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Kentrup H, Alzen G, Skopnik H, Büll U, Kleinhans E. Falsch-negatives SkelettSzintigramm bei einer biparietalen Schädelfraktur beim »Battered Child«-Syndrom. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1633281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungEs wird über ein kleines Mädchen berichtet, das nach einem Schädeltrauma radiologisch zwei Frakturen der Schädelkalotte aufwies, bei dem aber eine acht Tage später durchgeführte Skelett-Szintigraphie mit 99mTc-DPD unauffällig war. Die möglichen Gründe für diese Diskordanz werden diskutiert.
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Thome UH, Genzel-Boroviczeny O, Bohnhorst B, Schmid M, Fuchs H, Rohde O, Avenarius S, Topf HG, Zimmermann A, Faas D, Timme K, Kleinlein B, Buxmann H, Schenk W, Segerer H, Teig N, Gebauer C, Hentschel R, Heckmann M, Schlösser R, Peters J, Rossi R, Rascher W, Böttger R, Seidenberg J, Hansen G, Zernickel M, Alzen G, Dreyhaupt J, Muche R, Hummler HD. Permissive hypercapnia in extremely low birthweight infants (PHELBI): a randomised controlled multicentre trial. Lancet Respir Med 2015; 3:534-43. [PMID: 26088180 DOI: 10.1016/s2213-2600(15)00204-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/08/2015] [Accepted: 05/14/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Tolerating higher partial pressure of carbon dioxide (pCO2) in mechanically ventilated, extremely low birthweight infants might reduce ventilator-induced lung injury and bronchopulmonary dysplasia. We aimed to test the hypothesis that higher target ranges for pCO2 decrease the rate of bronchopulmonary dysplasia or death. METHODS In this randomised multicentre trial, we recruited infants from 16 tertiary care perinatal centres in Germany with birthweight between 400 g and 1000 g and gestational age 23-28 weeks plus 6 days, who needed endotracheal intubation and mechanical ventilation within 24 h of birth. Infants were randomly assigned to either a high target or control group. The high target group aimed at pCO2 values of 55-65 mm Hg on postnatal days 1-3, 60-70 mm Hg on days 4-6, and 65-75 mm Hg on days 7-14, and the control target at pCO2 40-50 mmHg on days 1-3, 45-55 mm Hg on days 4-6, and 50-60 mm Hg on days 7-14. The primary outcome was death or moderate to severe bronchopulmonary dysplasia, defined as need for mechanical pressure support or supplemental oxygen at 36 weeks postmenstrual age. Cranial ultrasonograms were assessed centrally by a masked paediatric radiologist. This trial is registered with the ISRCTN registry, number ISRCTN56143743. RESULTS Between March 1, 2008, and July 31, 2012, we recruited 362 patients of whom three dropped out, leaving 179 patients in the high target and 180 in the control group. The trial was stopped after an interim analysis (n=359). The rate of bronchopulmonary dysplasia or death in the high target group (65/179 [36%]) did not differ significantly from the control group (54/180 [30%]; p=0·18). Mortality was 25 (14%) in the high target group and 19 (11%; p=0·32) in the control group, grade 3-4 intraventricular haemorrhage was 26 (15%) and 21 (12%; p=0·30), and the rate of severe retinopathy recorded was 20 (11%) and 26 (14%; p=0·36). INTERPRETATION Targeting a higher pCO2 did not decrease the rate of bronchopulmonary dysplasia or death in ventilated preterm infants. The rates of mortality, intraventricular haemorrhage, and retinopathy did not differ between groups. These results suggest that higher pCO2 targets than in the slightly hypercapnic control group do not confer increased benefits such as lung protection. FUNDING Deutsche Forschungsgemeinschaft.
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Affiliation(s)
- Ulrich H Thome
- Division of Neonatology, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany.
