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Biomedical subjects

J E Benson

Publications and source records attributed to J E Benson.

At least 19 recordsLinked to original sources

Effect of oral sensorimotor treatment on measures of growth, eating efficiency and aspiration in the dysphagic child with cerebral palsy.

Twenty-seven children (mean age 5.1 years) with cerebral palsy and moderate eating impairment were studied to determine frequency of aspiration and the effect of 10 and 20 weeks of oral sensorimotor therapy on eating efficiency and measures of growth (weight, skinfold thickness). The eating efficiency of the children did not change markedly in response to oral sensorimotor therapy. Children maintained their centile rank in weight-for-age and skinfold-for-age measurements. However, there was no catch-up growth. The findings suggest that eating efficiency is not a good estimator of treatment outcome, but rather a diagnostic indicator of the severity of eating impairment. Monitoring of these children's growth is essential in order to provide nutritional rehabilitation as soon as their eating skills can no longer keep up with growth demands.

Cerebral Palsy

Eating problems and calorie intake levels in Swiss adolescent athletes.

The purpose of this study was to investigate the incidence of eating disorders (ED), calorie intake levels and body fat measures in Swiss female athletes. Thirty athletic and 34 non-athletic adolescent Swiss females were assessed for tendencies toward eating disorders and weight preoccupation using the Eating Disorders Inventory (EDI). Calorie intakes were calculated from 7-day intake records. Body compositions were determined using skin-fold measures. The athletes were divided into two groups: Those whose activities emphasize leanness (12 gymnasts, means age = 12.5 +/- 1.1 yrs), and those whose activities do not emphasize leanness (18 swimmers, mean age = 12.8 +/- 0.9 yrs). The non-athletic school-girls (mean age = 13.4 +/- 1.2 yrs) served as controls. ANOVA indicated that the gymnasts had lower body fat levels (p less than 0.01) and consumed fewer total calories (p less than 0.05) than swimmers or controls, but all groups consumed similar calories per kg/body weight. Chi square analysis indicated that similar numbers of swimmers (11%), gymnasts (1%) and controls (6%) were exceptionally preoccupied with weight (p greater than 0.05). However, more swimmers (38%) scored high on the body dissatisfaction subscale of the EDI than the gymnasts (1%) or control (9%) (p less than 0.01). In fact, more swimmers scored high on 3 subscales of the EDI compared to the other groups (p less than 0.05). It appears that disturbances in eating behaviors are not limited to sports that emphasize leanness.

Adolescent

Relationship between nutrient intake, body mass index, menstrual function, and ballet injury.

The effects of inadequate nutrition, menstrual dysfunction, and low body weight on the injury rate of ballerinas were studied. Forty-nine female ballet dancers, mean age 18.7 years, completed food frequency and injury questionnaires. Subjects were placed in one of two groups: those with an intake less than 70% of the Recommended Dietary Allowances (RDA) for key nutrients and those with an intake greater than 70% of the RDA for key nutrients. Sixty-nine percent of the dancers had intakes less than 70% of the RDA and were randomly assigned to either a vitamin/mineral supplement or to placebo for 6 months. The remaining dancers with diets adequate (greater than 70% RDA) in key nutrients received no treatment. All groups were questioned monthly about the incidence, severity, and nature of ballet injuries. Information regarding menses and height and weight was obtained. There were no significant differences in the severity or type of injuries among the dancers in the supplement, placebo, or no treatment groups. Dancers with abnormal menses had more bone injuries (mean = 15.00) than normally menstruating dancers (mean = 4.97) (p less than .05). Dancers with a Body Mass Index less than 19.0 spent more days with a low-grade injury (mean = 24.05) than dancers with a greater BMI (mean = 11.63) (p less than .05). There appears to be a relationship between dance injuries and both BMI and menstrual function.

Adolescent

A spectrum of bronchopulmonary anomalies associated with tracheoesophageal malformations.

The combination of tracheoesophageal and pulmonary malformations is unusual and reportedly carries a high mortality. We have observed six patients with esophageal atresia and tracheoesophageal fistula and one with a bronchoesophageal fistula who had associated bronchopulmonary anomalies ranging from lobar hypoplasia and agenesis to unilateral pulmonary hypoplasia or agenesis. All of the pulmonary malformations were right-sided. Vertebral or rib anomalies were present in five patients, congenital heart disease in two, imperforate anus in one and one patient had radial aplasia and Pierre Robin syndrome. The bronchopulmonary anomalies complicated the surgical care of tracheoesophageal malformations and required radiologic differentiation from aspiration pneumonia and atelectasis. Six of the seven patients survived. Mortality and morbidity were related to complications and associated cardiac anomalies as well as severity of the lung anomaly.

