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Biomedical subjects

A Bankier

Publications and source records attributed to A Bankier.

At least 73 records · Page 4Linked to original sources
PubMed1997

[MRI in radiologically occult scaphoid fractures. Initial experiences with 1.0 Tesla (whole body-middle field equipment) versus 0.2 Tesla (dedicated low-field equipment)].

The study was performed to determine the diagnostic value of different MR systems and field strengths in patients with occult scaphoid and wrist fractures. Twelve patients with clinical suspicion of a scaphoid fracture but normal plain radiographs were examined by MRI. A dedicated 0.2-T unit (Esaote) and a 1.0-T unit (NT10, Philips) were used. Coronal T1W-SE, STIR, and T2*W-GE sequences were obtained with both systems. Images were evaluated for a bone marrow abnormality, a trabecular or cortical fracture line, and were compared to the 6-week follow-up radiographs. Seven wrist fractures were found at 0.2 T and 1.0 T, proven in the follow-up radiographs. A bone marrow abnormality was present in all seven fractures on both systems. Trabecular and cortical fracture lines were visualized at 0.2 T in four cases and at 1.0 T in seven cases. Low-field MR imaging at 0.2 T and mid-field MR imaging at 1.0 T seem to be equivalent in the diagnosis of a fracture in radiographically occult scaphoid and wrist fractures. In the visualization of fracture details, important for therapeutic and prognostic considerations, 1.0 T seems to be superior.

Adolescent↗
PubMed1997

Exogenous surfactant therapy in a patient with adult respiratory distress syndrome after near drowning.

A 24-year-old woman developed adult respiratory distress syndrome (ARDS) after near-drowning due to attempted suicide. Conventional mechanical ventilation together with prone positioning and inhaled nitric oxide could not provide sufficient oxygenation. Surface tension data (gamma min = 27 dyn/cm, stability index = 0.341) from a lavage sample supported the hypothesis that the surfactant function of this patient was drastically reduced due to a washout effect by aspiration of fresh water. Porcine surfactant (Curosurf, 50 mg/kg for each lung) was instilled via fibreoptic bronchoscope. The partial arterial carbon dioxide pressure (paCO2) and fraction of inspired oxygen (FiO2) ratio as well as shunt fraction (Qs/Qt) improved impressively. When respiratory situation deteriorated again, surfactant application was repeated. Altogether, six bolus instillations of surfactant (total dose 300 mg/kg = 18,000 mg) were administered until the respiratory situation had stabilized and oxygenation could be maintained by conventional mechanical ventilation. The radiological findings did not show substantial amelioration. The patient developed septic shock and died 12 days after admission. Surfactant application apparently led to a significant improvement of the respiratory function. However, the outcome could not be influenced positively. The high cost of surfactant therapy prevents the more widespread early administration in patients at risk.

Adult↗
PubMed1997

A study of the effects of patient anxiety, perceptions and equipment on motion artifacts in magnetic resonance imaging.

We investigated to see if motion artifacts (MA) occurring in magnetic resonance imaging (MRI) are related to prescan anxiety measures and test the feasibility of identifying patients at risk for the development of MA before scanning. Furthermore, to determine a possible influence of constructional differences between a 1.5 and a 0.5 tesla scanner on the frequency of MA. Two hundred and ninety-seven first time MRI patients were surveyed before and after imaging with anxiety and attitude questionnaires. Frequency and impact on diagnostic quality of MA were documented. 12.8% of all scans showed MA not related to normal body pulsations. In 6.4% the diagnostic quality was impaired. Constructional differences did not influence the frequency of MA. Also, anxiety as determined with the most common anxiety measuring instrument was not related to the development of MA. Concern about the technical apparatus identified 70.6% of all individuals developing MA. Patients at risk for the development of MA can be identified prior to scanning. It seems necessary to further develop reliable methods to detect them and to evaluate strategies to prevent MA.

Adult↗
PubMed1997

Solitary median maxillary central incisor, short stature, choanal atresia/midnasal stenosis (SMMCI) syndrome.

