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Biomedical subjects

E Merz

Publications and source records attributed to E Merz.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Use of 3D ultrasound technique in prenatal diagnosis].

Within a few years 3-dimensional prenatal ultrasound has achieved such a high standard that this technique opens up a new way of image rendering in prenatal diagnosis both for the examiner and for the patient. Using a 3-D ultrasound probe, data acquisition and storage of defined volumes is possible under routine conditions. Within the stored volume every dimension can be visualised and high quality 3-D surface and translucency images can also be provided rapidly. In prenatal diagnosis the advantages are not only in demonstrating precisely the extent of a defect, especially of the surface, but also to convince the parents concerned by clear demonstration of the absence of a specific defect. In 3-D technology there are still some problems to be solved: in severe oligohydramnios, no surface images can be provided, and in the examination of moving objects movement artifacts can occur. On the other hand, improvements in computer technology will soon provide an accelerated image rendering.

Congenital Abnormalities↗
PubMed1995

[Normal ultrasound curves of the fetal osseous thorax and fetal lung].

Over and above the evaluation of fetal standard data, chest and lung measurements were performed in a prospective cross-sectional study with real-time ultrasound. The study group consisted of 610 patients between 12 and 41 weeks' gestation. Only uncomplicated pregnancies with carefully documented gestational age were included. Patients with multiple pregnancy, fetal anomalies, intrauterine growth retardation or macrosomia and patients with oligohydramnios were excluded. Transversal (BTTD) and sagittal (BTSD) diameter of the bony fetal thorax were measured as an outer-outer-measurement at the level of the atrioventricular valves; the thorax should be as circular as possible and at right angles to the fetal spine. Lung measurements (LD) were performed in the same plane in the direct extension of the long axis of the fetal heart. The circumference of the bony thorax (BTC) was calculated from the two thoracic diameters according to the formula BTC = (BTTD+BTSD)/2 x 3.142. For all parameters growth curves with 5., 50. and 95. percentiles were established. Growth of the bony thorax as well as the lung diameter was shown in a nonlinear function. Lung diameter and thoracic circumference were used to calculate the ratio of these two parameters with reference to the gestational age.

Anthropometry↗
PubMed1995

Three-dimensional ultrasonography in prenatal diagnosis.

Within the past five years, 3D ultrasonography has developed to the degree that it offers both the patient and the examiner an entirely new visual experience in prenatal diagnosis. With the system described here (Kretz-technik, Austria), any desired plane can be displayed within the stored volume, and within seconds a high-quality 3D surface or transparent image can be calculated and displayed on the ultrasound monitor without need for an external workstation. All of this can be performed routinely in the clinical setting. Since 1989 we have routinely examined a total of 458 fetuses (242 normal and 216 with anomalies) between 16 and 38 weeks of gestation, supplementing our conventional 2D ultrasound scans with a 3D examination using an abdominal volume transducer. A comparison of the 2D and 3D techniques shows that 3D provides a diagnostic gain in a large percentage of cases (64.2%). The simplest 3D technique of the orthogonal image display provided a diagnostic gain in 46.2% (61/132) of the cases owing to the accurate topographic depiction of the desired image plane. The combined 3D display (orthogonal format plus a 3D surface or transparent view) provided a diagnostic gain in 71.5% (233/326) of the cases. This higher percentage resulted from the additional 3D surface reconstruction, the ability to view and evaluate the fetus from various angles, the ability to determine the exact size of a fetal defect, the depiction of skeletal anatomy in the transparent mode, and the improved delineation of complex malformations. Problems with 3D imaging are encountered in patients with pronounced oligohydramnios, which prevents surface reconstruction, and in the examination of moving objects, which produce motion artifacts.

Congenital Abnormalities↗
PubMed1995

[Uterine diagnosis].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1995

[3-D ultrasound in prenatal diagnosis].

