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Biomedical subjects

R Kursawe

Publications and source records attributed to R Kursawe.

13 recordsLinked to original sources
PubMed1998

Right-sided pulmonary aplasia: longitudinal lung function studies in two cases and comparison to results from term healthy neonates.

Agenesis of the right lung was diagnosed prenatally in two neonates born at 36 and 37 weeks, respectively. Computed tomographic scans and magnetic resonance imaging indicated that both cases had a Type 2 pulmonary agenesis, which was confirmed later by bronchoscopy. Both patients were clinically stable during the neonatal period. Serial pulmonary function tests revealed a decrease in specific respiratory system compliance (sCrs) in both neonates and a marked discrepancy between functional residual capacity measured by the nitrogen washout technique (FRCN2) and by plethysmography (FRCpleth) on follow-up. Early decrease of respiratory system compliance (Crs) and increase of respiratory system resistance (Rrs) in one infant preceded the onset of tracheal stenosis, which remained asymptomatic until the age of 8 weeks, when the infant developed acute respiratory failure requiring intubation and mechanical ventilation with high airway pressures. Aortopexy, implantation of a tissue expander into the right hemithorax, and laser ablation of fibrotic tissue at the site of tracheal stenosis were performed to achieve successful extubation. The second infant remained asymptomatic. Values for lung mechanics and volumes for both infants with pulmonary aplasia were as follows: Crs, 3.43 and 10.60 mL x kP(-1) x kg(-1); sCrs, 0.23 and 1.28 kpa(-1); Rrs, 11.1 and 7.4 kpa x s x L(-1); FRCN2, 14.9 and 10.2 mL x kg(-1); FRCpleth, 28.2 and 25.8 mL x kg(-1); FRCN2: FRCpleth ratio, 0.56 and 0.54 for patients 1 and 2, respectively. These values differed considerably from results of a control group of nine term healthy neonates (Crs, 10.0+/-1.8 mL x kPa(-1) x kg(-1); sCrs, 0.43+/-0.08 kpa(-1); Rrs, 5.10+/-0.55 kpa x s x L(-1); FRCN2, 24.0+/-2.5 mL x kg(-1); FRCpleth, 31.1+/-6.0 mL x kg(-1); FRCN2:FRCpleth ratio, 0.78+/-0.10). In conclusion, serial assessment of lung mechanics and pulmonary gas volumes detects airway obstruction early in neonates with unilateral lung agenesis. Bronchoscopy is recommended. Along with conventional surgical procedures, an expandable implant may improve management or prevent respiratory failure in selected cases.

Bronchoscopy↗
PubMed1996

Neuroectodermal cyst may be a rare differential diagnosis of fetal sacrococcygeal teratoma: first case report of a prenatally observed neuroectodermal cyst.

In spite of the fact that most anomalies can be accurately diagnosed prenatally, one may be confronted with an extremely rare fetal abnormality that has never been described before. We report a case of a neuroectodermal cyst arising from the posterior neuropore. After 21 weeks of gestation a fetal anechoic intra- and extra-abdominal tumor was detected. The mass grew to 75 x 41 x 33 mm at 35 weeks. Initially it was believed to be a sacrococcygeal teratoma. Serial scans and Doppler ultrasound examinations were performed, which demonstrated fetal well-being. Color Doppler imaging failed to demonstrate increased tumoral perfusion. After elective Cesarean section, the tumor was excised. The postoperative course was complicated by recurrent infections of the urinary tract due to neurological damage to the bladder. There was also impaired function of the anal sphincter. The histological finding of a monolayer of neuroepithelial cells and melanocytes led to the diagnosis of a neuroectodermal cyst.

Adult↗
PubMed1995

Pulmonary agenesis in a newborn: implantation of tissue expander to prevent a mediastinal shift.

Unilateral pulmonary agenesis is a rare congenital anomaly whose aetiology is not completely known. Vitamin A deficiency, viral agents, or genetic factors are discussed. The incidence was estimated at 1 in 10,000-15,000 autopsies by several authors. Associated malformations, mainly affecting the cardiovascular, gastrointestinal, and musculoskeletal system influence the prognosis of patients as does the location of the missing lung. We report the implantation of a tissue-expander in a three-months-old infant suffering from a right-sided lung agenesis associated with sinus-venosus defect. Other malformations were excluded by sonographic methods. Mediastinal shift with dextropositio cordis in compensatory emphysema of the left lung and frequent infections were the cardinal symptoms. These led to cardiopulmonary decompensation twice. The implantation of the tissue-expander was performed following an aortopexy, which was only temporarily successful. This method allows the filler to be adapted with age to the pleural volume by instillation of sterile saline solution via a microport. Whether or not thorax deformities and scoliosis will be prevented cannot be predicted exactly at this time.

