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Biomedical subjects

V J Harris

Publications and source records attributed to V J Harris.

At least 19 recordsLinked to original sources

Localization of the portal vein for transjugular catheterization: percutaneous placement of a metallic marker with real-time US guidance.

Transjugular catheterization of the portal vein can be used to form a portosystemic shunt. Conventionally, the passage of a needle from the hepatic vein into the portal vein is performed with fluoroscopic monitoring only. Several methods to target the portal vein have been previously reported, including transhepatic venous catheterization, indirect portography (arterial catheterization), or skin marking based on ultrasound (US) mapping of portal landmarks. The authors used realtime US guidance to percutaneously place a small marking wire in the parenchyma next to the portal bifurcation. A 0.018-inch-diameter, 5-mm-long platinum wire is delivered through a 22-gauge echo-tipped needle placed adjacent to the right portal vein. This marking wire enabled rapid entry into the portal vein, helped avoid extrahepatic puncture, and was useful during stent deployment and positioning.

Adolescent

Indications for breast imaging in women under age 35 years.

To determine appropriate indications for breast imaging in young women, the authors correlated patient histories with mammographic and/or sonographic findings and biopsy or follow-up results for 625 patients aged 13-34 years. The only important indications were a palpable mass and suspicion of an abscess. Of the 335 studies performed for evaluation of a palpable mass, 184 (55%) were normal, 28 (8%) were compatible with benign disease, and 123 (37%) were suggestive of malignancy. Biopsies were performed in 73 patients; the findings were benign in 67 cases, and carcinoma was found in six. Imaging studies were considered helpful in four of the 15 cases of suspected abscess, in that the studies established the presence and extent of an abscess. Studies in 275 women were performed for a variety of other indications. The findings were normal in 239 (87%) studies, benign in 21 (8%), and suggestive of malignancy in 15 (5%); there were no known carcinomas in any of the patients. Women with the "low-yield" indications identified in this study should be followed up clinically rather than referred for imaging studies.

Adolescent

Facial bone infarcts in sickle cell syndromes.

Bone infarction in the sickle cell syndromes (sickle cell anemia, sickle beta thalassemia, and sickle C disease) is common in the long bones, but the facial bones, particularly the orbits, are infrequently involved. In a review of the literature, only 13 cases of facial bone infarcts in sickle cell syndromes were found. Seven episodes of facial bone infarcts--four orbital, two mandibular, and one in the zygomatic arch--in six patients encountered at the authors' institution are reported. Five patients had hemoglobin SS, and one had hemoglobin SC. Bone marrow scans were positive for infarction in five of the six episodes during which they were obtained, which highlights the usefulness of this technique in the diagnosis of facial bone infarction.

Adolescent

Acute Haemophilus pneumonia in childhood.

In our hospital Haemophilus influenzae type B seems to be a common cause of acute childhood pneumonia. In the past five years, 34 children with acute Haemophilus pneumonia were identified. Although these children generally had an uncomplicated segmental pneumonia associated with a bacteremia, 13 of the children had pneumonia with a pleural effusion. These children with Haemophilus pneumonia represented 18% of the children hospitalized with systemic Haemophilus disease and almost a third of those hospitalized with acute bacterial pneumonia from whom the causal agent was isolated.

Acute Disease

Fatal tuberculosis in young children.

Three young children with advanced cavitary pulmonary tuberculosis died between 1974 and 1978. Two of the patients had tuberculous meningitis as well. All diagnoses were verified at autopsy; however, all tuberculin skin tests were negative. These instances emphasize the difficulty of establishing the diagnosis of tuberculosis in young children. Tuberculosis should be considered in the differential diagnosis of cavitary chest disease in young children, even those with negative tuberculin skin tests.

Age Factors

Empyema as a complication of retropharyngeal and neck abscesses in children.

Empyema developing from retropharyngeal abscess is a rare complication. Two infants with clinical symptomatology and inital chest radiographic findings of pleural fluid which suggested the possibility of retrophoryngeal abscess are described. A child with submandibular and cervical abscesses is also reported; pleural fluid and mediastinal abscess developed less than 24 hours after admission. Pathological processes in the neck can spread into the chest or conversely, either by direct continuity or by dissection through the fascial planes enveloping the cervical compartments. The middle or visceral space which is in direct continuity with the mediastinum is generally the area in which cervicothoracic disease inter-relates.

Abscess

The frequency of radiolucencies underlying cephalohematomas.

The authors studied skull radiographs of 66 infants with cephalohematoma. Twenty-three (35%) had radiolucencies in the skull; most of the radiolucent defects were associated with beginning or extensive ossification over the cephalohematoma. Radiolucency associated with cephalohematoma is a frequent finding and rarely indicates local infection.

Absorptiometry, Photon

Caffey's disease: a case originating in the first metatarsal and review of a 12 year experience.

This paper describes an infant with Caffey's disease who presented with swelling of the first metatarsal shown as hyperostosis histologically. He then developed scapular sclerosis and new bone formation. The mandible became involved 26 days after onset. A review of a 12 year experience with Caffey's disease (33 patients) disclosed a definite decrease in the number and percentage of patients seen since 1968.

Bone Development

Congenital syphilitic osteitis of scapulae and ribs.

A newborn with congenital syphilis presented radiographically with a lack of ossification of the medial portions of several ribs and massive sclerosis and decalcification of scapulae. The uniqueness of syphilitic scapular and rib involvement is discussed. The infant also went on to develop skin lesions which appeared following penicillin therapy and also developed an extrahepatic biliary atresia.

Humans

Significance of radiographic findings in early-onset group B streptococcal infection.

Chest radiographs on 73 neonates with early-onset group B Streptococcus (GBS) infection were reviewed. Eighty-six percent of the infants were premature (less than 38 weeks); 68% weighed less than or equal to 1,500 g. In infants weighing less than or equal to 1,500 g, the predominant radiographic pattern was hyaline membrane disease (HMD) (80%). There was a significant increase in radiographic HMD in 1,000 to 1,500-g neonates with GBS infection (77%) when compared to a control group of infants without GBS infection (44%). Mortality in 1,000 to 1,500-g infants with GBS infection and radiographic HMD (95%) was also significantly higher than in the control group of infants with hmd HMD and no GBS infection (38%). In larger premature and full-term infants, the radiographic findings were not specific and also were not helpful in distinguishing GBS infection from other newborn respiratory disorders.

Female