PubMed Health⌕ Search

Biomedical subjects

R Fotter

Publications and source records attributed to R Fotter.

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

Ultrasound diagnosis of birth-related spinal cord trauma: neonatal diagnosis and follow-up and correlation with MRI.

Two neonates, one with complete and one with incomplete birth-related transection of the cervico-thoracic spinal cord, form the basis of this report. Ultrasound and MRI findings in primary diagnosis and follow-up are described. The aim of this contribution is to bring this serious birth complication to the attention of the reader, to present the obstetrical risk factors, to describe the clinical presentation of the newborns and to make suggestions to expand the field of indications for spinal sonography. The value of spinal ultrasound in the first six months of life is stressed, especially in comparison to MRI. For definitive assessment of the lesion (transectional or nontransectional) follow-up ultrasound studies for several weeks are required.

Birth Injuries↗
PubMed1994

Diagnostic imaging in necrotizing enterocolitis.

The incidence and diagnostic value of roentgenographic and sonographic signs in necrotizing enterocolitis are presented. The current status in clinical application of Duplex-Doppler sonography and colour-coded Doppler sonography are discussed and a description of the different roentgenographic and sonographic signs including Doppler sonographic findings is given. Radiographic and sonographic indications for surgical treatment are proposed. The role of the different diagnostic imaging modalities in the early diagnosis and evaluation of progress in NEC is defined and a diagnostic algorithm for different stages depending on the severity of the disease is proposed. Routine application of sonography in such an algorithm can improve diagnostic accuracy in necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗
PubMed1994

Late intestinal strictures following successful treatment of necrotizing enterocolitis.

Between 1975 and 1992, in 16 infants (14%) out of 113 neonates with previous necrotizing enterocolitis (NEC) a total of 25 intestinal strictures had to be treated. Four (16%) were found in the ileum and 21 (84%) in the colon, and in 50% multiple strictures were present. In these 16 patients initial treatment for acute NEC included conservative treatment in 5, primary resection and enterostomies in 6 and proximal diverting enterostomies in 5. Therefore, the incidence of late strictures was 11% after conservative therapy, 11% after primary resection and 55% after primary proximal diverting enterostomies. An average of 49 days elapses between the recovery from NEC and the diagnosis of late strictures in conservatively treated patients. After initial surgical treatment, late strictures were detected on contrast studies on an average of 80 days. In pathologic specimens, marked fibrosis in the submucosa was consistently present in all strictures, whereas inflammatory changes in the mucosa, disruption or hypertrophy of the muscle layers or absence of ganglion cells were seen less frequently. All strictures were resected and primary end-to-end anastomosis was performed. But despite the development of late intestinal strictures, bowel preservation was improved after initial restrictive surgical therapy and aggressive medical treatment.

Constriction, Pathologic↗
PubMed1994

[Radiologic diagnosis of Perthes disease].

In Legg-Calvé-Perthes disease (LCPD), magnetic resonance imaging (MRI) and conventional radiography in two planes are considered the most important methods of investigation for early diagnosis and for assessment of the course of the disease. MRI can reveal the early marrow oedema, thus allowing early differential diagnosis against diseases that are similar in clinical appearance (coxitis fugax, epiphyseal dysplasia). The extent of the necrotic area within the epiphysis, the most important indicator of the prognosis of the disease and thus for the therapeutic management, can be assessed earlier and more reliably with MRI than with other techniques. The loss of containment can be visualized by MRI, because depiction of the cartilaginous structures is possible earlier than with conventional radiography. Staging of LCPD is also possible with MRI, especially in stages I and II. Radiography shows the reossification and the osseous remodelling of the epiphysis better. A disadvantage of MRI seems to be the occasional need for sedation or anaesthesia of the child to avoid motion artefacts.

Diagnosis, Differential↗
PubMed1993

Congenital diaphragmatic hernia presenting after the newborn period.

