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Biomedical subjects

S G Robben

Publications and source records attributed to S G Robben.

At least 37 records · Page 2Linked to original sources
PubMed1998

US of the painful hip in childhood: diagnostic value of cartilage thickening and muscle atrophy in the detection of Perthes disease.

PURPOSE: To evaluate the combined use of several ultrasonographic (US) criteria in the detection of Perthes disease. MATERIALS AND METHODS: In a prospective study, 144 consecutive children with a painful hip underwent US. The thicknesses of the (a) anterior recess of the joint capsule, (b) cartilage of the femoral head, and (c) quadriceps muscle were assessed. Sixty-eight children with no symptoms, the control group, were also examined. RESULTS: The final diagnosis was transient synovitis (n = 58), Perthes disease (n = 21), slipped capital femoral epiphysis (SCFE; n = 5), or miscellaneous (n = 6). Fifty-four patients had no US or radiographic abnormalities, and symptoms disappeared during follow-up. The anterior recess in patients with transient synovitis was significantly wider than that in the other patients and control subjects (P < .001). Patients with Perthes disease showed significant cartilage thickening in the symptomatic hip compared with the other patients and control subjects (P < .001). Patients with Perthes disease and patients with SCFE showed significant atrophy of the ipsilateral quadriceps muscle compared with all other groups (P < .001). The combined use of these US criteria for the diagnosis of Perthes disease resulted in a positive predictive value of 95%, a negative predictive value of 95%, a sensitivity of 71%, and a specificity of 99%. CONCLUSION: The combination of several US criteria increases the diagnostic value of US of the painful hip in patients with Perthes disease.

Adolescent↗
PubMed1997

Primary hyperoxaluria type I: renal ultrasound before and after treatment.

Three patients with primary hyperoxaluria type I received therapy consisting of vitamin B6, magnesium oxide, and high oral fluid intake. Sonographic follow-up showed a variable response to treatment, ranging from normalization of renal tissue to no change at all. However, there is evidence of a correlation between laboratory findings and ultrasound findings during treatment.

Child↗
PubMed1997

L-2-hydroxyglutaric aciduria: clinical heterogeneity versus biochemical homogeneity in a sibship.

Three out of four sibs in a North-African family were affected with L-2-hydroxyglutaric aciduria. The youngest sib was most severely handicapped: she was diagnosed at 2.5 years of age, whereas the then 7- and 10-year-old siblings had a less pronounced psychomotor retardation. All patients had an increased head circumference in contrast to the healthy, non-affected sibling. Urine and plasma levels of L-2-hydroxyglutaric acid in the three sibs were similar and showed only a small variation. Magnetic resonance imaging (MRI) of the brain in the eldest sib showed hyperintense signal on T2-weighted images of the basal ganglia, dentate nucleus and subcortical white matter. The youngest sib showed identical white matter abnormalities of the corpus medullare cerebelli. These abnormalities were consistent with demyelination and/or spongiosis. On two occasions cerebrospinal fluid amino acid chromatography in the youngest sib showed an increased concentration of lysine and a decreased level of glutamine. Plasma lysine was normal. It is concluded that L-2-hydroxyglutaric aciduria is almost invariably associated with neurological disease; the severity of the symptoms does not seem to be completely dependent on the extent of the biochemical abnormalities and may even be variable within a family.

Ataxia↗
PubMed1995

Radiologic imaging of severe cervical spinal cord birth trauma.

UNLABELLED: The radiological approach of a child with severe cervical spinal cord injury after a difficult breech delivery is presented. This diagnosis is often missed due to concurrent asphyxia. Ultrasound studies clearly showed the localisation and the extent of the injury. These findings were later confirmed by MRI. CONCLUSION: Ultrasonography is recommended as the initial imaging technique to evaluate possible spinal cord lesions in the neonate.

