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Biomedical subjects

J A Bliesener

Publications and source records attributed to J A Bliesener.

At least 19 recordsLinked to original sources
PubMed1990

[Brain stem dysfunction in Arnold-Chiari II syndrome].

Among 76 patients suffering from myelomeningocele treated during 1978 to 1987 there were 12 children with brain stem signs as a sequel to Arnold-Chiari II syndrome. In 2 of these patients only stridor was seen, in 4 stridor with attacks of apnoea, in 2 attacks of apnoea with dysphagia, and in 4 children stridor, attacks of apnoea and dysphagia. Hence, it will be necessary to modify the classification given by Charney et al (4) in respect of brain stem patterns of signs according to three grades, since the signs of stridor, apnoea and dysphagia can be combined with each other in different ways. The prognosis is infaust if all 3 signs and hence grade III of brain stem lesions are present. On the whole, 6 out of 12 patients with brain stem signs died. For this reason, a possible Arnold-Chiari malformation should always be considered if stridor is observed, and, if necessary, early decompression treatment by means of a shunt revision should be performed.

Arnold-Chiari Malformation↗
PubMed1988

Imaging of uretero-pelvic junction obstruction with stimulated diuresis. With consideration of the reliability of ultrasonography.

Eighty-nine kidneys of 81 infants and children with uretero-pelvic junction obstruction were investigated using ultrasonography (US), diuretic urography (DUR) and diuretic renography (DREN). Results of the US were false-negative in 14%. This can be avoided by ensuring that the patients get an amount of fluid appropriate to their age before the examination or by performing diuretic ultrasonography with frusemide. False-positive results were found with US in 15%, but obstruction was excluded by using the DUR and/or the DREN. During post-operative follow up the DUS is useful and after 6 months the clearance with 123-iodine hippurate combined with the DREN should be performed. The performance of the Whitaker-test is unnecessary.

Child↗
PubMed1986

[Comparative results of ileal conduit and colonic conduit. Analysis of 50 children with bladder exstrophy].

During the last 20 years 50 children with exstrophy of the bladder were treated in the Department of Paediatric Surgery of the Children's Hospital of Cologne employing besides other surgical methods such as primary closure, ureterosigmoideostomy, ureterocutaneostomy etc., in 15 cases an ileal conduit and in 12 cases a colonic conduit. These children could be followed up on the average 8.5 or 3 years after the operation, clinically, roentgenologically and in some cases via scintigraphy. Late complications requiring surgical correction, such as stomatostenoses, conduit elongation, stenoses of the ureterointestinal anastomosis, calculus formation in the conduit, or complications like ureteral reflux, recurring infections of the urinary passages with pyelonephritis, occurred only with ileal conduits, whereas no late complications requiring surgery were seen with the colonic conduits. Similar results in respect of late complications were found among the patients in Munich from 1955 to 1983 with 35 exstrophies of the bladder (13 ileal conduits, 1 colonic conduit) in which additionally an adeno-carcinoma was seen after ureterosigmoideostomy with fatal outcome. Hence, we are of the opinion that the method of choice is the preparation of a colonic conduit in patients with exstrophy of the bladder where primary closure is not possible because the bladder lamina is too small or already epithelialised. This approach offers the safest possible long-term protection of the primary normally positioned upper urinary tract.

Bladder Exstrophy↗
PubMed1985

Bone metastasizing renal tumor (clear cell sarcoma) of childhood with epithelioid elements.

A case of bone metastasizing renal tumor (clear cell sarcoma) of childhood (BMRTC) is presented. Histologic examination demonstrated the typical histopathologic features of this type of tumor. In addition, epithelial cells were present which occurred in groups, either around a central eosinophilic core or occasionally around a small central lumen. To the authors' knowledge, the presence of epithelial cells in BMRTC has not been reported before. The histogenetic implication of this finding is discussed.

Bone Neoplasms↗
PubMed1985

[Diagnosis of Arnold-Chiari deformity in the newborn infant].