Late-presenting congenital diaphragmatic hernia (CDH) is often difficult to diagnose and delay in treatment is common. Seven patients were operated beyond the newborn period for left-sided Bochdaleck hernia. Their age ranged from 1 month to 9 years. Six of them became symptomatic within the 1st year of life (1 week to 9 months of age). Either feeding difficulties or recurrent respiratory infections were initially present. In all of them chest X-rays were performed but delay in diagnosis ranged from 1 week to 5 years. All diaphragmatic defects could be closed by an abdominal approach without postoperative complications. Clinical symptoms disappeared postoperatively. In children with respiratory complaints or feeding difficulties one should be aware of late presenting CDH. A careful analysis of chest films and searching for "connecting" bowel segments passing through the diaphragmatic defect may help to avoid incorrect diagnosis and undesirable delay in treatment. Confusion with pneumonia or pneumothorax can be diminished by placing a feeding tube and instillation of contrast material. Ultrasound should be used supportively in all suspected diseases of the diaphragm.

Child↗
PubMed1992

Delayed presentation of congenital diaphragmatic hernia.

Eight patients aged 1 month up to nine years with congenital diaphragmatic hernias (seven left sided postero-lateral, one right-sided antero-medial), who presented outside of the neonatal period, are reported, four are described in detail. Radiographic presentation was obvious in four patients, simulated inflammatory lung disease in one and pneumothorax in two. In one patient a Morgagni hernia was primarily missed. Two had previous normal chest X-rays. All cases with herniated bowel showed "connecting" bowel segments passing through the diaphragmatic defect. Primarily the lack of awareness of delayed presentation of congenital diaphragmatic hernia in children with uncharacteristic thoracic and/or abdominal symptoms led to an undesirable time delay between first chest X-ray and surgery up to 16 months in four of our cases. Life threatening complications can be the consequence of delayed diagnosis as in one of our cases.

Child↗
PubMed1992

[The place of mammography following breast-conserving therapy of breast cancer].

This study evaluates the radiographical signs of the breast in 168 patients with breast carcinoma who were treated with lumpectomy and radiation therapy. Two thirds of the postsurgical scars were radiologically seen only up to two years after operation. One-third showed only discrete scarred tissue after this period. The most characteristic sign was the continuous diminution of the post-surgical and post-radiation lesions in the follow-up mammograms (scar densities, fibrosis and architectural distortions). Microcalcification highly suspicious of malignancy developed in 6%; one-third, however, proved to be benign. Acute and chronic edema were the most striking symptoms up to one year after radiotherapy; the final stage of the post-radiation alterations was breast fibrosis which demonstrated in 60% of the cases rather discretely. The recurrence rate was 7%.

Austria↗
PubMed1992

[Epigastric colic after ceftriaxone therapy].

The following article describes a girl with right upper quadrant abdominal colic following Ceftriaxon therapy for purulent meningitis. Ultrasound made it possible to demonstrate sludge-balls, floating in the gallbladder, a follow up examination was normal. Moreover the features of gallbladder precipitations following Ceftriaxon therapy will be described, and the clinical consequences will be discussed.

Ceftriaxone↗
PubMed1991

Can MR contribute to the diagnosis of nephroblastomatosis? A report of one case.

Presenting one case of nephroblastomatosis (NB) the diagnostic approach by different imaging modalities is discussed. Ultrasound (US) of the kidneys as a basic examination showed one focus of NB but missed two further foci which were clearly shown by contrast enhanced CT and MR. Contrast enhanced CT has been considered to be the most sensitive method in primary diagnosis of NB and follow up. However, in our case contrast enhanced MR examinations showed the foci of NB more clearly than CT. Since the false negative rate of MR is not yet known, we recommend the use of a contrast enhanced MR study parallel to a basic CT examination. If MR findings are consistent with CT findings, no further CT examinations are necessary for follow-up. Since US can miss a considerable amount of foci of NB, basic evaluation of NB and associated lesions by US alone should be avoided.

Female↗
PubMed1991

Urethral morphology and bladder instability.