Asphyxia↗
PubMed1995

Hepatic artery ligation for hepatic vascular tumors with arteriovenous and arterioportal venous shunts in the newborn: successful management of two cases and review of the literature.

The authors report their experience with hepatic artery ligation in two newborns, as well as relevant findings from a literature review. A 2-day-old boy had progressive cardiac and respiratory difficulty. A firm liver was palpable, with an overlying thrill. Sonography and arteriography showed diffuse arteriovenous shunting in both liver lobes. Hepatic artery ligation provided remarkable hemodynamic and clinical improvement. Another boy was admitted 3 weeks after birth because of bilious vomiting with abdominal distension and bloody stools. Abdominal examination showed a large liver with a systolic bruit and thrill. X-rays showed cardiac enlargement and dilated bowel loops with air-fluid levels. Arteriography and sonography showed arteriovenous and arterioportal venous shunting. Laparotomy was performed, and a large vascular malformation was palpated in both liver lobes. The entire bowel was congested and cyanotic, but there were no signs of obstruction. This patient had acute portal hypertension imitating intestinal obstruction. Ligation of the hepatic artery improved the color of the bowel, and the thrill disappeared. Five and nearly 4 years after the operation, both boys are growing normally without medication or diet. Sonography showed almost complete resolution of the hemangiomas.

Arteriovenous Malformations↗
PubMed1995

Idiopathic isosexual central precocious puberty: magnetic resonance findings in 30 patients.

The purpose of this prospective study was to define the incidence of magnetic resonance imaging (MRI) abnormalities in the brain in patients with idiopathic central precocious puberty without any additional neurological signs and symptoms, and to evaluate the routine use of gadolinium contrast in these patients. 30 patients (29 girls, one boy; age range 1.9-11.9 years) with idiopathic central precocious puberty were studied. MRI of the brain in axial, coronal and sagittal planes was performed before and after administration of gadopentetate dimeglumine, with special attention to the region of the third ventricle. There are three major findings: (1) the height of the pituitary gland is increased up to adult size compared with normal individuals; (2) in four patients (13%) major structural abnormalities were found; three hamartomas of the tuber cinereum and one gliomatous process extending from the chiasm to the optic tract; and (3) the routine use of gadopentetate dimeglumine did not reveal new abnormalities although the lack of enhancement made a positive contribution to diagnostic certainty. We conclude that contrast enhanced MR examination is a safe and reliable method for the exclusion of abnormalities in children with precocious puberty and for the follow-up of those patients in whom abnormalities are present.

Adolescent↗
PubMed1995

Intrapelvic Wilms' tumor simulating xanthogranulomatous pyelonephritis.

A 2-year-old boy presented with an atypical renal mass with extension into the pyelocalyceal system and distal ureter which was diagnosed initially as xanthogranulomatous pyelonephritis (XGP). The final diagnosis was intrapelvic Wilms tumor extending into the ureter. In the literature, only three patients have been described with Wilms tumor extending into the ureter, none of whom had a continuous extension into the distal ureter.

Child, Preschool↗
PubMed1994

[3-week traction with 3-week spica-cast immobilization is as good as 6-week traction, and much cheaper].

OBJECTIVE: To gain insight into the clinical en economic results of the treatment of femoral shaft fractures in children by means of traction for 3 weeks and spica immobilization for 3 weeks as an outpatient in comparison with traction for 6 weeks. DESIGN: Retrospective. SETTING: Sophia children's hospital in Rotterdam. METHOD: Between 1981 and 1989, 278 children were admitted because of a femoral shaft fracture. This follow-up study concerned 229 children of whom 139 were treated by means of 6 weeks' traction (group 1) and 90 received the combination treatment (group 2). The two groups were comparable with regard to age, sex, cause, type and site of the fracture. RESULTS: All fractures healed, complications were rare and equally divided between the two groups. There was no significant difference between the two groups with regard to shortening and angulation of bone fragments. The mean duration of hospital stay was almost 47 days in group 1 as against 22 days in group 2, leading to a reduction of Dfl. 19,500.--in hospitalization costs per child. CONCLUSION: The results of treatment of femoral shaft fractures by means of traction in combination with spica immobilization equal those of 6 weeks' traction. The shortened duration of hospital stay leads to a considerable reduction in costs.