This article describes a series of 21 consecutive cases, each involving a solitary median maxillary central incisor; the patients were seen in the Department of Dentistry or the Victorian Clinical Genetics Unit, Murdoch Institute, at the Royal Children's Hospital, Melbourne, from 1966 to 1997. The spectrum of anomalies and associated features present in these cases--solitary median maxillary central incisor, choanal atresia, and holoprosencephaly--is described, and the literature related to the features, including genetic studies in these conditions, is reviewed. We relate our findings in these cases to current knowledge of developmental embryology. It is hoped that the findings, together with our interpretation of them, will help to clarify understanding of solitary median maxillary central incisor syndrome. This syndrome was previously considered a simple midline defect of the dental lamina, but it is now recognized as a possible predictor of holoprosencephalies of varying degrees in the proband, in members of the proband's family, and in the family's descendants.

Body Height↗
PubMed1997

A maternally transmitted lethal neonatal progeroid syndrome with prominent genitourinary and gastrointestinal features.

Twin brothers and their maternal uncle with a previously undescribed neonatal progeroid syndrome are presented. In addition to progeroid features, they had pseudo-obstruction of the urinary and gastrointestinal tracts, severe leucocytosis, liver dysfunction, and low complex III and IV in muscle but not in liver. Previously described neonatal progeroid syndromes and syndromes featuring pseudo-obstruction are discussed. The two most likely aetiological mechanisms are an X linked single gene disorder or a mitochondrial disorder. The evidence for these possibilities is presented.

Abnormalities, Multiple↗
PubMed1996

Pulmonary embolism. II. Diagnosis and treatment.

Pulmonary embolism is an often underestimated, underdiagnosed, and undertreated disease. As symptoms and signs of pulmonary embolism are nonspecific, the diagnosis still remains a challenge to the attending physician. Diagnostic and therapeutic procedures depend on the clinical presentation of the patient. First we must suspect pulmonary embolism and consider its likelihood in the presence of a number of clinical signs and symptoms. Once pulmonary embolism is suspected, heparin should be administered. Additional basic support is mandatory if required. If the patient's hemodynamic situation is stable, available preferable noninvasive diagnostic options should be considered to confirm or rule out the diagnosis of venous thromboembolism before further administration of anticoagulant or thrombolytic agents. If the patient's status has deteriorated, bedside diagnostic techniques should be applied to reinforce the suspicion or establish the diagnosis. To restore pulmonary perfusion more rapidly than conventional anticoagulation is suspected to do, several dosing regimens of thrombolytic agents are proposed, with recent interest in short-term thrombolysis and bolus lysis with urokinase or recombinant tissue plasminogen activator. If thrombolysis fails or is contraindicated, catheter embolectomy or surgical embolectomy is indicated. The main therapy is prevention. In this article, clinical assessment, imaging techniques, and therapeutic options described in the published literature are discussed and clinical experiences of an emergency department with a noninvasive diagnostic approach are described.

Causality↗
PubMed1996

Knotting of two central venous catheters: a rare complication of pulmonary artery catheterization.

An attempt was made to insert a balloon-tipped pulmonary arterial catheter (Swan-Ganz catheter) in a patient in cardiogenic shock during circulatory support by intraaortic balloon pumping, with a right jugular central venous catheter in place. Due to the low cardiac output it was impossible to advance the catheter tip into the pulmonary artery and after several futile attempts it was decided to withdraw the catheter. However, this was impossible because a knot had formed between the central venous catheter and the Swan-Ganz catheter and surgical removal become necessary. This is the first report on intravasal knot formation between two different catheters. This rare complication has to be included in the long list of complications associated with Swan Ganz catheterisation.

Aged↗
PubMed1995

Fetal brain disruption sequence in sisters.

We report two female siblings with the fetal brain disruption sequence. Extensive investigation of both children failed to define a definitive aetiology but clinical and laboratory findings are consistent with a hitherto unknown storage disease. We postulate that the accumulation of a neurotoxic metabolite may be responsible for the disease phenotype observed. This is the first report of recurrence of the fetal brain disruption sequence and supports the existence of a genetic form of this condition. Previous reports have emphasized possible environmental aetiologies. Infants with fetal brain disruption sequence should be investigated exhaustively and, in the absence of definitive evidence of an environmental cause, the possibility of a genetic aetiology should be considered. In some families the recurrence risk may be as high as one in four.

