Search PubMed⌕ Search

Biomedical subjects

A J Mares

Publications and source records attributed to A J Mares.

At least 73 records · Page 4Linked to original sources

Rib osteomyelitis in children. Early radiologic and ultrasonic findings.

The earliest radiographic changes of osteomyelitis in the long bones is deep-seated edema manifesting as soft tissue swelling and obliteration of the intermuscular planes adjacent to the affected bone. Similarly, the early change of rib osteomyelitis is pericostal edema demonstrated by soft tissue swelling of the thoracic wall accompanied by an adjacent inward pleural displacement. In both osteomyelitis of the rib and the long bones, the bony changes will appear 1-2 weeks later. Pericostal edema can be readily diagnosed by ultrasound scan. Pericostal edema, although non specific and can occur in other conditions, yet it is a strong warning sign, set within the overall clinical picture of osteomyelitis.

Child, Preschool↗

Infantile achalasia associated with deficient tear production.

Achalasia occurs rarely in infancy. We report a case of infantile achalasia associated with deficient tear production. This presentation, as well as the few extremely rare related reports, may suggest a common autonomic system pathophysiology.

Child, Preschool↗

Necrotizing enterocolitis beyond the neonatal period.

Necrotizing enterocolitis (NEC) is usually considered to be a neonatal disease, and is rarely described beyond the newborn period. During the last 15 years, 19 infants from the Negev region, Israel, with NEC were beyond the neonatal age group (range = 34-616 days, median = 90 days). Of this group only 16% were born prematurely, and only 16% had perinatal or neonatal pathology. Diarrhea and dehydration preceding NEC were common as was malnutrition. Bacteremia was detected in 42%. The mortality rate was 90%. Malnutrition, supposedly contributed to the formation of NEC and to the high mortality rate among these infants.

Age Factors↗

Posterior mediastinal accessory thymus.

A rare case of accessory ectopic thymus in the right upper posterior mediastinum in a 40-day-old infant is described. The clinical presentation was that of tracheal obstruction. The compression and displacement of the trachea and the identification of the mass was enabled thanks to the high KV filtration technique. The mass was further identified by ultrasonography. Surgical removal of the accessory thymus relieved the tracheal obstruction.

Humans↗

Infantile achalasia.

Achalasia in infancy is rare. A male infant who started to have symptoms at the age of 4 months, and who was operated at the age of 17 months is described. Post operatively the symptoms subsided and normal growth and development were regained. Achalasia should be included in the differential diagnosis of children with regurgitation, vomiting and failure to thrive.

Diagnosis, Differential↗

Discordant Hirschsprung's disease in monozygotic twins.

Two pairs of twins are being reported where monozygocity was supported by the observed sharing of a single and common placenta and by ABO and HLA identity. Only one of each pair of twins was affected by long-segment Hirschsprung's disease; the other twins were entirely normal. Discordant Hirschsprung's disease in monozygotic twins is very rare. The etiology in such cases is influenced by genetic or by environmental intrauterine factors rather than by postnatal influences, as suggested elsewhere.

Diseases in Twins↗

Thyroglossal duct remnant carcinoma.

Thyroglossal duct remnant carcinoma is a very rare malignancy arising from aberrant thyroid tissue. This diagnosis, however, should be considered in patients presenting with anterior neck masses. If there is no invasion of the capsule of the tumor, local excision with diligent follow-up is recommended as the treatment of choice.

Adenocarcinoma↗

Sacral (pelvic) "rib" or coccygeal "duplication"?

A 41/2-year-old girl with a sacral (pelvic) rib is reported. Three additional cases are reviewed from the literature. Histological, radiological and embryological evidence substantiate this "rib" anomaly, although coccygeal "duplication" rather than "rib" may be suggested by the presence of two bony elements separated by a "joint". All the affected cases were females, the "rib" being always right-sided, and possibly being a cause of feto-pelvic disproportion. Associated mild skeletal anomalies have occasionally been observed.

Child, Preschool↗

Aberrant (ectopic) adrenocortical tissue along the spermatic cord.

Aberrant adrenocortical tissue along the spermatic cord is a far more common finding than has previously been reported. During a period of 12 consecutive months, 360 children, aged 13 days to 13 yr, underwent 386 operations for common inguinoscrotal pathology at the Soroka Medical Center. In 12 cases ectopic adreno-cortical tissue was found along the spermatic cord, an overall incidence of 3.8%. None was found in females. Considering the group operated upon for undescended testis, in which by nature of the procedure the spermatic cord was dissected throughout its length, the frequency of ectopic adrenal tissue found rose to 9.3%, the highest figure cited for this location. The nature of aberrant adrenocortical tissue is briefly discussed, including its embryology, histology, and clinical implications. It usually appears as an incidental finding during surgery. Its removal is indicated whenever found although no special attempt should be made to search for it.

Adolescent↗

The aberrant cervical thymus. Embryology, Pathology, and clinical implications.

Cervical thymic anomalies are not as rare as previously suggested. Six cases were encountered over a relatively short period of time, prompting us to report them and emphasize the importance of this entity. Five of the six patients were children, two of them infants less than one year old. The occurrence of thymic remnants in the neck of young children is not surprising, considering the nature and behavior of the thymus at different stages of life. After a brief embryologic survey, the various types of cervical thymus (solitary ectopic, cystic, or partially arrested descent) and their pathogenesis are discussed. The rare occurrence of thyroid and parathyroid tissue within the mass of a large cervical thymic cyst is reported and evaluated. Cervical thymic lesions can either be symptomless or cause severe dyspnea and dysphagia, especially in the young infant. Accurate diagnosis and an intelligent surgical approach in the child with a cervical mass can avoid the obvious parental apprehension and lead to the correct treatment. Symptoms due to pressure on neighoring structures are promptly eliminated after excision, and prognosis is excellent.

Adult↗

Congenital cysts of the head of the pancreas.

A very rare case of an infant with a huge multilocular congenital cyst of the head of the pancreas is presented. The symptomatology, diagnosis and surgical approach are discussed, while reviewing the few scattered reports in the English literature. Selective celiac arteriography is considered to be of definite aid in the differential diagnosis of cystic lesions of the head of the pancreas and has important implications on the choice of surgical procedure. We believe this to be the first case of a congenital cyst of the head of pancreas to be diagnosed accurately preoperatively by means of selective celiac and gastroduodenal angiography. Cystoduodenostomy proved to be a simple and effective procedure.

Angiography↗