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Biomedical subjects

J Mayr

Publications and source records attributed to J Mayr.

At least 37 records · Page 2Linked to original sources
PubMed2001

Sonography and color Doppler sonography for monitoring conservatively treated infantile hypertrophic pyloric stenosis.

OBJECTIVE: To evaluate the role of sonography in infants with hypertrophic pyloric stenosis undergoing conservative medical treatment. METHODS: Twenty-two infants (17 male and 5 female; age range, 1-12 weeks) were clinically and sonographically considered suitable for conservative treatment and underwent follow-up during the course of the disease. Sonography was performed under a standardized protocol and included color Doppler sonography. RESULTS: Fifteen infants (mean age, 9 weeks) needed surgery. They initially had a mean pyloric length of 18 mm, a diameter of 10.5 mm, and a wall thickness of 4 mm, with visible passage of food into the duodenum. These values deteriorated during follow-up (mean preoperative values: length, 20 mm; diameter, 12 mm; and wall thickness, 4.5 mm); furthermore, passage of food through the pyloric canal ceased. Seven infants (mean age, 3 weeks) were successfully treated conservatively Their initial mean pyloric measurements were slightly smaller (length, 15 mm; diameter, 10 mm; and wall thickness, 3.8 mm) and did not deteriorate during follow-up. In all of them, sonography showed improvement of passage through the pyloric canal within several days, as shown and documented by color Doppler sonography; morphologic changes persisted longer despite clinical improvement. CONCLUSIONS: Sonography, including color Doppler sonography, is a valuable tool for monitoring infants with hypertrophic pyloric stenosis undergoing conservative treatment; however, initial sonograms cannot predict the further course of the disease.

Atropine Derivatives↗
PubMed2000

[Apophyseal fractures of the pelvis and trochanter minor in 20 adolescents and 2 young children].

From 1978 to 1999, 22 patients (17 male, 5 female) who suffered apophyseal fractures of the pelvis and femoral lesser trochanter (18 patients by avulsion, 4 patients by direct trauma) were treated. The median age of the patients was 12.5 years (range, 1-16 years). Eighteen patients were injured during sports activities. Predominantly the anterior inferior iliac spine (n = 9) was affected, followed by fractures of the femoral lesser trochanter (n = 3), periacetabular rim (n = 3), anterior superior iliac spine (n = 2), and iliac crest (n = 2), retrospectively. The diagnosis was established using plain x-ray films. The treatment was conservative in 21 patients (95%) and operative in one (5%). Of the patients, 20 (91%) were followed-up for a median interval of 12 months (3 weeks to 84 months). At follow-up, 15 patients (75%) reported that they were free of pain during sport activities, while five patients (25%), at an average time of 33 months after accident, complained of pain at the former fracture site when exercising vigorously during sport. At clinical examination no patient was found suffering from limitation of ROM (range of motion), adjacent joints, or muscular insufficiency. Plain [not readable: see text]

Acetabulum↗
PubMed2000

Treatment of varicoceles in childhood and adolescence with Tauber's antegrade scrotal sclerotherapy.

PURPOSE: The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy. METHODS: A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35). RESULTS: One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively. CONCLUSION: This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents.

Adolescent↗
PubMed2000

Gastroesophageal reflux and diaphragmatic motility after repair of congenital diaphragmatic hernia.

At the Department of Pediatric Surgery in Graz, 31 boys and 23 girls were operated on for congenital diaphragmatic hernia (CDH) from 1978 to 1994. In 49 patients the defect was on the left, in five on the right side. In 46 cases, the hernia was diagnosed within the first week of life; in eight children at a later date. 19 children (35%) died. 25 of the 35 survivors (71%) came to a follow-up examination on average 9.4 (1-17) years after the operation. 24 h pH-monitoring or manometry and Upper G.I. series revealed pathological gastroesophageal reflux (GER) in 16 patients. Nine children were treated conservatively; in seven patients an antireflux procedure was performed. A thoracic position of the stomach or left liver lobe, presence of a hernial sac, gestational age, prenatal diagnosis, use of a patch or severity of lung hypoplasia did not significantly influence the incidence of GER. In three patients, a hiatal hernia was found. The motility of the diaphragm was documented with M-mode sonography (n = 18); a restricted motility could be demonstrated in five patients. GER is very common in patients after repair of CDH. We recommend long-term follow-up with special interest in respect of GER.