Meningomyelocele patients with Arnold-Chiari deformity type II have a great number of complex malformations of the brain that can be diagnosed quickly, safely and--last but not least--at low cost via sonography. Follow-up or control examinations of the changing ventricle size before and after shunt operation can be repeated any number of times without radiation exposure. Determination of the circumference of the head does not seem to be very helpful in deciding whether a ventricular enlargement makes shunting imperative or not. Prognostically of greater value seems to be the determination of the angle between the clivus and the fourth ventricle, values around 40 degrees (SD 35 degrees-46 degrees) being normal, whereas angles around 30 degrees are indicative of growing hydrocephalus.

Arnold-Chiari Malformation↗
PubMed1982

[Posthaemorrhagic hydrocephalus and periventricular cerebral atrophy in preterm infants with birth weights of 1,500 gm or less. Determination of incidence by brain ultrasound].

Real time ultrasound examinations were performed on 80 consecutive born and surviving infants whose birth weights were 1,500 gm or less. Prior to discharge from the hospital 8 children were shown to have morphologic abnormalities caused by cerebral ischaemia or intraventricular haemorrhage. 6 children (7.5%) had non-progressive enlargement of parts of the ventricular system. 2 children (2.5%) developed a post haemorrhagic hydrocephalus. In one case ventriculostomy was performed, the other had spontaneous arrest. Ultrasound examination of the infant's brain is an ideal screening method to identify children at risk for later development.

Atrophy↗
PubMed1982

[Abnormal choledocho-pancreatico ductal junction causative of cystic-cylindric dilatation of intra- and extrahepatic bile ducts].

During the last 5 years there were 6 patients found to have abnormal ductal junction of the choledochus into the pancreas. Clinical signs were: repeating upper abdominal pain, intermittent icterus, signs of pancreatitis and/or palpable tumor. Sonography is the initial examination to show up a dilatation of the intra- and extrahepatic bile ducts. But intraoperative cholangiography alone reveals the true condition of the choledocho-pancreatico ductal junction. Only after this procedure the therapeutic step of a choledocho-jejunostomy should be done.

Adolescent↗
PubMed1981

[Intracranial alterations in infants and small children. Techniques and results of sonography (author's transl)].

As long as the fontanelle is open sonographical examination of intracranial alterations in infants and small children (maximally aged 2 years) is a rather helpful, rapid, cheap, non-invasive, and easily repeated method with no side-effects. Brain structures can be shown in two planes giving a fair amount of instructive results. The method should be used as a routine for screening in children at risk. The use of intracranial computer tomography in infants and small children can be significantly reduced by sonography, as we could show.

Brain Diseases↗
PubMed1981

[Value of brain sonography in newborns and children (author's transl)].

Intracranial changes of newborns and young children can easily be discovered by modern sonography, especially as long as fontanelles are still open. Sonography of brain first should be done before computed tomography, encephalography and/or ventriculography are performed. Correspondence of most sonographic findings and computed tomography by other authors, is supporting reduction of CT-investigations in favour of sonography. We cannot agree with the idea that computed tomography should be the most important first investigation. Technical reasons as thick skull or closed fontanelles are making sonography impossible and computer tomography should be used. Special examples out of about 1100 Sonograms of skulls of children are demonstrating, that sonography of newborns and children is the method, which is cheap, without risk, less time consuming, and without any radiation stress.

Arnold-Chiari Malformation↗
PubMed1980

Normal and pathological growth of the foramen occipitale magnum shown in the plain radiography.

The transverse diameter fo the foramen occipitale magnum (f. o. m.) in the semiaxial skull X-ray was measured and evaluated statistically in 174 cerebrally healthy children of different ages. These normal values are contrasted with the foramen diameters of 35 children with verified Arnold-Chiari malformation as well as children with macrocephaly and microcephaly. The values in children with Arnold-Chiari malformation are all above the norm, irrespective of whether or not there is a concomitant hydrocephalus.

Adolescent↗
PubMed1980

[Radiologic diagnosis of atrio-ventricular shunt function (valvogram) (author's transl)].

The valvogram by means of radiography is a simple, rapid and safe technique to determine the site of shunt blockade in valve dependent children. For this diagnostic procedure, reservoirs of the double-dome type are best suited. Indications and method with regard to clinical and radiological findings are described and discussed, including our own experience with 50 valvograms performed in 46 children. The value of other examination methods, e.g. CT and sonography, is compared with that of valvoraphy.

