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  • Articles  (5)
  • Doppler sonography  (3)
  • Anal stenosis  (1)
  • Antibiotics  (1)
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  • 1
    ISSN: 1432-1076
    Keywords: Key words Sacral dysgenesis ; Anal stenosis ; Currarino syndrome ; Chromosome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Most cases of sacral dysgenesis are considered to be sporadic events. We present two families in whom the presence of associated clinical features prompted specific investigation of chromosome 7, leading to the identification of an underlying chromosome 7q deletion causing sacral dysgenesis. All affected individuals had microcephaly and developmental delay. Detailed cytogenetic studies confirmed that all three affected individuals had a deletion of chromosome 7q associated with their sacral dysgenesis, developmental delay and related problems. The three affected patients were studied clinically, radiologically and cytogenetically. Eleven unaffected individuals from the two families were also investigated by genetic studies, specifically evaluating chromosome 7. Conclusion It is important that detailed family history, evaluation of associated malformations and the overall clinical picture be considered in identifying the underlying diagnosis in cases of anal stenosis/sacral agenesis. The cases we present demonstrate the value of detailed chromosome studies in such situations.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-8491
    Keywords: Doppler sonography ; Basilar artery thrombosis ; Doppler-Sonographie ; Basilaristhrombose
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 6380 Doppler-Untersuchungen in den letzten $$3{\raise0.7ex\hbox{$1$} \!\mathord{\left/ {\vphantom {1 2}}\right.\kern-\nulldelimiterspace}\!\lower0.7ex\hbox{$2$}}$$ Jahren wurde in sieben Fällen eine hochgradige Zirkulationsstörung der A. basilaris bzw. beider distaler Vertebralarterien angenommen. Kriterium dafür war, daß die Vertebralarterien entweder beidseits nicht darstellbar waren oder keine diastolische Flußkomponente aufwiesen („externa-a-typische” Pulskurven). Die in sechs Fällen anschließend erfolgte Angiographie bestätigte die Diagnose: Viermal fand sich ein Basilarisverschluß, einmal eine langstreckige Basilarisstenose und einmal ein beidseitiger distaler Vertebralisverschluß. Drei weitere im gleichen Zeitraum angiographisch diagnostizierte Basilarisverschlüsse erfüllten bei der Doppler-sonographischen Erstuntersuchung nicht die oben genannten Kriterien, zwei davon auch nicht bei wiederholter Untersuchung. Die Doppler-Sonographie der Vertebralarterien kann somit als ein wesentliches diagnostisches Hilfsmittel beim Nachweis signifikanter Läsionen auch der distalen A. vertebralis und der A. basilaris gelten.
    Notes: Summary We have investigated 6,380 patients with directional c-w Doppler sonography within the last $$3{\raise0.7ex\hbox{$1$} \!\mathord{\left/ {\vphantom {1 2}}\right.\kern-\nulldelimiterspace}\!\lower0.7ex\hbox{$2$}}$$ years, and have suspected obstruction of the basilar artery or of both distal vertebral arteries in 7 cases. Either bilateral sonographic silence or an absent diastolic flow component of the vertebral arteries were employed as criteria in the sonographic evaluation. Angiography of the vertebro-basilar system, performed in 6 cases, confirmed the diagnoses: basilar artery occlusion was found in 4 patients, 1 patient revealed tight stenosis of the basilar artery in its entire length, and 1 patient exhibited occlusion of both distal vertebral arteries. Three further basilar artery occlusions were detected by means of angiography despite initially negative Doppler sonography within the same period of time; l of those patients, however, met the above criteria for basilar artery occlusion upon sonographic reevaluation on the following day. Thus, we believe that directional c-w Doppler sonography is very useful in the diagnosis of basilar artery obstruction.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Intensive care units ; Streptococcus ; Antibiotics ; Antibiotic resistance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective The effect of selective decontamination of the digestive tract (SDD) on Intensive Therapy Unit (ITU)-acquired enterococcal infection and colonization was studied. Changes in the predominant species isolated and resistance patterns to antimicrobial agents were also studied. Design Three groups were investigated: historical control (HC), contemporaneous control (CC) and patients receiving SDD (topical polymyxin, amphoterecin B and tobramycin throughout ITU stay with intravenous ceftazidime for the first 3 days only). Setting Adult general ITU with 7 beds. Patients Patients with a nasogastric tube in situ and who were likely to remain in ITU for 48 h or longer were recruited. Results Enterococcal infections occured in 3 of 84 HC patients and 2 of 91 CC patients. There were no unit-acquired enterococcal infections in the SDD group. There were 140 episodes of enterococcal colonization occurring in 112 patients, with significantly more in the SDD and CC groups (p〈0.05. There were no significant differences in antibiotic sensitivities between the three groups.Enterococcus faecalis was the most frequently isolated species. Conclusion SDD does not predispose to enterococcal infection but does encourage colonization in patients receiving the regimen and other patients in ITU at the same. There is a complex interaction of factors which influence faecal flora and the likelihood of patients becoming colonized or infected with enterococci.
