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Biomedical subjects

K A Vergesslich

Publications and source records attributed to K A Vergesslich.

At least 19 recordsLinked to original sources
PubMed2000

[Malformations of the urinary tract in neonates. Current status of imaging procedures].

UNLABELLED: Malformations of the urinary tract are one of the most common types of anomalies in the neonatal period. Approximately 15-20% of all prenatally detected malformations require acute postnatal imaging. Sonography is the primary imaging modality in the evaluation of nephro-urologic problems in infancy. Hydronephrosis represents the most common pathology, followed by multicystic-dysplastic kidney. DISCUSSION: The result of the sonographic examination directs further imaging. An adequate diagnostic algorithm is decisive for accurate diagnosis, for the appropriate therapeutic regimen and for the prognosis of the patients.

Diagnosis, Differential↗
PubMed1992

Renal transplant hemodynamics in children: prospective analysis of colour coded versus pulsed Doppler sonography.

In 30 children with renal allografts the diagnostic validity of pulsed Doppler (PD) versus colour coded Doppler (CD) sonography was assessed prospectively. 46 PD examinations were performed calculating the resistive index (RI) in the segmental arteries in comparison to 46 CD scans, where renal blood flow throughout the grey-scale image was displayed. In addition, point-spectral analysis with calculation of the RI was also performed on the CD scans. The time for examination ranged from five to ten minutes for the PD and from three to five minutes for the CD study. Concordant findings for the PD and CD technique were generally obtained (normal blood flow pattern on PD-excellent visualization of renal blood flow on CD, reduced or reversed diastolic flow on PD-poor visualization of renal blood flow on CD). There was close correlation of the RI values obtained by the PD and CD scans. CD sonography facilitated point-spectral analysis in shortening the time for examination. The ability to visualize focal hemodynamic alterations provided a higher diagnostic accuracy in comparison to PD sonography.

Adolescent↗
PubMed1992

High resolution CT in children with cystic fibrosis.

High resolution CT (HRCT) was performed in 24 children (median age 57.9 months) suffering from cystic fibrosis (CF). In 23 patients (one examination unacceptable because of motion artifacts) the most frequent finding was bronchial wall thickening, shown in 21 patients (91%), followed by bronchiectasis in 15 patients (65%). Less frequent findings were mucus plugging and patchy consolidations, which could be demonstrated in 11 patients each (48%). Findings were classified using a CT scoring system and including only irreversible pulmonary changes; a statistically significant correlation with lung function tests (FEV1/FVC; MEF50) could be established. HRCT to date seems to be the most valuable method to determine extent and severity of lung involvement in children with CF and should therefore be routinely used for the staging of this disease.

Child↗
PubMed1990

Color-coded Doppler evaluation of cholecystic varices in portal hypertension.

A 11-year-old white girl presented with a diagnosis of thrombosis of the portal vein after newborn septicemia. Duplex sonography revealed significant narrowing of the portal vein and its right and left branches. A Doppler signal could only be obtained in certain short segments of the portal vein and indicated hepatopetal flow. Color-coded Doppler sonography showed extensive varicose veins in the gallbladder with a bigger draining vessel running to the porta hepatis. Documentation of varices like those in the gallbladder wall confirms the diagnosis of portal hypertension and may increase the sensitivity of Doppler sonography. Color mapping has the potential to detect unexpected flow and to analyze blood flow to better advantage.

Child↗
PubMed1989

Pharmacokinetics of intra-arterial indomethacin treatment for patent ductus arteriosus.

We present pharmacokinetic data of prolonged, intra-arterial indomethacin treatment (i.e. induction plus maintenance dose) for symptomatic patent ductus arteriosus (sPDA) in 26 ventilated premature infants. sPDA was assessed by two-dimensional and pulsed Doppler echocardiography. Permanent ductal closure occurred in 20 (76%) infants. Plasma levels of indomethacin were 1.18 +/- 0.74; 1.8 +/- 1.0; 1.51 +/- 0.93 and 1.25 +/- 0.98 micrograms/ml (mean +/- SD) at 12, 24, 48 and 72 h after initial dose administration. All except one patient who responded with ductal closure, showed plasma levels above 0.25 microgram/ml throughout the 3 day treatment period and no case of sPDA reopening was noted. Although target concentrations over time were not defined, the data indicate that the maintenance levels measured were within the therapeutic range. A negative correlation was found for plasma drug levels and postnatal age (r = 0.52; P less than 0.01). Volume of drug distribution was 0.23 +/- 0.18 l/kg, total clearance 0.1 +/- 0.11 ml/min and elimination constant 0.06 +/- 0.05 h-1 (mean +/- SD). The great variation in pharmacokinetic data reflects the heterogeneity of the population studied with respect to extracellular fluid space, cardiovascular status, serum protein and other parameters.

Ductus Arteriosus, Patent↗
PubMed1989

Portal venous blood flow in cystic fibrosis: assessment by Duplex Doppler sonography.