Bronchial Fistula

MR imaging of the skull base.

Fifty-four patients with abnormalities primarily involving the base of the skull were evaluated by magnetic resonance (MR) imaging. The results were compared with information obtained by other radiologic studies, primarily X-ray CT. On MR imaging, better anatomic definition of soft tissues in the deep compartments of the nasopharynx was achieved through the high level of tissue contrast discrimination and lack of bone artifacts. The parapharyngeal fat plane, separating pterygoid from pharyngeal musculatures, was consistently demonstrated. However, the inability of MR to image compact bone proved to be a major drawback where bony detail was required. In general, MR imaging demonstrated 100% sensitivity to abnormalities involving the posterior compartment (clivus and craniovertebral junction) and was least valuable in the evaluation of the anterior compartment (orbits, cribiform plate, and sinuses.

Adolescent

Head trauma evaluated by magnetic resonance and computed tomography: a comparison.

Magnetic resonance (MR) images and computed tomograms of 25 patients with head trauma were compared. MR proved to be superior in many ways for demonstrating extracerebral as well as intracerebral traumatic lesions. Isodense subdural hematomas, which present a diagnostic dilemma on CT images were clearly seen on MR, regardless of their varying CT densities. In a case of epidural hematoma, the dura mater was shown directly as nearly devoid of signal on MR. Direct coronal images provided excellent visualization of extracerebral collections along the peritentorial space and subtemporal area. In a patient with intracerebral hematoma, CT failed to demonstrate residual parenchymal changes in a 3-month follow-up study, but MR clearly depicted the abnormalities. The superiority of MR over CT was also well illustrated in a patient with post-traumatic osteomyelitis of the calvarium.

Adolescent

Magnetic resonance imaging in the evaluation of the brainstem.

Magnetic resonance (MR) images of the brainstem region from 100 normal or asymptomatic individuals were reviewed in addition to those of 17 patients with intra-axial brainstem lesions and 15 patients with extra-axial masses around the brainstem. MR was able to demonstrate consistently the normal anatomy of the brainstem and adjacent cisterns, though the distinction between gray and white matter was seldom possible with the present technology. Masses in and around the brainstem were all accurately identified on MR and its sensitivity was superior to that of x-ray computed tomography (CT). These study results show that despite its technical limitations, MR is presently the examination of choice for the evaluation of brainstem abnormalities and eventually it will undoubtedly replace metrizamide CT cisternography.

Adolescent

Magnetic resonance imaging of the orbit: a preliminary experience.

Eleven patients with various space-occupying lesions in the orbit were examined, using a 0.3-tesla superconducting magnet to assess the capabilities and limitations of magnetic resonance (MR) imaging in the investigation of orbital lesions. Although the images provided valuable anatomic data, the bright signal intensity of fat and the partial volume effects of large section thickness resulted in loss of resolution for small, low-signal-intensity structures. The limitations of MR imaging were also reaffirmed by the lack of visualization of calcifications and of the bony orbit. These preliminary results show that MR offers no advantage over x-ray computed tomography except for its lack of ionizing radiation. Further technical improvements are needed before MR imaging will be made useful in this area.

Adult

Magnetic resonance imaging in the spinal column and craniovertebral junction.

The sensitivity of magnetic resonance imaging (MRI) to tissue alterations is particularly useful in spinal cord imaging. In addition to excellent anatomic display of this compact and complex area, syrinx cavities, tumors, and degenerating disks can be identified before they cause the anatomic distortion often necessary for detection by conventional means.

Astrocytoma

Primary amyloid tumor of the lacrimal gland: CT findings.

We present a rare case of primary amyloid tumor originating in the lacrimal gland. The computed tomographic findings are similar to those of an orbital angioma, showing an enhancing soft tissue mass with multiple calcifications simulating phleboliths.

Amyloidosis

NMR imaging of the spine.

The usefulness of nuclear magnetic resonance (NMR) images in the evaluation of spinal disorders below the craniocervical junction was studied. Six normal subjects and 41 patients with various spinal abnormalities were examined. NMR proved capable of demonstrating important normal and pathologic anatomic structures; it was useful in the evaluation of syringohydromyelia and cystic spinal cord tumors, and the bright signal intensity of lipoma was quite impressive. In the evaluation of herniated disk, NMR images offered a new perspective by visualizing abnormal degradation of the signal intensity of the nucleus pulposus itself. NMR images were least valuable in the evaluation of spondylosis and spinal stenosis. Although NMR imaging of the spine is still in a very early developmental stage, the absence of both ionizing radiation and risks associated with contrast material makes it especially attractive as a new diagnostic method. This limited experience with currently available equipment suggests that, with technical refinement, the efficacy of NMR of the spine will increase.