Adult↗
PubMed1991

[Post-traumatic hemobilia in childhood].

We observed three patients with a hemobilia after surgically or conservatively treated liver lacerations. The diagnosis was suspected on clinical grounds and verified by ultrasonography, computed tomography or angiography or a combination thereof. Depending on the findings therapy was planned reaching from conservative treatment to liver resection. Because this complication is rare it should be cared for in a specialized institution.

Child↗
PubMed1990

[Diagnostic and therapeutic procedures in liver injuries in children].

Despite of severity of posttraumatic liver lesions after blunt abdominal trauma the availability of modern imaging diagnostic methods has changed the therapeutic concept. Nonoperative treatment attained an alternative place to operative procedures. For this kind of treatment personal and technical premises are mandatory. With ultrasound and computed tomography are non-invasive methods for diagnosis available. Paracentesis has lost of importance. This report of 7 children with liver laceration within 6 years discuss diagnostic and therapeutic practice. Decision for operative or nonoperative treatment depends on critical evaluation.

Child↗
PubMed1989

[Computed tomographic false diagnoses in acute pancreatitis].

With computed tomography acute pancreatitis can be differentiated into an oedematous, serous-exudative, hemorrhagic-necrotizing, suppurative-abscessing and a postacute necrotizing form with high diagnostic accuracy (83.2%). Problems occur in distinguishing necrotizing from abscessing pancreatitis. False negative and false positive errors are less frequent in detecting necrosis and its differentiation from less serious forms (4.4% and 2.1%). Dynamic CT discovers also parenchyma losses not detectable without contrast medium and allows to prove subtotal or total necrosis in case of discrete changes in the native scans. Sonographic tomography contributes to diagnostics by proving acute necrotizing pancreatitis due to a chronic inflammatory pancreatic process.

Acute Disease↗
PubMed1987

[Results of computed tomographic diagnosis in the grading of acute pancreatitis].

By means of computed tomography, it is possible to classify cases of acute pancreatitis into four grades of severity with reasonable accuracy: oedematous, sero-exudative, haemorrhagic-necrotic and abscess formation. Necrotic pancreatic tissue can be differentiated from normal tissue by means of dynamic computed tomography with a high degree of accuracy and the organ can be demarcated more clearly. Of 230 patients with acute pancreatitis, 89 were treated surgically. Correlation between the CT classification and surgical findings was achieved in 83% of the cases in the three serious grades. In 86 patients (96.6%, necrosis was correctly diagnosed. The problems that arise when trying to differentiate between the haemorrhagic-necrotic form and abscess formation are discussed, particularly when there is an absence of gas in the latter type.

Acute Disease↗
PubMed1985

CT guided percutaneous fine-needle biopsy of the pancreas.

147 CT guided fine-needle biopsies of the pancreas were carried out on 141 patients (45 malignant tumours, 79 chronic pancreatitis and pancreas without lesions, respectively). In 23 pseudocysts a malignant lesion could be excluded. By analysing the remaining 124 biopsies (non-cystic targets) an overall accuracy of 79%, a sensitivity of 71% and a specificity of 84% in differentiating between benign and malignant lesions were obtained. By excluding 12% of biopsies with no diagnostic material, an overall accuracy of 90% might be recorded. The comparison between the number of aspirates per examination and the cytological diagnoses would indicate that a minimum of four aspirates is required for satisfactory results.

Biopsy, Needle↗
PubMed1983

CT guided percutaneous fine needle biopsy in the diagnosis of small adrenal tumours.

In the diagnosis of expansive lesions of the pancreas, liver, kidneys, lymph nodes and other organs, percutaneous fine needle aspiration biopsy has proved its value. For small objects computed tomography is particularly suitable as a localization aid. This article reports on the diagnostic advantages of CT and biopsy in the diagnosis of lesions of the adrenals, demonstrated by 6 selected examples of small tumours, 5 of them smaller than 2 cm., and 1 smaller than 3 cm. The cytological diagnosis of an adrenal adenoma in 5 patients and a metastasis in one provided an important contribution towards therapy and prognosis.

Adenoma↗