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Biomedical subjects

G M Steiner

Publications and source records attributed to G M Steiner.

At least 19 recordsLinked to original sources
PubMed1997

Imaging the neonatal chest.

Explore the source record for details and available documents.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1994

The appropriateness of use and the clinical impact of micturating cystourethrography in paediatric practice.

STUDY OBJECTIVE: To determine the appropriateness of use and the clinical impact of micturating cystourethrography (MCU) in paediatric practice. DESIGN: Retrospective medical record review. SETTING: A major teaching children's hospital in the Trent region. PATIENTS: Consecutive sample of 120 children undergoing MCU during 1991-1992, identified from the radiology records. MAIN OUTCOME MEASURES: The referring clinician's reasons for requesting an MCU; the clinical management plan pursued before and after the MCU, and the change in management initiated by the result of the examination; the appropriateness of use of the test, as determined by the presence or absence of a valid indication for MCU in the specific clinical situation. RESULTS: The change in patient management attributable to the MCU result could be categorized as: no change (19%); decision to end the imaging investigation of the patient (33%); decision to end all investigations, and prophylactic or therapeutic interventions (16%); decision to discontinue chemoprophylaxis (2%); decision to end the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (6%); decision to continue the imaging investigation and introduce chemoprophylaxis and follow-up for bacteriuria (13%); and decision to operate or help in planning the surgical treatment required (11%). Inappropriate use of the test was observed in 20% of the cases. CONCLUSIONS: This study provides a basis for understanding the use of MCU in paediatric practice. The findings that 19% of the cystourethrograms had no appreciable effect, and that 20% of the examinations were used inappropriately show the need for increased effort to minimize overuse of the test.

Child↗
PubMed1992

The value of ultrasound in the assessment of bone.

The impenetrability of bone to ultrasound can be turned to advantage and the effects of bony lesions on the adjacent soft tissues can be analysed. Fractures, bone destruction, inflammation, distraction of bone and new bone formation can be diagnosed.

Bone Diseases↗
PubMed1988

What happens to the pylorus after pyloromyotomy?

The rate of return to normal of the pylorus muscle in infantile hypertrophic pyloric stenosis was measured by ultrasound, using a simple pyloric volume calculation and a pyloric muscle index. The muscle hypertrophy took from two to 12 weeks to resolve.

Follow-Up Studies↗
PubMed1988

Paediatric radiology 1: gastrointestinal tract.

Clinical symptoms in the infant differ from those in the adult in that they are most likely to have a congenital or developmental cause. These symptoms are discussed together with the history and imaging techniques most likely to reveal their cause in the gastrointestinal tract. (The genitourinary and respiratory tracts will be dealt with separately in future articles in this series.)

Barium Sulfate↗
PubMed1987

Infantile hypertrophic pyloric stenosis--diagnosis from the pyloric muscle index.

Measurements of pyloric length, diameter and muscle thickness were made from ultrasound images of 39 babies, 21 of whom were subsequently found at operation to have infantile hypertrophic pyloric stenosis. From these measurements, the volume of pyloric muscle in cm3 was estimated for each case and divided by the body weight in kilograms. The resulting pyloric muscle index proved to be a much more reliable guide to the diagnosis of pyloric stenosis than any of the individual measurements or the volume estimation alone.

Humans↗
PubMed1987

Screening for polycystic kidney disease: importance of clinical presentation in the newborn.

Fifty per cent of the offspring of adults with the adult (dominant) form of polycystic kidney disease are carriers of the abnormal gene. Clinical symptoms and signs before adolescence are rare, but renal ultrasonography may detect evidence of cyst formation. Twenty two children, all offspring of parents with known adult polycystic kidney disease, have undergone renal ultrasonography. In six cases evidence of disease was detected without clinical manifestations at the ages of 1, 2, 5, 8, 13, and 14 years. There were no renal masses, hypertension, haematuria, or evidence of renal insufficiency. In four children from three sibships, whose families had no previous history of renal disease, bilateral renal masses were noted to be present at birth. In each case one parent was subsequently found to have adult polycystic kidney disease. At the ages of 1, 4, 6, and 20 years, while renal masses were still palpable, there was no evidence of renal insufficiency or hypertension in the younger children, while the oldest had mild renal failure. An analysis of the reported cases in childhood is suggestive of a bimodal distribution of enlarged kidneys, with a number of cases diagnosed at birth or soon after, followed by an increasing incidence during later childhood. Adult polycystic kidney disease presenting at birth may be qualitatively different from the disease detected by screening programmes of children at risk.

Adolescent↗
PubMed1986

Barium enema after biopsy: current practice and opinion.