Child↗
PubMed2000

Sonographic evaluation of the thenar compartment musculature.

The thenar region was studied with ultrasonography in 10 healthy volunteers. All thenar muscles could be identified and their course followed entirely. In addition, their function could be assessed by scanning during unresisted or resisted active movements. Standard approach, normal appearance, and dynamic tests for each muscle are described.

Adolescent↗
PubMed1999

The import pathway of human and Thermoplasma 20S proteasomes into HeLa cell nuclei is different from that of classical NLS-bearing proteins.

Wild-type proteasomes of human erythrocytes and the archaeon Thermoplasma acidophilum compete with each other for transport into nuclei of digitonin-permeabilized HeLa cells in the presence of an energy-regenerating system and rabbit reticulocyte lysate. 'NLS'-mutated Thermoplasma proteasomes were also able to compete with human proteasomes in the same assay, although with lower efficiency. Furthermore, in contrast to the other archaeal and bacterial cell lysates tested, the Thermoplasma cytosol efficiently supported nuclear import of human and Thermoplasma proteasomes. However, the same lysate could barely direct the nuclear transport of BSA-NLSsv40 peptide conjugates or the classical NLS-bearing protein, nucleoplasmin. Finally, additional importin alpha/beta significantly decreased the import efficiency of both human and Thermoplasma proteasomes. Taken together, these results suggest that nuclear import of proteasomes may use a novel pathway that is different from that of classical NLS-bearing proteins.

Animals↗
PubMed1999

[Ultrasound identification and size determination of the palmaris longus tendon].

Since the palmaris longus tendon is subject to a wide range of anatomical variations (in 10% of the cases, aplasia is observed), the identification and determination of its length and thickness is of importance for the pre-operative planning of ligament reconstructive surgery. Thirty healthy volunteers aged between 6 and 50 years were examined using high-resolution 10-12 MHz US probes. We determined the length and thickness of the tendon, and its relationship to the median nerve in the distal region of the forearm. Thanks to the dynamic nature of the examination and the typical tendinous echo structure, the palmaris longus tendon was accurately identified by US in both children and adults. Ultrasonography is highly suitable for the identification of the palmaris longus tendon and aids the pre-operative planning of ligament reconstructions.

Adolescent↗
PubMed1998

Late events in the assembly of 20S proteasomes.

Electron microscopy and STEM mass measurements have been used to characterize late intermediates in the assembly pathway of wildtype and mutant Rhodococcus proteasomes. A proteolytically inactive and processing-incompetent mutant, betaK33A, allowed a short-lived late intermediate of the pathway to be captured, the preholoproteasome. In this fully assembled 20S complex the 14 propeptides with an aggregate mass of 100 kDa fill the whole central cavity and most of the two antechambers. It is further shown that in wildtype Rhodococcus proteasomes the propeptides are degraded in a processive manner undergoing multiple cleavages before the products are discharged and the inner cavities are cleared. It appears that the docking of two half-proteasomes, i.e., preholoproteasome formation, is sufficient to trigger autocleavage of the Gly-1/Thr1 bond necessary for active site formation and the subsequent degradation of the propeptides.

Amino Acid Substitution↗
PubMed1998

[Femoral neck fractures in childhood].

In a retrospective multicenter study we followed-up 30 fractures of the neck of the femur in children aged 11 years (1.5-15 years) for 4.8 years (0.5-20.0 years). It is the aim of this study to analyse factors possibly related to outcome, like age at injury, type of fracture, interval between injury and treatment, method of stabilization and postoperative interval until full weight bearing. At follow-up subjective parameters (pain, weather sensitiveness), clinical parameters (range of motion, claudication, leg length discrepancies) and radiological parameters (hip series) were investigated and medical charts and roentgenograms were reviewed using a standardized protocol. 29 of 30 children (96.7%) have sustained displaced fractures. Non-operative treatment has been applied in 4 children. 26 femoral neck fractures (type I: 1, type II: 8, type III: 17) were stabilized by internal fixation using screws and/or pins. Following non-operative treatment one child suffered a coxa vara and another child suffered a avascular femoral head necrosis in combination with coxa vara and leg length shortening of 4 cm. Following operative treatment 9 of 26 children (34.6%) suffered a avascular femoral head necrosis and 3 children (11.5%) suffered a coxa vara. In 6 of 26 children (23%) we observed leg length discrepancies > 2 cm. We were not able to demonstrate any significant follow-up result differencies between the groups of children who have sustained type II or type III fractures, or between the groups of children aged < 10 years when compared to children aged > 10 years, or between the group of children who were operated on within 6 hours after the accident when compared to the group of children operated > 6 hours after the accident. We observed no significant follow-up result differences between the groups of children who had different intervals between operation and full weight bearing. Operative fracture management remains the treatment of choice in the majority of displaced femoral neck fractures in children. However, in our limited study we were not able to demonstrate any significant follow-up result differences between the group of children treated by immediate open reduction and internal fixation (interval injury - operation < 6 hours) when compared to children who had been operated > 6 hours after the injury.

