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Biomedical subjects

S Laurin

Publications and source records attributed to S Laurin.

At least 37 records · Page 2Linked to original sources
PubMed1992

Ductus arteriosus aneurysm imaging using modern diagnostic methods.

An aneurysm of the ductus arteriosus carries a high risk of rupture. The radiologic findings are described, based on a review of the literature, and on our experience of 5 patients, successfully diagnosed and treated. A left-sided mediastinal mass is always present, obscured only if the aneurysm has already ruptured. Although the lesion seems to be congenital, conventional radiology sometimes demonstrates wall calcifications. Ultrasonography is well suited to demonstrate the vascular nature of the mass, but interpretation may be difficult because of intervening air-containing lung parenchyma. CT, especially using dynamic scanning with contrast enhancement, is an excellent noninvasive diagnostic method. Angiography is frequently necessary to demonstrate patency or occlusion of the aortic and pulmonary ends of the ductus. The differential diagnosis must include a large number of mediastinal tumors. A temporary widening of the ductus in the newborn is common and must be differentiated from a true aneurysm. Surgical treatment today is usually successful.

Aneurysm↗
PubMed1991

Cross-sectional echocardiographic measurements of right ventricular size and growth in patients with pulmonary atresia and intact ventricular septum.

Fifteen patients with pulmonary atresia or critical pulmonary stenosis and intact ventricular septum were studied. All were operated on in the neonatal period, with valvotomy or a systemic to pulmonary arterial shunt, or both. In 12 patients, right ventricular to pulmonary arterial communication was established in the neonatal period. In three patients, only systemic to pulmonary arterial shunts were constructed. Six patients died. The median follow-up period for the surviving patients was 64 months (range, 12-87 months). Right and left atrial and ventricular dimensions and areas, the tricuspid annular diameter, and the cross-sectional area of the aortic root were measured in cross-sectional echocardiograms from the neonatal period, at the age of 1 year, and at the latest clinical follow-up. A classification of right ventricular morphology was made, based on identification of the inlet, the trabecular, and the outlet parts. Most of the patients had hypoplastic right ventricles at birth but at the latest follow-up, seven of nine surviving patients had right ventricles in the normal range. Right ventricular growth was better in patients who were given a right ventricular to pulmonary arterial communication in the neonatal period and those with complete right ventricular anatomy. The patients who died had severely hypoplastic right ventricles and small tricuspid valves.

Child, Preschool↗
PubMed1990

Computed tomography and magnetic resonance tomography findings in children operated for anal atresia.

Computerised tomography and magnetic resonance tomography were performed in nine faecally incontinent patients more than eight years after rectoplasty for high imperforate anus. No statistically significant correlation was found between function, i.e. degree of faecal incontinence, and anatomical findings. Thus, in spite of a detailed demonstration of the post-operative anatomy, the information does not seem to be directly applicable in indicating a way to reoperate for faecal incontinence in this group of patients.

Adolescent↗
PubMed1990

Diagnostic cyst puncture of multicystic kidney in neonates.

In the neonatal period it is important to differentiate hydronephrosis from cystic disease of the kidney, since treatment of these entities differ. Early surgery in hydronephrosis may be indicated to salvage kidney function. We studied a group of 29 infants with renal cysts or hydronephrosis. In 10 cases some doubt about diagnosis remained after thorough diagnostic imaging. These infants were examined using percutaneous puncture of the kidney to verify the suspected diagnosis of multicystic renal disease. The studies were performed using local anesthesia and sedation. Ultrasonography was used for puncture and contrast medium was injected during fluoroscopy. The cysts communicated in 7 out of 10 cases, and a true renal pelvis was never seen. Irregular tubular structures joining the cysts were identified in 7 cases and seem to be characteristic of the multicystic dysplastic kidney. One instance of the hydronephrotic type of multicystic kidney was found at surgery. Large size of the cysts can make diagnosis difficult. Percutaneous puncture was successful and gave the diagnosis in all cases. No complications ensued.

Diagnosis, Differential↗
PubMed1988

Efficacy and safety of rilmenidine for arterial hypertension.

To assess the long-term acceptability and efficacy of rilmenidine (S 3341), patients with placebo-resistant hypertension (diastolic blood pressure [BP] greater than or equal to 95 mm Hg and less than 115 mm Hg) were included in an open 1-year treatment study. Eight examinations allowed treatment adaptation if diastolic BP remained greater than or equal to 90 mm Hg (monotherapy with rilmenidine, 1 or 2 mg/day, followed by the addition of a diuretic, then tritherapy). Three hundred seventeen patients, aged 58.0 +/- 0.7 years, were included. Two hundred sixty-nine were followed for 1 year and 48 withdrew from the trial without any symptom suggesting a withdrawal syndrome: 4 because of adverse effects; 6, lack of efficacy despite triple therapy; 9, intercurrent diseases; 10, noncompliance independent of adverse effects; 18, personal reasons not associated with treatment; and 1, lost to follow-up. On the 12th month, the decrease in supine systolic and diastolic BP reached 25 and 17 mm Hg with monotherapy (n = 150), 26 and 17 mm Hg with double therapy (n = 90) and 20 and 15 mm Hg with triple therapy (n = 29). BP was normalized (diastolic BP less than or equal to 90 mm Hg) on months 6 and 12 in 80 and 84% of the patients, respectively. Monotherapy was maintained in 66 and 60% of these patients, respectively, two-thirds being treated with 1 mg once daily. Adverse effects with monotherapy were mainly observed at the beginning of treatment in 3 to 8%: dry mouth, asthenia, gastralgia, palpitations, drowsiness, insomnia; other adverse effects were rare (1 to 2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Agonists↗
PubMed1987

Mediastinal pseudomass: pneumonia and atelectasis behind the left pulmonary ligament.

