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Biomedical subjects

M H Reed

Publications and source records attributed to M H Reed.

At least 19 recordsLinked to original sources
PubMed1998

Biliary tract complications of side-to-side without T tube versus end-to-end with or without T tube choledochocholedochostomy in liver transplant recipients.

BACKGROUND: Biliary anastomotic complications remain a major cause of morbidity in liver transplant recipients, ranging between 10% and 50% in large clinical series. An end-to-end choledochocholedochostomy with or without T tube (CDCD EE with T tube and CDCD EE w/o T tube) and a Roux-en Y choledochojejunostomy have been standard methods for biliary drainage. METHODS: The objectives of this retrospective study were to: (1) evaluate the incidence of biliary tract complications using a new method of side-to-side choledochocholedochostomy without T tube (CDCD SS w/o T tube) and (2) compare the results of CDCD SS w/o T tube with those of CDCD EE with T tube and CDCD EE w/o T tube. From September 1991 through June 1996, 279 orthotopic liver transplants were performed in 268 patients and followed through December 1996 (minimum of 6 months' follow-up). A total of 227 CDCD anastomoses in 220 patients were studied (7 retransplants > 30 days): CDCD EE with T tube (n=124), CDCD EE w/o T tube (n=44), and CDCD SS w/o T tube (n=59). RESULTS: Sixty-nine biliary complications were observed in 220 patients (30%). Anastomotic and/or T-tube leaks were seen in 43 patients (19%), and anastomotic strictures were found in 26 patients (12%). Forty patients (18%) required percutaneous or endoscopic stent placement (6%) or surgical interventions (12%). CDCD EE with T tube had the highest incidence of biliary leak requiring rehospitalization but the lowest anastomotic stricture and intervention rate and the lowest 6-month mortality rate. CONCLUSIONS: CDCD EE with T tube was superior to CDCD EE or CDCD SS w/o T tube despite the increased number of rehospitalizations. CDCD SS w/o T tube did not offer significant advantages over conventional biliary anastomotic techniques.

Bile Ducts, Extrahepatic↗
PubMed1998

SAMS: provisionally unique multiple congenital anomalies syndrome consisting of short stature, auditory canal atresia, mandibular hypoplasia, and skeletal abnormalities.

We report on a young Mennonite child born with short stature, atresia of the external auditory canal, mandibular hypoplasia, and skeletal anomalies. The skeletal defects consist of bilateral humeral hypoplasia, delayed ossification of the pubic rami, and the previously unreported anomaly of humeroscapular synostosis. This girl is the product of a consanguineous mating. This phenotype is unique and does not match that of any previously described condition.

Abnormalities, Multiple↗
PubMed1995

Pulmonary blastomycosis in children: findings on chest radiographs.

OBJECTIVE: The purpose of this study was to identify characteristic radiographic findings in children with pulmonary blastomycosis. SUBJECTS AND METHODS: We reviewed the charts and radiographs of 18 children with culture-proven acute pulmonary blastomycosis. The 10 boys and eight girls were from 1 to 16 years old. Sixteen were Native Canadian Indians, and two were white. All available chest radiographs, including those obtained in follow-up after treatment was terminated, were reviewed by a pediatric radiologist. Consolidation was classified by location and extent, and other abnormalities were noted. RESULTS: Initial chest radiographs showed consolidation in 16 patients. Seven patients had single lobe involvement, most commonly of the left lower lobe. Nine patients had multiple lobe involvement. The left lower lobe was most commonly involved in these cases, but the middle lobe was most severely affected. The upper lobes were involved only in children with multiple lobe disease and were only mildly affected. Cavitation developed in two patients, followed by bronchogenic spread of the disease. Pleural effusions were seen in three patients; two also had rib lesions. Hilar adenopathy developed in two children. Five patients had radiographs available, which had been obtained more than a year after onset, and three of these were abnormal. CONCLUSION: The most common radiologic finding in children with pulmonary blastomycosis is pulmonary consolidation in one or several lobes, which may undergo cavitation. Lymphadenopathy and pleural effusions are uncommon. Chronic abnormalities may develop.

Acute Disease↗
PubMed1994

A criterion for a true lateral radiograph of the elbow in children.