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  • 4
    ISSN: 1432-1920
    Keywords: Doppler sonography ; Intracranial carotid artery disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have investigated 6,587 patients with directional continuous-wave (c-w) Doppler sonography of the carotid arteries during the last 33 months, and have developed criteria for the diagnosis of a significant increase in peripheral resistance of the internal carotid artery in conjunction with 1,671 retrograde brachial and direct carotid angiograms. We distinguished stenoses proximal (15 cases) and distal (4) to the origin of the ophthalmic artery, supraclinoid internal carotid artery occlusions (8), stenoses (2) and acute occlusions (10) of the middle cerebral artery. Stenoses in the carotid siphon (proximal or distal to the origin of the ophthalmic artery) of at least 60% reduction in lumen diameter showed a reduction of the relative end-diastolic flow velocity (modified Pourcelot's index) of more than 40%; additionally, stenoses proximal to the origin of the ophthalmic artery exhibited a variable alternating flow, or flow reversal, in the supratrochlear artery. Stenoses distal to the origin of the ophthalmic artery rarely revealed the theoretically expected increase in orthograde flow velocity in the supratrochlear artery. Stenoses of the middle cerebral artery consisting of more than atherosclerotic irregularities proved to be an exception. Supraclinoid occlusions of the internal carotid artery were reliably demonstrated by Doppler sonography. However, the majority of acute occlusions of the middle cerebral artery could not be detected by this means, probably due to anastomoses between the anterior and the middle cerebral arteries, which were detected by angiography. Thus, we believe that c-w Doppler sonography is a reliable tool to detect stenoses of the carotid siphon of more than 60% reduction in lumen diameter and supraclinoid carotid artery occlusions. Barriers to the cerebral blood flow located more peripherally cannot be diagnosed reliably with this technique.
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  • 5
    ISSN: 1432-1920
    Keywords: Doppler sonography ; basilar artery occlusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We have investigated 6,972 patients with directional continuous-wave Doppler sonography within the last three and a half years, and have derived criteria for the sonographic diagnosis of basilar artery occlusion or tight stenosis in conjunction with 1,071 retrograde brachial angiograms. By sonographic patterns, we have suspected obstruction of the basilar artery or of both distal vertebral arteries in nine cases. Either bilateral sonographic silence or the absence of a diastolic flow component of the vertebral arteries served as criteria in the sonographic evaluation. Angiography of the vertebro-basilar system, performed in eight cases, showed near or complete occlusion in the distal vertebrals or in the proximal basilar artery. Degrees of stenosis less than an 80 percent reduction in lumen diameter could not be detected sonographically. Two further basilar artery occlusions were detected by means of angiography despite negative Doppler sonography: one of these patients showed an extensive collateral circulation between the posterior inferior and the superior cerebellar arteries, and one patient had an occlusion only of the middle and rostral thirds of the basilar artery, the proximal third and the anterior inferior cerebellar arteries being widely patent. Thus, we believe that directional CW Doppler sonography is very useful in the diagnosis of near or complete occlusion of both distal vertebral arteries or of the proximal basilar artery.
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