glucocorticoids in experimental uremia, an open-labeled prospective study in 17 short children with renal allografts was designed to investigate the efficacy of rhGH therapy (30 IU/m2/week) with special emphasis on the safety regarding graft function and carbohydrate metabolism. Height velocity in prepubertal children (N = 10) increased from baseline median 2.2 cm/year to 7.9 cm/year after one year (P < 0.01), 7.2 cm/year after two years (P < 0.01), and 5.5 cm/year (P < 0.05) after three years of rhGH therapy. This resulted in a normalization of height in three out of seven patients after two years and in three out of five after three years of therapy. Growth stimulation in pubertal children was less consistent. Bone maturation paralleled chronological age. The effect of rhGH treatment on longitudinal growth may be partially attributable to the improved ratio between the serum concentration of the insulin-like growth factor (IGF)-I and its major binding protein (BP) IGFBP-3 leading to a normal IGF bioactivity. The incidence of acute rejection crises in the study group (corrected for time after grafting) did not differ from that of untreated retrospective "controls" (0.10 vs. 0.12 episodes per patient and year). No systematic effect of rhGH on glomerular filtration rate assessed by repeated inulin and creatinine clearances was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[Integrative imaging of nephroblastomas and nephroblastomatosis].

Studies on Wilms' tumor have led to intensive investigation of the relationship between nephroblastosis and nephroblastomatosis. Diagnostic strategies have changed: excretory urography is no longer recommended since all information needed is readily obtained by other imaging modalities. Ultrasound is used for the initial examination and confirms the presence and the localization of the mass. CT scan reveals perirenal invasion, and MRI allows the determination of tumor volume and confirmation or exclusion of vascular involvement.

Humans↗
PubMed1993

["Rare" urography by MRI: an alternative to IVU?].

The authors describe the technique of RARE sequences (Hennig, 1986) and their hydrographic application to urinary imaging, RARE urography. Heavily T2-weighted non-tomographic images of the urinary tract are obtained in less than 30 seconds, without contrast medium or ionizing radiation. The whole urinary tract is visualised on one image with a spatial resolution superior to that of sonography. The semiology of RARE urography is similar to that of the intravenous pyelogram. Silent kidneys are also visualised.

Adult↗
PubMed1993

The Castillo-Morales approach to orofacial pathology in Down syndrome.

Infants with Down syndrome often present with a familiar orofacial disorder which exists at birth or becomes more pronounced by the end of the first year. The primary pathology includes hypotonicity of the perioral muscles, lips, and masticatory muscles and a protruding tongue, later followed by active tongue protrusion. This results in problems with sucking, swallowing, drooling and dentition. Early intervention methods employing the combination of Castillo-Morales Manual Orofacial Therapy and his specially designed palatal plate, can improve orofacial function, facial appearance and prevent secondary conditions like pseudoprognathism, dental diseases, malocclusions, open mouth habit and pseudomacroglossia. This retrospective study examines the outcome of therapy, as prescribed by Castillo-Morales, in 39 children with Down syndrome. Normally, the average age to begin oral therapy is between six to eight months. The children were treated with the Castillo-Morales Manual Orofacial Therapy and his palatal plate for an average of 17.9 months. In this study, clinical evaluations at the beginning and the end of therapy focused only on open mouth posture and tongue protrusion. In addition, the direct stimulating effect of the palatal plate on tongue protrusion was evaluated. Significant positive results were observed in all three areas.

Child, Preschool↗
PubMed1992

Growth hormone treatment in children with preterminal chronic renal failure: no adverse effect on glomerular filtration rate.

Impaired growth and stunting remains a major therapeutic problem in children with chronic renal failure (CRF). Recombinant human growth hormone (rhGH) treatment may be beneficial, but concern has been raised about possible side-effects, i.e. deterioration of renal function and glucose intolerance. We have treated 10 prepubertal children with CRF (median age 7.5 [1.7-10.0] years) with 4 IU rhGH/m2 per day s.c. over a period of 1 year. Height velocity increased significantly (P less than 0.03) from basal 4.6 (2.0-14.0) cm/year to 9.7 (6.8-17.6) cm/year. Height velocity SDS for chronological age and for bone age increased in all children from basal median -2.3 to +3.8 (P less than 0.005). Median glomerular filtration rate (GFR) measured by single injection inulin clearance at onset was 18 (11-66) ml/min per 1.73 m2 and did not change significantly during the treatment year. The loss of GFR as estimated by creatinine clearance was similar during the treatment year (median loss 1.3 ml/min per 1.73 m2) compared to the year before treatment (median loss 3.7 ml/min per 1.73 m2). Serum glucose levels during an oral glucose tolerance test did not change, but fasting as well as stimulated insulin levels increased significantly with time during the study period. It is concluded that the rhGH regimen employed was remarkably effective in improving growth velocity in children with CRF without adversely affecting GFR. Glucose homeostasis remained stable, but at the expense of increased serum insulin levels.

Blood Glucose↗
PubMed1992

[Indications for magnetic resonance tomography of abdominal space-occupying lesions in children].

The frequency of magnetic resonance imaging for investigation of abdominal tumors in childhood is increasing. Malignancies of the liver can be visualized. For benign lesions the accuracy is high particularly in the case of hemangiomas. Magnetic resonance investigations are advisable in the presence of abdominal tumors, in order to differentiate lymph nodes and vascular involvement. Magnetic resonance imaging is mandatory in the case of retroperitoneal and presacral masses to depict any intraspinal tumor spread. RARE myelography can replace computed tomography myelography.

