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Biomedical subjects

S K Fernbach

Publications and source records attributed to S K Fernbach.

At least 55 records · Page 3Linked to original sources
PubMed1989

Radiographic evaluation of subureteric injection of teflon to correct vesicoureteral reflux.

The imaging studies of 83 children (115 ureters) with vesicoureteral reflux who were treated by subureteric injection of Teflon (STING) were reviewed. On plain films, the Teflon rarely may be seen as faintly radiodense. On sonography, it is echogenic and has variable acoustic shadowing. On CT it is dense (160-466 H). Postsurgical cystography showed cessation of reflux in 83 ureters (72%). Complications of STING were uncommon. No granulomatous masses were identified in the region adjacent to the STING. Transient, free peritoneal fluid developed in three children and ureteral dilatation in six, three of whom required intervention. In one child, most of the Teflon disappeared from the original site of injection, as noted on a follow-up CT scan; possibly it had been extruded into the bladder. The STING procedure probably will become more popular. Knowledge of its radiologic appearance is important for the radiologist in order to effectively evaluate these children postoperatively.

Adolescent↗
PubMed1988

The expanded spectrum of limb anomalies in the VATER association.

The radiographs of 230 children who had undergone neonatal surgery for imperforate anus and/or esophageal atresia/tracheoesophageal fistula were reviewed. Of the 31 children with limb anomalies thus detected, the 24 who had no radiologic or laboratory evidence of chromosomal abnormality form the basis of this report. In 16 children the limb anomalies fell within the commonly described spectrum of the VATER association. In the other 8 children and in 3 of the children with typical VATER limb anomalies additional anomalies were encountered: Sprengel deformity [2], hypoplasia of the humerus [3], radioulnar synostosis [1], midline anomalies of the hand [1], absence of the pubis, femur, tibia, and fibula and two rays of the foot [1], and other foot deformities. Subtle anomalies of the hand were common and included: clinodactyly, syndactyly, shortening of the middle phalanx of the fifth digit, and rotary malposition of the digits.

Abnormalities, Multiple↗
PubMed1988

Undiversion of the urinary tract: the pre-and postoperative evaluation.

Each uroradiologic procedure performed in the pre- and postoperative evaluation of the child undergoing undiversion contributes unique information. Function and anatomy of both the upper and lower urinary tracts must be carefully assessed. If the immediate postoperative studies show that the undiversion has been successful, the patient should be monitored yearly with excretory urography. If urinary tract symptoms develop, a more extensive radiographic evaluation (voiding cystourethrography, excretory urography, scintigraphy) may be warranted.

Child↗
PubMed1988

Nephroblastomatosis: comparison of CT with US and urography.

A review of the imaging studies of five children with Wilms tumor and nephroblastomatosis demonstrated that contrast-enhanced computed tomography (CT) can show the multifocal involvement of nephroblastomatosis more accurately than either excretory urography or real-time ultrasound (US). In all five children, CT demonstrated multiple areas of nephroblastomatosis along the renal cortex. US showed a single intrarenal mass in each child (one bilaterally) but did not show the cortical nephroblastomatosis. Excretory urography also demonstrated only the dominant mass of the Wilms tumor. The superiority of CT is attributed to better spatial resolution and soft-tissue contrast differentiation and clear demarcation between nonenhanced nephroblastomatosis and enhanced normal renal parenchyma. Contrast-enhanced CT is therefore recommended for the evaluation of clinically abnormal and contralateral kidneys in all children with suspected Wilms tumor.

Child, Preschool↗
PubMed1987

The evolving uroradiographic evaluation of the lower urinary tract in neonates with myelomeningocele.

Radiographic cystography (VCUG) has been advocated to detect dynamic and anatomic abnormalities of the lower urinary tract in the neonate with myelomeningocele (MM). We reviewed the VCUG in 120 neonates and the radionuclide cystograms (RNC) or cystometrograms (RNCMG) in 30 neonates to reevaluate the role of cystography in this population. Surgery was not required to treat the anatomic abnormalities detected by VCUG. The absence/presence of reflux and a bladder residual volume of greater than 15 cc were the two most important criteria in determining the neonatal voiding regimen. Because RNC provides this information equally well with a much smaller radiation dose and because of the additional functional information available from RNCMG, we now recommend that RNC or RNCMG be used to evaluate the lower urinary tract of neonates with MM.

