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Biomedical subjects

R Bollmann

Publications and source records attributed to R Bollmann.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Torsion of the myoma pedicle as a rare cause of ileus in puerperium].

Myoma of the uterus could not only complicate pregnancy and delivery but also puerperium. The paper reports on an unusual, but severe complication due to myoma. A 35-year old woman with myoma of the uterus was admitted with an acute abdomen and ileus on the 16th day after delivery. Pregnancy, delivery and early puerperium were uneventful. During laparotomy a twisting of a pedicle of a myoma and compression of the bowel were found. The myoma was resected and the postoperative course was normal.

Abdomen, Acute↗
PubMed1995

[Differential breast tumor diagnosis by comparing blood circulation of the tumor with the contralateral breast using color coded, pulsed Doppler ultrasound].

74 breast tumor patients were preoperatively examined by means of colour and pulsed-wave Doppler sonography using the ultrasonic instrument ALT Ultramark 9 HDI with a broad-band linear scanner, 5-10 MHz. The Doppler flow velocity waveforms, from the vessels of the mammary lesion (affected breast) and the corresponding quadrant of the contralateral breast (non-affected breast), respectively, were compared in respect of the four parameters maximal systolic velocity, minimal diastolic velocity, pulsatility index (PI) and resistance index (RI). In 48 cases we succeeded in representing arterial vessels both inside the affected and the contralateral breast. The aim of the study was to examine whether these parameters show a significantly different degree of deviation in correlation with the tumours being either benign or malign. In cases with benign lesions (n = 24) we did not find any significant differences in all the parameters that we examined. In cases with cancer, however (n = 18), a significantly higher systolic velocity was found in the affected breast compared to the contralateral breast, but there were no differences in the other parameters. Although the quantitative Doppler measurements are angle-dependent parameters, the study showed that the maximal velocity in the affected breast compared to the contralateral breast is the most useful parameter in differential diagnosis of breast tumours.

Blood Flow Velocity↗
PubMed1995

[Indirect transplacental therapy of the fetus].

UNLABELLED: The paper is a review on the actual possibilities and indications of the transplacentar therapy of the fetus. At first some principles of the pharmacodynamics of the materno-placento-fetal unit are explained in order to enable an effective drug administration and reach therapeutic levels in the fetus. Common and less common diseases of the fetus and their therapy are exposed, such as the acceleration of lung maturation with corticosteroids, the cardioversion of tachycardias with digoxin and other antiarrhythmic drugs, the therapy of toxoplasmosis with pyrimethamine, the treatment of polyhydramnios using indomethacin, the therapy of very rare inborn errors of metabolism, the therapy of thrombocytopenia and the prevention of neural tube defects by folic acid supplementation. For these diseases the pathophysiologic background, the therapy rationale and possible side effects of therapy were exposed. Prior to an intrauterine therapy the perinatologist has to ask himself the 5 "W"- QUESTIONS: Which fetus to treat? Why to treat? When to treat? Who will treat? Way of treatment?

Congenital Abnormalities↗
PubMed1995

[Doppler echocardiographic analysis of blood flow through the fetal aorta and pulmonary valve in the second half of pregnancy].

Pulsed Doppler velocimetry of the fetal aortic and pulmonary valves derived in the five-chamber-view and short-axis view were performed in 88 uncomplicated pregnancies between the 20th and 40th week of gestation. The maximal and mean velocities were assessed for both semilunar valves. Considering the valve diameters and heart rate the stroke volume and cardiac output for both ventricles were calculated. Furthermore, the common stroke volume, common cardiac output and the ratio of right to left cardiac output were calculated. Normal ranges for all these parameters were constructed and correlated with gestational age. The maximal velocities were higher in the aorta than in the pulmonary trunk, but no differences were found in the mean velocities. The stroke volume and cardiac output of the right ventricle were in higher ratio 1.3:1 than that of the left ventricle as an expression of the right ventricular dominance in the fetus. Intracardiac Doppler flow velocimetry gives an insight into the physiology of fetal circulation and is a basis for the analysis of blood flow under pathological conditions.

Aorta↗
PubMed1995

[An isolated fetal kidney cyst as a sign of congenital neuroblastoma. A case report and overview of the literature].

