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Biomedical subjects

M Ries

Publications and source records attributed to M Ries.

84 records · Page 5Linked to original sources

A method to determine the true angulation of long bone deformity.

A new method of geometrical analysis is capable of determining bone deformity from routine anteroposterior (AP) and lateral roentgenograms. The maximum angulation may occur in a plane other than the AP or lateral roentgenogram planes. Therefore, the maximum angulation may exceed the apparent angulation seen on routine AP and lateral views. The AP and lateral views will underestimate the true angulation most when the angulation seen on the AP and lateral views is similar.

Bone and Bones↗

Facial palsy with elevated protein in otherwise normal CSF in a child with Lyme disease.

This is a report on an eight-year-old girl who presented with facial palsy, headache, fatigue, arthralgias and myalgias six weeks after two tick bites. Physical examination was unremarkable with the exception of a left-sided facial palsy. Laboratory investigation revealed normal complete blood count, ESR and CRP. The spinal tap showed a protein of 63 mg/dl, glucose 45 mg/dl and no cells. IFT titres to Borrelia burgdorferi in serum and CSF were significantly elevated. The diagnosis was supported by Western blot analysis. Treatment was started with ceftriaxone i.v. for a total of 14 days. Under this therapeutic regimen the patient improved substantially within five days. Investigation of CSF in patients with facial palsy may help to establish the diagnosis of Lyme disease by simultaneously measuring IFT to B. burgdorferi in serum and spinal fluid, even in cases where CSF shows little or no signs of inflammation.

Cerebrospinal Fluid Proteins↗

Balloon valvuloplasty of critical pulmonary valve stenosis in a premature neonate.

Balloon dilatation of critical pulmonary valve stenosis in neonates with a weight of less than 2.5 kg is associated with specific problems, including temperature loss during the procedure, venous access, and problems related to the small size of the cardiac structures. We report our experience with balloon valvuloplasty in a premature newborn weighing 1.22 kg. Venous access was gained with a 4 French sheath, and balloon dilatation was performed with a 3.5 French 7-mm balloon catheter. Temperature loss of the baby was avoided by puncturing the femoral vein prior to the procedure on a neonatal open care system, wrapping the child in cotton, and covering the extremities with aluminium foil. The good result in our patient demonstrates that balloon valvuloplasty is a therapeutic option for treatment of critical pulmonary stenosis in premature infants.

Angiography↗

Functional MRI of the kidney.

Functional MR imaging of the kidney has a great potential of development because the functional parameters, which can be approached noninvasively, are multiple: glomerular filtration, tubular concentration and transit, blood volume and perfusion, diffusion, and oxygenation. Until now, its limitations in clinical applications are due to the difficulties in obtaining reproducible and reliable information in this mobile organ and, sometimes, in understanding the physiologic substrate of the signal changes observed. These approaches require either endogeneous contrast agents, such as water protons (for perfusion and diffusion) or deoxyhemogobin (for oxgenation), or exogeneous contrast agents such as gadolinium chelates (for filtration and perfusion) or iron oxide particles (for perfusion). Clinical validation of these methods and evaluation of their clinical impact are now worthwhile before diffusing them in clinical practice.

Contrast Media↗

[Spontaneous subdural hematoma in a 18-day-old male newborn infant with severe hemophilia A].

Most intracranial bleedings in hemophiliacs occur in patients more than 6 months of age. In the neonatal period, this complication is rare and almost always observed in the first week of life. Based on a review of the literature, intracranial hemorrhage is an exceedingly rare occurrence in infants with hemophilia aged 2 weeks-6 months. We report on a male infant with hemophilia A who was referred to our hospital on day 18 because of pallor and jaundice. The neurological examination was normal. A cerebral ultrasound showed a left sided subdural hematoma with a shift of the midline structures to the right. Packed red blood cells (10 ml/kg) and factor VIII replacement (250 IU) were rapidly instituted and a craniotomy with evacuation of the hematoma was performed. The postoperative course was uneventful. On discharge, the neurological examination was considered normal.