Adolescent↗
PubMed1998

[Ultrasound anatomy and pathology of the elbow joint in the child and in the adult].

The aim of this study was to evaluate the sonographic anatomy of the elbow joint in children and adults and to point out the indications for an ultrasound examination after elbow joint trauma. The study was carried out using isolated joint specimens, muscle specimens and cadaver limbs. Additionally, a clinical trial was performed using high-resolution ultrasound probes (7.5-12 MHz). When assessing standard sections, one has to consider both the position of the elbow joint in the frontal plane and the position of the forearm during pro- and supination. The outstanding advantage of this method, especially in children, is the possibility of a dynamic examination with evaluation of the articular cartilage and with a comparison to the healthy contralateral elbow joint.

Adult↗
PubMed1998

Spontaneous gastrointestinal perforation in very-low-birth-weight infants--a rare complication in a neonatal intensive care unit.

Over a 6-year period (1989-1995), gastrointestinal (GI) perforation was diagnosed in nine preterm infants (mean gestational age 27 weeks, mean birth weight 872 g). Three presented with necrotizing enterocolitis (NEC), two with indwelling-tube-induced perforation of the stomach, one with small-left-colon syndrome, and another with meconium ileus. Spontaneous intestinal perforation occurred in two similar very-low-birth-weight (VLBW) infants, in the distal ileum, on days 8 and 9 of life, respectively. The only clinical sign was extensive abdominal distension, and abdominal X-ray studies revealed free peritoneal air. All findings were distinct from those associated with NEC. Their further clinical course was complicated by reperforation on day 32 and 39, respectively. They subsequently recovered and presented without GI problems at the corrected ages of 4 and 2 months, respectively. In contrast to high mortality of 57% in the group with non-spontaneous intestinal perforations, spontaneous perforation seems to have a good prognosis even in VLBW infants if diagnosed and treated promptly.

Female↗
PubMed1998

Postprandial tachygastria is frequent in infants with gastroesophageal reflux.

Cutaneous electrogastrography (EGG) enables non-invasive recording of gastric electrical activity (GEA). Controversial EGG and ultrasonographic (US) results have been described in infants suffering from gastroesophageal reflux (GER). It was the aim of this study to investigate GEA using transcutaneous EGG in a group of infants free of symptoms indicative of GER and a group with GER (mean age 10 months, (range 3-36 months)) and to investigate gastric emptying in both groups using US. We also investigated possible correlations between EGG and US parameters of the gastric emptying curve. The EGG was recorded over a period of at least 120 min (60 min preprandial to 60 min postprandial). US measurements were made just after completion of the meal and then every 30 min up to 180 min. In infants with GER significantly more tachygastria occurred in the postprandial period when compared to healthy infants, in whom normogastria was predominantly observed (P < 0.05). The sonographically-measured gastric emptying curve could be defined in all infants using an exponential function. No significant differences between the groups were noted; there was no significant correlation between EGG parameters and the De Meester score or parameters of the sonographically-measured gastric emptying curve. From the results of this study, transcutaneous EGG recorded within the postprandial period can be of potential clinical value for non-invasive GER screening in infants. However, the EGG cannot be utilized to investigate gastric emptying in infants.

Child, Preschool↗
PubMed1998

Long-term results of unstable pelvic ring fractures in children.

Seventeen patients less than 12 years old sustained unstable pelvic ring fractures and were treated non-operatively. They were followed for 2 to 25 years. The subjective long-term results depended on the presence or absence of low back pain. This correlated strongly with pelvic asymmetry. Five patients complained about chronic back pain, two were functionally impaired by severe pelvic asymmetry. Healing of an unstable pelvic fracture in malposition with asymmetry causes poor results and must be prevented.

