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Biomedical subjects

P H Hoogland

Publications and source records attributed to P H Hoogland.

At least 19 recordsLinked to original sources
PubMed2002

A 43-year-old male with untreated panhypopituitarism due to absence of the pituitary stalk: from dwarf to giant.

A 43-yr-old male was referred because of an x-ray made after a fall, which showed open epiphysis of the arm. The man had always been short for his age; during childhood he once consulted a pediatrician because of short stature, but thereafter he never sought medical attention. At age 18 yr he was not allowed to join the army because of his height of 147 cm. He continued to grow steadily and finally reached 193 cm. He had no complaints and considered himself reasonably fit. Physical examination showed a disproportional man with a body mass index of 29.3 kg/m(2) and Tanner stage P1G1. Laboratory investigations showed hormone levels consistent with multiple pituitary deficiency, with dynamic tests consistent with hypothalamic or pituitary stalk disease. Magnetic resonance scanning of the brain showed a small anterior pituitary remnant, no pituitary stalk, and an ectopic neurohypophysis. This case of untreated panhypopituitarism shows a particular growth curve with an average growth velocity of 2 cm/yr, resembling patients with estrogen receptor mutation or aromatase deficiency. A literature study of other adult patients with untreated panhypopituitarism shows a variable growth pattern. Some speculations about possible reasons for this variability in clinical characteristics are presented.

Growth↗
PubMed2000

Contrast enhanced color duplex for diagnosis of subtotal stenosis or occlusion of the internal carotid artery.

BACKGROUND AND PURPOSE: We initiated this prospective study to investigate the usefulness of contrast enhancement in combination with color Doppler-assisted duplex imaging (CDDI) for the distinction of subtotal internal carotid artery (ICA) stenosis and ICA occlusion. METHODS: During 1 year all patients with a previously unknown subtotal ICA stenosis (>90%) or ICA occlusion on routine CDDI were included in the study. These patients underwent a CDDI with and without intravenous contrast, Levovist 300 mg/ml. RESULTS: The study group consisted of 32 patients, 15 with subtotal stenosis and high velocity at the ICA stenosis, two with subtotal stenosis and minimal residual color flow and relative low velocity at the ICA stenosis and 15 with ICA occlusion. In all patients the diagnosis by CDDI without and with contrast were the same. Image quality was improved with contrast in 13 of the 17 patients at the subtotal ICA stenosis. There was no significant difference in mean velocities at the subtotal ICA stenoses without and with contrast. CONCLUSION: The usefulness of contrast enhancement with CDDI for differentiating subtotal ICA stenosis and ICA occlusion is limited. Possibly it is useful in patients with moderate image quality of the CCA and ICA and in patients with a subtotal stenosis with minimal residual color flow and relative low velocity at the ICA stenosis.

Carotid Stenosis↗
PubMed1994

The pathogenesis of syringomyelia in spinal cord ependymoma.

A spinal cord ependymoma with syringomyelia is presented. The pathogenesis of syrinx formation, associated with intramedullary tumors is not fully understood. In order to examine the mechanism of formation of the tumor-associated syrinx, syrinx fluid was obtained during surgery and concentrations of proteins were measured in the syrinx fluid, the cerebrospinal fluid (CSF) and blood serum. Protein analysis of fluid specimens showed the fluid in tumor-associated syrinx to be an exudate. This strongly indicates that, in this case, intramedullary tumor-associated syringomyelia is based on disruption of the blood-brain barrier.

Blood Proteins↗
PubMed1992

Chemonucleolysis. Predictive factors.

The aim of this study was to identify factors in the patient's history and parameters of the neurologic, roentgenographic, and electromyographic examinations as well as cerebrospinal fluid analysis before chemonucleolysis that might be used to predict the results of this treatment after 1 year. On the basis of a combination of three factors, that is, the presence or absence of a narrowed intervertebral space on the lumbosacral survey film, the localization of the disc herniation (medial, mediolateral or lateral) on the computerized tomographic scan and the number of cells in the cerebrospinal fluid, a satisfactory result could be predicted for 92% of the patients.

Adult↗
PubMed1991

CT examination of 91 patients after chemonucleolysis.

