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Biomedical subjects

J Tröger

Publications and source records attributed to J Tröger.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Ureterocele in childhood. Clinical and radiologic picture].

This is a retrospective analysis of the clinical and radiological data recorded in 45 children with ectopic and 5 children with orthotopic ureteroceles diagnosed from 1965 to 1982. As shown in this article, it is mandatory to perform an ultrasonic examination of kidney and bladder whenever there are signs of urinary tract infection or any abnormalities of voiding. Ureterocele is diagnosed by i.v. urogram in more than 90% of cases; before treatment it is obligatory to perform a voiding cystourethrogram in addition.

Child↗
PubMed1987

[Intestinal invagination. Analysis of case reports in the last 45 years].

The retrospective study analyses 219 children with intussusception, who were treated in the Dpt. of Pediatric Surgery, university of Heidelberg between 1942 and 1986. The patients were divided into three groups. The mortality of the first group (1942-1966) was 20%. Since 1966, however, no patient with intussusception was lost. Recent diagnosis advances with ultrasonography allowed early diagnosis and at the same time the complication rate dropped from 34 (group 2, 1967-1981) to 11% (group 3, 1981-1986). Simultaneously the intestinal resection rate was reduced. The developments in diagnosis and therapy during the last 45 years, based on the analyses of the three groups, are discussed in detail with the literature.

Child, Preschool↗
PubMed1985

[Clinical course and scar development in operated vesico-renal reflux in a long-term study].

62 patients (14 boys, 48 girls) representing 85 refluxive renal units (Grade 2-4) were investigated after successful operation for the development of further urinary tract infections (UTI) and renal scars (RS). The mean follow-up was 9.3 years. With the exception of one boy, none of the male patients developed any UTI or new RS. A similar result was obtained for about 45% of the girls. These two groups of patients presented with high-grade reflux before surgery. The remaining female patients (about 55%), however, presenting with lower-grade reflux before surgical treatment, developed further UTI as well as new RS despite surgical correction of their reflux. Investigations on the capacity of uroepithelial cells (UEC) to suppress bacterial growth revealed a deficient antibacterial effect of UEC in these patients. Such an UEC defect has also been shown in patients with asymptomatic bacteriuria. In conclusion, different reasons seem to be responsible for recurrent UTI and the development of RS in patients with reflux.

Adolescent↗
PubMed1984

Sonographic evidence of intraperitoneal fluid. An experimental study and its clinical implications.

In order to evaluate the sensitivity of ultrasound to intraperitoneal fluid, such as ascites or blood, an experimental study was performed in the pig. Various amounts of fluid were injected into the peritoneal cavity to investigate distribution and diagnostic criteria in different positions. As little as 10 ml of fluid was visualized around the urinary bladder in an upright position. In the supine position, 20 ml could be detected around the bladder and 30 ml around the liver. The injection of at least 60 ml resulted in a pattern of free-floating bowel loops. The sonographic findings of fluid distribution were correlated to radiological studies. As different amounts of fluid produce characteristic sonographic patterns, an approximate estimation of the intraperitoneal fluid volume can be made.

Animals↗
PubMed1984

The radiological diagnosis of the sinus urogenitalis.

The mechanisms and disturbances in the differentiation of male and female genitalia are described in relation to a correct radiological diagnosis. The methods of investigations include the flushing technique and the catheter technique. The advantage of the flushing technique (retrograde injection of contrast medium under moderate pressure) is its minimal invasiveness. In the catheter technique the bladder is filled with the help of a second catheter or suprapubic puncture, and a micturating cystourethrogram is conducted. The authors use a combination of both methods, filling the lower section of the urogenital sinus with a catheter and the upper by intravenous pyelography accompanied at times with a suprapubic bladder puncture. Quality of the radiographic picture ensures visualisation of all the important structures, as demonstrated by the accompanying figures.

Adolescent↗
PubMed1983

[Special features in the roentgen diagnosis of ischiopubic synchondrosis and the femur head in children].

Problems in the diagnosis and differential diagnosis of skeletal changes and abnormalities in children are frequently caused by differences in bone size and shape during maturation, by many normal variations, and finally by many skeletal disease, which mainly occur in childhood. Special difficulties are arising from the differentiation of normal findings and diseases, which need treatment. The problems are demonstrated by example of ischiopubic synchondrosis and femoral head and the most important differential diagnostic considerations are pointed out.

Adolescent↗
PubMed1982

[The so-called "battered child syndrome" from the viewpoint of the pediatric radiologist].

The diagnosis of the Battered-Child Syndrome (BCS) is made by the pediatrician and the radiologist. The recognition of this entity by the radiologist is possible because of the high frequency of the typical skeletal lesions. This skeletal changes are illustrated by X-ray pictures and bone scans. Not only skeletal trauma can be discovered but also visceral injuries may be combined and diagnosed in the BCS. For the detection of all changes in the BCS nowadays all possible imaging procedures should be used. Some forensic problems in this field are added.

Abdominal Injuries↗
PubMed1980

[Radiographic evidence of small amounts of pleural effusion in infant stage individuals. Animal experiments (author's transl)].