| | - Orsolya Genzel-Boroviczeny
- Division of Neonatology, Dr. von Hauner University Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Bettina Bohnhorst
- Division of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Manuel Schmid
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Hans Fuchs
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Oliver Rohde
- Division of Neonatology and Pediatric Critical Care, Elisabeth Children's Hospital, Klinikum Oldenburg, Medical Campus, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Stefan Avenarius
- Hospital for General Pediatrics and Neonatology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Hans-Georg Topf
- Division of Neonatology, University Hospital for Children and Adolescents, Friedrich-Alexander University Erlangen, Erlangen, Germany
| | - Andrea Zimmermann
- Mutter-Kind-Zentrum, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dirk Faas
- University Hospital for General Pediatrics and Neonatology, Justus Liebig University Giessen, Giessen, Germany
| | - Katharina Timme
- Division of Neonatology, Hospital for Children and Adolescents, Vivantes-Hospital Neukölln, Berlin, Berlin, Germany
| | - Barbara Kleinlein
- Hospital for Children and Adolescents, Children's Hospital of the Third Order, Munich, Germany
| | - Horst Buxmann
- Division of Neonatology, University Hospital for Children and Adolescents of the J.W. Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Wilfried Schenk
- Hospital for Children and Adolescents, Central Hospital Augsburg, Augsburg, Germany
| | - Hugo Segerer
- St. Hedwig Hospital, University of Regensburg, Regensburg, Germany
| | - Norbert Teig
- Department of Neonatology and Pediatric Intensive Care, Katholisches Klinikum, Ruhr University Bochum, Bochum, Germany
| | - Corinna Gebauer
- Division of Neonatology, University Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Roland Hentschel
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Matthias Heckmann
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Rolf Schlösser
- Division of Neonatology, University Hospital for Children and Adolescents of the J.W. Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Jochen Peters
- Hospital for Children and Adolescents, Children's Hospital of the Third Order, Munich, Germany
| | - Rainer Rossi
- Division of Neonatology, Hospital for Children and Adolescents, Vivantes-Hospital Neukölln, Berlin, Berlin, Germany
| | - Wolfgang Rascher
- Division of Neonatology, University Hospital for Children and Adolescents, Friedrich-Alexander University Erlangen, Erlangen, Germany
| | - Ralf Böttger
- Hospital for General Pediatrics and Neonatology, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jürgen Seidenberg
- Division of Neonatology and Pediatric Critical Care, Elisabeth Children's Hospital, Klinikum Oldenburg, Medical Campus, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Gesine Hansen
- Division of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Maria Zernickel
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
| | - Gerhard Alzen
- Division of Pediatric Radiology, University Hospital of the Justus Liebig University Giessen, Giessen, Germany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Rainer Muche
- Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
| | - Helmut D Hummler
- Division of Neonatology and Pediatric Critical Care, University Hospital for Children and Adolescents, University of Ulm, Ulm, Germany
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Schenk JP, Alzen G, Klingmüller V, Teufel U, El Sakka S, Engelmann G, Selmi B. Measurement of real-time tissue elastography in a phantom model and comparison with transient elastography in pediatric patients with liver diseases. Diagn Interv Radiol 2015; 20:90-9. [PMID: 24317333 DOI: 10.5152/dir.2013.13116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE We aimed to determine the comparability of real-time tissue elastography (RTE) and transient elastography (TE) in pediatric patients with liver diseases. MATERIALS AND METHODS RTE was performed on the Elasticity QA Phantom Model 049 (Computerized Imaging Reference Systems Company Inc., Norfolk, Virginia, USA), which has five areas with different levels of stiffness. RTE measurements of relative stiffness (MEAN [mean value of tissue elasticity], AREA [% of blue color-coded stiffer tissue]) in the phantom were compared with the phantom stiffness specified in kPa (measurement unit of TE). RTE and TE were performed on 147 pediatric patients with various liver diseases. A total of 109 measurements were valid. The participants had following diseases: metabolic liver disease (n=25), cystic fibrosis (n=20), hepatopathy of unknown origin (n=11), autoimmune hepatitis (n=12), Wilson's disease (n=11), and various liver parenchyma alterations (n=30). Correlations between RTE and TE measurements in the patients were calculated. In addition, RTE was performed on a control group (n=30), and the RTE values between the patient and control groups were compared. RESULTS The RTE parameters showed good correlation in the phantom model with phantom stiffness (MEAN/kPa, r=-0.97; AREA/kPa, r=0.98). However, the correlation of RTE and TE was weak in the patient group (MEAN/kPa, r=-0.23; AREA/kPa, r=0.24). A significant difference was observed between the patient and control groups (MEAN, P = 5.32 e-7; AREA, P = 1.62 e-6). CONCLUSION In the phantom model, RTE was correlated with kPa, confirming the presumed comparability of the methods. However, there was no direct correlation between RTE and TE in patients with defined liver diseases under real clinical conditions.
