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Biomedical subjects

W D Winters

Publications and source records attributed to W D Winters.

At least 19 recordsLinked to original sources
PubMed1997

Congenital masses of the lung: changes in cross-sectional area during gestation.

PURPOSE: We assessed the growth of congenital masses of the lung during gestation using computer-assisted planimetry. METHODS: The prenatal sonograms of 8 fetuses with congenital masses of the lung were reviewed. RESULTS: The cross-sectional area of the mass and chest were measured on the same transverse image using computer-assisted planimetry, and the percentage of the chest occupied by the mass was determined for each study. Four masses had pathologic features of type II congenital cystic adenomatoid malformation and intralobar sequestration (CCAM/ILS), 2 were type II CCAM, 1 was type I CCAM, and 1 was bronchial atresia with bronchiectasis. Four masses increased in cross-sectional area during gestation, 1 decreased, 2 were essentially unchanged, and 1 showed an initial increase in cross-sectional area followed by a decrease later in gestation. No consistent growth pattern was seen among masses with similar histologic characteristics. The percentage of the cross-sectional area of the chest occupied by the mass decreased in 7 fetuses and was virtually unchanged in 1 during gestation. All the fetuses survived to term; the infants had an uncomplicated postnatal course and underwent surgical resection of the mass during the first year of life. CONCLUSIONS: This study showed that in a fetus with a congenital mass of the lung and a favorable clinical outcome, growth of the chest exceeds any growth of the mass that may occur and masses with the same pathologic diagnosis have different patterns of growth in utero.

Bronchial Diseases↗
PubMed1997

Disappearing fetal lung masses: importance of postnatal imaging studies.

BACKGROUND: The "disappearance" of congenital masses of the lung on prenatal sonograms has been described, but the importance of postnatal imaging studies in these children is unknown. OBJECTIVE: The objective of this work was to study the utility of radiographs and CT scans in asymptomatic infants with congenital masses of the lung that partially or completely resolve on prenatal sonograms performed late in gestation. MATERIALS AND METHODS: The prenatal sonograms, postnatal imaging studies, surgical findings, and pathologic diagnoses of seven children with an echogenic mass of the lung that improved or disappeared on prenatal sonograms were reviewed. RESULTS: All masses were type II congenital cystic adenomatoid malformation, with features of intralobar sequestration also being found in four. An unsuspected extralobar sequestration adjacent to a left lower lobe mass was found at surgery in one patient. All masses were hyperechoic compared with normal lung on sonograms prior to 32 weeks of gestation, with cysts being seen in four. On scans after 32 weeks, four of the masses had resolved completely and three showed subtle increased echogenicity compared with normal lung. Cysts completely resolved in two of four cases. Postnatal radiographs showed subtle abnormalities in four infants, a hyperlucent lobe in one, a soft tissue mass with adjacent hyperlucency in one, and normal findings in one. CT scans were abnormal in all cases, with air-filled cysts and soft tissue in six and a hyperinflated lobe in one. CONCLUSION: Children with "disappearing" fetal lung masses have persistent abnormalities after birth that are often subtle on radiographs but are well demonstrated with CT.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1997

CT scan abnormalities in a series of patients with hemorrhagic shock and encephalopathy syndrome.

BACKGROUND: Hemorrhagic shock and encephalopathy syndrome (HSES) affects children under 1 year of age and is characterized by seizures, shock and certain laboratory abnormalities, including coagulation abnormalities. It has a high mortality and many of the survivors are neurologically abnormal. OBJECTIVE: To describe abnormalities observed on initial and follow-up CT scans in a group of patients suffering from HSES. MATERIALS AND METHODS: Retrospective review of records and CT scans of ten patients with HSES who were admitted to the intensive care unit of the Children's Hospital and Medical Center, Seattle. RESULTS: Cerebral edema was seen in all cases when the CT scan was obtained between 1 and 7 days after onset of HSES. The basal ganglia and cerebellum were relatively spared, and no hemorrhage was seen. Patients with moderate or marked cerebral edema usually had a poor prognosis. All survivors had significant neurologic sequelae. CT scans obtained after 7 days often showed encephalomalacia with ex vacuo ventricular enlargement. CT scans obtained between 24 h and 4 days after onset will show the acute changes of HSES. CT scans during the initial and convalescent stages of HSES can provide useful information about cerebral edema and encephalomalacia, which occur frequently with this illness.

