Biomedical subjects
Publications and source records attributed to W H McAlister.
A patient with a recurrent left neck abscess was found to have a branchial fistula from the pyriform sinus. This uncommon anomaly was demonstrated by CT and barium swallow. The embryology, pathology and clinical features of this lesion are discussed and contrasted with those of the branchial cyst.
A marked thoracic deformity associated with intrathoracic tracheal narrowing was seen in a 17-year-old with achondroplasia and dyspnea. The role of chest deformity and its evaluation by CT and MRI in achondroplastic patients with respiratory symptoms are considered.
Congenital solitary nonparasitic cysts of the liver (CSNCL) are extremely rare causes of abdominal masses in newborns and infants. We describe a cystic abdominal mass virtually all extrahepatic in a newborn that proved to be a CSNCL.
Occipital horn syndrome, a rare genetic disorder of copper metabolism, was recognized in 2 unrelated patients. Radiographs of these patients at various ages allowed confirmation of previously described radiographic findings. In addition, new radiographic manifestations were encountered. These pathognomonic radiographic findings are presented and the clinical and biochemical features of occipital horn syndrome are reviewed.
Public perception is that nursing home residents receive less than adequate health care. To confirm or refute this view we provided routine optometric services to 47 residents in a nursing home who had ready access to primary medical care. Average refractive error, intraocular pressure, visual acuity, and the prevalence of ocular disease were analyzed. Despite the fact that routine primary medical care was provided in-house and ophthalmologic care was provided on a consultation basis, our study revealed a need for further medical intervention. Seven percent of the patients received a legend prescription for drugs for ocular conditions, whereas 11% received an over-the-counter preparation. Although 11% were already under ophthalmological care, we requested consults from ophthalmology for another 11%. An additional patient was referred to an internist. This study shows that even in nursing homes where residents have access to in-house medical management, routine vision care provided by optometrists can disclose undetected medical problems and improve the quality of life.
A mailed questionnaire was used to survey federal service optometrists in the U.S. Air Force, U.S. Army, U.S. Navy, U.S. Public Health Service, and the Department of Veterans Affairs. The purpose of this survey was to determine the scope of practice and level of job satisfaction of these optometrists. The results of the study were compared with those of a similar survey conducted 5 years earlier.
A child with vertebral anomalies and tubular communicating duplications of the esophagus and stomach had a post-natal ultrasound interpreted as normal. This complex anomaly was delineated by barium studies and surgically confirmed.
Testicular cysts are an uncommon in the pediatric population unlike adults where they occur frequently. We describe a case of cystic dysplasia of the testis in a prepubertal boy. The known literature is reviewed and the sonographic appearance of the lesion is correlated with pathologic findings.
Osteodysplastic primordial dwarfism, type II manifests typical skeletal features which have not previously been described in the radiographic literature. We present an infant with characteristic findings and discuss related conditions, especially the Seckel syndrome.
Two pediatric patients are presented with progressive dysphagia due to esophageal strictures secondary to unrecognized foreign bodies. Diverticula were present above the strictures.
The restrictions on the central and peripheral visual fields, resultant from wearing a M17 series mask, were measured on a subject with normal field of vision. The results showed a decrease in visual field in all meridians, with the nasal area being the most dramatically restricted.
Newborns with neonatal cirrhosis may have confusing clinical pictures. The demonstration of a small liver on abdominal radiographs may be helpful in suggesting the diagnosis of intrauterine hepatic damage.
This report describes a unique clinicopathologic entity characterized as a malignant small cell tumor of the thoracopulmonary region in 20 children and adolescents (average age 14.5 years). There was a female predilection (75%) for this tumor which appeared to originate in the soft tissues of the chest wall or the peripheral lung. The neoplasm tended to recur locally and did not seem to disseminate as widely as some of the other small cell tumors of childhood (rhabdomyosarcoma, Ewing's sarcoma, neuroblastoma and malignant lymphoma). However, the median survival was only 8 months. Electron microscopy of 3 cases suggested a neuroepithelial derivation, but, at the present, the histogeneis remains a subject for further investigation.
Multilocular renal cysts are benign lesions with an unknown histogenesis. We report 3 children and summarize information currently known about these lesions. Capsular veins were seen in two patients during the early phases of intravenous urography. Intravenous urography with sonography and arteriography may suggest the diagnosis prior to surgery.
A patient with fibrous dysplasia and precocious puberty, with pneumogynographic demonstration of an enlarged uterus and ovaries at age 16 months has been followed up to age 14 years. The pneumogynographic findings and the chemistries implicate central nervous system stimulation as the cause of the precocious puberty.
Congenital tracheal bronchus is an uncommon condition that may occur together with other, sometimes clinically significant anomalies of the tracheobronchial tree. Two such patients are reported. Both presented with respiratory distress, and one was initially diagnosed as having a pulmonary cyst. Radiographic demonstration of an upper-lobe cyst, particularly on the right, should suggest a tracheal bronchus.
The axial projection of the spine is a useful view for evaluation of possible neural arch defects in children. The projection is easy to perform and allows visualization of the arches without confusing overlap by other structures.
Calyceal diverticulum is a relatively rare lesion that is usually asymptomatic but can assume clinical significance if drainage is impaired. Three patients are presented with unusual complications directly referable to a calyceal diverticulum. One child had a mobile calculus. In 2 others, intrarenal inflammatory masses developed in the area previously occupied by a calyceal diverticulum. One of these children had proved xanthogranulomatous pyelonephritis, and the other had an infected diverticulum.