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Affiliation(s)
- Jens-Peter Schenk
- From the Division of Pediatric Radiology (J-P.S., S.E.S., B.S. e-mail: ), Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany; the Department of Pediatric Radiology (G.A., V.K.), University Clinic Giessen & Marburg, Giessen, Germany; the Department of General Pediatrics (U.T., G.E.), University Hospital of Heidelberg, Germany
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Woitzik C, Grychtol B, Ferrario D, Böhm S, Robitaille N, Adler A, Alzen G. Ermittlung von Messdaten und Proportionen des menschlichen Thorax aus CT-Schnitten zur mathematischen Korrektur von Rohdatensätzen der Elektrischen Impedanztomografie (EIT). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Harth S, Behrens CB, Roller FC, Alzen G, Krombach GA. Mammasonografie in der Pädiatrie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Klinzmann M, Läßig M, Klingmüller V, Behrens C, Hamscho N, Papst S, Alzen G. Zur Qualitätsbeurteilung von Thoraxaufnahmen pädiatrischer Intensivstationen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lavi L, Wilhelm B, Burkhardt B, Meinhardt A, Alzen G. Beurteilung der Therapieresponse mediastinaler Lymphome mittels CT/MR-Volumetrie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Woitzik C, Grychtol B, Ferrario D, Böhm S, Robitaille N, Adler A, Alzen G. A priori Informationen für die elektrische Impedanztomografie (EIT) aus CT-Daten des Thorax - Erhebung und Bearbeitung anthropometrischer Daten und Konturanalysen unter besonderer Berücksichtigung von pädiatrischen Patienten. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1352558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Behrens CB, Yildiz SM, Lehmann H, Harth S, Alzen G, Krombach GA. MRT-Diagnostik entzündlicher Erkrankungen von Knochen, Gelenken und Weichteilen im Kindesalter - ein symptomorientierter Ansatz. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1352548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berthold LD, Steiner D, Scholz D, Alzen G, Zimmer KP. Imaging of chronic inflammatory bowel disease with 18F-FDG PET in children and adolescents. Klin Padiatr 2013; 225:212-7. [PMID: 23519750 DOI: 10.1055/s-0033-1334878] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Standard for diagnosis of inflammatory bowel disease (IBD) is the endoscopy of the stomach and the intestine. Aim of this study was to determine the value of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in pediatric patients with mild to moderate IBD.We included 23 children and adolescents between 8 and 17 years (median 15 years, 13 boys, 10 girls) in this retrospective study in a routine clinical setting. Diagnoses were Crohn's disease in 19 and ulcerative colitis in 4 cases.3 children had a conventional FDG-PET, 20 patients a combined FDG-PET-computed tomography exam. All children had upper and lower intestinal endoscopy with biopsy and a Hydro-MRI exam to assess the jejunum and proximal ileum. The gastrointestinal tract was divided in 7 segments: Stomach plus duodenum, jejunum and proximal ileum, terminal ileum, cecum plus ascending colon, transverse colon, descending colon, and rectosigmoid.Superficial gastric lesions were missed, gastric ulcerations were detected. For the stomach, the sensitivity was 0.25, the specificity was 1.00, the positive predictive value was 1.00, for the lower intestine (terminal ileum and colon) the values were 0.74, 0.88, and 0.96; for the terminal ileum 0.89, 0.75 and 0.94, respectively.The sensitivity and specificity for of ileal and colonic lesions is high. FDG-PET has to be discussed as a tool for the determination of extent and degree of inflammation, especially in those parts of the small bowel that are not accessible to endoscopy. This has to be weighed against the additional radiation exposure administrated.
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Affiliation(s)
- L D Berthold
- Diagnostische und Interventionelle Radiologie, Medizinische Hochschule Hannover, Deutschland.
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Peter C, Wenzlaff P, Kruempelmann J, Alzen G, Bueltmann E, Gruessner SE. Perinatal morbidity and early neonatal mortality in twin pregnancies. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojog.2013.31017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Klinzmann M, Klingmüller V, Läßig M, Behrens C, Alzen G. Qualität von Thoraxaufnahmen auf einer pädiatrischen Intensivstation einer privatisierten deutschen Universitätsklinik. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Alzen G, Lottig K, Zahrt S, Baumhakl G, Behrens CB, Goebeler M. Sonographische Beurteilungskriterien von High-Flow-Hämangiomen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Behrens CB, Langholz JH, Eiler J, Harth S, Hamscho N, Naehrlich L, Atzenberger K, Fuchs K, Jenewein R, Krombach GA, Alzen G. Messung der Leberelastizität bei Kindern mit zystischer Fibrose mittels Acoustic Radiation Force Impuls Imaging (ARFI). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Berthold LD, Renne J, Weidemann J, Schubert K, Scholz D, Alzen G. Vergleich der Hydro-MRT und der Sellink-MRT bei Kindern mit chronisch-entzündlichen Darmerkrankungen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Fuchs K, Eiler J, Behrens C, Schmidt D, Lüdemann M, Alzen G. ARFI-Elastografie nach herzchirurgischen Eingriffen am Beispiel der totalen cavopulmonalen Anastomose (TCPC). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Dupuytren's disease in childhood and adolescence is extremely rare. As in adults most patients are male. We report on a girl at the age of 7 years with a cord in the palm.
