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Biomedical subjects

K H Deeg

Publications and source records attributed to K H Deeg.

At least 37 records · Page 2Linked to original sources
PubMed1993

Doppler sonographic detection of increased flow velocities in the celiac trunk and superior mesenteric artery in infants with necrotizing enterocolitis.

Fourteen infants (gestational age 28.4 +/- 4.4 weeks; birth weight 1170 +/- 910 g) with clinical and radiological signs of necrotizing enterocolitis (NEC) were investigated by pulsed Doppler sonography. Pulsed Doppler recordings were performed in the celiac trunk and the superior mesenteric artery at an age of 15 +/- 10 days. The peak systolic, end-systolic, end-diastolic and time average velocities were measured and compared with the flow velocities of a healthy control group. Infants with NEC showed a significant increase in peak systolic and time average velocity within the celiac trunk and the superior mesenteric artery in comparison with healthy infants.

Blood Flow Velocity↗
PubMed1993

Diagnosis of subclavian steal in infants with coarctation of the aorta and interruption of the aortic arch by color-coded Doppler sonography.

We report the noninvasive diagnosis of subclavian steal by color-coded Doppler ultrasonography in nine infants with congenital heart disease. The underlying cardiovascular malformations included coarctation of the aorta in four infants, interrupted aortic arch type B in three patients, truncus arteriosus communis type A4 (one patient), and isolation of the right subclavian artery (one patient). In all patients both vertebral arteries could be displayed through the anterior fontanel in coronal sections. Normally the flow in both vertebral arteries, as well as the flow in the basilar artery, is displayed in red. In eight patients with angiographically proved unilateral subclavian steal, an antegrade (red) flow could be shown in one vertebral artery, whereas the contralateral vertebral artery was displayed blue, indicating reverse flow. In one infant with interrupted aortic arch type B and associated aberrant right subclavian artery, both vertebral arteries and the basilar artery were displayed blue, indicating bilateral subclavian steal. Color-coded Doppler sonography seems to be a sensitive, noninvasive method for diagnosing congenital subclavian steal, especially in infants with obstruction of the aortic arch.

Aortic Arch Syndromes↗
PubMed1993

[Congenital cystic bile duct dilatation. Presentation of clinical symptoms, diagnostic possibilities and therapy based on 6 cases].

BACKGROUND AND METHODS: Congenital cystic dilatation of the bile ducts represents an uncommon anomaly of the biliary system. We report on 6 patients suffering from cystic biliary duct dilatations which were treated in our hospital between 1980 and 1992. Clinical signs included upper abdominal pain, white or clay-colored stool, icterus and/or palpable tumor. According to the classification of Todani, 4 children had type Ia cysts, 1 child a type Va cyst and 1 child a type Ia cyst with extrahepatic biliary atresia. RESULTS: Among the diagnostic methods sonography is preeminent and permitted demonstration of intra- and extrahepatic biliary duct dilatations in all of our patients. In 2 patients small cystic dilatations could be distinguished from hepatic vessels by colour-coded Doppler sonography. CONCLUSION: The treatment of choice is the resection of the dilated extrahepatic biliary ducts followed by hepaticojejunostomy using the Roux-en-Y-technique.

Abnormalities, Multiple↗
PubMed1992

Diagnosis of intralobar lung sequestration by colour-coded Doppler sonography.

Intralobar lung sequestration in a 5-month-old dyspnoeic infant was diagnosed by colour-coded Doppler sonography (CDS). Grey scale imaging showed an echogenic mass adjacent to the right hemidiaphragm. CDS demonstrated an abnormal arterial blood supply via a vessel originating from the descending aorta at the level of the diaphragm.

Bronchopulmonary Sequestration↗
PubMed1992

Diagnosis of neonatal aortic thrombosis by colour coded Doppler sonography.

We report on a neonate with complete aortic thrombosis following umbilical artery catheterization. Diagnosis was established by colour coded Doppler sonography which showed absent flow in the region distal to the thrombosis. After thrombolytic therapy with recombinant tissue plasminogen recanalization of the descending aorta could be shown by Colour Doppler imaging (CDI).

Aorta, Thoracic↗
PubMed1992

Colour Doppler imaging of intracranial vasculopathy in severe infantile sialidosis.

Neonatal ascites is usually attributed to prenatal infections, lysosomal storage disease and anomalies of the genitourinary tract, gastrointestinal tract or cardiovascular system. We report one case of neonatal ascites associated with infantile sialidosis. Cerebral sonography showed stripe-like intracerebral echogenicities in the region of the basal ganglia. Colour Doppler imaging demonstrated blood flow within the echogenicities confirming the suspected diagnosis of intracranial vasculopathy.

Adult↗
PubMed1992

[Hereditary prolonged QT interval (Romano-Ward syndrome) in a female patient with non-elective cesarean section].

