Acute appendicitis in children: an evaluation with ultrasound.
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Acute Disease↗
Biomedical subjects
E L Effmann
Publications and source records attributed to E L Effmann.
Tracheobronchiomegaly. The Mounier-Kuhn syndrome in a patient with the Kenny-Caffey syndrome.
A 36-year-old woman with features of both the Mounier-Kuhn syndrome and the Kenny-Caffey syndrome is described. To our knowledge, this is the first reported case of these syndromes occurring together. Three-dimensional computed tomographic reconstruction of the upper airway revealed marked dilatation of the trachea and main-stem bronchi and several large diverticulae of the trachea.
Abnormalities, Multiple↗
John Caffey Award. Determination of functional residual capacity from digital radiographs of the normal neonatal chest: studies in a rabbit model.
Spirometric measurement of lung volume in an infant or uncooperative child is often a difficult and time-consuming procedure. Previous investigators have successfully estimated total lung capacity in adults and older children by using chest radiography. The purpose of this study was to assess the accuracy of functional residual capacity (FRC) determination from chest radiographs in an animal model of the normal neonatal chest. FRC was determined with the helium dilution (HeD) method in 13 anesthetized, intubated, and paralyzed rabbits (weight range, 1.5-3.9 kg). FRC was then estimated from digital frontal and lateral chest radiographs. The radiographic estimate was made by applying measurements taken from the radiographic film pair to a geometric model of the chest. The best-fit model assumed an elliptical cross section for the intrathoracic cavity, heart, paraspinal structures, and diaphragm in the axial plane. Linear regression on independently determined HeD and radiographically determined FRC yielded a slope of 1.02 (p less than .001), an intercept of -3.02 cm3 (p = .565), and a correlation coefficient of 0.96 (p less than .001). We conclude that radiographic FRC estimates closely approximate HeD estimates in a rabbit model of the normal neonatal chest.
Algorithms↗
Goitrous cretinism manifesting as newborn stridor: CT evaluation.
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Congenital Hypothyroidism↗
Variability of renal length in type I glycogen storage disease.
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Adolescent↗
Meconium peritonitis and pleuritis: a clue to perforation of an incarcerated Bochdalek hernia in a neonate.
The case of a neonate presenting with respiratory distress who had an incarcerated Bochdalek hernia with perforation and meconium peritonitis and pleuritis is reported. The patient had an associated jejunal atresia in an incarcerated segment of intestine, which undoubtedly contributed to the obstruction, strangulation, and perforation in the incarcerated hernia. Gastrointestinal complications attributable to the hernia are most unusual in the neonate, and aggressive preoperative resuscitation and stabilization with the earliest possible surgical intervention are imperative features in management.
Female↗
Duplex Doppler ultrasound evaluation of calcified inferior vena cava thrombosis.
We describe the use of duplex Doppler ultrasound in the noninvasive assessment of inferior vena cava patency and abdominal venous flow dynamics in a four month old infant with calcified inferior vena cava thrombosis.
Calcinosis↗
Hyperimmunoglobulinemia E syndrome: radiographic observations.
Susceptibility to recurrent staphylococcal cutaneous and respiratory infections beginning in infancy associated with extreme hyperimmunoglobulinemia E is a recently described primary immunodeficiency syndrome. Other clinical features include depressed cellular immunity and deficient antibody formation. Recurrent pneumonia and cyst formation with variable persistence and expansion characterized the radiographic couse in 11 patients. Five cysts resolved with continuous antistaphylococcal therapy; 2 were resected without recurrence; and 4 persisted after surgery and/or antibiotics (2--8 years). The cysts had dense, necrotic surfaces with fibrous walls, eosinophilic and other inflammatory cell infiltrates, and frequent, persistent, bronchial connections. Sinusitis (9/9) and mastoiditis (3/4) were also observed radiographically.
Adolescent↗
Ether cystitis.
Two children are reported in whom chemical cystitis developed when ether was used to dissolve a Foley catheter balloon that would not deflate. The irritative effects of ether and preventive measures are discussed.
Child↗
Radiographic aspects of total parenteral nutrition during infancy.
In a retrospective radiographic study the authors reviewed the position of 82 central venous catheters in 57 consecutive infants receiving total parenteral nutrition between 1972 and 1976. Sixteen of the 82 catheters (19%) were initially not positioned within the superior vena cava and 11 (14%) migrated from a satisfactory position during therapy; peripheral edema, pleural effusion, and vascular thrombosis occurred more frequently in this group than in those infants with the catheter remaining in the superior vena cava. Unusual complications of intersititial pulmonary edema, hydrocephalus, and cardiac arrhythmia were noted in three different patients. An increased incidence of clinical complications is associated with catheter malposition or migration during total parenteral nutritional therapy. Radiographic monitoring with repositioning or removal of a malpositioned catheter may reduce the number of clinical complications.
Catheterization↗
The radiographic features of early onset Group B streptococcal neonatal sepsis.