Current research shows that sigmoidoscopy or endoscopy together with a superficial mucosal biopsy taken with a fibreoptic-type instrument should not delay the subsequent performance of a barium enema. Rigid biopsy instruments are less controllable and may take 'deep', full-thickness bites when superficial biopsies are attempted. After such a biopsy, an enema should be delayed at least 7 days to allow re-epithelialisation. Neither of these two approaches is common practice as shown in our survey of British radiologists and clinicians. The radiologist should be responsible for performing the barium enema but the survey shows that there is a difference of opinion over who should be responsible for any complications arising from it. Close contact between the referring clinician and radiologist should be maintained at all times.

Barium Sulfate↗
PubMed1981

The radiology of Meconium Ileus Equivalent.

Meconium Ileus Equivalent is a condition which occurs in patients with cystic fibrosis where the ileum becomes obstructed by bowel content of abnormal consistency. Intercurrent chest infection or absence of pancreatic extract supplements are often the exacerbating cause. Plain films of the abdomen show small bowel obstruction and in some a nodular pattern in the small bowel, the nodules being larger than those seen in quiescent cystic fibrosis. Gastrografin enemas and/or enemas with acetyl cysteine can be used in the treatment of the condition, the Gastrografin having the advantage of confirming the diagnosis radiologically. The condition is important as it can be the presenting feature of cystic fibrosis in childhood and even in early adult life, and the operative mortality and morbidity are high. Conservative treatment should be pursued vigorously and operation only undertaken if unavoidable.

Child↗
PubMed1979

Hydrocephalus associated with arterio-venous malformation - the vein of Galen aneurysm.

Aneurysm of the vein of Galen is a rare cause of hydrocephalus. It should be suspected clinically when there are dilated frontal veins, and/or an intra-cranial bruit. Nearly all cases present in infancy. CAT brain scans will demonstrate the vascular lesion and the degree of hydrocephalus. Arteriography is only thought to be necessary if ablative surgery is planned; embolisation treatment may be applicable. Four cases from the Sheffield Children's Hospital are reported in detail and the methods of diagnosis and possible treatment are discussed.

Child↗
PubMed1978

The misplaced caecum and the root of the mesentery.

Five cases presenting in late infancy and childhood with symptoms and signs referable to malrotation of the midgut are described. The condition may present with jaundice, malabsorption or the signs and symptoms of intestinal obstruction due to internal hernia or volvulus. It may also result in volvulus and gangrene of the midgut. A short root of the mesentery predisposing to this event will be seen on a barium meal and follow through examination and will warn of its impending occurrence.

Cecum↗
PubMed1977

Gastro-oesophageal reflux, hiatus hernia and the radiologist, with special reference to children.

Gastro-oesophageal reflux can lead to peptic oesophagitis and stricture formation. This is particularly true in infants in whom the condition should be suspected if the patient presents with vomiting, anaemia and failure to thrive. The anatomy of the oesophago-gastric junction is described. The inferior oesophageal sphincter is the main barrier to reflux, and marks the functional junction between oesophagus and stomach. It is under nervous and hormonal control. It is weak in the neonate who therefore frequently refluxes. An hiatus hernia can cause problems due to its bulk but the main problem of peptic oesophagitis is due to gastro-oesophageal reflux. The radiological examination should be carried out carefully with the patient swallowing in a prone position. The patient should be put in the Trendenlenberg position and compression applied to the abdomen. Reflux is intermittent and a negative examination should be repeated if the clinical findings suggest a diagnosis of peptic oesophagitis. Associated pyloric stenosis should always be excluded. Radiological examination of the gastro-oesophageal junction remains the quickest, simplest, and most convenient and safe technique as long as its limitations are appreciated.

Child↗
PubMed1975

Postmortem assessment of chronic airways obstruction by tantalum bronchography.

Tantalum bronchography was performed on 22 left lungs obtained at necropsy. Seven were from patients dying in cor pulmonale as a result of chronic airways obstruction and 15 were from unselected necropsies. Of the latter group, nine had no evidence of respiratory disease and six had pathological changes of emphysema and bronchial mucous gland enlargement when the lungs were examined following formalin fixation. A range of changes in the bronchographic appearances from the normal to the groosly abnormal is illustrated. The main changes in severely diseases lungs were: irregularity of the bronchial walls, failure of the walls to taper towards the periphery, areas of narrowing and dilatation, and 'pooling' of tantalum at the ends of airways. A count was made of the numbers of small airway branches in the most distal 4 cm of the lung and also of the number of airways of less than 1 mm in diameter. Patients dying in cor pulmonale had a significantly reduced total number of patent small airways in the area measured and also fewer patent airways of less than 1 mm diameter compared to both the other groups. Histological study of four of the lungs in greater detail revealed that the reduction in small airways filling was the result of a combination of obliteration and obstruction of the lumen by pus. Tantalum bronchography provides a good indication of the state of the bronchial tree at the time of death, and the changes seen are the result of both acute and chronic disease processes.

Adult↗