Brain↗
PubMed1997

Bilateral cystic neuroblastoma: imaging features and differential diagnoses.

Neuroblastoma is one of the most common malignant tumors of childhood, with 40 % arising in the adrenal glands. Bilateral adrenal involvement from synchronous development or metastatic spread of the tumor is seen in less than 10 % of children with neuroblastoma [1]. Neuroblastoma rarely presents as a cystic suprarenal mass that is difficult to differentiate from adrenal hemorrhage, extralobar sequestration, or dilated upper-pole renal calyces. To our knowledge, bilateral cystic neuroblastoma has not been previously reported. We present a case of bilateral cystic adrenal neuroblastoma to demonstrate the imaging features of this unusual entity, and to expand the differential diagnosis of bilateral cystic suprarenal masses in an infant.

Adrenal Gland Neoplasms↗
PubMed1997

The detection of murine autosomal recessive polycystic kidney disease using real-time ultrasound.

Using currently available ultrasound equipment, 38 BPK and CPK mice were evaluated at 7 days of age for the presence of autosomal recessive polycystic kidney disease (ARPKD). The kidneys were less echogenic than adjacent soft tissues and measured between 5.1 and 6.3 mm from pole to pole in 32 unaffected mice and 1 with ARPKD. In 5 mice with ARPKD, the kidneys were similar in echogenicity to adjacent soft tissues and measured between 6.9 and 8.4 mm from pole to pole. Renal sonography is able to identify most mice with polycystic kidney disease prior to the development of abdominal enlargement and laboratory abnormalities, and shows promise for future applications in animal research.

Animals↗
PubMed1997

Humoral hypercalcemia due to an occult renal adenoma.

Humoral hypercalcemia refers to the elevated blood calcium levels caused by neoplasms which release a bone resorptive substance into the circulation. Previously reported infants with malignant and benign solid tumors causing humoral hypercalcemia have presented with large abdominal masses. The case we describe, a hypercalcemic infant due to an occult parathyroid hormone-related protein-containing metanephric adenoma of the kidney, shows that radionuclide bone scanning can be a useful test to identify humoral hypercalcemia. Humoral hypercalcemia stemming from a soft tissue neoplasm should be ruled out, even in the absence of clinical signs of a tumor, if bone scans show generalized uptake in the absence of hypervitaminosis D or radiological signs of bone lesions, and serum parathyroid hormone is low.

Adenoma↗
PubMed1997

The differential expression of NGFS-like substance from fresh pilose antler of Cervus nippon Temminck.

Extracts of cartilage from antlers of non-mature deer, e.g. Cervus nippon Temminck, have been used as Chinese traditional medicines and restoratives. Since bioactivities attributed to the antler extracts resembled growth factor activities, the objective of our study was to compare the biological activities of different deer antler extracts with those of known growth factors. Extracts of the deer antlers were found to stimulate the growth of nerve fibers and to induce morphologic changes during differentiation and effect DNA synthesis in PC-12 cells, thus sharing with a known growth factor, NGF, several bioactivities.

Animals↗
PubMed1996

Environmental magnetic fields change complementary DNA synthesis in cell-free systems.

A number of studies have shown that exposures to environmental magnetic fields (MFs) increase cellular transcription and enhance DNA synthesis. However, little is known about the basic mechanisms underlying specific biological responses to MFs. We looked directly at the effect of MFs by using a cell-free rabbit globin cDNA synthesis system. cDNA synthesis reaction mixtures were placed in each of four exposure conditions and were tested simultaneously. Condition one was the control, with no exposure during either single-strand or double-strand synthesis (M-M-). The second condition was MF exposure only during single-strand synthesis (M+M-). The third condition was exposure only during double-strand synthesis (M-M+). The fourth condition was exposure during both single-strand and double-strand synthesis (M+M+). Results showed that cDNA synthesis was affected by 5-100 microT, 60 Hz MFs. Double-strand cDNA synthesis increased with MF exposure only during double-strand synthesis reactions (M-M+), and the greatest increase of double-strand cDNA synthesis was detected when MF exposure was at 10 microT, only during double-strand synthesis. Double-strand cDNA synthesis decreased when only single-strand synthesis reactions were exposed (M+M-; 100 microT). An increase of cDNA synthesis caused increased synthesis of rabbit globin cDNA and large-sized molecules. These results suggest that exposure to MF induced structural changes of synthesized cDNA, therefore altering the amount of cDNA. Our results show that environmental MFs can significantly alter cDNA synthesis in a cell-free system.