Changes of portal venous hemodynamics were investigated in 32 patients with cystic fibrosis (CF) with a mean age of 11.6 years. Hepatic profile of these patients included total bilirubin and albumin together with determination of size and echogenicity of the liver and spleen, determination of the diameter of the portal vein by real-time sonography and quantitation of flow volume of the portal vein using Duplex Doppler sonography. As a control, 35 age matched healthy children were also examined. Diameter of the portal vein was significantly increased in CF patients versus controls. Comparison of the mean flow volume of the portal vein showed a significant increase in CF-patients over 12 y old versus controls. In patients less than 12 y no significant difference of flow volume of the portal vein between CF-patients and controls was noted. The increase of diameter and flow volume of the portal vein suggest an adaptive mechanism in the pressure-volume relationship of the portal venous system in patients with CF.

Adolescent↗
PubMed1989

Cerebral blood flow in newborn infants with and without mechanical ventilation.

The influence of mechanical ventilation with low mean airway pressure (MAP) on cerebral blood flow (CBF) veolocity in newborn infants was assessed in fifteen ventilated infants by Duplex Doppler Sonography (Duplex DS). As a control, CBF velocities were examined in 15 age and weight matched non-ventilated infants. For quantitation, maximal systolic velocity, enddiastolic velocity and the semiquantitative Pourcelot index were determined as representative flow variables. There was no significant difference of these flow variables between ventilated and non-ventilated infants. The pH, pO2 and pCO2 did not differ significantly between the two groups and there was no correlation between the flow variables, pH, pO2, pCO2 or MAP. Mechanical ventilation with low MAP is not associated with adverse effects on cerebral hemodynamics in newborn infants when significant alterations of the blood gases are avoided.

Cerebral Arteries↗
PubMed1989

Hemodynamic significance of the paraumbilical vein in portal hypertension: assessment with duplex US.

Hemodynamic evaluation of portal and umbilical venous flow with duplex ultrasound (US) was performed in 11 patients with cirrhosis of the liver and a large umbilical vein. Two of these patients had hepatofugal flow in the umbilical vein exceeding hepatopetal flow in the portal vein. These two patients had no evidence of esophageal varices and bleeding. The remaining nine patients had esophageal varices. In these patients, the hepatopetal flow in the portal vein exceeded the hepatofugal flow through the umbilical vein. The authors conclude that duplex US may help identify the massive hepatofugal flow through a large umbilical vein that may reduce the likelihood of esophageal varices and variceal bleeding.

Adult↗
PubMed1989

[The relevance of duplex Doppler sonography in pediatrics].

Since the introduction of duplex Doppler sonography the noninvasive assessment of hemodynamic changes in children has become possible. The clinical application comprises the depiction of cerebral hemodynamics in infants, where characteristic flow patterns can be found in patent ductus arteriosus, hypoxic-ischemic encephalopathy, cerebral hemorrhage, hydrocephalus or in brain death. Moreover, Duplex Doppler Sonography play an important role in the evaluation of renal hemodynamics, especially in kidney transplants. Finally, the examination of the portal venous system can demonstrate thrombosis of the portal vein, portosystemic collaterals or a hepatofugal flow in severe portal hypertension. Thus, invasive investigative procedures may become unnecessary in certain cases. The future potential of this technique lies in the development of quantitative measurements of volume flow and in Doppler color flow imaging.

Adolescent↗
PubMed1988

Acute renal transplant rejection in children: assessment by Duplex Doppler sonography.

Over a two year period 74 consecutive Duplex Doppler scans were performed in 23 children with renal allografts and were compared to the Doppler sonographic findings in orthotopic kidneys of 25 age matched healthy controls. The Doppler waveforms of renal arterial flow were analyzed qualitatively assessing systolic and diastolic flow amplitudes, for quantitation the Pourcelot index (PI) was used. There was no variation between the Doppler waveforms in recipients with normal allograft function and healthy controls. In 12 patients with biopsy proven acute rejection a decrease or absence of the diastolic flow amplitude was noted, resulting in increased pulsatility of the Doppler waveform. The mean PI in acute rejection differed significantly from the mean PI in normal allograft function. Duplex Doppler sonography is a useful imaging modality in the differentiation between acute rejection and normal allograft function and should therefore be integrated in the screening of children after renal transplantation.

Adolescent↗
PubMed1988

[Changes in renal echogenicity in pediatric obstructive uropathies].

Renal cortical echogenicity of 40 children with obstructive uropathies was analysed in relation to the grade of obstruction and thinning of the renal cortex. In 35 percent of the children an increase in echogenicity was noted. The increase in cortical echogenicity paralleled the grade of dilatation of the intrarenal collecting system and the grade of thinning of the renal cortex. Evaluation of the cortical echogenicity should be integrated into the primary diagnostic setup as well as into the follow-up of children suffering from obstructive uropathies.

Adolescent↗
PubMed1987

[Clinical use of sonography in neonatology].