In the search for a fracture of the elbow in children, the position of the anterior humeral line is a valuable aid. It has been stated that a true lateral radiograph is required to use this sign, although no criteria for assessing true laterality have been described. To develop such criteria, the authors examined 74 lateral radiographs of the elbow for 42 patients ranging in age from 9 months to 5 years, 9 months. Thirty-five of the patients did not have supracondylar fractures, and 7 did. In all of the radiographs the direction and degree of rotation, as well as the position of the anterior humeral line, were assessed relative to a series of radiographs of a cadaveric humerus in standardized positions. Examination of the humeral anatomic features in the radiographs showed that superimposition of the posterior supracondylar ridges of the humerus is the best means of confirming true laterality. This criterion is easily applied to lateral radiographs of the elbow in children. Of the radiographs reviewed, only seven were considered to represent true lateral views. Of those exposed in other degrees of rotation, the anterior humeral line gave a false indication of fracture in 19.

Child, Preschool↗
PubMed1994

Staging of healing of femoral fractures in children.

Although the rate of fracture healing has been studied in adults, little such work has been done in children. The authors' objective was to develop staging criteria for assessing callus formation in fractures in children and to determine the relation between the age and sex of the patient and callus formation. They studied callus formation in healing fractures of the femoral diaphysis in 25 patients, 15 boys and 10 girls, ranging in age from birth to 14 years. The patients were selected on a random basis from children presenting with femoral fractures (and no other injuries) to a tertiary-care pediatric hospital in Winnipeg over the period 1988 to 1991. The following staging criteria were developed from other examples of femoral fracture: stage 1, earliest radiographically visible calcification of the callus; stage 2, callus completely bridging the fracture site; and stage 3, mature callus. For the patients in the study, the average times to reach stages 1, 2 and 3 were 11.7, 18.7 and 55.3 days respectively. The sex of the patient had no effect on callus formation. The final stage of healing appeared to take longer with increasing patient age, although this observation was not statistically significant.

Adolescent↗
PubMed1993

Types and complications of femoral neck fractures in children.

This multicenter collaborative study was undertaken to review the types and complications of femoral neck fractures in children. It is a retrospective clinical and radiological review of 108 femoral neck fractures. Cases originated from four different pediatric hospitals. All the patients had plain radiographs. Fractures occurred at all ages (one day to 18 years), and 63% of the patients were boys. Forty-nine fractures were traumatic; 37 were pathologic, 19 were insufficiency fractures; and three were fatigue fractures. Unless the underlying bone was abnormal, significant high velocity trauma, fall from a height or other severe violence was required to fracture the femoral neck. A unicameral bone cyst was the underlying lesion in 40% of pathologic femoral neck fractures and malignancy in 35%. Osteoporosis as in myelodysplasia, osteogenesis imperfecta and from other causes was responsible for 52% of insufficiency fractures. Because of the unique osseous and vascular anatomy of the femoral head and neck in the growing child, these fractures have a high incidence of complications. Complications included avascular necrosis 13%, premature closure of the epiphyseal plate 12%, varus deformity 8.3%, and nonunion 3.7%. Unless there is a clear history of significant violence, a cause for a femoral neck fracture should be sought, e.g. an underlying bone lesion or a metabolic bone disease. These fractures are rare, but are serious injuries since their complications may lead to a life-long disability.

Adolescent↗
PubMed1993

Restrictive dermopathy.

Restrictive dermopathy is an inherited syndrome characterized clinically by severe growth retardation, abnormal skin, characteristic facies, and multiple congenital contractures. Distinctive radiologic features include deficient mineralization of the clavicles and the skull, overtubulation and frequent modeling defects of the long bones, and occasional abnormalities of the ribs and scapulae.

Abnormalities, Multiple↗
PubMed1993

Contact thermography in the diagnosis of childhood migraine.

The objective of our prospective study was to assess the role of contact thermography in children with migraine. Contact thermograms were done in 54 children aged 4.2-16.5 years (median 10.5 years), who were seen for headache and on 10 age-matched controls, between July and December 1991. Thermograms were interpreted as definitely normal, equivocally normal, equivocally abnormal, and definitely abnormal by a radiologist who was blinded to clinical information. Forty-eight children had the test between headaches; of these, four out of 26 patients (15%) who had migraine without aura and 3 out of 14 children (21%) who had migraine with aura had definitely abnormal thermograms. Nine out of 10 normal controls had definitely normal thermograms. The sensitivity of contact thermography in the diagnosis of childhood migraine, when done between headaches, was low in our study.

Adolescent↗
PubMed1993

Ossification of the hyoid bone during childhood.

Normal ossification of the hyoid bone was studied on the basis of postpartum radiographs of 10 stillborn children and radiographs of the cervical spine or the lateral neck of 86 children ranging in age from newborn to 16 years old. None of the patients was suspected of having any abnormality of skeletal ossification. Ossification of the hyoid was seen only after 30 weeks' gestation. The body of the hyoid was ossified in all infants older than 4 months, and the greater cornua were ossified in all those older than 6 months. Ossification of the lesser cornua did not appear in children less than 15 years of age. Normal measurements for the body of the hyoid and the greater cornua were determined.

