Biomedical subjects
Publications and source records attributed to T E Sumner.
A case of medullary type of nephrocalcinosis in hypophosphatasia is presented. Sonography revealed medullary calcification not visible on abdominal radiography. Calcification could also be demonstrated by CT scanning.
The radiographs of 19 pediatric patients with aspiration-proven bacterial infections of the hip were analyzed. The hip radiograph was abnormal in all neonates showing lateral subluxation. The radiograph was negative in eight of ten children more than 1 year of age. It is emphasized that children with suspected septic hip require immediate joint aspiration regardless of radiographic findings.
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The logistic approach in diagnosis of focal nodular hyperplasia (FNH) of the liver is discussed, based on the experience with three children. In only one child could the diagnosis be made without angiography. In that child the combination of hypervascularity on the radionuclide angiogram and uptake of the radiocolloid by Kupffer cells was sufficient for the diagnosis of FNH. If the radionuclide scintigraphy is inconclusive, angiography has to be done to show the typical features of FNH, seen in all three patients. Only if scintigraphy and angiography are not able to differentiate FNH from hepatic adenoma, biopsy or exploratory laparotomy is indicated as a final diagnostic procedure. Ultrasonography or computerized tomography is of value only in screening for hepatic mass lesions.
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Inflammatory polyps that arise in the maxillary antra may extend into the nasal cavity and result in nasal obstruction. In some instances a combination of roentgenographic findings is helpful in diagnosis. This combination includes diminished aeration of the involved maxillary antrum, expansion of the antrum, and a soft tissue mass within but not arising from the nasopharynx.
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A 14-month-old child presented with severe respiratory distress from an anterior mediastinal mass. Since its gross appearance suggested malignancy, radical surgical excision was performed. In retrospect, secondary hemorrhage, fibrosis, and chronic inflammation were responsible for the atypical appearance of a benign cystic hygroma. Etiology, clinical presentations, diagnosis and recommended treatment of this relatively rare mediastinal lesion are discussed.
Pancuronium bromide treatment in severely ill, mechanically ventilated infants has been shown to result in lower peak transpulmonary pressure, with an accompanying lower-than-expected incidence of pneumothorax. Infants, treated with pancuronium often demonstrate an ominous abdominal roentgenographic finding: the "gasless abdomen." Of 38 mechanically ventilated infants, 22 of 24 pancuronium-treated infants (as compared with four of 14 untreated infants) had diminished or absent bowel gas. There was no significant difference between the two groups with regard to birth weight, mortality, or incidence of respiratory distress syndrome. Pancuronium prevents swallowing of air but does not inhibit gut peristalsis, thus accounting for the evacuation of abdominal gas three hours or more after administration of the drug. Clinicians who treat infants with pancuronium should be aware of the phenomenon, to avoid needless roentgenographic studies.