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Biomedical subjects

E R Graviss

Publications and source records attributed to E R Graviss.

At least 19 recordsLinked to original sources
PubMed1991

A magnetic resonance imaging study of the upshoot-downshoot phenomenon of Duane's retraction syndrome.

Patients with Duane's retraction syndrome may have an associated upshoot or downshoot of the involved eye in adduction. This vertical movement has been attributed to the lateral rectus muscle slipping over or under the globe and acting as an elevator or depressor, respectively ("bridle-effect"). We used magnetic resonance imaging to investigate this phenomenon in two patients, one with an overshoot and the other with an undershoot. Minimal vertical displacement of the lateral rectus muscle in relation to the orbit was noted both on upshoot and downshoot. The bridle-effect theory must be modified to account for this finding.

Adult↗
PubMed1990

Long term radiologic outcome of Pseudomonas osteomyelitis of the foot.

The medical records of 27 patients with puncture wound-induced Pseudomonas aeruginosa osteomyelitis/septic arthritis of the foot hospitalized from 1980 through 1988 were reviewed. Twenty patients received anti-Pseudomonas therapy for greater than 21 days and 7 patients received anti-Pseudomonas therapy for less than or equal to 21 days. There was no difference in age, sex, race, duration of wound or symptoms before admission or in admission physical findings including temperature, lymphadenopathy, puncture site appearance or admission laboratory data including white blood cell count or erythrocyte sedimentation rate between the two groups. All children but two in the long term therapy group had surgical as well as parenteral anti-Pseudomonas therapy. Fifteen patients returned for follow-up radiographs 1 to 8 1/2 years after hospitalization, 10 of 20 who had received therapy for greater than 21 days and 5 of 7 who had received therapy for less than or equal to 21 days. Poor radiologic outcome, ranging from bony deformity to joint space abnormality, was noted in 4 patients, of whom 3 had had joint involvement. Clinical abnormality was noted in only one adolescent male, and he had the most severe radiologic sequelae. The longer term functional significance of these radiologic anomalies awaits further delineation.

Adolescent↗
PubMed1988

Neurosonographic changes in newborns treated with extracorporeal membrane oxygenation.

Ten out of 40 near-term neonates on extracorporeal membrane oxygenation (ECMO) therapy developed abnormal neurosonograms. We identified two abnormal patterns. Hyperechoic areas of intracranial hemorrhage were observed in two patients (a significantly lower incidence than previously reported). Diffuse or focal echogenic areas of hypoxia-ischemia resulting from periventricular leukomalacia, cerebral edema or large vessel infarction had not previously been noted in nine of these patients. Three of the ten patients survived with neurological sequelae. Recognition of hemorrhage or a hypoxic-ischemic pattern should serve as a warning to initiate or accelerate the weaning of infants from ECMO.

Brain Diseases↗
PubMed1986

Arthrography in the diagnosis of fractures of the distal end of the humerus in infants.

Single-contrast arthrography was performed in six infants who had an injury to the elbow because the exact nature of the injury was uncertain from interpretation of the plain radiographs and clinical findings. A correct diagnosis was made in all six patients, and it significantly altered the treatment in five. Four lesions were a Salter-Harris Type-I fracture and two were a Salter-Harris Type-II fracture. Three patients had a closed reduction, two required no reduction, and one had an open reduction. Child abuse of two infants was confirmed, and it was suspected in another two.

Arthrography↗
PubMed1985

Bronchogenic cysts in children.

Radiographic, surgical and pathological features of 33 paediatric patients with bronchogenic cysts are reviewed. These congenital lesions usually presented as spheroid mediastinal masses, near the carina or right paratracheal area, 2-3 cm in diameter with sharply delineated borders. Occasionally, the masses were lobulated or triangular in shape. Some cysts produced considerable airway distortion. All intrapulmonary cysts had connections, sometimes patent, with the trachea or main-stem bronchi. Thin-walled, completely aerated cysts became thick-walled with infection. A few air-filled and solid cysts grew rapidly. Cystic lung disease distal to central bronchogenic cysts was observed.

Adolescent↗
PubMed1979

Preoperative embolization of Wilms' tumors.

In two patients with Wilms' tumors, the ipsilateral kidney was nonfunctional. To facilitate initial surgical removal of the tumors, a preoperative transcatheter embolization was performed following diagnostic arteriography. Preoperative embolization of a renal tumor reduces the vascularity of the lesion prior to surgery, and a patient in whom primary surgical removal of the tumor would carry unacceptable risk may be converted into one in whom primary surgical removal is safe.

Child↗
PubMed1979

Some vagaries of the capitellum.

The capitellum is the first epiphyseal center of the elbow to ossify. Its normal position is easily subject to misinterpretation as a separation fracture because: (1) the ossification center for the capitellum is situated anteriorly, (2) it is often tilted downward during development, and (3) its epiphysis tends to be wider posteriorly than anteriorly. The capitellum frequently fuses with the trochlea and lateral epicondyle before uniting with the humerus. We reviewed the normal anatomical configuration of the elbow. Some useful methods for evaluating the position of the normally situated and minimally displaced capitellum and distal end of the humerus are presented.

Adolescent↗
PubMed1978

Imperforate anus: avoiding a colostomy.

Early assessement of imperforate anus, combining clinical and radiographic data, determines the course of treatment. "High" lesions most often require combined abdominal and sacroperineal repair, usually preceded by a decompression colostomy. "Low" lesions are repaired through a perineal or sacroperineal approach not requiring a previous colostomy. Patients who do not have an apparent fistulous tract through which accurate radiographic assessment can be made frequently undergo preliminary colostomy to avoid colonic perforation. This occurs in patients who have "low" lesions and in whom colostomy may be avoided. Combining a new procedure and an old procedure may avoid unnecessary colostomy. A 14 Medicut intravenous cannula is inserted in the perineum and under fluoroscopic control is advanced into the radiolucent area identified in the pelvis as the probable lower rectal pouch. The position is confirmed by aspiration of gas or meconium and injection of contrast material. A limited contrast enema will clearly identify the level of the lesion and identify a fistula if one is present. If a low lesion is identified and no fistula is present to allow temporary colonic decompression, a fistulous tract may be created mechanically. A No. 4 Fogarty catheter is inserted through the previously placed cannula, the catheter balloon is inflated, and the entire apparatus is extracted under tension. This creates a small fistulous tract to the perineal surface. Subsequent dilation of this tract allows colonic decompression, and definitive operative repair may be planned at the most appropriate time. By employing this technique, we have avoided colostomy in 4 of 6 patients.

Anus, Imperforate↗
PubMed1977

Lymphangiography and bone scan in the study of lymphangiomatosis.

Lymphangiomatosis is a rare congenital systemic lymphatic malformation involving multiple bones and other sites. A 12-year old boy with lymphangiomatosis was studied with lymphangiography and bone scan. Lymphangiogram demonstrated irregular pooling of contrast medium in both the mediastinal tumor and bones. Bone scan also revealed increased activity in areas which were not demonstrated radiographically.

Bone Neoplasms↗