Adolescent↗
PubMed1994

Ultrasonography is accurate enough for the diagnosis of intussusception.

For more than 10 years the authors have been using ultrasonography to confirm clinically suspected intussusception without performing a contrast enema. The aim of this study is to review this diagnostic policy. Between 1980 and 1989, 163 children who, on clinical examination and plain abdominal radiographs were suspected of having intussusception, underwent ultrasonography to confirm the diagnosis. In 33 children, ultrasonography did not show intussusception; of the remaining 130 children, intussusception was diagnosed in 128. In two children in whom intussusception was noted subsequently, the diagnosis was not established on ultrasound. Thus, ultrasonography had a sensitivity of 98.5% and a specificity of 100% in the diagnosis of intussusception. It is a quick, simple, noninvasive method to diagnose intussusception, with high accuracy. The role of contrast enema is limited to therapeutic application.

Child↗
PubMed1994

Plain film diagnosis in intussusception.

In early childhood intussusception a characteristic gas pattern is often visible on plain radiographs which can be used for diagnosis. To test this hypothesis, radiographs of 163 children with intussusception, and as many controls, were reviewed. By using multivariable analysis, it appeared that five out of seven parameters (reduced amount of gas in the jejunum; lateralization of the ileum; indiscernible caecum; reduced amount of feces in the colon; and visibility of the intussusceptum) had discriminatory value. For each parameter a weighting (in points) was derived and the patients were classified: the higher the score the more likely that an intussusception was present. A sensitivity of 90% and a specificity of 90% were obtained.

Cecum↗
PubMed1993

[Liver rupture in a newborn infant; diagnosis, treatment and prognosis].

Between August 1989 and August 1992 four neonates with rupture of the liver were admitted to the Neonatal Intensive Care Unit of the Sophia Children's Hospital in Rotterdam, the Netherlands. Two neonates were born after breech delivery, two after caesarean section because of foetal distress. All four patients had Apgar scores < 5 after 1 minute and of < 8 after 5 minutes and required artificial ventilation for a prolonged period. All infants collapsed within 6 hours after birth. Surgical treatment was not considered because of the poor clinical condition. All patients were treated conservatively. Clinical signs were: rapid onset pallor, hypotension, tachycardia and abdominal distension. Ultrasonography of the abdomen confirmed the clinical diagnosis of rupture of the liver. Despite rapid diagnosis and maximal non-surgical treatment mortality was 75%. Surgical intervention is indicated in neonatal liver rupture with significant intra-abdominal bleeding.

Female↗
PubMed1992

Iatrogenic perforation of the lamina cribrosa by nasogastric tube in an infant.

A case of iatrogenic perforation of the lamina cribrosa, followed by intracranial placement of a nasogastric tube in a preterm neonate is described. By routine ultrasound examination of the brain an echogenic structure was seen, which was radiographically diagnosed as a nasogastric tube. The tube was manually removed under antibiotic prophylaxis. No complications were observed. The false route disappeared and long-term follow-up showed no neurological side effects.

Ethmoid Bone↗
PubMed1992

Pelvic phleboliths: is there an association with diverticulitis?

Pelvic phleboliths are familiar structures to radiologists although their pathogenesis is not fully understood. The literature suggests a relationship between the prevalence of phleboliths and diverticular disease, and with a low-fibre diet. Phleboliths are said to be seen more frequently in women and on the left side in the pelvis. Their number seems to increase with advancing age. We have attempted to establish relations of phleboliths with diverticulitis, diverticulosis, sex, age and pelvic location. In this study the only statistically significant relation was an increase of the number of phleboliths with advancing age.

Adult↗