Humans↗
PubMed1987

Ectopia cordis and the radiographic changes of a new surgical repair technique.

Preliminary repair of the midline thoracic defect in a newborn with ectopia cordis entailed the use of a prosthetic silo and fluid-filled tissue expanders placed under the lateral chest wall. On post-operative radiographs these expanders simulated the appearance of massive subcutaneous oedema of the chest wall.

Female↗
PubMed1987

Hypertension induced by occult renal tissue.

Hypertension was noted in 2 children thought to have a solitary kidney after multiple radiological studies. Aggressive diagnostic evaluation allowed for detection of occult contralateral renal tissue. Surgical removal of this parenchyma resulted in a return to normal blood pressure.

Child↗
PubMed1987

Septated urinomas in the neonate.

Perirenal urinomas may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Such fluid collections have been described as mainly sonolucent. However, in the last 2 years, we have imaged five neonates with multiple, marked septations of the urinoma, four with posterior urethral valves and one with a ureteropelvic junction obstruction. Diagnostic confusion may arise when the kidney is not identified, when the septated nature of the urinoma is not recognized, and when urinary tract obstruction is not seen.

Female↗
PubMed1986

Pericardial effusion presenting as an anterior mediastinal mass.

The authors present a case of pericardial effusion in a patient with previous cardiac surgery. Because the pericardium is opened and not reclosed during surgery, fluid can extend superior to the normal upper reflections of the pericardium and simulate an anterior mediastinal mass.

Child↗
PubMed1986

The abnormal renal axis in children with spina bifida and gibbus deformity--the pseudohorseshoe kidney.

The axes of the kidneys in children with a thoracolumbar gibbus deformity may be distorted to simulate a horseshoe kidney. Measurements of the angle of the gibbus and the angle of intersection of the renal axes were made in 68 children with thoracolumbar meningomyelocele. Thirty-eight children with a gibbus deformity and thoracolumbar meningomyelocele had an abnormality of the renal axis on supine urography, including 19 (28 per cent) in whom a horseshoe kidney was suggested. Three additional children with a gibbus deformity and thoracolumbar meningomyelocele had a normal renal axis. Regression analysis of these data indicated a linear relationship between the angle of the gibbus and the amount of deviation of the renal axis for the values studied. Nuclear scintigraphy, ultrasound studies and clinical records were reviewed in all 41 children with a gibbus deformity. In none were the kidneys fused. There were 21 children with thoracolumbar myelomeningocele who had no gibbus deformity and a normal renal axis. Six other children will be described in detail, 2 of whom were excluded because of severe scoliosis and 4 with congenital renal anomalies.

Child↗
PubMed1986

Uroradiographic manifestations of Burkitt's lymphoma in children.

The radiological studies of 18 children with biopsy proved Burkitt's lymphoma were analyzed retrospectively. Before therapy the genitourinary tract was evaluated in 15 children by excretory urography, sonography, computerized tomography and/or gallium citrate scintigraphy. Genitourinary abnormalities were detected in 9 children. Changes due to tumor included renal or ureteral displacement in 4 children, hydronephrosis in 3 and intraparenchymal masses in 4. Extrinsic compression of the bladder causing no compromise of function was seen in only 2 children. Gonadal involvement occurred in 2 boys and 1 girl. The modality of choice for evaluating the genitourinary tract in patients with Burkitt's lymphoma has been excretory urography. Since ultrasound and computerized tomography provide more direct information about tumor deposits within the kidney and retroperitoneum, either should be performed in this population before initiation of chemotherapy.

Adolescent↗
PubMed1986

Coin ingestion: unusual appearance of the penny in a child.

The United States of America changed the composition of the penny in 1982. It is now a copper-plated, zinc-based coin. Erosions of the edge of this new coin were observed when it was impacted in the esophagus of a 13-month-old child.

Copper↗