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Affiliation(s)
- R Kraus
- Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Giessen und Marburg GmbH, Standort Giessen.
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Schmitt Z, Bauer R, Steiner D, Zimmer KP, Alzen G. Bildgebende Verfahren bei chronisch entzündlichen Darmerkrankungen (CEDE) in der Pädiatrie: Primärdiagnostik und Verlaufsbeurteilung. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Berthold LD, Weidemann J, Shin HO, Linderkamp C, Alzen G. Einfluss der Intubationsnarkose auf die Bildqualität bei Thorax-CT-Untersuchungen von Kleinkindern. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Driedger J, Zimmer KP, Alzen G. Klinik und bildgebende Diagnostik der Cholelithiasis im Kindesalter. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
BACKGROUND The German Federal Law on Radiation Control contains no special provisions for X-ray studies in children and adolescents, even though exposure to ionizing radiation must be kept especially low in young persons, because their tissues are highly radiosensitive. Children, who have many years left to live, are more likely than adults to develop radiation-induced cancer; also, as future parents, they are at risk for passing on radiation-induced genetic defects to the next generation. Whenever possible, radiological studies on children and adolescents should be of a type that does not involve ionizing radiation, such as ultrasonography or magnetic resonance imaging. Pediatric conventional X-rays and computerized tomography (CT) require special examining techniques and protocols that are adapted to the patient's age and to the indication for the study. METHODS We selectively review the literature on pediatric dose reduction and discuss our own investigations on the subject as well. RESULTS The essential technical prerequisites for lowering the dose of ionizing radiation in conventional X-ray studies include the proper setting of tube voltage, the use of tube filters, suitable patient positioning and fixation, variable use of a scattered-radiation grid, and a modern storage-plate system. In CT studies, the use of age- and indication-adapted protocols can lower radiation exposure by as much as 95%. CONCLUSION There are now many ways to lower the exposure of children and adolescents to ionizing radiation without sacrificing diagnostic reliability. The main factors in lowering exposure are proper attention to clinical indications, the use of special X-ray protocols, the use of alternative imaging studies without ionizing radiation wherever possible, and the expertise of the examiner.
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Affiliation(s)
- Gerhard Alzen
- Abteilung Kinderradiologie, Medizinisches Zentrum für Radiologie, Justus-Liebig-Universität Gießen, Gießen, Germany.
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Eiler J, Kleinholdermann U, Hermann F, Ruppert S, Dahms J, Klingmüller V, Alzen G. Wertigkeit der Elastographie von Kindern und Jugendlichen mit Leberfibrose im Vergleich zum Normkollektiv. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ruppert S, Beiderwellen K, Volz M, Berthold LD, Fiebich M, Alzen G. Dosisreduktion bei Thoraxaufnahmen im Kindesalter unter Verwendung von digitalen Speicherfolien. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Beiderwellen K, Ruppert S, Volz M, Berthold LD, Läßig M, Fiebich M, Alzen G. Bildqualität von dosisreduzierten digitalen Thoraxaufnahmen im Kindesalter. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Quast D, Eiler J, Alzen G, Klingmüller V. Elastografie von Lebergesunden und Patienten mit Leberfibrose im Kindesalter. Klin Padiatr 2011. [DOI: 10.1055/s-0031-1273795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alzen G, Basedow J, Luedemann M, Berthold LD, Zimmer KP. Partial Splenic Embolization as an Alternative to Splenectomy in Hypersplenism – Single Center Experience in 16 Years. Klin Padiatr 2010; 222:368-73. [DOI: 10.1055/s-0030-1263183] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hirschburger M, Enders J, Alzen G, Padberg W, Wagner HJ. An inflammatory myofibroblastic tumor of the stomach as a rare cause of gastric outlet obstruction in an 8-month-old infant. Klin Padiatr 2010; 222:192-3. [PMID: 20514627 DOI: 10.1055/s-0029-1238320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Inflammatory myofibroblastic tumors (IMT) are a rare entity. Localization in the stomach is extremely seldom and almost exclusively seen in children. Invasive growth of IMT may lead to irresectability or recurrence. In an 8-month-old girl presented with repetitive vomiting for several days. Complete surgical resection of a gastric IMT was possible.