In the Romano-Ward syndrome, an inherited form of abnormally prolonged QT duration is the matter of concern. The frequency-corrected QTc value in the ECG amounts to more than 0.44 s (upper mean value: 0.44 s). Persons suffering from Romano-Ward syndrome are vitally endangered by attacks of arrhythmia, syncope, and cardiac arrest that are triggered or aggravated by stress or certain drugs. In obstetrical anesthesia, attention should be paid to the fetus, which, due to the genetic dominance, will have a 50% probability of having the disorder. A 28-year-old para I was admitted with cervical dilation on her predetermined date of delivery. Romano-Ward syndrome had been diagnosed 10 years earlier; the patient had been free of complaints and had received no treatment. Due to cephalopelvic disproportion and the cardiac syndrome, a primary cesarean section was performed. Following premedication and provision of a beta-blocker, defibrillator, and drugs for resuscitation, intubation anesthesia with methohexital, nitrous oxide, enflurane, and succinylcholine was carried out. The QTc values were pathologically prolonged (0.47 s; 0.48-063 s) during the pre- and intraoperative period. Hemodynamic irregularities did not occur in the perioperative period. The newborn was vital (3,830 g, 50 cm; Apgar scores 10/10/10; umbilical cord pH 7.29). Directly postpartum isolated supraventricular extrasystoles occurred, and the QTc duration increased to 0.51 s. Simultaneous registration of the ECG and phonocardiogram showed premature occurrence of the second cardiac sound, which is typical of Romano-Ward syndrome.

Adult↗
PubMed1992

[Tumors of the adrenal gland and lumbar sympathetic chain. Differential ultrasound diagnosis in childhood].

In a retrospective study from 1979 to 1989 17 tumors of the sympathic chain and the adrenal gland were analysed according to typical sonographic patterns. 13 tumors (10 neuroblastomas, 2 pheochromocytomas, 1 adenoma of the adrenal gland) were localized within the abdomen, 4 tumors (3 neuroblastomas, 1 ganglioneuroma) originated from the mediastinum. Neuroblastomas usually were great suprarenal masses with bad delineation and inhomogenous increased echogenicity in comparison with the liver. In more than 50% calcifications occurred, whereas cysts (15%) could rarely be found. The upper pole of the ipsilateral kidney usually was compressed and displaced caudally and laterally. The great intraabdominal vessels were usually displaced anteriorly and to the opposite side. The disturbed flow within the compressed intraabdominal vessels could reliably be shown by colour Doppler sonography as well as tumor vascularity. The 2 pheochromocytomas as well as the ganglioneuroma and the adenoma of the adrenal gland were round or oval, well delineated nodules with homogeneous liver like echogenicity. According to their typical sonographic patterns tumors of adrenal gland and sympathic chain can be differentiated from each other as well as from kidney tumors.

Abdominal Neoplasms↗
PubMed1991

Determination of the anatomical size of ventricular septal defects on the basis of hemodynamic data and noninvasive assessment of pulmonary to systemic vascular resistance ratio Rp/Rs by Doppler-echocardiography.

The pulmonary and systemic flow (Qp/Qs) and resistance ratios (RP/Rs) were determined in children with isolated ventricular septal defects (VSD) to derive an "effective defect resistance" (Rd/Rs) representing the ratios of the resistance of the defect to the systemic vascular resistance. The defect size (expressed as the ratio of the area of the defect to the cross-sectional area of the ascending aorta) was related to the calculated "effective defect resistance," where a significant (non-linear) correlation was found. The effective resistance of the defect is a useful aid for estimation of the anatomical size of a ventricular septal defect. The close correlation between anatomical size and the hemodynamic parameter Rd/Rs allows one to calculate the ratio Rp/Rs with this concept using noninvasive Doppler-ultrasound and echocardiography. This was performed in 21 children with VSD who underwent cardiac catheterisation. The noninvasive calculated flow ratio Qp/Qs and the resistance ratio Rp/Rs showed a close correlation to the values measured at cardiac catheterisation.

Cardiac Catheterization↗
PubMed1991

Pancreatic growth and function following surgical treatment of nesidioblastosis in infancy.

Pancreatic exocrine and endocrine function was assessed in four patients 4-31 months after 88%-95% pancreatectomy. Postoperative exocrine and endocrine function was not seriously impaired. Extensive pancreatic regrowth occurred. The amount of regenerated pancreatic tissue, estimated by sonographic measurement of the sectional area, was not significantly different from that of healthy controls. Pancreatic endocrine and exocrine function and pancreatic regeneration remained satisfactory and no additional pancreatic resection became necessary. These results indicate that 95% pancreatectomy may be tolerated without loss of pancreatic function.