In order to calculate the relationship between Spinning top urethra (STU) and bladder instability 160 voiding cystourethrogramms (VCU), performed in 102 girls, have been analysed retrospectively. 28 girls had STU, 16 of those had bladder instability as well (57%). We could not find the highly positive correlation between unstable bladder and STU as reported by other authors, although there was a statistically positive correlation between STU and bladder instability. However the confidence interval was very broad (38%-75%). We conclude that bladder instability may contribute to STU but cannot render the etiological explanation for all cases. STU seems to be a polyetiological sign. In our opinion only the combination of STU and bladder instability has a diagnostic impact, since several therapeutical concepts are available in cases of bladder instability. The finding of STU in the VCU should alert the examiner's attention to functional disorders of the lower urinary tract. If no instability can be found, STU should be considered to be a normal variant.

Child↗
PubMed1991

[Congenital intrahepatic arterioportal fistula as a cause of necrotizing enteritis--Doppler sonographic and angiographic detection].

A case of congenital arterioportal fistulas in a girl of 4 months of age is presented. Clinical signs of necrotising enteritis developed due to portal hypertension. The diagnosis was established via Doppler-duplex ultrasound showing a pulse-synchronous bidirectional flow pattern in the portal vein and its major branches. The diagnosis was confirmed by angiography.

Arteriovenous Malformations↗
PubMed1990

Ceftriaxone monotherapy for bacterial meningitis in children.

A total of 33 patients with bacterial meningitis were treated with single daily doses of ceftriaxone (CTR 100 mg/kg/day i.v.) for a median duration of 13 days. Pathogens isolated by culture and/or determined by latex agglutination were 15 Haemophilus influenzae b, 7 Neisseria meningitidis, 2 Streptococcus pneumoniae, 1 group B streptococcus, 2 Streptococcus viridans and 2 Staphylococcus epidermidis. In 4 cases a diagnosis of purulent meningitis could only be made by means of the inflammatory liquor parameters. All cerebrospinal fluid (CSF) drug levels even at the end of the dosing interval were at least 10-fold higher than the MICs of the respective bacterial isolates. The average penetration of CTR into the CSF was 6.6%. Within 12-46 h after the first dose, control spinal taps were performed. Cultures were sterile in all cases. Side effects encountered were diarrhea, exanthema, neutropenia and transient elevation of glutamic oxaloacetic transaminase, but none caused a change of therapy. One patient developed a biliary concrement. No patient died; 5 patients had prolonged fever (greater than 5 days), and 2 were left with persistent hearing deficiencies. CTR can be recommended as a safe and effective antibiotic agent for once daily treatment of bacterial meningitis in children.

Adolescent↗
PubMed1989

Magnetic resonance imaging in children with acute hip pain.

45 children presenting with acute hip pain were prospectively evaluated with conventional radiography, radioisotope bone scan, and magnetic resonance imaging (MRI). The final diagnoses were transient synovitis (n = 17), septic arthritis (n = 2), Legg-Calve-Perthes disease (LCPD, n = 13), epiphyseal dysplasia (n = 2), other conditions (n = 4), and normal findings (n = 7). In the work-up MRI provided more morphologic information than other techniques and enlarged the diagnostic possibilities. It was the only imaging technique able to give an early indication of bone marrow involvement in systemic diseases. For the early diagnosis of LCPD, MRI was as sensitive as isotope bone scan and more precise than conventional radiography. In the follow-up of LCPD patients MRI was not able to indicate the start of revascularisation of the necrotic area, which bone scans showed reliably in six patients: but MRI provided excellent evaluation of the position, form and size of the femoral head and the surrounding soft tissues.

Acute Disease↗
PubMed1988

[Computer-assisted diagnosis of bone tumors and tumor-like skeletal diseases: critical evaluation of its clinical use].

Thirty-four patients with bone tumours and tumour-like abnormalities of the skeleton, of varying ages, were examined by a computer-aided diagnostic program; the accuracy, clinical usefulness and specific advantages and disadvantages of the program have been evaluated. This was done by two statistical methods, both with showed high accuracy and reliability of the system (97% and 88.2%). In addition to the diagnostic results, the growth rate of the lesion could be estimated. This indicates the biological behaviour of the tumour independently of the histological diagnosis.

Bone Neoplasms↗