PubMed Health⌕ Search

Biomedical subjects

M Pery

Publications and source records attributed to M Pery.

At least 19 recordsLinked to original sources
PubMed2000

Comparing thyroid ultrasonography to thyroid function in long-term survivors of childhood lymphoma.

BACKGROUND: We studied the value of thyroid ultrasonography as a follow-up tool in survivors of childhood lymphomas and correlated morphologic abnormalities with thyroid function tests. PROCEDURE: A prospective follow-up study of 45 long-term survivors of histology-proved childhood lymphomas was performed. Mean age at diagnosis was 9.1 years (range 2.1-16.4 years) and mean follow-up duration 10.9 years (range 3.9-22.2 years). RESULTS: Among the 26 survivors of Hodgkin disease (HD) who received mantle field irradiation, 14 (54%) had abnormal ultrasonograms. Elevated thyroid-stimulating hormone (TSH) concentrations were found in 14 (54%), and 6 of them (42%) had normal thyroid functions. Six of twelve patients with normal ultrasonograms had abnormal thyroid function, and 5 of 11 patients with normal function had abnormal sonograms. Among the 19 non-HD survivors who did not receive radiotherapy, 18 (95%) had both normal sonograms and normal function. Thus thyroid gland abnormalities were detected in 54% of HD survivors after mantle field irradiation. No correlation between the abnormalities detected on ultrasonography and serum levels of TSH and thyroid hormones were found. CONCLUSIONS: Both ultrasound and thyroid function tests independently provide clinically useful information; the former examines gland morphologogy and the latter evaluates hormonal changes associated with thyroid disease. The high frequency of thyroid abnormalities detected by ultrasonography suggests that periodic thyroid ultrasonography is advisable in the follow-up of patients treated with mantle irradiation to screen for morphologic changes that may presage malignant transformation.

Adolescent↗
PubMed1999

The hypothyroidism in an inbred kindred with congenital thyroid hormone and glucocorticoid deficiency is due to a mutation producing a truncated thyrotropin receptor.

Growth and function of the thyroid and adrenal glands are maintained and controlled by thyrotropin (TSH) and adrenocorticotrophic hormone (ACTH), respectively. The action of these trophic hormones requires the presence of functional TSH and ACTH receptors. We describe a large inbred Bedouin kindred in which profound congenital hypothyroidism and hypoadrenocortisolism occurred alone or together in eight family members belonging to four nuclear families. The high serum TSH and ACTH levels in the presence of normal or hypoplastic thyroid glands and low glucocorticoid, but not mineralocorticoid concentrations, are characteristic of resistance to TSH and ACTH. Linkage analysis, using specific polymorphic markers, excluded the involvement of the ACTH receptor but not thyrotropin receptor (TSHR). A novel point mutation was identified in exon 10 of the TSHR that replaces the normal cytosine in nucleotide 2024 with a thymidine. As a result the normal arginine in codon 609 (CGA) is replaced with a stop codon (TGA). This mutation produces a truncated TSHR lacking the third intracellular and extracellular loops, the sixth and seventh transmembrane segments, and the intracytoplasmic tail. The presence of hypothyroidism did not affect the timing, severity, and manner of clinical manifestation of hypoadrenocortisolism.

Adolescent↗
PubMed1995

Application of a bedside whole blood D-dimer assay in the diagnosis of deep vein thrombosis.

Cross-linked fibrin degradation products have been used to detect venous thrombosis. While the sensitivity of plasma D-dimer measured by ELISA in the diagnosis of deep vein thrombosis (DVT) is high, the utility of ELISA methods is limited in a clinical setting. This study analysed the diagnostic value of a rapid D-dimer assay performed on whole blood samples (SimpliRed D-dimer) compared with latex and ELISA in 86 patients suspected of having DVT. SimpliRed D-dimer was positive in 47/50 of patients with DVT established by Doppler ultrasound (DU; sensitivity 94%). SimpliRed D-dimer was positive in 35/37 of patients with proximal DVT, nine out of nine with popliteal DVT and three out of four with superficial thrombophlebitis. The specificity of SimpliRed D-dimer in the diagnosis of DVT was 61%. The sensitivity of the SimpliRed D-dimer assay was at least comparable with the ELISA (87%) and superior to the latex assay (80%). The positive predictive value (77%), the negative predictive value (88%) and the overall accuracy (80%) of the SimpliRed assay were better than the ELISA and latex methods. It is concluded that SimpliRed D-dimer is a rapid useful assay for screening of patients suspected of having deep vein thrombosis.