Bed Rest↗
PubMed1998

Modified Toupet wrap for gastroesophageal reflux in childhood.

UNLABELLED: It was the aim of our study to follow up our clientele of infants and children who had undergone a partial (posterior) Toupet wrap or modified Toupet wrap. METHODS: All 22 children who had undergone a posterior partial wrap within a 4-year period were followed up for 4.0 years (0.6-5.7 years). 36.4% of children had associated anomalies such as operated esophageal atresia, operated congenital diaphragmatic hernia, Gregg's syndrome or arthrogryposis multiplex congenita. 14% of children suffered from some form of neurological impairment. Prior to operation the 4 main examinations for detection and documentation of gastroesophageal reflux (GER) disease were carried out where possible. Five children underwent Toupet fundoplication and in 17 children a modified Toupet fundoplication with reinforcement of the wrap fixation using a Vicryl-mesh was applied. A pH-metric study and upper gastrointestinal series with reflux testing were done in all 22 children at least 6 months postoperatively. Successful control of GER was documented in 21 of 22 children (95.5%). In the remaining child a reoperation was necessary to correct recurrence of a sliding hiatal hernia and GER. In three children (13.6%) postoperative complications occurred within the first 2 weeks following fundoplication and were managed medically. Following the postoperative 24-hour pH-metric study and the upper gastrointestinal series with reflux testing, one child with normal results at these investigations was lost to follow-up. The remaining 21 children were followed up for another 10 months to 5 years. Four children (18.2%) were found to suffer from functional complications (mild dumping syndrome, retrosternal pain, vomiting during episodes of asthma, dysphagia). No gas bloat syndrome occurred within the follow-up interval and all children were able to belch and vomit. There was no mortality in our limited series. Our series indicates that the partial (posterior) Toupet wrap and the modified Toupet fundoplication are safe and effective procedures for surgical correction of GER in children which preserve the ability of infants and children to belch and vomit.

Adolescent↗
PubMed1998

[Pediatric scaphoid fractures--treatment and prognosis].

From 1990 to 1994, we treated 28 children aged eight to fourteen years, with a scaphoid fracture. In eight of them, the initially suspected fracture could not be verified by X-ray earlier than two weeks after the injury. Eleven more patients--after false initial suspect of fracture--were discharged after two weeks without any complaints and negative X-ray control. These were not included in the series. Patients with radiologically evident fracture or clinically typical history and symptoms of scaphoid fracture--even without positive X-ray--were treated by below-elbow-thumb spica-cast for two weeks. After that period, all patients went for repeated clinical and radiological examination. All children with radiologically visible fracture or continuous, typical complaints underwent cast fixation for another four weeks. Symptom-free patients without radiological evidence of fracture were discharged. One displaced fracture was reduced and stabilized with a screw. In follow-up examination after six to forty months, all fractures showed good radiological consolidation, four patients reported occasional pain on straining the wrist. Scaphoid fractures in children seem to be more difficult to diagnose than to treat. Nondisplaced or slightly displaced fractures can be treated easily with plaster cast. Fractures that show dislocation of more than 1 mm should undergo open reduction and stabilization by a screw.

Adolescent↗
PubMed1998

[Dynamic splinting after flexor tendon injuries of the hand in childhood].

Ninety severed flexor tendons were repaired in 24 boys and 14 girls in a four-year-period at the Department of Pediatric Surgery in Graz. Mean age was 4.9 years. In 16 patients (42%) additional lesions were found. Direct repair was performed with modified techniques of Kirchmayr (23) or Kleinert (8). In four fingers, flexor tendon reconstructions were carried out. Postoperatively, the dynamic Kleinert splint was used for early nonresistive motion, beginning on average on the second postoperative day. Intensive training of motion was performed in physiotherapeutic sessions during a mean period of five months, postoperatively. In five cases tenolysis was performed; in one case a rupture of a sutured tendon had to be corrected. 27 patients (71%) with 42 injured fingers were followed-up on average 2.7 years after the operation. In accordance with the Buck-Gramcko classification, very good results were achieved in 37 cases (88%), and a poor result in one patient (2%). Atraumatic technique, dynamic splinting, consequent physiotherapeutic training by experienced physiotherapists, and well informed parents will yield excellent results after flexor tendon repair in the paediatric age group.

Child↗