Ninety-one patients underwent a repeat CT examination 2-3 months after chemonucleolysis. In 39 patients the size of the herniation was unchanged; no correlation could be found between the CT examination and the clinical results. One year after chemonucleolysis, 27 of the patients underwent a third CT examination. The majority of the scans revealed a reduction of the herniation, while 16 of the patients still had a hernia. No correlation could be found between the clinical results and the CT examination. We conclude that a repeat CT examination after chemonucleolysis does not permit evaluation of patients with persistent or recurrent radicular pain.

Adult↗
PubMed1986

Diastematomyelia presenting in two male adults with low back pain.

Two cases of diastematomyelia with adult onset are added to the 19 patients already reported in the literature. Seventeen of them exhibited a neurological deficit, whereas our patients presented with low back pain only. Cutaneous, neuromuscular and/or radiological signs of spinal dysraphysm were found in all patients with adult diastematomyelia. If the presence of these signs were to receive more attention, more cases of adult diastematomyelia would be recognized.

Adult↗
PubMed1986

The role of digital subtraction angiography in neuroradiology. An evaluation of intravenous and intra-arterial digital subtraction angiography.

A few years after the introduction of intravenous digital subtraction angiography (DSA) in clinical practice it became clear that, although the method had been developed as an alternative to arterial angiography, especially for the analysis of cerebral ischemia, its application was not as successful as the earlier reports had indicated. Based on the results of a study comparing intravenous DSA, intra-arterial DSA, and the Doppler examination, in 168 consecutive patients, a diagnostic algorithm for the management of these patients is proposed. A second and more important application of digital subtraction is its use with arterial angiography, especially with a high resolution system configuration.

Angiography, Digital Subtraction↗
PubMed1986

Renovascular hypertension and digital subtraction analysis.

Intravenous digital subtraction angiography (DSA) is a good imaging modality for the renal arteries and their main branches. Using an anterior-posterior beam direction, a considerable reduction in X-ray exposition is achieved, and by taking 3 runs with the patient in prone position, the renal arteries are adequately visualized in a high percentage. Nevertheless we advocate arterial DSA as a screening procedure for renovascular hypertension, especially in younger patients, because of the higher diagnostic output and the possibility of taking therapeutic action in the same session in about 1 out of 3 patients.

Adolescent↗
PubMed1980

Angiographical findings and risk factors in cerebral ischaemia. A retrospective study.

Reviewing the angiograms of 100 patients with RIA or stroke we found intracranial lesions in 67%, extracranial lesions in 64%, and normal angiograms in 13% of the cases. Risk factors occurred more often as the angiographic lesions were more extensive. These findings confirm the importance of angiographic examination of the intracranial vessels in patients with cerebral ischaemia.

Adult↗
PubMed1978

Diagnostic value and limitations of selective spinal angiography in different lesions of the vertebral bones.

The technique, diagnostic results and significance, differential diagnostic considerations and limitations of selective spinal angiographies in chronic inflammatory processes (Pott's disease 11 cases). hemangiomas (21 cases) and aneurysmal bone cysts (9 cases) as well as benign and malignant tumors (26 cases) of the vertebral bones and adjacent tissues are described and demonstrated with regard to radiological findings.

Adolescent↗
PubMedDate not supplied

The role of venous digital subtraction angiography of the carotid bifurcation in the evaluation of patients with reversible ischemic attacks or stroke.

The diagnostic value of venous digital subtraction angiography (VDSA) was evaluated in 168 consecutive patients with suspected or known atherosclerotic lesions of the internal carotid artery. The VDSA findings were correlated with that of arterial angiography (AA) in 50 patients, yielding a sensitivity of 84%, a specificity of 93% and an accuracy of 89%. Correlation of the results of Doppler with that of AA and VDSA provided support for the reliability of VDSA. Clinical data relevant to the selection of angiographic technique was collected, comparing patients who underwent only VDSA, only AA and VDSA followed by AA. The conclusions of our study are: If the image quality is good a normal VDSA practically excludes the presence of surgical lesions in the internal carotid artery and obviates the need for AA. The presence of therapeutically relevant obstructive disease is reliably detected by VDSA, but the degree of obstruction cannot be determined accurately enough to proceed with cerebrovascular surgery without AA. Patients with ischemic events in the carotid territory who are potential candidates for surgery should undergo VDSA when the non-invasive tests are normal and AA when these tests indicate the presence of a stenosis or occlusion.

Angiography↗