During the neonatal period, sonography mostly represents the primary imaging modality of choice. Noninvasiveness, no exposure to ionizing radiation and no harmful side effects in biologic tissues contribute to the advantages of this technique. Validity of ultrasonic imaging in the neonatal age group lies primarily in the detection of congenital anomalies. Intraacerebral (2.39 per 1000 live births) as well as intracardiac (6 per 1000 live births) and intraabdominal anomalies can be diagnosed sonographically. Anatomic sites of origin of neonatal abdominal masses are renal (55%), genital (15%), gastrointestinal (15%), non-renal retroperitoneal (10%) and hepato-spleno-biliary (5%). Furthermore, changes of echogenicity reflect structural changes and thus impairment of function in various organs. Finally, Duplex sonography, the combination of real time imaging and Doppler flow measurement, can differentiate between vascular and avascular lesions and normal and abnormal flow patterns. The application of diagnostic ultrasound in the neonatal period is demonstrated.

Abdominal Neoplasms↗
PubMed1987

[Relation between pulsed and continuous Doppler velocimetry of the anterior cerebral artery in newborn infants].

Continuous wave (cw) and pulsed wave (pw) Doppler velocimetry are both used to measure blood flow velocity in cerebral arteries. We examined whether data obtained with the two methods are interchangeable and equally useful for clinical application. We studied 20 infants at an age between 1 day and 2 1/2 months and a body weight between 1.2 and 3.4 kg. Cw Doppler measurements were performed using an Angiomatic (Medimatic) and pw measurements using a Mark 600 Duplex Scanner (ATL). We applied both methods within an interval as short as possible. For the data analysis the pulsatility index (PI) was used, a parameter fairly independent of the emission angle. PI was 0.66 +/- 0.06 (mean +/- SD) using the cw and 0.8 +/- 0.08 using the pw method. The linear correlation between the pulsatility indices obtained with the cw and the pw method respectively was statistically significant (r = 0.53, n = 20, p less than 0.0025), the variation around the regression line rather large. The slope of the regression line differed significantly from that of the identity line (y = 0.391x + 0.54). Therefore the PI values obtained with the two methods are not interchangable and require to be judged according to normal values. Both methods, however, yield PI values which correlate and can thus be equally used. The choice of the method rather depends on the goal to be achieved. The pw method seems to be more suitable for precise momentaneous descriptions and the cw method for continuous monitoring of cerebral blood flow.

Blood Flow Velocity↗
PubMed1987

[Effect of vesicoureteral reflux on kidney density in children].

In 59 children with vesicoureteric reflux (VUR) renal echogenicity was analyzed. The density of the kidneys increase with the intensity of the VUR. The children with VUR grade 1 and 2 mainly showed a normal report. In 50% of the cases with VUR grade 3, a normal report was also found, whereas in the other 50% echogenicity was increased to 1 and 2. Highly significant increases in renal density were seen in ultrasound in children with VUR grade 4-5.

Acute Kidney Injury↗
PubMed1987

Acute renal failure in children. An ultrasonographic-clinical study.

Acute renal failure (ARF) may be due to obstructive uropathy or renal parenchymal disease. Twenty-five children with acute renal failure secondary to renal parenchymal disease underwent ultrasonographic examination of the kidneys. Changes of renal size and cortical echogenicity were correlated with renal function. All patients presented with bilaterally enlarged kidneys with the exception of those in the neonatal age group (12%). Improvement in renal function resulted in normalization of renal size. With regard to cortical echogenicity two groups were formed. Group A comprised 11 patients whose kidneys had the same echogenicity as the liver, while in group B the kidneys were more echogenic (14 patients). Cortical echogenicity was always increased. Determination of creatinine levels showed a statistically significant difference between group A (3.32 mg% +/- 1.40 S.D.) and group B (5.95 mg% +/- 1.96 S.D.), p less than 0.001. Changes in renal function were paralleled by rapid changes in renal size and cortical echogenicity.

Acute Kidney Injury↗
PubMed1986

[Familial juvenile nephronophthisis--a cause of chronic renal failure in childhood].

Familial juvenile nephronophthisis (FJN) represents an important cause of chronic renal insufficiency in the first two decades of life. Its frequency is reported to vary between 7 and 20% of all cases of terminal renal failure in childhood. Usually the onset is insidious, with polyuria, polydipsia and anaemia being the main clinical features. The diagnosis is based on clinical, laboratory and pathological findings. The purpose of our report is to emphasize the importance of this pathological entity with respect to the clinical symptoms and signs and diagnostic approach on the basis of the case reports of four patients.

Adolescent↗
PubMed1986

[Diagnosis of an aneurysm of the great cerebral vein of Galen using duplex sonography].

The combination of two-dimensional sonography of the skull and pulsed Doppler measurements (= Duplex-scan-technique) was used to detect an aneurysm of the vein of Galen in a three months old infant, who presented with clinical signs of congestive heart failure. Excellent correlation of sonography with computed tomography and intravenous digital subtraction angiography could be demonstrated. A short review of the pathological and clinical findings of this lesion is given. The value of Duplex-scanning in the diagnostic approach of arterio-venous malformations of the brain in comparison with other radiological methods is discussed.

Cerebral Veins↗