Adolescent↗
PubMed1994

Image-directed Doppler ultrasound in the diagnosis of lower-limb venous insufficiency.

Ninety-eight legs in 73 patients were evaluated with image-directed Doppler ultrasound for suspected chronic venous insufficiency. Examinations of the entire venous system were performed to determine lumen patency and valvular competence. Reflux during Valsalva maneuver in the femoral and great saphenous vein, and, after release of distal compression in the popliteal vein, indicated valvular incompetence. Twenty limbs had normal veins; Baker's cysts were found in three. Superficial venous insufficiency was found in 25 cases. Deep reflux, either alone or in combination with superficial reflux, was the predominant pathological feature (53 legs). Photoplethysmographic studies of the veins were performed on 24 limbs. Image-directed Doppler ultrasound was more successful in defining the exact site of venous incompetence and in detecting nonvenous pathology. By the combination of real-time imaging of the vein with gated Doppler sonography of flow, image-directed Doppler sonography is becoming the method of choice for the investigation of chronic venous insufficiency.

Adult↗
PubMed1994

Fibromatosis (desmoid tumor) following radiation therapy for Hodgkin's disease.

Fibromatosis (desmoid tumor) can sometimes develop at sites of previous surgery or previous trauma, but it is very rarely detected at sites of prior irradiation. We report two cases of fibromatosis following radiotherapy for Hodgkin's disease. The fibromatoses, developing in the radiation fields, were detected at the posterior area of the neck 11 years after irradiation in one case and in the peritoneal cavity 3 years after laparotomy and irradiation in the second case. The tumors did not differ clinically or histologically from those seen in patients who did not undergo irradiation. Although rare, fibromatosis should enter the differential diagnosis of masses developing in irradiated fields in patients with treated Hodgkin's disease.

Adult↗
PubMed1992

Abscess of corpus cavernosum.

A rare case of abscess of the corpus cavernosum is described. Culture of the abscess yielded beta-hemolytic streptococcus. Ultrasound scan and cavernosography confirmed the physical examination findings of involvement of the corpus cavernosum. The patient was treated successfully by percutaneous ultrasound-guided aspiration drainage and systemic antibiotic therapy.

Abscess↗
PubMed1990

The value of ultrasound in Schoenlein-Henoch purpura.

We report the results of ultrasound studies on 11 children with Schoenlein-Henoch purpura. In 8 children the ultrasound examination was normal. In two of three patients with macroscopic haematuria, haemorrhagic cystitis, a previously undescribed finding in Schoenlein-Henoch purpura, was found. In one case the gall bladder wall and the wall of several adjacent loops of bowel were markedly thickened. Follow up examinations after clinical recovery demonstrated complete resolution of these abnormalities. Our observations demonstrate that diagnostic ultrasound may have an important role before more expensive and invasive procedures are employed in patients with Schoenlein-Henoch purpura.

Child↗
PubMed1990

Late changes in veins after deep venous thrombosis: ultrasonographic findings.

In a prospective trial, 43 patients (45 legs) were re-examined by high resolution and continuous-wave Doppler ultrasonography 3-32 months after an acute episode of deep venous thrombosis (DVT). The veins were abnormal in 31 legs (69%). Abnormal veins were either narrowed with a highly echogenic lumen (thought to represent persistent occlusion) or with a relatively sonolucent lumen and thickened walls (thought to represent recanalized veins). Collateral veins were present. Some compression by probe could be achieved in partially occluded veins, but full collapsibility was absent. Continuous-wave Doppler studies were similar to those in acute DVT. In order to be able to diagnose new episodes of DVT in patients who have had DVT in the past, a baseline ultrasound study should be carried out approximately 6-12 months after an acute episode. In the absence of such a baseline study, contrast phlebography should be resorted to.