The pleural cavity of ten young pigs was punctured and pilled with specific amounts of fluid. Subsequently chest films were obtained in ap and lateral erect and in cross-table lateral decubitus position. Only 2 cases of these pigs radiographed in the erect position (after injection of 80 and even 100 ml of fluid) gave clear evidence of pleural effusion. Indirect signs of pleural effusion (such as blunting of the costophrenic angles; unsharpness, flatting or "elevation" of the diaphragm as a sign of subpulmonic effusion), however, were already noted with only 20 ml of pleural fluid. In contrast to these exams done in the erect position, the radiographs obtained in cross table lateral decubitus position showed as little as 5 ml of fluid. Therefore, the cross table lateral decubitus position is ideal for the work up of suspected pleural effusion.

Animals↗
PubMed1979

[Course of metastatic osteogenic sarcoma treated with chemotherapy only (author's transl)].

The case of a six year old girl with metastatic (or primarily multifocal) osteogenic sarcoma is reported, which was treated with chemotherapy only. Within 15 months--the primary tumor regressed and at least a transient inactivation has resulted until now;--the pulmonary metastases showed no progression;--an osteoplastic destruction of the sacrum has completely regressed. At the time of report (15 months after initiation of treatment) neither on X-ray controls nor on bone scan signs of tumor regrowth are evident. The child is without any complaints and the leg has no loss of function.

Antineoplastic Agents↗
PubMed1979

[Diagnosis and differential diagnosis of acute hematogenous osteomyelitis in infants (author's transl)].

Clinical and laboratory data are frequently unspecific in acute hematogenous osteomyelitis of infants. As prognosis is dependent on early treatment, a timely radiologic diagnosis is mandatory. Because of specialties in the vascular supply, the roentgenmorphologic alterations of acute hematogenous osteomyelitis in infants differ from the appearance of the disease in other age groups. The acute osteomyelitis in infants frequently leads to destruction of the epiphysis and purulent joint effusion. A subtle analysis of soft tissue lesions will already rise suspicion for acute hematogenous osteomyelitis before destructive or reactive osseous alterations prove the diagnosis by roentgenology. Nuclear medicine examinations of the bone have contributed significantly to radiologic diagnosis of acute hematogenous osteomyelitis in infants despite of few negative results. Osseous trauma and other diseases should be included in differential diagnosis. Especially in neonatals and premature infants, variations in the typical course and appearance of the disease may occur.

Acute Disease↗
PubMed1979

[Complications and survival rate in preterm infants and neonates treated with mechanical ventilation (author's transl)].

Between January 1972 and December 1976 201 preterm infants and neonates were treated with mechanical ventilation. These children were classified into 6 groups according to the indications for mechanical ventilation: P = respiratory failure caused by pulmonary disease; Z-P = respiratory failure caused by cerebral disturbance with simultaneous respiratory disease; Z = respiratory failure caused by cerebral disturbance; C = respiratory failure caused by cardiac disease; SCH = respiratory failure through shock; M = respiratory failure caused by mechanical disturbance; Bronchopulmonary complications developed in 70% of the survivors and in 60% of the fatalities. The most serious bronchopulmonary complications were infections which occured with similar frequency in all indication groups as late-onset complications, and air-leaks which occured as early complications. The latter complication was significantly higher (38%) in the first than in the other groups. The most serious extrapulmonary complications were seizures, intracerebral hemorrhages and septicemia. 71 of the 201 patients survived. There was a significant increase in the survival rate from 21.2% in 1972-1973 to 43% in 1974-1976. The survival rates differed significantly within the indication groups. The best result was found in the p-group followed by the Z-group. The highest mortality rate was found in the SCH and C-group.

Bronchial Diseases↗
PubMed1978

[The battered child (author's transl)].

The diagnosis of the battered child syndrome is the first and most important step for adequate therapy and prevention. The recognition of this entity by the radiologist is possible because of the high frequency of skeletal lesions. Osteoepiphyseolysis with fragmentation of the edges and periosteal calicifications are characteristic for the roentgenographic pattern of the battered child syndrome. In addition to the Roentgen diagnosis total body bone scans should be performed because the diagnostic accuracy will improve, the lesions will be detected earlier, and the radiation dose can be decreases in numerous children.

Battered Child Syndrome↗
PubMed1977

Renal sonography in pediatric patients. A comparative study between sonography and urography.

Renal sonograms of 260 children were compared with the corresponding excretory urograms. Since each kidney was evaluated separately 520 sonographic and urographic findings could be compared. The study is based on single investigations only, serial investigations were not included. 326 kidneys could be classified as being normal, primarily on the basis of the urogram. By sonography only 10 out of these 326 were misinterpretated as being pathological, 2 by urography. 194 kidneys could be classified as being pathological either by urography or- if necess -by other methods. In 16 out of these 194 no evidence for a pathological process could be found in the sonogram (7 cases of destructive pyelonephritis, 3 cases of double kidneys, 2 cases of slight obstruction of urine flow, 2 cases of small kidneys, 2 cases of ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of preversial ureteral buds), in 10 cases no evidence was seen in the urogram (6 cases of glomerulonephritis, 2 cases of polycystic kidneys, 1 case of prevesical ureterolith, 1 case of ureteral bud). In 2 cases pathological alterations of the kidney was found by both methods, however, the diagnosis differed. Nonfunctioning kidneys were found in 15 cases. In all of these the sonogram provided important complementary information. Our results show 1) that by a systematic application of sonography the early diagnosis of urinary tract malformations can be improved 2) that renal sonography provides the basis for a stricter application of excretory urography and 3) that by the combination of both methods the diagnosis of renal diseases can be improved.

Adolescent↗