As a normal scan at 20 weeks of gestation a pregnant woman was referred at 36 weeks because of a cystic tumour in the fetal kidney. The cyst, 27 mm in diameter, was localised at the cranial pole of the right kidney. A fetal neuroblastoma was suspected. At the fourth day after birth adrenalectomy was performed and the histological finding confirmed the prenatal diagnosis. Two years later the child is healthy. In review of the literature we found that sonographic pattern and localisation of fetal neuroblastoma are different, but in all cases the detection was performed in the third trimester of gestation.

Adrenal Gland Neoplasms↗
PubMed1995

Oto-palato-digital syndrome with features of type I and II in brothers.

We report on the oto-palato-digital syndrome (OPD) in two sons of a mother showing minimal signs of the condition. The index patient, a 10-year-old boy, presents typical symptoms of OPD type I together with bowing of the long bones and abnormalities of the thorax and spinal column. During the following pregnancy ultrasonographic studies of the male fetus in the 16th week of gestation revealed severe micrognathia, short and wide thumbs, and big toes, and bowed tibiae. After termination of the pregnancy further features were observed which fulfilled the diagnostic criteria of both OPD I and II. A possible explanation of these findings is that OPD type I and II and the features in the described cases are part of a continuous clinical spectrum of the same underlying mutation, or that several different alleles are involved in the OPD type I, type II, and mixed phenotypes.

Abnormalities, Multiple↗
PubMed1994

[Intrauterine device-associated genital actinomycosis. Diagnosis and therapy with reference to five case reports].

Between 1992 and the beginning of 1993, 5 patients attending the gynecological department of the Charité Hospital in Berlin were treated for IUP-associated actinomycosis. The IUP had been used by these women for periods of between five and sixteen years. The primary diagnosis was established on the basis of a histological examination in three cases. In two cases, dysplasias had been diagnosed on the basis of the cytological examination. In one case, the primary diagnosis was suspected by the finding of actinomycetes in the cytological preparation. The treatment of choice is high-dose intravenous penicillin administered over the long term.

Actinomycosis↗
PubMed1994

Feto-amniotic shunting--report of the experience of four European centres.

Few reports concerning intrauterine shunting are available. We investigated the impact of this method. In order to evaluate intrauterine shunting and the complication rate for different indications, we sent a questionnaire to all German-speaking level 3 centres. In four level 3 centres, 52 intrauterine catheters were inserted in 34 fetuses. The indications were uni- or bilateral hydrothorax in nine cases, cystic adenomatoid malformation of the lung in four cases, infravesical stenosis in 13 cases, and fetal ascites in eight cases. In three cases (6 per cent), difficulties occurred when the drain was inserted. In 15 cases (29 per cent), the function of the drain was reduced by dislocation or occlusion. The mortality rate caused by shunting was as high as eight per cent (four cases). The application of an intrauterine shunt currently represents a rarely performed ultrasound-guided therapeutic intervention in the fetus. In all cases, the indication for shunting is to avoid compression of normal tissue by cystic structures. A high complication rate restricts the application of drainage to selected cases.

Ascites↗
PubMed1994

Biochemical diagnosis in prenatal uropathy.

Thirty-two fetuses, six with prune-belly syndrome, seven with renal cyst, 19 with obstructive uropathy, underwent intrauterine fluid aspiration during weeks 15-37 of gestation. Fluid samples were analysed for Na, K, creatinine, urea, alpha 1-, and beta 2-microglobulin. Aspirate concentrations of sodium below 130 mmol/L and creatinine above 115 mumol/L indicate an active kidney and exclude a renal cyst. However, aspirates from fetal cysts or fetuses with obstructive uropathy showed analyte concentrations for sodium, potassium, creatinine, and urea corresponding to extracellular fluid (ECF). In conclusion fluid aspirates of fetuses with ultrasonographically detectable cystic cavities in the abdomen should be examined for sodium and creatinine to assess remaining renal function for planning of obstetric management.

Alpha-Globulins↗
PubMed1994

[Fetal color Doppler echocardiography. Part 1: General principles and normal findings].