Adolescent

MR imaging of pediatric cerebral abnormalities.

One hundred sixteen magnetic resonance (MR) imaging studies from 105 pediatric patients with a variety of cerebral abnormalities were reviewed to determine the diagnostic efficacy of MR in the pediatric population. All subjects tolerated the MR procedure well, although sedation was necessary for younger children. Compared with CT, MR proved to be advantageous in detection and characterization of the pathology in 23 of 105 patients, especially when the abnormality was located along the base of the brain and midline, or when it involved primarily the white matter. Intracranial calcification was the one abnormality not detected with MR although dense calcifications could be seen as areas of low signal intensity. Some characteristics of various pathological entities were compared in an attempt to differentiate among abnormalities in the same anatomical location: craniopharyngioma from optic chiasm and hypothalamic glioma, cystic glioma from arachnoid cyst, and chronic subdural hematoma from subdural hygroma. The lack of ionizing radiation in MR is of particular interest in pediatric neuroradiology since radiation is of special concern in the young age group.

Adolescent

MR imaging of brain stem gliomas.

Magnetic resonance (MR) and CT examinations of 26 patients with the established or clinically suspected diagnosis of brain stem glioma were reviewed. Eleven tumors were seen on both MR and CT. The entire extent of the abnormality was better outlined on MR, although CT was more advantageous in demonstrating cystic components and calcium deposition. Magnetic resonance and CT depicted focal intratumoral hemorrhage equally. Magnetic resonance was found to be particularly suitable to follow up the progression or regression of the disease. Of particular interest were two patients with evidence of aqueductal obstruction but normal CT appearance of the midbrain; the causative abnormality, believed to be a glioma, was clearly shown by MR imaging. In nine patients the normal appearance was helpful to exclude the possibility of a brain stem glioma. Thus far, results have shown 100% sensitivity (true positive ratio) and specificity (true negative ratio) with MR in the evaluation of brain stem gliomas. It is concluded that MR imaging should be the examination of choice and could be the definitive screening procedure in patients with suspected brain stem glioma.

Adolescent

Diagnosis of ruptured intracranial dermoid cyst: value MR over CT.

The CT and MR findings of seven patients with pathologically proved ruptured dermoid cysts were reviewed to analyze the MR characteristics and to see if MR evaluation had significant advantages over CT. In six cases, both CT and MR identified fatty material in the CSF spaces. Hemorrhage complicated preoperative diagnosis in one case. Patterns of extraaxial fat distribution were as follows: intraventricular fat/CSF levels (three patients), generalized subarachnoid spread (six patients), and localized subarachnoid spread with sulcal widening (one patient). There was no correlation between fat distribution and clinical symptoms. MR showed the vascular involvement better than CT did in five of seven cases, and showed extension of the cysts into the skull base in two cases. Signal intensity of the solid mass was low on T1-weighted MR images and inhomogeneously high on T2-weighted images, which correlated pathologically with the presence of crystal cholesterol, hair, sebaceous glands, and epithelial cells in all cases. On MR, brain parenchyma showed little edema or other reaction to the masses, which were typically large. The value of MR over CT in the examination of ruptured dermoid cysts is the conspicuity of the extent of subarachnoid spread, involvement of the extraaxial structures, and evidence of vascular compromise, which can obviate angiography. MR had no advantage over CT in making the initial diagnosis of ruptured dermoid, but it would be the preferred preoperative study.

Adult

Demonstration of diastematomyelia and associated abnormalities with MR imaging.

Three patients were studied with a 0.3 T superconducting magnet to assess the role of magnetic resonance (MR) imaging in the recognition and evaluation of diastematomyelia and associated abnormalities. Comparison was made with other imaging techniques, including metrizamide computed tomographic (CT) myelography. With MR imaging, the divided spinal cord was well imaged in its entire craniocaudal extent, comparable to CT myelography. The bony septum, when it contained a marrow cavity, was also seen well. In two patients, dural ectasia and low position of the spinal cord with and without associated lipoma were clearly imaged. MR imaging demonstrated associated syringohydromyelia in one patient that was not detected by other radiologic studies. This preliminary experience with MR imaging of diastematomyelia suggests that once the bony details of the abnormality are defined, MR imaging can delineate the presence and extent of the divided spinal cord as well as its associated abnormalities adequately, obviating other studies.

Adolescent