Abdominal Neoplasms↗
PubMed1991

[RARE-MR urography: a rapid MR tomographic imaging procedure for the diagnosis of urinary tract malformations in childhood].

RARE-MR urography (so called "water-pictures") is a fast MR imaging technique that selectively depicts fluid without contrast application. Acquisition time is 6.4 s per slice with 1 excitation, or 23 s per slice with 2 averages respectively. From Sept. 1989 to April 1990 24 children with anomalies of the urinary tract have been examined each by RARE MR urography and one T1-weighted spin-echo sequence. Independent of excretory function, the technique can show dilated calices and renal pelvis, pelviureteric obstruction, renal duplication, and megaureter. However, it cannot distinguish between vesicoureteric reflux and obstructive megaureter. Our first results suggest that RARE MR urography combined with ultrasound, reflux cystography and isotope nephrography, can replace excretory urography in certain circumstances--or at least postpone it to the preoperative phase.

Adolescent↗
PubMed1991

Effects of two years of growth hormone treatment in short children with renal disease. The German Study Group for Growth Hormone Treatment in Chronic Renal Failure.

The effect of 1-2 years of growth hormone (GH) treatment (28-30 IU/m2/week) on growth rate, bone age, renal function and metabolic parameters was studied in 61 short, slowly growing children with chronic renal disease (20 with preterminal chronic renal failure (CRF), 24 with end-stage renal failure (ESRF) and 17 with functioning renal transplants). Height velocity (2-year data) significantly increased in children with preterminal CRF from a baseline median of 4.1 cm/year to 9.2 cm/year after 1 year and to 6.6 cm/year after 2 years of treatment. In patients with transplants, the corresponding values were 2.6 cm/year before GH treatment and 8.6 and 7.2 cm/year after 1 and 2 years, respectively. This resulted in normalization of height in 8 of the 16 children who completed 2 years of treatment. The growth response after 1 year in children with preterminal CRF was significantly higher than that in children with ESRF. Bone maturation was in proportion to the increase in chronological age; the expected final height of the children therefore increased by approximately 8-10 cm. In children with preterminal CRF, the decrease in glomerular filtration rate was not affected by 2 years of treatment with GH. The incidence of acute rejection in children with transplants was low; however, a slight stimulatory effect of GH could not be excluded. The major metabolic change induced by exogenous GH was an increase in serum levels of insulin in the three treatment groups, though all glucose tolerance tests remained stable over the 2-year period.

Adolescent↗
PubMed1990

[Differential diagnosis of inflammatory lung diseases in childhood].

The response to lower airway infection in childhood is different from that in later life. Agent-specific reactions and the age of the child have to be considered in differential diagnosis. Indicators of a bacterial or a viral etiology of the pulmonary findings are often present. However, in some cases the etiology cannot be determined because mixed infections are present. Furthermore, the roentgenographic findings in viral pneumonia may mimic the signs of bacterial infection. Age-specific radiographic findings in pulmonary infections are discussed.

Child↗
PubMed1988

[Spontaneous pneumothorax in cystic fibrosis].

The clinical course of 13 cystic fibrosis patients with a total of 24 episodes of pneumothorax was analysed. The study is based on 488 (273/215) patients seen over 20 respectively 10 years at the University Children's Hospitals Frankfurt/Main and Essen. A pneumothorax was observed with a frequency of 2.7% mainly in adolescents of young adults with advanced pulmonary disease (mean age 17.4 years). It was not seen before the age of 10 years. Thus among 255 patients at risk above 10 years a pneumothorax occurred in 5.1%. Presenting symptoms were acute chest pain (n = 17), dyspnea (n = 17) and irritating cough (n = 8). In two patients pneumothorax was an incidental diagnosis. A tension pneumothorax was seen in 7 (= 30%; 3 initial, 4 recurrences of which 3 were ipsilateral). Out of 11 recurrences (n = 6, ipsi- and n = 5, contralateral) 4 occurred only once, one twice and in one patient five times. Two patients died as a consequence of the event (one initially due to tension pneumothorax, one due to heart failure). The therapeutic approach was conservative. Without specific treatment pneumothorax resolved in 12 cases. Ten patients were treated by chest tube drainage and only one patient by pleurodesis with a sclerosing agent. Though the therapeutic results were favorable in the patients presented, the authors suggest more aggressive treatment in view of the high ipsilateral recurrence rate. Detailed recommendations are given.

Child↗
PubMed1986

[Therapy of pituitary dwarfism with recombinant human growth hormone. A multicenter study].

During the period from 1982 to 1985, biosynthetic growth hormone (methionyl-hGH) was administered to 55 children with pituitary growth deficiency, 49 with idiopathic, six with other forms of the disorder. Preparations with a relatively high content of Escherichia coli polypeptides (ECP) were given to 32 children (group I), those with a markedly reduced ECP content to 12 (group II), while 11 children received almost ECP-free preparations (group III). The treatment achieved an intensive rise of growth acceleration in all three groups. At the same time, somatomedin C, biological somatomedin activity and alkaline phosphatase rose steeply, reaching a maximum after six months and remaining at high concentrations even thereafter. High antibody titres against ECP and hGH (with high binding capacity) were demonstrated in group I children, significantly lower titres with little binding capacity in those of group II, while most of those in group III had no measurable antibodies. Even in high concentrations the antibodies did not have any inhibiting effect on growth. No positive correlation between antibody titre and growth velocity was demonstrable. An exception was a boy with an allergy in group I, who had a maximal antibody titre and, at the same time, a high serum concentration of IgE. He had marked delay in growth which, however, quickly became normal on administration of extractive hGH.

Bacterial Proteins↗