In children, left lower lobe pneumonia posterior to the pulmonary ligament may mimic a paramediastinal mass. Over a period of 6 years we have seen 12 children with this unusual appearance, which we attribute to a peculiar type of atelectasis or infiltration of the left lower lobe or a segment of it. The radiographic appearance is thought to be the result of incomplete anchoring of the left lung by a short pulmonary ligament. The radiographic findings are demonstrated, and the benign clinical course is emphasized.

Child↗
PubMed1987

Evaluation of renal parenchyma in children by DMSA scintigraphy, X-ray computed tomography and intravenous urography.

The demonstration of diminished or scarred renal parenchyma in children is often the decisive factor in determining the future management of children with urinary tract malformations. Renal scintigraphy using technetium 99m-labelled dimercaptosuccinic acid (DMSA), computed tomography (CT) and intravenous urography (IU) were used to evaluate the renal parenchyma prior to ureter re-implantation in a series of 13 children. Their ages ranged from 5 months to 3 years 8 months. The indication for operation was ureteric reflux in 8 children and distal ureteric stenosis in 5. CT was performed on a Toshiba TCT-80 scanner. Renal scintigraphy was performed 3 hours after intravenous injection of DMSA. Compared with IU, DMSA imaging gave more information about the renal parenchyma in 6 children, gave equal information in 6 and less in 1. Compared with CT, DMSA imaging gave more information in 2 children, was equally informative in 8 and less so in 3. Accordingly, DMSA imaging was judged to be more sensitive than IU and as sensitive as CT. DMSA imaging can be used both for the initial evaluation and for follow-up assessment of renal parenchymal damage.

Child, Preschool↗
PubMed1987

Transluminal balloon dilation of ureteral stricture in a child. A case report.

A 12-year-old girl complained of left flank pain 4 months after the onset of symptoms of polyarthritis nodosa with hypertension, multiple neuritis and impaired renal function. Intravenous pyelography (IVP) revealed no stone. Several months later the flank pain recurred, and IVP now showed a calcified stone midway in the left ureter. Ureterolithotomy was performed, and a 3 cm long stone embedded in the mucosa was removed. Two months postoperatively IVP showed severe ureteric obstruction due to stenosis at the level of the incision. Dilation of the stricture was accomplished with a 4 mm balloon, and further dilation 2 weeks later with a 6 mm balloon. A third dilation was performed with a 4 mm balloon. At examination 3 months later the girl was free from symptoms and IVP with forced diuresis was normal, as were the findings after 6 more months. Transluminal balloon dilation of postoperative ureteral strictures in children should be considered as an alternative to surgery.

Child↗
PubMed1986

Rickets in very low birthweight infants. Influence of supplementation with vitamin D, phosphorus and calcium.

The influence of extra phosphorus (P) and calcium (Ca) on the incidence of rickets was studied in 40 infants with a birthweight below 1.5 kg. All were fed breastmilk and all received vitamin D 1200 IU/day. Half of the infants were supplemented with P 20 mg/kg/day and Ca 30 mg/kg/day. Rickets, diagnosed with X-ray at 5 to 7 weeks of age, developed in 12 infants, 11 of whom weighed below 1.0 kg. In infants below 1.0 kg rickets was significantly more common in the group not receiving extra P and Ca. After diagnosis all were substituted and radiographic healing occurred in all. Serum Ca concentrations were normal in both groups whereas serum P was significantly lower in non-supplemented patients. Serum alkaline phosphatases (ALP) were normal in all patients at the time of diagnosis demonstrating the risk of using ALP as a diagnostic test for rickets in very low birthweight.

Alkaline Phosphatase↗
PubMed1986

Magnetic resonance imaging of the pediatric thorax: initial experience.

Magnetic resonance imaging (MRI) is particularly useful in the pediatric patient. No ionizing radiation is used; there are no complicating side effects; the technique is noninvasive and painless. We reviewed our experience using a 0.15 T. resistive imager for diagnostic MRI of the pediatric thorax. We studied 16 children, aged 8 days to 16 years, with various thoracic diseases. Correlation of the MRI findings with computerized tomography (CT) was obtained in 10 children and with the surgical findings in 8. Spatial resolution was slightly less with MRI than with CT. Medium and large vessels are well seen without contrast medium injection. Tissue characterization with MRI is superior to CT and the normal thymus is well seen. The long scanning time can be a problem in young children but can be overcome using intramuscular sedation. Cardiac gated imaging was successfully tested.

Adolescent↗
PubMed1984

Diagnosis of liver-spleen abscesses in children--with emphasis on ultrasound for the initial and follow-up examinations.

Seven children with hepatic and one with splenic abscess were evaluated using at least two of the following imaging modalities: ultrasound, radionuclide liver-spleen scan, computed tomography (CT) and angiography. Seven children had pyogenic, and one mixed pyogenic-amebic abscess. In all cases ultrasound demonstrated the lesions, which in 6/7 of hepatic abscesses were located only to the right liver lobe. 99mTc -sulphur colloid liver-spleen scans were positive in 4/4 cases while 67Ga failed to demonstrate 2/2 lesions. CT gave additional information in regard to etiology of lesions observed at ultrasound examination. Angiography performed in four cases showed vessel displacement by poorly vascularized mass lesions and arterioportal shunting in one but, overall, did not contribute to patient management. In clinically suggested hepatic-splenic abscesses, ultrasound together with CT will provide the diagnostic information needed for treatment. Follow-up studies should be performed by ultrasound.

Abscess↗