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Biomedical subjects

R I Macpherson

Publications and source records attributed to R I Macpherson.

13 recordsLinked to original sources

Intrahepatic encystment of umbilical vein catheter infusate.

Massive hepatomegaly in a 2.1 kg female infant, with an indwelling umbilical vein catheter for total parenteral nutrition, occurred on the 10th day of life. Ultrasound and computed tomography studies revealed a large hepatic cyst filled with the catheter infusate. Percutaneous drainage brought about subsequent recovery. To our knowledge, this complication of umbilical vein catheter use has not been previously reported.

Catheterization, Central Venous

Acampomelic campomelic dysplasia.

Two newborn infants with respiratory distress showed all the clinical and radiologic stigmata of the campomelic dysplasia except campomelia itself.

Abnormalities, Multiple

Effects of sleeping with the bed-head raised and of ranitidine in patients with severe peptic oesophagitis.

Sleeping with the bed-head raised is commonly recommended as treatment for patients with troublesome oesophagitis, but its effect has not been objectively tested. Ranitidine therapy is useful in oesophagitis, but it does not often produce complete relief of symptoms. The effects of each of these treatments alone and in combination have been studied in 71 patients with severe (grade III) peptic oesophagitis. Each treatment improved both symptoms and endoscopic appearances significantly more than placebo did. However, the combination of the two treatments was much better than either alone; the reduction in pain score and the area of ulceration healed were about twice those with either treatment alone. Smoking more than five cigarettes per day or drinking more than 30 g alcohol per day significantly reduced the effectiveness of ranitidine therapy, but age, sex, body weight, or the presence of a hiatus hernia had no detectable effect.

Adult

Supernumerary kidney: typical and atypical features.

The clinical and radiologic features of three children with accessory renal units are presented. On the basis of the pyelographic and ultrasound findings, the first two clearly had free supernumerary kidneys. The third had a more complex "supernumerary variant," wherein the accessory renal unit formed the isthmus of a horseshoe or "pseudohorseshoe" kidney.

Adolescent

Midline central nervous lipomas in children.

We review the clinical, radiologic, surgical, and pathologic features of 15 children with central nervous system lipomas. Three were situated in the corpus callosum and 12 at the conus medullaris. The intracranial and the intraspinal disorders share several features suggesting that they are related. Both are midline developmental abnormalities associated with dysraphism and both may have extrinsic as well as intrinsic components. Both can occur as occult asymptomatic lesions, particularly early in life, or can be part of extensive dysraphic malformations. Computed tomography is the best way to demonstrate the nature and extent of these lesions prior to treatment.

Adolescent

Percutaneous puncture of abdominal cystic masses in children.

A technique of percutaneous puncture and opacification of cystic abdominal masses is outlined, and its diagnostic and therapeutic potential demonstrated in a series of 16 masses in 15 children. It is suggested as an alternative to ultrasound and computed tomography in certain situations.

Child

Mental retardation and osteosclerosis.

We report a girl with profound mental retardation who, at 3 years of age, began to show a progressive osteosclerosis on bone roentgenograms. The bony changes were slightly suggestive of osteopetrosis from which they differed by a number of unusual features.

Adolescent

Skeletal diseases associated with angiomatosis.

Basically, there are two conditions in which angiomatosis is associated with underlying skeletal disease. The first is Maffucci's syndrome in which angiomatosis is associated with multiple enchondromatosis. Two patients with this disease are presented and its clinical and radiologic features are reviewed. The second is "congenital angiectatic hypertrophy" in which angiomatosis is associated with localized hypertrophy of underlying bones, soft tissues and occasionally internal vercera. Four patients with this condition are presented, illustrating the subtypes of closely related diseases within a broad spectrum.

Angiomatosis

Pseudosequestration.

Three children with radiologic findings consistent with right-sided pulmonary sequestration were found at surgery to have a defect in the right hemidiaphragm which permitted a portion of normal liver to herniate into the chest and was associated with an anomalous systemic circulation to the right lower lobe. We refer to this abnormality as "pseudosequestration" and feel it is related to true pulmonary sequestration within the sequestration spectrum.

Blood Vessels

The hypertelorism-hypospadias syndrome.

Recently, an association between telecanthus and/or hypertelorism and hypospadias has been reported in several families. We describe six more families in whom we have found this association. Seven of the eight affected individuals were males. The other was a girl with hypertelorism and a minor urethral abnormality. The mothers in all six families had hypertelorism and/or telecanthus. Mental retardation and cleft palate were also common in our families and those reported previously. The radiologic findings in our first family, which was reported elsewhere as the "branchio-skeletal-genital syndrome," are considered in detail and include skull abnormalities, maxillary hypoplasia, dentigerous cysts and vertebral abnormalities.

Adolescent