Animals↗
PubMed1996

CT of intussusception in the pediatric patient: diagnosis and pitfalls.

Intussusception in the pediatric patient may have a varied clinical presentation depending on its location, presence of lead point, intermittent occurrence, or underlying systemic disease. Computed tomography (CT) may be used at times in the evaluation of children with complicated presentations. The purpose of this investigation was to review the findings of CT images obtained in children with intussusception. Five patients with intussusception were diagnosed by CT at our institution between 1989 and 1994. An intraluminal mass was found in all patients. Intraluminal eccentrically located fat, as well as the target sign of alternating layers of high and low attenuation, was seen in most patients. In patients with a more long-standing process, fluid-distended loops, inflammation, and loss of tissue planes were seen and corresponded with necrosis and areas of nonviable bowel found at surgery. Finally, potential pitfalls with the layered or target appearance are discussed in the form of two patients who were initially felt to have intussusception at CT, but in whom the target appearance was later found to be due to other processes.

Adolescent↗
PubMed1996

Beneficial effect of Aloe on wound healing in an excisional wound model.

Recent evidence from in vitro and in vivo experiments suggests that topical antimicrobials may be toxic to fibroblasts and keratinocytes and retard wound healing. The purpose of this study was to determine the effects of Aloe, a potential wound-healing agent, on wound contraction in excisional wounds treated with topical antimicrobials. Sprague-Dawley rats were prepared with four 1.5 cm2 dorsal defects through the skin and panniculus. The animals were divided into five groups (n = 10 per group): (1) Aloe, (2) NaOCl solution (0.025%), (3) mafenide acetate, (4) mafenide acetate + Aloe, and (5) control. Wounds were treated topically for 14 days 3 times a day. Serial standard photographs and serial wound planimetry were performed weekly. Following healing, the breaking strength of each resultant scar was determined using an Instron tensiometer. Kruskal-Wallis, ANOVA, and multiple comparison methods were used for data analysis. Aloe and NaOCl solution significantly accelerated wound contraction (p < 0.05). In the mafenide acetate + Aloe group, contraction was similar to the control, whereas the mafenide acetate alone retarded wound healing. The addition of Aloe in combination and alone in wounds increased the breaking energy when compared to controls (p < 0.05). Aloe appears to expedite wound contraction and neutralize the wound retardant effect seen with the topical mafenide acetate alone. This effect appears to be due to an increased collagen activity, which is enhanced by a lectin, consequently improving the collagen matrix and enhancing the breaking strength.

Aloe↗
PubMed1996

Power Doppler sonographic evaluation of acute pyelonephritis in children.

Twelve children admitted to the hospital with a clinical diagnosis of acute pyelonephritis were studied with power Doppler sonography and either renal cortical scintigraphy or contrast-enhanced CT. Imaging studies were normal in four patients. A single focus of pyelonephritis was seen by cortical scintigraphy in five children, with a matching defect observed on power Doppler sonography in four patients and a small focus of infection not detected on power Doppler sonography in one child. Multifocal pyelonephritis was identified correctly by power Doppler sonography in two children, although this imaging modality underestimated the extent of involvement in one of the children. One child with diffuse pyelonephritis had a normal power Doppler sonogram. In this study, power Doppler sonography had an overall sensitivity of 75% and specificity of 100% in the evaluation of children with acute pyelonephritis.

Acute Disease↗
PubMed1995

A prospective study of femoral catheter-related thrombosis in children.

OBJECTIVES: To establish the incidence and correlate clinical findings of femoral venous catheter-related thrombus formation in critically ill children. RESEARCH DESIGN: Observational prospective blinded study. SETTING: University-affiliated pediatric hospital intensive care unit. PATIENTS: Twenty children admitted to the pediatric intensive care unit who had percutaneous femoral venous catheters placed while in the pediatric intensive care unit. INTERVENTIONS: None. MEASUREMENTS: Duplex Doppler ultrasonography evaluation of femoral vein catheters at 1 to 2, 3 to 5, and 7 to 10 days after placement was used to detect the presence of thrombus formation and venous occlusion. Demographic patient data, pediatric risk of mortality scores, and clinical findings, including leg swelling and whether catheters would aspirate blood, were also recorded. Continuous data were analyzed using the Mann-Whitney U Test, and categorical data were compared with Fisher's Exact Test. Statistical significance was assigned at a P value of .05 or less. CONCLUSIONS: The overall incidence of catheter-related femoral vein thrombus formation was 35% (7/20). Ipsilateral leg swelling and the inability to aspirate blood from the catheter were significantly associated with thrombus formation. Patients who developed thrombi were younger and smaller than those who did not. In six of seven patients, thrombus formation was clinically occult when first demonstrated by ultrasonography.