Collateral Circulation↗
PubMed1990

Intracorporeal calcifications after self-injection of papaverine.

Penile indurations were found at follow-up examination in six of 120 patients with erectile dysfunction who practice intracavernosal self-injection of papaverine-phentolamine. In four of these six, cavernosal calcifications were demonstrated by means of ultrasound (US) and radiography. Most of the calcifications were close to the site of injection, but some were more distant. Cavernosal calcifications must be considered a possible complication of self-injection of papaverine-phentolamine. Baseline US and radiographic studies of the penis are advisable before starting treatment.

Adult↗
PubMed1989

[Ultrasonographic diagnosis of deep vein thrombosis of the leg].

142 patients with the clinical diagnosis of deep vein thrombosis (DVT) of the legs were examined by high resolution ultrasound. The deep and superficial femoral and popliteal veins were examined with 6.5 and 10 MHz transducers. 124 of the patients were also examined with continuous wave Doppler ultrasound and in 46 contrast phlebography was performed. The overall accuracy of ultrasound compared to phlebography was 90%. If only the deep femoral vein was considered, ultrasound and phlebography correlated in 100%. The ultrasonographic characteristics of DVT are increased echogenicity of the involved vein, absence of response to the Valsalva maneuver and non-collapsibility of the thrombosed vein on pressing with the transducer probe. High resolution ultrasonography should be the primary tool for the diagnosis of DVT.

Humans↗
PubMed1989

Immotile cilia syndrome including polysplenia, situs inversus, and extrahepatic biliary atresia.

Here we report on 2 sibs with immotile cilia syndrome (ICS), born to consanguineous Arab parents. Both had the Kartagener triad. In addition, one sib had polysplenia and extrahepatic biliary atresia. This observation, together with other literature reports, suggests that the occurrence of ICS with polysplenia and extrahepatic biliary atresia represent the result of a single dysmorphogenetic process. It is concluded that polysplenia and extrahepatic biliary atresia are rare and unusual manifestations of ICS.

Biliary Atresia↗
PubMed1989

Ultrasonographic detection of plastic materials in various organs of the human body.

The ultrasonographic appearance of different plastic catheters, tubes, and prostheses used in medical practice were tested in vivo and in vitro. According to the direction of the sound beam, the different plastic catheters and tubes appeared as parallel echogenic lines if scanned longitudinally, or as echogenic dots if scanned transversely. The exact position of the tip of the catheter and its relationship to neighboring organs can be established by ultrasonography. Repositioning of tubes, if necessary, can be done under ultrasonographic guidance. The flexibility and mobility of modern ultrasound scanners allows one to examine the sick patient with minimal disturbance, and to evaluate the location and effect of the various plastic catheters and tubes inserted into the body for medical reasons.

Catheters, Indwelling↗
PubMed1989

Familial distal renal tubular acidosis with neurosensory deafness: early nephrocalcinosis.

Nephrocalcinosis was observed in 3 children of one family with distal renal tubular acidosis (dRTA). At presentation, all 3 patients had failure to thrive, rickets, hyperchloremic metabolic acidosis, hypokalemia, hypophosphatemia and hypercalciuria. At a later age, sensorineural hearing impairment was detected. Nephrocalcinosis was diagnosed in the index case at the age of 5 years, when a plain abdominal roentgenogram was first made; in the younger brother and sister, nephrocalcinosis was detected earlier at the age of 4 months and 5 weeks, respectively. All 3 patients required large doses of alkali (7.5-9.5 mEq/kg body weight/day) during infancy and early childhood to correct the acidosis and to prevent progression of the nephrocalcinosis. Contrary to the current notion that in children with dRTA, nephrocalcinosis is observed only after the age of 3 years, it appears that in some instances nephrocalcinosis may develop in early infancy. The occurrence of nephrocalcinosis at a very young age may be a manifestation of a severe genetically transmitted variant of dRTA and emphasizes the need for early diagnosis and optimal treatment of these patients from the first days of life.