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Affiliation(s)
- M Hirschburger
- University Hospital, Department of General, Thoracic- and Pediatric Surgery, Giessen, Germany
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Verhoff MA, Fischer L, Alzen G, Ramsthaler F. [Reconstruction of stab wounds from preoperative CT data--diagnostic report of a clinical forensic examination]. Arch Kriminol 2009; 224:73-81. [PMID: 19938403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A young man with multiple penetrating wounds was admitted to a hospital for emergency treatment after a knife attack. The following day, a clinical forensic examination to document and interpret the injuries was ordered. However, by then, only the changed postoperative condition of the injuries could be assessed. Photos, detailed descriptions, or sketches of the original wounds had not been made. By using CT data sets that had been acquired prior to treatment, it was possible to localize and reconstruct the injuries inflicted to the skin, soft tissues and bones. With the aid of the attending physician, the injuries could be classified as stab wounds.
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Affiliation(s)
- Marcel A Verhoff
- Institut für Rechtsmedizin am Universitätsklinikum Giessen und Marburg, Giessen
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Abstract
Hepatic hemangioma and focal nodular hyperplasia are both frequently observed benign lesions of the liver. Whereas hepatic hemangioma is the most frequent benign liver tumor in children, focal nodular hyperplasia occurs predominantly in adult patients. Concomitance of both entities has been described in adults, suggesting a similar pathogenesis. We report on a 6-month-old child with a continuously shrinking hepatic hemangioma after interventional therapy and a growing hepatic mass 5 years later, which emerged as focal nodular hyperplasia at the site of the former hemangioma. Diagnostic and therapeutic strategies regarding this patient are discussed. The present case supports the theory that these two entities may share a similar pathomechanism.
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Affiliation(s)
- Carmen Turowski
- Department of Pediatric Surgery, Hannover Medical school, Hannover, Germany.
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Hunold A, Alzen G, Wudy SA, Bluetters-Sawatzki R, Landmann E, Reiter A, Wagner HJ. Ovarian tumor in a 12-year old female with severe hypothyroidism: A case of Van Wyk and Grumbach syndrome. Pediatr Blood Cancer 2009; 52:677-9. [PMID: 19127572 DOI: 10.1002/pbc.21920] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report a 12-year-old female presenting with an abdominal tumor. Diagnostic workup revealed giant bilateral ovarian cysts, severe hypothyroidism as well as an elevation of CA 125. We refrained from ovariectomy, which would be necessary for a malignant tumor, in view of an evident Van Wyk and Grumbach syndrome. The patient promptly responded to L-thyroxine with complete regression of all symptoms. Hypothyroidism should be considered in the evaluation of ovarian cysts. Although the Van Wyk and Grumbach syndrome is rare, it is crucial to rule it out in order to avoid unnecessary ovarian surgery when thyroid replacement is completely sufficient.