Catheterization, Central Venous↗
PubMed1995

Nontraumatic pediatric musculoskeletal MR imaging: comparison of conventional and fast-spin-echo short inversion time inversion-recovery technique.

PURPOSE: To compare conventional short inversion time inversion-recovery (STIR) with fast spin-echo (FSE) STIR techniques to evaluate suspected nontraumatic musculoskeletal abnormalities. MATERIALS AND METHODS: Thirty STIR and FSE-STIR examinations in 26 pediatric patients with suspected nontraumatic musculoskeletal abnormalities were prospectively evaluated. Qualitative (subjective) and quantitative (five-point rank score) analyses of the images were performed. RESULTS: FSE-STIR was faster than STIR (mean, 2 minutes 25 seconds and 6 minutes 35 seconds, respectively). Fat suppression was slightly better with STIR. Image degradation due to motion was judged similar. Lesion contrast to muscle was slightly better with STIR than FSE-STIR, and lesion contrast to fat was equivalent. Qualitatively, lesion conspicuity was similar: All lesions were seen with both techniques. CONCLUSION: FSE-STIR can replace STIR when an inversion-recovery fat-suppression sequence is desired. Considerable imaging time is saved.

Adolescent↗
PubMed1995

Hypercalciuria and nephrocalcinosis in the oculocerebrorenal syndrome.

The oculocerebrorenal (Lowe) syndrome is an X-linked recessive disorder characterized by congenital cataracts, hypotonia, developmental delay, poor growth and renal tubular dysfunction. Although the disorder has been mapped to chromosome Xq24-26, the underlying metabolic defect remains unknown. The renal component of the Lowe syndrome comprises tubular dysfunction, that is tubular proteinuria and generalized aminoaciduria progressing to the renal Fanconi syndrome, with later glomerular disease. Clinical problems typically include polyuria, acidosis, hypophosphatemia with rickets and eventually end stage renal disease. Hypercalciuria and its sequelae (nephrocalcinosis and nephrolithiasis) have not been described as cardinal features of the untreated disorder although they reportedly complicate vitamin D and calcium therapy of rickets. We discuss 5 boys with congenital cataracts, hypotonia, developmental delay, failure to thrive and the renal Fanconi syndrome who were diagnosed with the Lowe syndrome and in whom hypercalciuria was documented at diagnosis. We conclude that hypercalciuria and its sequelae may occur commonly in patients with the Lowe syndrome as a component of tubular dysfunction or a complication of therapy.

Calcium↗
PubMed1993

In vivo studies of the effect of magnetic field exposure on ontogeny of choline acetyltransferase in the rat brain.

Developmental increases of the activity of choline acetyltransferase (ChAT) were examined in the brains of fetuses and offspring from parent rats continuously exposed to a 500 mG, 60 Hz circularly polarized (CP) magnetic field (MF) prior to pregnancy, and further, during pregnancy and lactation. In developing rats between 12 days and 20 days of embryogenesis that were housed in a control unit, i.e., nonexposed to MF, the specific activity of ChAT in whole brain specimens increased from 2.4% to 6.9% of adult activity, while specific activity of ChAT in rat brain specimens between 12 days of embryogenesis and 10 days of postpartum increased from 2.4% to 21.6% of adult activity. On the other hand, the specific activity of ChAT in whole brain specimens from rats under housed MF exposure conditions was found to increase from 2.6% to 6.7% of adult activity between 12 days and 20 days of embryogenesis and from 2.6% to 21.6% of adult activity between 12 days of embryogenesis and 10 days postpartum. Furthermore, the effect of the same test magnetic environment on the specific activity of ChAT in the brains of parental rats was examined in order to determine whether magnetic field exposure of parental rats might reflect onto the development of fetal brain. It was observed that continuous exposure of parental rats to a 500 mG, 60 Hz CP MF did not show any significant changes in the specific activity of ChAT in the septodiagonal band complex, dorsal and ventral hippocampus, striatum, and frontoparietal cerebral cortex, as compared with the same brain regions of control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