Adolescent↗
PubMed1993

Abnormal ossification of the hyoid bone in cleidocranial dysplasia.

Radiographs of the hyoid region of 13 patients with cleidocranial dysplasia were reviewed. In all but one the hyoid bone was less ossified than normal. Delayed ossification, affecting the skull, the teeth, the pelvis and the extremities, is a known, frequent manifestation of this abnormality.

Adolescent↗
PubMed1992

Heterotopic ossification in children after iliopsoas release.

Heterotopic calcification or ossification of the soft tissues adjacent to the lesser trochanter was observed in the radiographs of 4 patients during a retrospective review of the records of 68 patients with Perthes' disease. This abnormality has since been seen in one other patient with Perthes' disease and in five with spastic quadriplegia. All 10 patients are known to have undergone iliopsoas release as part of adductor tenotomy. The authors believe that the heterotopic ossification is related to the surgery.

Adolescent↗
PubMed1991

Newly recognized syndrome of cerebral, ocular, dental, auricular, skeletal anomalies: CODAS syndrome--a case report.

We report on a child with a unique constellation of congenital anomalies suggesting a new syndrome. These consist of developmental delay; craniofacial abnormalities, including bilateral cataracts, ptosis, median nasal groove, malformed ears with associated neurosensory hearing loss; dental anomalies consisting of anomalous cusp morphology with unusual pointed extensions and delayed tooth eruption; short stature with marked delay in epiphyseal ossification; coronal clefts involving vertebrae T11-S2; and dislocated hips. A literature search and use of a computer-assisted syndrome-identification program failed to uncover an identical case.

Abnormalities, Multiple↗
PubMed1991

Forearm deformities in multiple cartilaginous exostoses.

Sixteen patients with 20 forearm deformities were reviewed. The deformities were classified into three types. The degree of ulnar tilt of the radius, ulnar displacement of the carpus, and relative ulnar shortening were determined. The severity of the deformity correlated with these measurements. Metacarpal lengths were also measured. Significant metacarpal shortening without exostoses was seen in 10 of 11 patients and with exostoses remote from the metaphysis in 10 of 13 patients. Metacarpal shortening correlated with the type and severity of deformity.

Adolescent↗
PubMed1991

Computer assisted analysis of hand radiographs in infantile hypophosphatasia carriers.

Hand radiographs of 49 carriers of infantile hypophosphatasia and 67 non-carriers were evaluated using two Apple IIe Computer Programs and an Apple Graphics Tablet. CAMPS (1) was used to determine the bone lengths and calculate the metacarpophalangeal profiles. A newly developed program (ADAM) was used to determine bone density based on percent cortical area of the second metacarpal. Carriers of infantile hypophosphatasia had significantly less dense bones.

Adolescent↗
PubMed1991

Spondylometepiphyseal dysplasia congenita, Strudwick type.

A case of spondylometepiphyseal dysplasia congenita, Strudwick type is presented. At birth, this condition cannot be distinguished from spondyloepiphyseal dysplasia congenita. Features in common include delayed ossification of the public bones and proximal femoral epiphyses, coxa vara, odontoid hypoplasia and lumbar lordosis. The distinguishing radiologic feature of this condition is the striking irregularity of long bone metaphyses which develops during infancy.

Bone and Bones↗
PubMed1991

The radiology of juvenile rheumatoid arthritis. A review of the English language literature.

The radiologic abnormalities seen in patients with juvenile rheumatoid arthritis (JRA) include disturbances of growth, various types of joint destruction, abnormalities of bone density, periostitis, and soft tissue abnormalities. We review the English language literature, which deals with the radiologic abnormalities in general, and at specific sites. We also review briefly radiologic abnormalities seen in other organ systems. The role of the other imaging modalities in the assessment of JRA is discussed.

Arthritis, Juvenile↗
PubMed1991

Radiologic features of congenital transverse deficiency of the forearm.

The records of fifteen patients (11 girls and 4 boys) with a congenital transverse deficiency of the forearm were studied. In 11 patients the lesion was on the left. The deficiency occurred in the proximal third of the forearm in 13 patients. The radius and the ulna were usually bowed, and their shafts were sometimes irregular. The radial head was dislocated in six patients, and minor abnormalities occurred in the distal humerus in five and the proximal ulna in five.

Adolescent↗