OBJECTIVE: Within the past several years, 3-D ultrasonography has developed to a highly advanced diagnostic procedure. The aim of this study was to define the advantages of 3-D ultrasound in prenatal diagnosis in comparison to the conventional 2-D technique. METHODS: Since 1989 we have routinely examined a total of 458 fetuses (242 normal and 216 with anomalies) between 16 and 38 weeks of gestation, supplementing our conventional 2-D ultrasound scans with a 3-D examination using an abdominal volume transducer (Combison 330 and 530, 3.5/5 MHz, Kretztechnik Austria). With this system all 3 orthogonal planes can be displayed on the ultrasound monitor and high-quality 3-D surface or transparent images can be calculated and displayed on the ultrasound monitor as well without need for an external workstation. RESULTS: The comparison of the 2-D and 3-D techniques shows that 3-D provides a diagnostic gain in a large percentage of cases (64.2%). The simplest 3-D technique of the orthogonal image display provided a diagnostic gain in 46.2% (61/132) of the cases owing to the accurate topographic depiction of the desired image plane. The combined 3-D display (orthogonal format plus a 3-D surface or transparent view) provided a diagnostic gain in 71.5% (233/326) of the cases, due to the additional 3-D surface reconstruction and the ability to depict the skeletal anatomy in the transparent mode. Problems with 3-D imaging are encountered in patients with oligohydramnios, which prevents surface reconstruction, and in the examination of moving objects, which produce motion artifacts. CONCLUSION: Today 3-D ultrasonography offers both the patient and the examiner an entirely new visual experience in prenatal diagnosis.

Congenital Abnormalities↗
PubMed1995

Age-related reference ranges for growth parameters.

We propose an approach to the computation of age-related reference ranges which guarantees that the proportion of sampled data points covered by the reference band has an arbitrarily specified value. Unlike other approaches in the literature, this method does not have to rely on parametric distributional assumptions. The boundaries of the bands are given by smooth curves, and for modeling the mean as a function of age, a sufficiently flexible class of monotonically increasing functions is used, since in the applications all measured variables are biological growth parameters. The width of the reference band is allowed to be proportional to any suitably fixed function of age which we propose in practice to be taken linear. The approach is illustrated by examples from a large-scale study of the distribution of fetal size measurements obtained by routine prenatal sonography.

Age Factors↗
PubMed1994

[Current status of vaginal sonography. Part I: Basic principles and gynecologic diagnosis].

During the last 8 years transvaginal sonography or vaginosonography has become an essential part of diagnosis in gynaecology and obstetrics. Due to the outstanding image quality of the pelvic viscera without requiring a full bladder technique, vaginosonography is performed more and more often in clinical and private medical practice. In several applications transvaginal scanning has replaced transabdominal scanning. Due to the development of small-diameter probes it is now possible to examine patients with an intact hymen or with a very narrow vagina. The combination of transvaginal probe and Doppler-/colour Doppler technique opens up new avenues in gynaecological ultrasound, especially for tumour diagnosis in the lower pelvis. However, transvaginal sonography cannot be used universally in gynaecology and obstetrics as the diagnosis is limited to findings in the lower pelvis because of the limited penetration depth.

Female↗
PubMed1994

[Current status of vaginal ultrasound. Part II: Obstetrical diagnosis, new aspects and future perspectives].

In obstetrics the main advantage of transvaginal sonography is in the first trimester. It is possible to diagnose normal or abnormal pregnancy or ectopic pregnancy earlier and more exactly than with transabdominal ultrasound. Furthermore different foetal malformations can be detected within the first trimester. Applications in the second and third trimesters are the evaluation of the cervix to detect cervical incompetence or the evaluation of the lower placental segment in case of placenta praevia. In contrast to transvaginal ultrasound the assessment of the foetus in the second and third trimesters remains a domain of abdominal ultrasound. However, transvaginal scanning can be a useful adjunct in cases where the foetal head is deeply engaged or for the visualisation of a foetal organ that is close to the vaginal probe. Transvaginal colour Doppler as well as transvaginal 3 D-volume scanning represent new aspects of transvaginal sonography in obstetrics and gynaecology. These techniques will provide progress especially in tumour diagnosis in the lower pelvis in the future.

Blood Flow Velocity↗
PubMed1994

[Rupture of a splenic artery aneurysm intra partum].

The rupture of a splenic artery aneurysm in pregnancy and during labour is a rare event with a high maternal and fetal mortality rate. This report is, in view of previously reported cases, on the thirteenth case of a ruptured splenic artery aneurysm reporting survival of both mother and fetus. The etiology, clinical signs, diagnosis and therapy are discussed with reference to consideration of the literature. The necessity of an early differential diagnostic consideration of this rare occurrence is discussed, because this is the only way to achieve survival of mother and fetus.