Echoencephalography↗

[Changes in the activation markers of blood coagulation and fibrinolysis in the neonatal period].

BACKGROUND: Activation markers of the clotting and fibrinolytic systems are elevated immediately after birth and decline to near adult levels during the first 24 hours of life. The aims of this study were to investigate, whether the activation of both clotting and fibrinolysis is dependent on the mode of delivery, and to measure activation markers in newborns with infection beyond the first days of life. PATIENTS: We have studied activation markers thrombin-antithrombin III complex, prothrombin fragment 1 + 2, D-dimer and plasmin-antiplasmin complex by use of commercially available ELISA techniques in 20 newborns after elective Cesarean sections because of previous sections, in 20 newborns after Cesarean sections and a trial of labor with uterine contractions over a period of > 20 hours and in 20 newborns (34.-41. gestational week) aged 10-25 days with infection. 20 healthy adults served as controls. RESULTS: A significant elevation of all activation markers was observed both in the newborns after Cesarean sections and in the 10-25 days old children with infection. There were no differences among newborns after elective sections compared to newborns after section and a trial of labor with uterine contractions over a period of > 20 hours. CONCLUSIONS: The clotting and fibrinolytic systems reveal increased activation immediately after delivery, but uterine contractions over a period of > 20 hours seem not to make a difference. During infection, the activation markers of the hemostatic system in newborns aged 10-25 days behaves similarly to the mature adult system.

Adult↗

[Multiple cerebral infarcts with resulting multicystic encephalomalacia in a premature infant with Enterobacter sakazakii meningitis].

Enterobacter sakazakii is an uncommon cause of neonatal meningitis. The prognosis of newborns with meningitis due to Enterobacter sakazakii is poor, the fatality rate is reported as high as 50%. Survivors usually have severe neurologic complications. Most computed tomography (CT) findings were low density lesions of white matter and cortex suggesting infarctions which underwent cystic degeneration. We present one premature baby with meningitis due to Enterobacter sakazakii and large bilateral regions of hypo- and hyperdensity suggesting massive hemorrhagic and nonhemorrhagic intracerebral infarctions leading to multiple cystic encephalomalacia.

Cerebral Infarction↗

Successful systemic low-dose lysis of a caval thrombus by rt-PA in a neonate with congenital nephrotic syndrome.

PURPOSE: Thrombotic complications in nephrotic syndrome due to renal loss of antithrombin III (AT III) are well known. With this case report, we want to demonstrate the possibility of achieving the lysis of such a thrombosis in the neonatal period with low-dose rt-PA. PATIENTS AND METHODS: We treated a 10-day-old newborn who had congenital nephrotic syndrome, who developed a caval thrombosis during the first days of his life. After a trial of heparin (up to 20 IU/kg/hour) over a period of 24 hours and treatment with AT III (2 x 250 IU/day) proved to be ineffective, we started systemic thrombolytic therapy with rt-PA. An initial bolus of 0.4 mg/kg during 1 hour was followed by an infusion of 0.5 mg/kg/d rt-PA over a period of 36 hours. Low-dose heparin (5 IU/kg/hour) was given simultaneously. Complete clot dissolution could be achieved this way. No adverse effects were observed, including no clinical signs of bleeding. CONCLUSION: It seems that low-dose rt-PA treatment is safe and effective in dissoluting large caval thromboses in neonates.

Dose-Response Relationship, Drug↗

On the origins of high in vivo wear rates in polyethylene components of total joint prostheses.

Scanning electron microscope examination of the polyethylene components of 8 total hip and 16 total knee prostheses which had been implanted 4--96 months revealed that in many cases severe wear may not necessarily be caused by the presence of acrylic cement debris or other abrasives. The craters and cracks observed on severely worn surfaces are associated with fusion defects in the plastic itself. The fusion defects were seen to occur as a result of the low temperature necessary to mold ultrahigh molecular weight polyethylene and are (at least at present) difficult to avoid. As a consequence of the above and variability of molecular weight in this material, relatively wide variations in wear rate should be expected even in the absence of acrylic debris.

Acrylates↗