The clinical and radiographic features of 27 newborn infants with early onset Group B streptococcal infection as documented by blood culture have been reviewed. Initial chest radiographs revealed a wide spectrum of patterns. These included changes usually associated with the respiratory distress syndrome, extensive pneumonia, and small infiltrates as well as a normal appearance. Premature birth and a fatal outcome were associated with extensive radiographic changes. At autopsy some of the infants with a radiographic appearance of respiratory distress syndrome had pathologic features of Group B streptococcal infection with no apparent evidence of coexisting respiratory distress syndrome.
Humans↗
Renal growth.
Application of the renal growth chart may yield considerable information on longitudinal growth of normal and diseased kidneys. Its systematic use in following patients with urinary tract infection and vesicoureteral reflux is established, and application to other forms of renal disease in childhood may increase current knowledge of the natural history of these diseases.
Child, Preschool↗
Traumatic perforation of the pharynx in the newborn.
Two newborn, low-birth-weight infants with traumatic perforation of the pharynx and an additional 18 previously reported cases are presented. Injury produced by pharyngeal suction catheters and nasogastric and endotracheal tubes is generally unrecognized until the baby develops signs of esophageal obstruction or radiographic evidence of pharyngeal perforation, usually in the posterior mediastinum. The catheter may enter the pericardial space. Conservative management with intravenous antibiotics and a feeding gastrostomy is favored, except in instances that require mediastinal decompression. The key to prevention is the use of soft-tipped suction catheters and nasogastric tubes and careful visualization of the cords during endotracheal intubation. The use of metal stylets to direct the endotracheal tube is condemned. Pediatrics, 56:1019-1022, 1977, PHARYNX, PERFORATION, SUCTION CATHETER, NASOGASTRIC TUBE, ENDOTRACHEAL TUBE, METAL STYLET.
Esophagus↗
A comparison of early-onset group B streptococcal neonatal infection and the respiratory-distress syndrome of the newborn.
In attempting to differentiate early-onset Group B streptococcal infection from hyaline-membrane disease we found features of severe Group B infection to be rupture of the membranes for more than 12 hours before delivery (four or eight versus one of nine), gram-positive cocci in the gastric aspirate (four or four versus none of one), apnea and shock in the first 24 hours of life (seven of eight versus none of nine), and the generation of lower peak inspiratory pressures on avolume-cycled respirator (mean of 36.5 +/- 2.8 versus 63.9 +/- 6.2 cm of water; P = 0.005). In eight fatal cases of Group B infection, four patients had radiographic features indistinguishable from hyaline-membrane disease whereas the other cases were consistent with neonatal pneumonia. Seven of the eight infected infants had no histologic evidence of coexisting hyaline-membrane disease. Microscopical features of Group B infection included cocci in unevenly distributed hyaline membranes and minimal atelectasis. Group B streptococcal infection differs clinically and pathologically from hyaline-membrane disease. Differentiating clinical features include early apnea and shock and lower inspiratory pressures on mechanical ventilation.
Diagnosis, Differential↗
Duplication of the urethra.
Ten patients with patent urethral duplication are presented. Nine patients had two independent patient channels originating from the bladder or the posterior urethra. Both voiding cystourethro and retrograde urethrography are necessary to completely evaluate this anomaly. In each instance the ventral channel, regardless of the position of its meatus, proved to be the more functional urethra. In those patients whose dorsal channel was in an epispadiac position, the symphysis pubis was abnormally wide. A functionally and anatomically accurate classification is proposed, and the embryology of these anomalies is discussed.
Child↗
Tracheal agenesis.
Tracheal agenesis is a rare anomaly that produces neonatal respiratory distress and has been uniformly lethal to date. In this malformation the entire trachea is usually absent, air reaching the bronchi through a communication with the esophagus, and the lungs are normally formed. The diagnosis should be suspected in any infant in whom improved ventilation is obtained despite difficult intubation and abnormal tracheal tube placement. Coexistent cardiac, gastrointestinal, and genitourinary anomalies are common. The growth of the tracheoesophageal septum and the elongation of the dividing foregut are crucial phases in the morphogenesis of this malformation.
Abnormalities, Multiple↗
MR microscopy of chick embryo vasculature.
Six-day-old chick embryos were examined with magnetic resonance microscopy after vascular perfusion fixation and perfusion with gadolinium-doped gelatin to high-light the developing vascular anatomy. Gadolinium gelatin, with its short T1, provided a source of signal contrast within the vessels. The entire embryo was embedded in gelatin to minimize susceptibility artifacts that are prevalent at the high field strength (7.0 T) used. A series of single-section spin-echo images were acquired with various TRs to determine the optimal imaging sequence for a three-dimensional (3D) acquisition. The combination of gadolinium gelatin in the vascular spaces, gelatin embedding of the specimen, and optimal acquisition parameters yielded a 3D stack of high-resolution images that was readily reconstructed and rendered to effectively demonstrate the developing thoracic vessels in the embryo.
Animals↗