Adult↗
PubMed1994

[Minimally invasive therapy of peritoneal leiomyomatosis. A case report of diagnostic and therapeutic problems].

Leiomyomatosis peritonealis disseminata (LPD) is a rare benign disease characterised by the presence of multiple intraabdominal nodules, consisting of benign smooth muscle. LPD has only been found in women, predominantly in their late reproductive age. There is a very high association with excess exogenous and endogenous female gonadal steroids, specifically oestrogen and progesterone. Since it is grossly indistinguishable from diffuse carcinomatosis of the peritoneum, several unnecessary radical procedures have resulted. We describe the 44th documented case and the first case of minimal invasive surgery in a 42-year-old women with peritoneal leiomyoma on the right pelvic wall and uterine subserous and submucous leiomyoma.

Biopsy↗
PubMed1993

Serial measurements of transient evoked otoacoustic emissions (TEOAEs) in healthy newborns and in newborns with perinatal infection.

Detection of hearing impairment in early childhood is difficult. We serially recorded transient evoked otoacoustic emissions (TEOAEs) to search for signs of ototoxicity in term, healthy newborns and compared the results to a second group of term babies treated for perinatally acquired bacterial infection with ampicillin plus either cefotaxime or plus aminoglycoside. At initial evaluation, in the group of 45 healthy children born at term, well reproducible emissions were observed in all but two children. In each of these two, initially well reproducible TEOAEs were detected in one ear only. At the time of the second recording (mean at day 8.5) excellent emissions were seen in all ears of all children. Similarly, in the second group receiving ampicillin plus either cefotaxime or plus aminoglycoside, the height of emissions as well as TEOAE-reproducibility was equal or even increased at the time of the second evaluation in all 17 patients. In the following group of 59 patients, all receiving ampicillin plus aminoglycoside, again TEOAEs were equal or improved at the time of follow-up examinations. In all patients, a reduced general condition tended to be associated with less reproducible TEOAEs. We conclude that at conventional doses in low-risk infants, aminoglycosides are unlikely to cause ototoxicity and that in early childhood serial TEOAE-recording may be useful for evaluation of inner ear function.

Ampicillin↗
PubMed1993

[Prenatal diagnosis of fetal teratomas].

Teratomas are the most frequent tumours in a newborn child. Prenatal ultrasound allows an early diagnosis with high significance. Six cases are described by prenatal sonographic signs, clinical management and pathologic-anatomic findings. Since teratomas are mostly benign and surgery is often successful, sufficient cooperation between obstetricians, surgeons and neonatologists is important.

Adult↗
PubMed1992

Fetal presentation of Morquio disease type A.

A fetus with mucopolysaccharidosis type IV A (Morquio type A) is described. The family had one affected child exhibiting symptoms of classical Morquio A disease, and late in the subsequent pregnancy prenatal diagnosis was requested. At 23 weeks' gestation, moderate ascites was detected by detailed ultrasound scan and keratan sulphate was found in the amniotic fluid. The pregnancy was terminated by prostaglandin induction and the diagnosis of mucopolysaccharidosis type IV A was confirmed by demonstration of a deficiency of N-acetylgalactosamine-6-sulphate (GalNac-6-S) sulphatase in cultured amniotic cells and in post-mortem fibroblast cultures. The activities of beta-galactosidase and arylsulphatase A were normal, ruling out Morquio disease type B and multiple sulphatase deficiency. These results indicate that mucopolysaccharidosis IV A (a disease that predominantly affects the skeletal system) may produce ascites in the fetus to such an extent that it can be detected by ultrasound.

Amniocentesis↗
PubMed1990

[Ultrasonic diagnosis of fetal triploidy].

It can be assumed that among the most frequent pointers to triploidy are the sonographic proof of the existence of a voluminous and vacuolic placenta, early retardation of growth, and the presence of an oligohydramnios. Occasionally, other malformations are also observed, such as hydrocephalus or neural tube defects. Sonographic findings are demonstrated in two cases of triploidy found to exist before the 24 weeks of pregnancy in the living foetus. The clinical signs and patterns are discussed.

Abnormalities, Multiple↗