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Affiliation(s)
- Andrea Hunold
- Department of Pediatric Hematology and Oncology, Center of Child and Adolescent, Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
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Mett R, Tam Bui TT, Ruppert S, Alzen G, Klingmüller V, Schmidt H, Tröger J, Fiebich M. Technischer Vergleich von Speicherfoliensystemen für den Einsatz in der Pädiatrie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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32
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Faas D, Merz C, Hahn A, Alzen G, Heckmann M. Aicardi-Goutières Syndrom: Differentialdiagnose intrazerebraler Verkalkungen. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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33
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Ilgaz D, Klauwer D, Horn M, Alzen G, Heckmann M. Bacillus cereus als seltene Ursache einer neonatalen Meningoenzephalitis. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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34
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Lüdemann M, Alzen G. Erwartungen des Kinderkardiologen an die MRT. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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35
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Faas D, Klauwer D, Alzen G, Hügens-Penzel M, Reiter A, Kuchelmeister K, Heckmann M. Ependymopathia granularis bei einem Frühgeborenen von 26 Gestationswochen. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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36
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Alzen G, Lüdemann M. Morphologie angeborener Herzfehler im MRT. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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37
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Berthold LD, Haras G, Goldbach JM, Läßig M, Alzen G. Kann die trabekuläre Knochendichte der Lendenwirbelsäule bei Kindern aus Spiral-CT-Daten ermittelt werden? ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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38
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Alzen G, Beiderwellen K, Volz M, Fiebich M. Vergleichende Beurteilung von Dosis und Bildqualität eines konventionellen 400er Film-Folien-Systems mit einem digitalen Speicherfoliensystem an Hand von Thoraxaufnahmen im Kindesalter. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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39
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Berthold LD, Haras G, Mann M, Alzen G. Trabekuläre Knochendichte der Lendenwirbelsäule bei Kindern und Jugendlichen in der quantitativen CT: Referenzwerte und Peak Bone Mass. ROFO-FORTSCHR RONTG 2006; 178:1235-42. [PMID: 17136647 DOI: 10.1055/s-2006-927151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to assess bone density values in the trabecular substance of the lumbar vertebral column in children and young adults in Germany from infancy to the age of peak bone mass. MATERIALS AND METHODS We performed quantitative computed tomography (QCT) on the first lumbar vertebra in 28 children and adolescents without diseases that may influence bone metabolism (15 boys, 13 girls, mean ages 11 and 8 years, respectively). We also measured 17 healthy young adults (9 men, 8 women, mean ages 20 and 21 years). We used a Somatom Balance Scanner (Siemens, Erlangen) and the Siemens Osteo software. Scan parameters: Slice thickness 1 cm, 80 kV, 81 or 114 mAs. We measured the trabecular bone density and the area and height of the vertebra and calculated the volume and content of calcium hydroxyapatite (Ca-HA) in the trabecular substance of the first lumbar vertebra. RESULTS Prepubertal boys had a mean bone density of 148.5 (median [med] 150.1, standard deviation [SD] 15.4) mg/Ca-HA per ml bone, and prepubertal girls had a mean density of 149.5 (med 150.8, SD 23.5) mg/ml. We did not observe a difference between prepubertal boys and girls. After puberty there was a significant difference (p < 0.001) between males and females: Mean density (male) 158.0, med 162.5, SD 24.0 mg/ml, mean density (female) 191.2, med 191.3, SD 17.7 mg/ml. The Ca-HA content in the trabecular bone of the first lumbar vertebra was 1.1 (med 1.1, SD 0.5) g for prepubertal boys and 1.1 (0.9, 0.4) g for prepubertal girls. For post-pubertal males, the mean Ca-HA content was 3.5 g, med 3.5, SD 0.5 g, and for post-pubertal females, the mean content was 2.8, med 2.7, SD 0.4 g. CONCLUSION The normal trabecular bone mineral density is 150 mg/ml with a standard deviation of 20 mg/ml independent of age or gender until the beginning of puberty. Peak bone mass (bone mineral content) in the trabecular substance of the lumbar vertebral column is higher in males than in females, and peak bone density is higher in young female adults than in young male adults.
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Affiliation(s)
- L D Berthold
- Kinderradiologie, Zentrum für Radiologie, Universitätsklinikum Giessen und Marburg GmbH, Standort Giessen.
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40
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Dempfle A, Wudy SA, Saar K, Hagemann S, Friedel S, Scherag A, Berthold LD, Alzen G, Gortner L, Blum WF, Hinney A, Nürnberg P, Schäfer H, Hebebrand J. Evidence for involvement of the vitamin D receptor gene in idiopathic short stature via a genome-wide linkage study and subsequent association studies. Hum Mol Genet 2006; 15:2772-83. [PMID: 16905557 DOI: 10.1093/hmg/ddl218] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Stature is a highly heritable trait under both polygenic and major gene control. We aimed to identify genetic regions linked to idiopathic short stature (ISS) in childhood, through a whole genome scan in 92 families each with two affected children with ISS, including constitutional delay of growth and puberty and familial short stature. Linkage analysis was performed for ISS, height and bone age retardation. Chromosome 12q11 showed significant evidence of linkage to ISS and height (maximum non-parametric multipoint LOD scores 3.18 and 2.31 at 55-58 cM, between D12S1301 and D12S1048), especially in sister-sister pairs (LOD score of 1.9 for ISS in 22 pairs). These traits were also linked to chromosomes 1q12 and 2q36. The region on chromosome 12q11 had previously shown significant linkage to adult stature in several genome scans and harbors the vitamin D receptor gene, which has been associated with variation in height. A single nucleotide polymorphism (SNP) (rs10735810, FokI), which leads to a functionally relevant alteration at the protein level, showed preferential transmission of the transcriptionally more active G-allele to affected children (P=0.04) and seems to be responsible for the observed linkage (P=0.05, GIST test). Bone age retardation showed moderate linkage to chromosomes 19p11-q11 and 7p14 (LOD scores 1.69 at 57 cM and 1.42 at 50 cM), but there was no clear overlap with linkage regions for stature. In conclusion, we identified significant linkage, which might be due to a functional SNP in the vitamin D receptor (VDR) gene and could be responsible for up to 34% of ISS cases in the population.