Female↗
PubMed1991

[Presystolic increasing maximal flow velocity in the intracranial vessels in 3 children with heart failure].

The doppler-sonographic examination of flow velocities in intracerebral arteries is of central importance in the diagnostic evaluation of potential neurologic complications in intensive care patients. Furthermore pulsed Doppler-sonography can assess the hemodynamic consequences of several congenital heart defects (e.g. the ductus arteriosus Botalli). Characteristics of the normal flow profile in the intracranial arteries are the systolic and diastolic forward flow caused by the "Windkessel" function of the aorta. Well known pathologic flow profiles (systolically and diastolically increased flow velocities, diastolically decreased flow velocities and diastolic retrograde flow) occur in neurologic and cardiovascular diseases. We have investigated three children after cardiac surgery, who showed a presystolic increase in the flow velocities, which is clearly different from the flow profiles mentioned above. In our opinion, this abnormal flow pattern is due to a decreased ventricular output in combination with an elevated central venous pressure in these patients.

Aortic Valve Stenosis↗
PubMed1990

Colour Doppler imaging of arteriovenous malformation of the vein of Galen in a newborn.

We report a neonate with congestive heart failure due to a huge arteriovenous malformation of the vein of Galen. Two dimensional ultrasound showed a large cystic structure behind the 3rd ventricle and the quadrigeminal plate. The cyst compressed the posterior part of the 3rd ventricle and the aqueduct and caused an obstructive hydrocephalus. The diagnosis was established by colour Doppler imaging (CDI). With the help of CDI, flow within the aneurysm could be shown as well as feeding arteries originating from the posterior and middle cerebral arteries. The straight sinus and the torcular Herophili were markedly dilated.

Cerebral Veins↗
PubMed1990

Demonstration of perivascular echogenicities in congenital cytomegalovirus infection by colour Doppler imaging.

Two children with congenital cytomegalovirus infection and intracerebral echogenicities were investigated by computer sonography and colour Doppler imaging (CDI). By simultaneous imaging of brain tissue and CDI, blood flow within the stripe-like echogenicities of the basal ganglia was demonstrated. Using CDI the echogenicities were identified as the walls of thalamostriate vessels.

Basal Ganglia↗
PubMed1990

Dopplersonographic classification of brain edema in infants.

25 infants, 23 newborns and 2 older infants with B-mode sonographic evidence of cerebral edema (gestational age of the newborns 39.1 +/- 2.1 weeks, weight 3270 +/- 672 g) were examined by means of pulsed Doppler sonography. Pulsed Doppler recordings were obtained in the anterior cerebral, internal carotid, basilar, and middle cerebral arteries. In all measured arteries the peak systolic peak endsystolic, peak enddiastolic and the time averaged mean velocities, as well as the resistance index and the pulsatility index were determined. In addition to the flow parameters the pH, pCO2, pO2, oxygen saturation and the blood pressure were measured. The flow velocities were compared with the normal values established by our group. Three different types of flow profiles and velocities could be found: Group 1: 12 infants had normal flow velocities. Group 2: 7 infants showed increased diastolic flow velocities. Group 3: 6 infants demonstrated decreased diastolic flow velocities. There were no significant differences according to gestational age, weight, pH, pCO2, pO2, oxygen saturation and blood pressure in the three groups. The outcome of the 12 children in group 1 was favourable: normal development 10; minor retardation 2. In group 2 only 1 child showed normal development; 2 infants had minor, 1 major handicaps; 2 infants died. Patients in group 3 had the worst outcome: no patient developed normally; 4 infants died; 2 severely handicapped infants showed polycystic leucomalacia and brain atrophy; 1 infant had minor psychomotoric problems.

Blood Flow Velocity↗
PubMed1990

Prenatal ultrasound diagnosis of multiple cardiac rhabdomyomas.

We report on a neonate with multiple cardiac rhabdomyomas, including a huge rhabdomyoma of the left ventricular posterior wall. Prenatal ultrasonography performed because of supraventricular tachycardia led to the diagnosis in the 28th week of gestation. Postnatal echocardiography confirmed the prenatal diagnosis. The tumor could not be removed surgically and the child died as a result of intractable arrhythmia at the age of 5 days. The diagnosis of multiple cardiac rhabdomyomas was confirmed by autopsy.

Female↗
PubMed1990

Sonographic diagnosis of biliary ascariasis.

In an 11.5-year-old boy with obstructive jaundice sonography revealed a worm-like structure within the dilated biliary tree. Cross-section showed a bull's eye configuration, whereas longitudinal planes demonstrated an echogenic strip with a central longitudinal anechogenic tube. Diagnosis of ascariasis was established by identification of ascarid eggs in the stool. After anthelminthic treatment several ascarid worms were excreted with the stool.

Ascariasis↗