Acidosis, Renal Tubular↗
PubMed1989

Intravenous pyelography in children with urinary tract infection and vesicoureteral reflux.

In a previous study of the radiologic evaluation of children with urinary tract infection it was recommended that IVP be performed in all patients with either abnormal ultrasonographic or voiding cystourethrographic findings. However, the benefit from IVP was believed to be questionable in children with normal ultrasonography findings and vesicoureteral reflux of only a low grade (I or II of V). To gain a better understanding of the need for IVP in the radiologic evaluation of such children, the database was expanded and the findings concerning ultrasonography and IVP were analyzed in 52 children with urinary tract infection and vesicoureteral reflux seen during the last 3 years. Of a total of 72 instances of reflux, 44 (61.1%) were of low grade (I or II), 14 of medium grade (III), and 14 of high grade (IV or V). Of the 44 urinary systems with low-grade reflux, results were as follows: renal ultrasonography appeared normal in 38 and in 34 of these, the IVP also appeared normal; in the other four, only minor and negligible changes were seen with IVP. Surgical intervention was not necessary in any of these 38 urinary systems. In six systems with low-grade vesicoureteral reflux but with abnormal ultrasonography findings, IVP results were also abnormal, and surgery was necessary in two instances. Of the 14 urinary systems with medium-grade reflux, ultrasonography appeared normal in ten but in six of these the IVP appeared abnormal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

The use of ultrasound scanning in the management of developmental disorders of the hip.

Ultrasound was used, together with clinical examination, to help in the diagnosis and to evaluate the treatment of 48 babies with congenital disorders of the hip. The femoral head, and its relation to the acetabulum, can be demonstrated before it becomes visible on radiographs. Ionising radiation is avoided. Ultrasound scanning can be used to visualise the repositioning of the femoral head. It is also possible to examine babies on an abduction frame.

Hip Dislocation, Congenital↗
PubMed1988

High-resolution real-time ultrasonography in the diagnosis of deep vein thrombosis.

The contribution of high-resolution real-time ultrasonography to the diagnosis of deep vein thrombosis (DVT) was evaluated in a prospective study performed on 96 patients. 45 patients were also examined with contrast venography and 79 with continuous wave Doppler ultrasound. The femoral and popliteal veins were examined for compressibility by pressure with the transducer probe, response to deep inspiration and Valsalva's manoeuvre and presence of an intraluminal mass. The contralateral veins were routinely screened for comparison. The diagnostic sensitivity versus phlebography was 87%, and the specificity 100% for the femoral vein. When including the popliteal vein the specificity was 91%. Real-time ultrasonography together with Doppler ultrasound examination is an effective non-invasive approach for the diagnosis of DVT. Phlebography can be avoided if these two examinations are unequivocally positive or negative for DVT.

Humans↗
PubMed1988

Percutaneous kidney needle biopsy in children is less traumatic than in adults.

Hemorrhagic complications following percutaneous kidney needle biopsy were prospectively assessed in 20 children and adolescents (age 2-17 years) undergoing a total of 22 biopsies. Macroscopic hematuria was observed in 1 case and hematocrit reduction of more than 3% in 2. Gray-scale ultrasonography performed in all patients 48 h after the biopsy detected peri- and intrarenal hematomas in 2 cases. Based on these data and those from another study on children, comparison to three similar studies in adults showed a 9.3% mean incidence of macroscopic hematuria in children versus 36.2% in adults (p less than 0.01), a 9.1 versus 31.3% mean incidence of hematocrit reduction of more than 3% (p less than 0.05), and a mean incidence of only 10.9% in children versus 65.6% in adults of radiologically detected peri- and intrarenal hematomas (p less than 0.001). We conclude that percutaneous kidney needle biopsy in children is less traumatic than in adults. Hence when relating to hemorrhagic complications of the procedure, the two populations have to be addressed separately.

Adolescent↗