Adolescent↗
PubMed1980

[Ultrasonographic screening of the cranium in risk newborn (author's transl)].

This article goes into the question whether prophylactic examination of the cranium of risk newborn via ultrasonography would be meaningful or not. A total of 443 patients was examined during the period January to September 1980. Of these, 160 had shown clinical signs, whereas the remaining 283 clinically apparently normal risk newborn were subjected to ultrasonography before discharge. In 21 cases, findings were pathological (7.4%). Ventricles which were pathologically deformed and of plump shape, represented the main group, followed by hydrocephalus, subdural effusion and intraventricular haemorrhage.

Brain Diseases↗
PubMed1979

Ventriculography with positive contrast medium in early infancy.

42 ventriculographies (PV) were carried out in infants between 10 days and 10 months of age using positive contrast medium. Indications, technique of PV and complications are discussed; PV is compared with CT and it is concluded that PV is a simple method of clarifying the causes of a macrocephalus in infancy without great technical effort and that the roles of CT and PV are valuable diagnostic modalities which are complementary.

Arnold-Chiari Malformation↗
PubMed1979

[Positive ventriculography and computer assisted tomography of the skull in the evaluation of megalocephaly in newborns and infants (author's transl)].

To clarify indications and limits of computer assisted tomography and positive ventriculography the results of both methods were compared with each other retrospectively in 55 macrocephalic newborns and infants. It could be shown that positive ventriculography, even if combined with coronal views, was superseded by computer assisted tomography to only a certain extent. To complete the appropriate diagnosis preoperatively positive ventriculography was necessary most often in patients with paranatal disturbances who had undergone intensive care treatment. The non-invasive method of computer assisted tomography often yielded sufficient information on localisation, size, and nature of the underlying pathologic process. Both methods turned out to be complementary when topographical and functional interrelations of cranial cysts had to be demonstrated, especially structures of the midline and of the posterior fossa, which could not be visualized by computer assisted tomography alone.

Brain Neoplasms↗
PubMed1978

A simple screening method for detecting gastrointestinal protein loss in intestinal lymphangiectasia.

A ten month old female Turkish child with chylous ascites, diarrhea, steatorrhea, peripheral edema and hypoproteinemia was investigated for protein losing enteropathy which probably dated from the first weeks of life. Gastrointestinal protein loss appeared to be due to abnormalities of the intestinal lymphatics. In order to detect a localized lymphoenteric fistula, lymphangiography was tried but failed due to hypoplasia of peripheral lymphatics. However, three hours after intradermal injection of Patent Blue, the dye appeared in the stools of the patient, suggesting intestinal protein loss via a lympho-enteric fistula. This observation may provide the basis for a diagnostic test for gastro-intestinal protein loss in patients with intestinal lymphangiectasia.

Coloring Agents↗
PubMed1978

Positive ventriculography using water-soluble contrast media in infants with myelomeningocele and hydrocephalus.

Ventriculography with meglumine iocarmate (Dimer X) or Metrizamide (Amipaque was carried out in 15 infants with myelomeningocele and progressive hydrocephalus. In all cases, an Anold-Chiari-Malformation type II was diagnosed with compression of the structures of the posterior cranial cavity and their displacement within or below the level of the foramen magnum. The aqueduct was always patent but laterally compressed. In the region of the third ventricle there was often encountered an enlargement of the massa intermedia with indentation of the lamina terminalis and enlargement of the recessus suprapinealis. Aspects of pathogenesis of the malformation and possible causes of hydrocephalus originating from these findings are discussed. Methods and advantages of positive ventriculography using water-soluble media are presented.

Arnold-Chiari Malformation↗
PubMed1977

[The diagnosis of cystic malformations of the biliary tree during childhood (author's transl)].

Percutaneous, transhepatic cholangiography was carried out in a child aged 1 year and 10 months suffering from obstructive jaundice when non-invasive radiological methods had proved useless. PTC is of considerable value in the diagnosis of cystic disease of the biliary system. Its advantages in planning surgery are described. The technique, indications and contra-indications are discussed.

Biliary Tract↗