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Biomedical subjects

P Schmit

Publications and source records attributed to P Schmit.

At least 19 recordsLinked to original sources
PubMed2003

Intellectual prognosis of the Dandy-Walker malformation in children: the importance of vermian lobulation.

Half of patients with the Dandy-Walker malformation (DWM) have normal intellectual development. We aimed to identify feature on MRI associated with good intellectual prognosis. We reviewed 20 patients with DWM diagnosed on MRI, mean age 14.6+/-9.9 years. We assessed their intellectual development and related it to the MRI features. We found two groups with a statistically different intellectual outcome. All 14 patients with normal intellectual development had a normal lobulation of the vermis, without supratentorial anomalies. Of the six patients with mental retardation, three had an abnormal vermis, together with dysgenesis of the corpus callosum. In the other three, there were normal vermian anatomy with associated anomalies. Normal lobulation of the vermis, in the absence of any supratentorial anomaly, appears to be a good prognostic factor in DWM. Preservation of cerebrocerebellar pathways and neonatal plasticity could explain the normal intellectual development. These findings might be useful in prenatal diagnosis.

Adolescent↗
PubMed2001

Imaging of fungal, viral, and parasitic musculoskeletal and spinal diseases.

There are many nonbacterial infections that have musculoskeletal manifestations and radiologic findings. These infections produce a limited range of tissue responses, depending on the organism, the tissue compartment affected, and the immune competence of the host. Diagnosis is dependent on obtaining an appropriate travel or geographic history, the clinical and laboratory features, and on occasion the specific radiologic findings.

Humans↗
PubMed2001

[Epidural hematoma in a child with hemophilia: diagnostic difficulties].

UNLABELLED: Spinal epidural hematoma is an uncommon complication in hemophilia. CASE REPORTS: The cases of an extensive epidural hematoma in two boys with severe hemophilia are reported. CONCLUSION: Acute onset of severe neck pain or backache leads to the diagnosis of epidural hematoma in children with hemophilia, even in the absence of neurologic symptoms. Early diagnosis is important and relies on magnetic resonance imaging. Replacement therapy is mandatory and must be prescribed before neuroradiologic imaging. Generally, children have a good neurologic outcome.

Back Pain↗
PubMed2001

[Prenatal semiology of diastematomyelia].

Diastematomyelia is a rare spinal malformation characterized by a division of the spinal cord. More often, the two hemicords are separated by a midline and sagittal osseous or fibrocartilaginous spur. In this report we describe two cases of diastematomyelia detected at routine second trimester detailed sonography and further assessed by MRI and spiral CT with surface shaded 3D-reconstructions. In addition to providing diagnosis, prenatal evaluation helps differentiate between diastematomyelia with good or bad prognosis.

Adult↗
PubMed2000

[Ulnar dimelia: imaging modalities and surgical implications].

PURPOSE: To report 2patients with ulnar dimelia. METHODS: Plain radiographs (2patients), angiography (1patient), MR (2patients), CT (2patients) with 3Dreconstruction (1patient) were performed. RESULTS: Unilateral polydactyly with absence of the thumb, ulnar duplication with absence of radius were observed in both patients. Shoulder dislocation was present in one patient. Vascular anomalities were observed in one patient who underwent angiography but did not interfere with polydactyly surgical treatment and pollicisation. CT with 3D helped in delineating the elbow and shoulder bone abnormalities and thus in planning elbow osteotomies. MR was helpful in imaging muscle anatomy. CONCLUSIONS: Ulnar dimelia or "mirror hand" is a rare congenital disorder of the upper limb. Approximately 70cases have been reported, including 3 with shoulder dislocation. A multimodality imaging approach, exploring the various aspects of the malformation is mandatory to help the surgeon in order to obtain a functional and aesthetic upper limb after complex surgical procedures taking into account the various aspects of the malformation.

Adolescent↗
PubMed1999

Juvenile rheumatoid arthritis and lymphoedema: lymphangiographic aspects.

We report a 5 1/2-year-old boy with juvenile rheumatoid arthritis (JRA) and lower-limb lymphoedema. US, MRI and lymphangiography were performed. Based on the lymphangiographic study, we propose a pathogenesis based on obstruction of normal superficial lymphatic vessels in the affected limb. This is discussed with other pathogenetic factors proposed in the 16 previously reported cases of lymphoedema complicating JRA.

Arthritis, Juvenile↗
PubMed1999

Intestinal intussusception survey about diagnostic and nonsurgical therapeutic procedures.

OBJECTIVE: To provide an overview of the diagnostic and therapeutic procedures performed by European paediatric radiologists in the management of intussusception. MATERIALS AND METHODS: A postal survey was sent to the European members of ESPR. Items surveyed included diagnostic imaging procedures (plain films, US, contrast enema [CE]), contrast medium used (barium, iodine, air, saline solution), and imaging technique used for monitoring during reduction (films, fluoroscopy, US). Multiple answers were possible. Other data, including contraindications, maximum pressure, pressure and irradiation monitoring, presence of a surgeon, sedation, number and duration of attempts, and hospitalisation were also obtained and analysed. RESULTS: There were 204 respondents (60.2 %). Regarding diagnosis, 72.5 % of respondents used plain radiographs, 93 % US, and 34 % CE. Reduction was performed using air (55 %), a barium suspension (32 %), iodinated contrast medium (24 %), or a saline solution (10 %). Reduction was monitored using fluoroscopy alone (46 %), fluoroscopy and radiographs (49.5 %), US alone (9.5 %), or a combination of radiology and US (18 %). Pressure was monitored by 81 % of respondents. Most respondents (82.4 %) used a maximum pressure between 100 and 120 mm Hg. CONCLUSIONS: US is widely used for diagnosing intussusception. For treatment, contrast medium and air reduction are used almost equally. A large number of radiologists are now performing intussusception reduction using US monitoring.