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Affiliation(s)
- Astrid Dempfle
- Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Germany.
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Berthold LD, Moritz JD, Soenksen S, Alzen G. [Assessment of bone density in children and adolescents by quantitative CT of one lumbar vertebra only]. ROFO-FORTSCHR RONTG 2006; 178:292-7. [PMID: 16508836 DOI: 10.1055/s-2006-926534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIM The aim of this study was to determine whether measuring the trabecular bone density in one lumbar vertebra (L) instead of three has an effect on the assessment of bone density in children. MATERIALS AND METHODS Bone density was measured in 70 patients (38 male, 32 female), ages 1 to 22 years (mean age 12.4, median 13 years) using a Somatom Balance Scanner (Siemens). The trabecular bone density was measured (1-cm slice, 80 kV, 81 mAs) in L1 through L3. RESULTS The mean bone density in the lumbar vertebrae was 139.9 mg/ml calcium-hydroxylapatite per ml bone in L1, 133.9 in L2, and 131.7 in L3, and the mean of all three vertebrae was 135.2 mg/ml. Measurements in L1 were 4.7 mg/ml (standard deviation [SD] 4.7 mg/ml) above the mean value of the three upper lumbar vertebrae. The density in L2 was 1.3 mg/ml below the mean (SD 3.1 mg/ml). On average, L3 was 3.5 mg/ml below the mean (SD 4.6 mg/ml). This minor systematic deviation in the measurement values for the individual vertebrae from the mean value was so low that there was no statistical evidence for a deviation from an ideal regression line. CONCLUSIONS When using an adequate technique, especially accurate analysis of the topogram (scout view) and the tomogram, measurement of the bone density of one lumbar vertebra provides satisfactory information regarding the trabecular bone density in children, but the values differ in the three upper lumbar vertebrae. The bone density of L2 is close to the mean of the upper three vertebrae. In the case of pathologic values or a pathologic trabecular pattern, three vertebrae should be measured.
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Affiliation(s)
- L D Berthold
- Abteilung Kinderradiologie, Medizinisches Zentrum für Radiologie, Universitätsklinikum Giessen und Marburg, Standort Giessen.
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Alzen G, Lüdemann M. Kardio – MRT im Kindesalter. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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Berthold LD, Hahn A, Petzinger J, Alzen G. Quantitative CT-Messung bei Patienten mit Mukolipidose Typ II/III. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wudy SA, Hagemann S, Dempfle A, Ringler G, Blum WF, Berthold LD, Alzen G, Gortner L, Hebebrand J. Children with idiopathic short stature are poor eaters and have decreased body mass index. Pediatrics 2005; 116:e52-7. [PMID: 15995019 DOI: 10.1542/peds.2004-1684] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In children with idiopathic short stature (ISS), studies investigating body mass index (BMI) or parameters of satiety regulation are scarce, and studies analyzing eating behavior are lacking. METHODS We recruited 214 children (123 index cases and 91 siblings) with ISS from 123 families. Affected children had to have a body height <5th percentile, or, in the case of siblings, the body height of 1 child had to be <5th percentile and the other <15th percentile. Medical histories were recorded by using structured and standardized interviews. Eating behavior was assessed by using the Child Eating Behavior Questionnaire. Percent energy intake as fat was assessed by using the Leeds Food Frequency Questionnaire. Endocrine markers of body weight regulation (leptin, ghrelin) were determined in serum. RESULTS Compared with population norms, BMI was significantly lower (mean: -0.33 standard deviation score). Furthermore, there was decreased food responsiveness (mean Child Eating Behavior Questionnaire score: 1.9; population mean: 2.4), reduced enjoyment of food (3.2 vs 3.9), emotional undereating (2.6 vs 3.0), lower desire to drink (2.0 vs 2.8), and increased fussiness over food (3.2 vs 2.9). When the sample was subdivided into the 2 groups of "good" and "poor" eaters according to the mothers' assessment of the current eating behavior, reduction in BMI as well as the behavioral characteristics already delineated in the total sample were found to be even more consistent in the subgroup of poor eaters. In the total sample of our children, as well as in both subgroups, serum leptin (adjusted for gender, BMI, and Tanner stage) was found to be moderately raised but did not differ between poor and good eaters. Total serum ghrelin was not different between poor and good eaters. CONCLUSIONS Our clinical, behavioral, and endocrinologic findings in patients with ISS point to an altered eating behavior that possibly contributes to their short stature.
