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H Butler

Publications and source records attributed to H Butler.

15 recordsLinked to original sources

Magnetic resonance imaging of rectal carcinoma.

Five patients with a diagnosis of rectal carcinoma were examined by magnetic resonance and computerized tomography (CT) to determine if magnetic resonance imaging (MRI) added any information to that obtained by computerized tomography. In each case, the imaging studies agreed with the surgical description of the tumor. The studies agreed on the presence of perirectal fat invasion and tumor position. Both modalities were positive for involved lymph nodes in the patient with metastatic disease to pelvic nodes, but both studies underestimated the number of nodes involved. These five cases were examined using two magnetic resonance scanners. The older one operated at 0.3 tesla (T) while the newer scanner operated at 1 T. Spatial resolution was improved with the newer scanner. In addition, the difference in signal intensity between tumor tissue and normal tissue was greater on the 1 T scanner. Tissue differentiation was useful in one case in which CT suggested extension of tumor into the vagina. The extension was confirmed on the MRI scan.

Adenocarcinoma

Unsuspected adrenal masses in the neonate: adrenal cortical carcinoma and neuroblastoma. A report of two cases.

Masses involving the adrenal in the neonate are most commonly due to hemorrhage. The literature involving the neonatal adrenal reflects this propensity. Although there have been reports of newborns with neuroblastoma [1, 2] and other tumors [3], which are more common in older children, ultrasonographic descriptions of masses involving the adrenal secondary to such tumors are rare [1]. Within a 6-month span we have discovered a clinically unsuspected adrenal carcinoma and adrenal neuroblastoma.

Adrenal Cortex Neoplasms

Surgically correctable fecal incontinence.

A significant percentage of children who are fecally incontinent are so from improper operation or failure to recognize a surgically correctable problem. Over the past five years, we have managed ten children who had operations for anorectal problems and two with anterior anus. Seven were seen after poorly positioned pull-through procedures for imperforate anus and had anal repositioning, four successfully. Gracilis sling was successful in two of the other three. In two children overflow after a Duhamel operation for Hirschsprung's disease was corrected by division of a persistent anorectal septum. The third child with a disrupted Duhamel procedure was cured by anolevatorplasty. In two children an anterior ectopic anus was made continent by posterior anoplasty. Primary and secondary deviations from proper anatomy of the anorectal region will result in incontinence, which may be recognized by physical examination and defecograms. Proper operation usually produces acceptable continence.

Adolescent

Magnetic resonance imaging of the abnormal female pelvis.

Twenty-three women with 27 instances of pelvic pathology were evaluated by magnetic resonance imaging (MRI). Different pulse sequences were used, which varied the dependence of the images on T1 and T2. Sonography was performed on 22 of the 23 patients. Five patients had CT examinations, including the patient who did not have sonography. MRI was also done in four normal volunteers. The spatial resolution of the MRI scans with short TR and TE intervals approached that of CT. There was overlap of MRI signal characteristics between various pathologic entities and also within the same entity (e.g., cystadenomas and endometriomas).

Appendicitis