Child↗
PubMed1999

[Ultrasonographic diagnosis of an epiphyseal detachment of the upper end of the humerus due to birth injury].

Injuries to the proximal humerus in infants are often missed or misinterpreted because of the non ossification of the epiphysis. Ultrasound allows direct visualisation of the proximal humeral epiphysis, metaphysis, joint space, and relationship with the glenoid cavity. Ultrasound diagnosis of other epiphyses birth trauma has been reported. Ultrasound should be considered as the first imaging modality if traumatic epiphyseal dislocation is suspected in a newborn.

Birth Injuries↗
PubMed1997

[Management of anxious and painful manifestations in pediatric uroradiology].

Two hundred and seven children undergoing either intravenous pyelography (i.v.p.) or voiding cystourethrography (VCUG) were examined. Under the age of 5 years, children received intra-rectal midazolam (0.5 mg/kg) with a maximum of 5 mg. Children over 5 years, self-inhaled an equimolar mixture of oxygen and nitrous oxide. Pain and stress were evaluated in children under 5, by the pediatric radiologist according to the 4 non verbal items of the Le Baron-Zeltzer scale and in children over 5 by the child himself with a visual analogic scale. Under 5 years of age, midazolam significantly reduced pain and stress during i.v.p. (p < 0.0001), VCUG both in boys (p < 0.0001) and girls (p < 0.0001). In children over 5, nitrous oxide inhalation reduced pain during i.v.p. (p = 0.0004), during VCUG in girls (p = 0.0025), but not in boys ((p > 0.05). Pediatric radiologists should evaluate pain and stress in their patients as they can be easily and safely limited.

Administration, Rectal↗
PubMed1997

Breast conservation after induction chemotherapy for locally advanced breast cancer.

Neoadjuvant chemotherapy (NC) has been shown to reduce primary breast tumor size in 80 to 90 per cent of patients. This study prospectively evaluated a series of women with locally advanced operable breast cancer treated with NC with the purpose of identifying eligibility for breast conservation surgery (BC) and clinical parameters predictive of chemotherapy response. Patients with stage IIB and III primary operable breast cancer were evaluated prospectively between 1/1/91 and 12/31/95. Thirty-two patients received NC consisting of three cycles of 5-fluorouracil, doxirubicin, and cyclophosphamide. Prechemotherapy tumor size was assessed by palpation and mammography. Patients were offered BC depending on clinical response. Initial tumor size averaged 7 cm (range, 4-15 cm). Reduction of > 50 per cent in tumor size occurred in 17 patients (53%). Twenty-one patients (66%) were potential candidates for BC based on a post-NC pathologic tumor size of less than 4 cm. Five patients (16%) had no residual breast tumor. Four patients underwent BC (13%). Partial response was not associated with patients age, menopausal status, tumor steroid receptor or Her-2/NEU positivity, or tumor size. Patients with a clinically negative axilla had a higher likelihood of partial or complete response. NC in patients with locally advanced breast disease has a high response rate (88%) and can significantly reduce tumor size to enable conservation of the breast.

Age Factors↗
PubMed1997

[The neuropathies of IgM monoclonal gammopathies].

A peripheral polyneuropathy is often associated with an IgM monoclonal gammapathy. The monoclonal protein often binds to carbohydrate epitopes on glycoproteins and/or glycolipids of the human peripheral nerve. The clinical syndrome is related to the antigen-specificity of the IgM protein. Detection of anti-myelin antibodies and further characterization of their immunogenic specificity provide an important aid in the differential diagnosis of late-onset chronic polyneuropathies.

Glycolipids↗
PubMed1996

[Presence of parents in pediatric imaging].

The purpose of this study was to evaluate the attitude of French pediatric radiologists regarding the presence or absence of parents during pediatric imaging of their child. A mail survey was sent to the French members of the "Société Francophone de Radiologie Pédiatrique". We asked about the inclusion of parents during pediatric imaging procedures. They gave the reasons for their choice and stated if parental presence was helpful or not for the achievement of imaging procedures. Responses were received from 76% of those surveyed. Excluding vascular and interventional procedures, few respondents (13%) permit parents to be present for all types of examinations. One respondent excluded parents from every procedure. Others excluded parents from selected studies: plain films (18%), upper gastrointestinal series (33%), contrast enema (44%), retrograde (47%) and suprapubic (67%) voiding cystourethrography, intra-venous pyelography (45%), US (5%), CT (27%), MRI (25%). Regarding angiography, only 2% of the respondents allow parental presence. Every respondent performing interventional procedures did not accept parents in the interventional suite. When parents were present, they were close to their child (76%) and could help in his immobilization (47%). Most of the respondents (49%) thought parental presence to affect examination in a favorable way. The opposite opinion was supported by 25% of them. An equivocal response was given in 26% of the answers. Numerous reasons supported these responses, they could be classified according to the child and his illness, the parents, the radiologist and his team, the examination performed. Most pediatric radiologists in France allow parents to accompany their children during selected examinations. Radiologists vary in their perception of how parental presence affects the outcome of the pediatric imaging procedures.

Adult↗