The first part gives an overview of the practical application of colour-coded Doppler sonography in foetal cardiology. After a comparison between colour-coded and pulsed spectral Doppler in the assessment of foetal intracardiac haemodynamics, the basic principles of colour Doppler are presented. Some practical aspects important in the optimal analysis of the foetal heart are emphasised considering the possibilities and limits of the method. The typical patterns of colour Doppler flow in normal foetal hearts and possible pitfalls are explained viewing different cross-section planes. After the analysis of the cardiac structures in Real-Time, the colour Doppler sonography enables the examiner to assess rapidly and reliably the intracardiac haemodynamics in the foetus. This diagnostical mean improves the accuracy of foetal echocardiography in the diagnosis of congenital cardiac diseases.

Blood Flow Velocity↗
PubMed1994

[Fetal color Doppler echocardiography. Part 2: Abnormalities of the heart and great vessels].

The second part gives an overview of the usefulness of colour Doppler in the diagnosis of congenital heart anomalies in the foetus. Typical colour Doppler findings in anomalies of the right ventricular inflow and outflow tract are presented especially in tricuspid atresia, in Ebstein's anomaly, in pulmonary stenosis and pulmonary atresia. Furthermore exposed are the findings in malformations of left ventricular inflow and outflow tract like in hypoplastic left heart syndrome or in aortic stenosis. The typical shunt patterns detected in atrioventricular or ventricular septal defects are also presented. The analysis of the perfusion of the great vessels bei colour Doppler is important and enables a reliable assessment of some cardiac defects like the Tetralogy of Fallot, the transposition of great arteries or the double outlet right ventricle. At least the application of the colour coded M-Mode echocardiography is explained. Colour Doppler echocardiography is a non-invasive method which is helpful in the detection and the description of abnormalities of the foetal heart and is nowadays indispensable in the prenatal diagnosis of congenital heart defects.

Blood Flow Velocity↗
PubMed1994

[Ultrasound measurements of the fetal heart in the 4-chamber image plane].

Foetal cardiac measurements performed in the four-chamber-view plane were performed in uncomplicated pregnancies between the 20th and the 40th week of gestation. Using cine-loop- and zoom-techniques, the heart length, width, area, and width/length ratio (n = 143) were measured. Including the thoracic diameter and the thoracic area (n = 128), the ratios heart width/thoracic width (CT-ratio) and heart area/thoracic area (CTA-ratio) were also calculated. Normal ranges for the measured parameters and calculated ratios were constructed. Viewing the foetal four-chamber-plane is nowadays a routine scan in obstetrics, and such proposed reference curves could help the sonographer, to detect an abnormal heart and differentiate heart dilation from normal heart in a growth-retarded foetus.

Echocardiography↗
PubMed1994

[Non-puerperal mastitis in real time and color Doppler ultrasound].

Differential diagnosis distinguishing between nonpuerperal mastitis and inflammatory cancer of the breast is difficult, the conventional method being mammography. In our study, we present the typical findings gained by sonography of 16 patients with nonpuerperal mastitis. They do not differ significantly from those cases with breast cancer. From these 16 patients, 7 were additionally examined using Colour and Pulsed Wave Doppler Sonography. International literature offers little practical knowledge in this field. In the immediate surroundings of the inflammation, we were able to represent up to four arterial vessels per patient. The parameters of the flow velocity wave form of these vessels were compared to those of the vessels in the correspondent quadrant of the contralateral breast. In all cases, the maximum systolic and the minimum end diastolic velocities were higher than in the contralateral breast, giving evidence of an increased vascularity. In 6 cases, the pulsatility and resistance indices in the inflammatory vessels were lower because of a decreased peripheral resistance of the vessel. Under therapy with antibiotics or Bromocriptine, these parameters were equalized in both breasts. The model of nonpuerperal mastitis shows, that Colour and Pulsed Wave Doppler Sonography makes it possible to differentiate tumours of the breast on the basis of an analysis of their vascularity and the comparison with the parameters of the vessels in the contralateral breast. The effects of a pharmacological therapy on the vascularity of breast tumours can also be measured with this method.