Biopsy↗
PubMed1995

Gingival fibromatosis and Klippel-Trénaunay-Weber syndrome. Case report.

A case of a young male with the Klippel-Trénaunay-Weber syndrome is described. Typical features of hemihypertrophy, hemangiomata, macrodactyly, and macrocephaly were present. The most striking oral feature was generalized severe gingival hypertrophy confirmed histologically, ultrastructurally, and by collagen analysis. In the absence of other known systemic causes of gingival enlargement, a diagnosis of familial gingival fibromatosis in association with Klippel-Trénaunay-Weber-syndrome is concluded. The combination of gingival fibromatosis and Klippel-Trénaunay-Weber syndrome has not been reported to our knowledge, it is uncertain whether this occurrence is significant or coincidental.

Child↗
PubMed1995

Absent iris stroma, narrow body build and small facial bones: a new association or variant of SHORT syndrome?

We report four patients from two unrelated families with strikingly similar facial appearance, short stature, narrow body build and, in two of the patients, abnormalities of the iris stroma. The birth of an affected offspring suggests that this syndrome is likely to have autosomal dominant inheritance. The facial appearance and some of the features resemble the SHORT syndrome, the name being an acronym for Short stature, Hyperextensible joints, Ocular depression, Rieger anomaly and abnormalities of the Teeth. The relationship of the syndrome to the SHORT syndrome is discussed.

Abnormalities, Multiple↗
PubMed1995

Menkes disease.

Explore the source record for details and available documents.

Female↗
PubMed1994

Karyotype abnormalities in fetuses diagnosed as abnormal on ultrasound before 20 weeks' gestational age.

This study examined rates of karyotype abnormalities in fetuses diagnosed by ultrasound as abnormal before 20 weeks' gestational age and which prompted a follow-up amniocentesis or chorionic villus sampling. Those diagnosed before 20 weeks were compared with those diagnosed at or after 20 weeks. A retrospective study identified ultrasonographically abnormal fetuses in whom karyotyping had been undertaken, 306 fetuses before 20 weeks' gestational age and 241 after. Isolated malformations before 20 weeks had, on average, an 18 per cent risk of karyotype abnormality, compared with 20 per cent later. Specific rates were calculated; for example, heart abnormality was associated with karyotype abnormality in 7 per cent of cases before 20 weeks and in 14 per cent later. Multiple malformations and karyotype abnormalities were found together in 28 per cent of fetuses prior to 20 weeks and in 33 per cent of the older fetuses. Specific associations included nuchal oedema and trisomy 21 in 21 per cent of fetuses before 20 weeks. No karyotype abnormalities were found in fetuses diagnosed with choroid plexus cysts. An overview of trisomies in Victoria, in 1991, showed that 50 per cent of trisomy 18, 42 per cent of trisomy 13, and 9.5 per cent of trisomy 21 cases were identified by ultrasound in women less than 37 years of age. Another 28.6 per cent of trisomy 21 fetuses were detected in women of advanced maternal age who underwent amniocentesis or chorionic villus sampling, making a total of 38.1 per cent of trisomy 21 that were detected prenatally.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[The long-term changes after the implantation of silicone breast prostheses].

In a prospective study 60 patients with unilateral or bilateral mammary implants underwent mammography and sonography. Location, form and structure of the implants were evaluated. Additionally capsular fibrosis and its influence on the imaging quality of parenchyma was scored. We found increasing implant deformities and increasing density of the implants with increasing postoperative interval. There was poor statistically significant correlation between the thickness of the periprosthetic capsular and the postoperative interval in prepectoral implants (r = 0.555, p < 0.01); in case of subpectoral implants there was no such correlation. In 88% of the cases imaging quality was scored as adequate by two independent observers, with additional views in all cases. We conclude that sufficient imaging quality for the assessment of parenchyma and of potential implants complications may be obtained by the combination of mammography and sonography.

Adult↗