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Affiliation(s)
- Stefan A Wudy
- Department of General Pediatrics, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany.
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Berthold LD, Moritz JD, Sönksen S, Alzen G. Dosisreduktion bei der Messung der Knochendichte der Lendenwirbelsäule mittels quantitativer CT bei Kindern und Jugendlichen an einem Lendenwirbelkörper. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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46
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Moritz JD, Berthold LD, Sönksen S, Alzen G. Ist die sonographische Frakturdiagnostik bei Kindern eine unnötige Quälerei? ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Gronau J, Berthold LD, Ludwig M, Alzen G. Kryptorchismusdiagnostik mittels MRT: Ist der Nachweis des Ductus deferens hilfreich? ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alzen G. Diagnostik der angeborenen Herzfehler beim Kind. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
INTRODUCTION In case of increased intracranial pressure (IICP), the inflow of cerebrospinal fluid widens the space between the optic nerve (ON) itself and the surrounding dura mater leading to the sonographic appearance of increased diameter of the ON. The purpose of the study was to gain clinical experience in children and to determine (a) the mean values for patients without proven IICP and (b) pathologic values of those with proven IICP. MATERIALS AND METHODS Ultrasound of the optic nerve was performed in 483 children with symptoms consistent with IICP, comprising 287 males and 196 females at an age ranging from 4 days to 24 years with a mean age of 7.5 + 5.1 years. The measured diameter of the ON of both eyes and the morphologic criteria concerning nerve sheath and papilla were evaluated retrospectively. RESULTS Most of the investigated patients (n = 466) had no IICP as confirmed by neurological examination, EEG, sometimes CCT and/or MRI and clinical follow-up. The typical morphological findings in patients with normal intracranial pressure (ICP) were a clear and longitudinally extended demarcation of the ON with a well-delimited nerve sheath and without prominent papilla. The mean diameter of the ON in patients with normal ICP was 3.4 mm + 0.7 mm. In 17 patients with proven IICP, the mean diameter of the ON increased to 5.6 mm + 0.9 mm. Typically, the nerve sheath was indistinguishable from the hypoechoic ON, often but not invariably associated with a prominent papilla. In patients with IICP, the diameter of the ON alone matches the diameter of the ON plus nerve sheath in patients with normal ICP. CONCLUSION IICP was detected with a high sensitivity by ultrasound using the diameter and the morphological criteria of an indistinguishable nerve sheath. A diameter of more than 4.5 mm is definitely pathologic and requires further investigation. Prominence of the papilla is an unreliable criterion for acute IICP.
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Affiliation(s)
- F Körber
- Kinderradiologie, Justus-Liebig-Universität Giessen.
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Hahn A, Gross C, Uyanik G, Hehr U, Hügens-Penzel M, Alzen G, Neubauer BA. X-linked lissencephaly with abnormal genitalia associated with renal phosphate wasting. Neuropediatrics 2004; 35:202-5. [PMID: 15248105 DOI: 10.1055/s-2004-817955] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
X-linked lissencephaly with abnormal genitalia (XLAG) is a rare disorder caused by mutations in the aristaless-related homeobox (ARX) gene. We report on the clinical data of a boy with a 1-bp deletion (790 delC) resulting in a frame shift in the ARX gene and prolonged survival until age 18 months. Similar to other patients, the boy showed postnatal microcephaly, hypothalamic dysfunction, intractable neonatal seizures, and chronic diarrhoea. In addition, he suffered from exocrine pancreatic insufficiency and renal phosphate wasting became apparent from age 5 months, both of which have not been described previously in XLAG. This allows us to speculate that the phenotype of XLAG is more complex than hitherto known and may include renal phosphate wasting which might not have been observed in other patients due to early death.
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Affiliation(s)
- A Hahn
- Department of Neuropediatrics, University of Giessen, Giessen, Germany.
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