Abscess↗
PubMed1994

[Pseudo-sulfur granules (pseudo-actinomycotic granules) in intrauterine device patients].

In 14 tissues from uterine curettages from women with intrauterine contraceptive devices (IUD) we found structures were discovered, which could easily be mistaken for actinomycotic sulphur granules. These were characterised by radial filamentous eosinophilic structures with peripheral club-like swellings. The dissimilarities to a true sulphur granule are evident with Gram staining which shows single filaments substantially wider than those of the true actinomycotic granules. Until now the nature of the described structures is not clear. They are possibly deposits on the copper thread of the IUD.

Actinomyces↗
PubMed1994

[Ultrasound measurements of the diameter of the aorta and pulmonary trunk of the fetus].

Fetal cardiac measurements derived in the five-chamber and the short-axis view were performed in uncomplicated pregnancies between the 20th and the 40th week of gestation. Using cine loop and zoom techniques, the diameters of the aortic and pulmonary valve were measured (n = 157) and the pulmonary trunk/aorta ratio calculated. Normal ranges for both parameters were constructed and correlated with gestational age. Both diameters showed a linear increase during gestation (aorta r = 0.87, pulmonary trunk r = 0.91). The mean pulmonary trunk/aorta ratio had a constant value of 1.25 and showed no changes throughout pregnancy. In 128 fetuses the heart width was further measured and the vessel diameters were presented in correlation to the heart width.

Aorta, Thoracic↗
PubMed1994

[Vaginal ultrasound cervix imaging in pregnancy--predictive value of suspicious findings on the subsequent course of pregnancy].

To evaluate the use of serial measurement of cervical length and width of internal os by means of vaginal ultrasound 144 pregnant women were examined prospectively. We hypothesized, that cervical length and width of the internal os would be significantly different in normal patients and those with preterm labor or cervical incompetence. Predictive validity of suspicious findings indicating the occurrence of preterm labour and cervical incompetence in further course of pregnancy should be assessed. Anamnestic, sonographic and outcome data were analysed. To assess sensitivity, specifity, positive and negative predictive values, different values of cervical length and width of internal os between 20 and 27 weeks were analysed. Significant differences of cervical length and width of internal os in normal and pathologic pregnancies could be documented early in pregnancy course. By further investigation early suspicious findings indicating the developing pathology were found only for the subgroup with cervical incompetence. Sensitivity of vaginal ultrasound examination between 20 and 27 weeks indicating the whole pathologic collective was only 30%, whereas up to 55.5% of pregnancies complicated by cervical incompetence were detected. Specifity (up to 95%) and negative predictive value (90%) were high. The results show that cervical examination by vaginal ultrasound allows early detection of developing cervical incompetence. The high specifity and the high negative predictive value may be useful to exclude cervical incompetence in clinically unclear cases thus helping to avoid unnecessary therapeutical interventions.

Adult↗
PubMed1994

[Cystic kidney dysplasia of variable expression--prenatal ultrasound, cytogenetic and patho-anatomic findings based on 3 case examples].

The present study reports on 3 cases of cystic renal dysplasias of Potter II type with variable characteristics and different clinical symptoms. The prenatal sonography revealed multicystically altered kidneys in the 19th to 33 rd week of gestation. Amniotic fluid cells and fetale lymphocytes were investigated to exclude possible chromosomal disorders. In case one, a unilateral cystic renal dysplasia was diagnosed by sonography in the 19th week of gestation. The chromosome analysis revealed one additional and altered chromosome 22 (partial trisomy). In case two, a bilateral cystic renal disease with oligohydramnios was distinguished in week 21 of gestation. In both cases, the pregnancies underwent artificial abortions and the stillborn infants were subjected to post mortem examinations. The patho-anatomical examinations confirmed the results of prenatal diagnoses and the classification of the cystic renal alteration as renal dysplasia of Potter II type. In case two, extrarenal malformations were found additionally. In case three, sonography revealed a unilateral multicystic kidney. In this case, there had not been any clinical symptoms in the prenatal stage, neither originating from the affected organ nor from other disorders. After delivery at predicted day a unilateral nephrectomy was performed because of space-consuming growth inside the abdominal cavity.

Abortion, Eugenic↗