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Biomedical subjects

D F Merten

Publications and source records attributed to D F Merten.

At least 55 records · Page 3Linked to original sources
PubMed1981

Occult humeral epiphyseal fracture in battered infants.

Complete fracture-separation of humeral epiphyses, proximal or distal, represents unusual skeletal injuries in the battered infant. Radiographic identification of the type and extent of epiphyseal injury may be difficult due to lack of ossified epiphyseal centers. While arthrography can be a useful diagnostic and therapeutic supplement, radionuclide scintigraphy appears to be of limited value in the detection of such epiphyseal-metaphyseal injuries.

Battered Child Syndrome↗
PubMed1981

Massive calcification of the mitral annulus in a 17-year-old patient with juvenile rheumatoid arthritis and systemic lupus erythematosis.

Mitral annulus calcification (MAC), while a relatively frequent autopsy finding in older patients, is rare in childhood. Such calcification has generally been regarded as a degenerative change and of no clinical significance. Recent studies have shown that MAC may be associated with hemodynamically significant lesions including mitral insufficiency, arrhythmias, heart block, and, rarely, mitral stenosis. We have studied a case of massive calcification in the mitral annulus in a 17-year-old girl with juvenile rheumatoid arthritis and systemic lupus erythematosis. In this case, the MAC was considered secondary to the rheumatoid disease. MAC in younger patients with no history of rheumatic fever or bacterial endocarditis suggests an associated connective tissue disorder.

Adolescent↗
PubMed1981

Pulmonary alveolar proteinosis in children.

Three cases of childhood pulmonary alveolar proteinosis (PAP) are presented with emphasis on the radiographic findings on plain chest films and computed tomography. Three different radiographic patterns may be seen on chest radiography: (1) reticulonodular, (2) small acinar nodular mimicking miliary disease, and (3) coalescense of various-sized acinar nodules leading to focal consolidation. Absence of cardiomegaly, pleural effusions, or adenopathy are important differential points. Chest computed tomography (CT) shows scattered linear densities and areas of focal coalescence corresponding to filled alveoli, most prominently at the lung bases. Radiographic improvement after lavage is due to decrease in the amount of periodic acid-Schiff (PAS)-positive material within the alveoli. Progressive enlargement of acini during childhood may account for the variable pattern seen in PAP in children and contrasts to the more confluent pattern found in the adult. CT is of limited value in diagnosis or management of PAP. Although detailed examination of sputum and bronchopulmonary washings may yield diagnosis, open lung biopsy is required for confirmation.

Adolescent↗
PubMed1981

Prevention of umbilical artery catheter clots with heparinized infusates.

49 neonates requiring umbilical artery catheters (UACs) were randomly assigned to receive standard or heparin-containing infusates. 3 of 23 (13%) of the patients receiving heparin had catheters removed because they became functionally occluded compared to 15 of 26 (58%) in the control group (p less than 0.005). 4 of 13 (31%) single injection aortograms obtained in control infants demonstrated thrombi, compared to none of 7 in the heparin group. 1 patient in the heparin group had an aortic clot demonstrated at post-mortum examination. There were neither clinical coagulopathies nor abnormalities of partial thromboplastin time attributable to the administration of heparinized fluids. Heparinization of UAC infusates appears to be a safe method of reducing the risk of catheter occlusion. Heparin effect on large vessel clot risk remains unproven.

Blood Coagulation Disorders↗
PubMed1980

Stridor in infants and children due to esophageal inflammatory disease.

Esophageal inflammatory disease is an unusual cause of stridor in infants and children. Pediatric patients with upper respiratory tract obstructive symptoms secondary to foreign body esophagitis and esophageal moniliasis are presented. The importance of esophageal abnormalities as a potential cause of stridor is emphasized.

Airway Obstruction↗
PubMed1980

The value of radionuclide bone imaging in selected patients with osteogenic sarcoma metastatic to lung.

Bone scintigraphic findings are presented in three pediatric patients with osteogenic sarcoma metastatic to lung. The bone imaging radionuclide was concentrated to a variable degree within the pulmonary metastases. Radionuclide bone imaging was valuable in confirming the presence of metastatic disease to lung in two patients and diagnosing previously unsuspected pulmonary metastatic disease in one patient.

Adolescent↗
PubMed1980

Radiological observations during transpyloric tube feeding in infants of low birth weight. Perforation of the duodenum and variations in normal duodenal anatomy.

Perforation of the duodenum is a serious complication of transpyloric tube feeding in infants of low birth weight. Polyvinyl chloride and (less commonly) silicone tubes have been implicated. Altered radiographic configuration of the tube in the region of the superior or inferior flexure, associated with clinical deterioration, pneumoperitoneum, peritonitis, or a retroperitoneal fistula, is diagnostic of duodenal perforation. The configuration of the tube may vary during uncomplicated transpyloric alimentation and is frequently incompatible with the expected anatomical course. Contrast examination may demonstrate normal anatomy or mobility of the distal duodenal loop as an adaptation to rigidity of the tube. The possibility of perforation appears to be increased at or adjacent to the flexures.

Duodenal Diseases↗
PubMed1980

Pulmonary sarcoidosis in childhood.

Clinical and radiologic characteristics of pulmonary sarcoidosis in 26 children are presented. Initial nonspecific symptomatology and decreased pulmonary function are almost invariably accompanied by radiologic evidence of pulmonary disease. Bilateral hilar lymphadenopathy frequently associated with bilateral paratracheal adenopathy is characteristic. Other mediastinal lymphadenopathy (subcarinal, anterior, and posterior) is sporadically present, and is invariably associated with the more specific bilateral patterns of thoracic adenopathy. Pulmonary parenchymal involvement is common and predominantly appears radiographically as small irregular densities. Pleural effusion, pneumothorax, and cardiomegaly are unusual findings. Extrathoracic radiographic manifestations are uncommon. Lytic lesions of the tubular bones of the hands and feet are rare in childhood.

Adolescent↗