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Biomedical subjects

C E Blane

Publications and source records attributed to C E Blane.

At least 55 records · Page 3Linked to original sources
PubMed1987

Arthrography in evaluation of birth injuries of the shoulder.

Birth injuries of the shoulder and proximal humerus of infants can be difficult to evaluate on plain radiographs because of lack of ossification in the proximal humeral epiphysis. We here describe arthrography of the infant shoulder and advocate it as a useful diagnostic procedure in the evaluation of humeral fractures and brachial palsies. Two infants with birth injuries of the shoulder are described. The value of dynamic fluoroscopic evaluation of the injured joint in conjunction with arthrography is illustrated in evaluation of a brachial plexus palsy.

Arthrography↗
PubMed1986

The role of arthrography in the management of dysplasia epiphysealis hemimelica.

Dysplasia epiphysealis hemimelica can be diagnosed on plain radiographs of the affected areas. However, double contrast arthrography in three new cases provided additional information. The cartilaginous portions of the lesion at the articular surface of the bone were precisely demonstrated, aiding the orthopedic surgeon in deciding which patients should have surgery and planning the extent of operation necessary.

Adolescent↗
PubMed1986

Gastroesophageal reflux in children: is there a place for the upper gastrointestinal study?

Objective tests for gastroesophageal reflux in children have shown only fair correlation with clinical symptoms. Thirty-four children referred to the pediatric surgery service for evaluation of gastroesophageal reflux had both 24-hour pH probe monitoring and standardized upper gastrointestinal examinations. A total of 16 children (47%) had documented significant or pathologic gastroesophageal reflux, 11 on pH monitors and 9 on contrast examinations. There were 4 in whom both tests were positive. None of the pH monitoring criteria correlated with the radiographic studies. The patient population documented by contrast study did not differ from the general test-positive population by age or associated clinical findings. The 2 studies probably measure different aspects of significant gastroesophageal reflux, are confirmatory and complementary, and must be correlated with the clinical symptoms.

Adolescent↗
PubMed1986

Sonography of ruptured appendicitis.

Three girls and 4 boys with the final diagnosis of ruptured appendicitis underwent 19 sonographic studies, 5 before any therapy was instituted and 14 follow-up studies. Four abscesses identified before treatment and 2 seen postoperatively were ovoid, irregularly marginated, and contained low-amplitude echoes. Gastrointestinal ileus with gas-and fluid-filled loops of bowel made the studies technically difficult. Follow-up studies also showed fluid collections distant from the original abscesses. The complete resolution of the abscess was followed sonographically in 1 patient treated with antibiotics. Ultrasound can be useful in confirming or suggesting the diagnosis of ruptured appendicitis in the child with abdominal pain, but careful attention to detail is necessary in these technically difficult studies.

Abscess↗
PubMed1986

Guidelines for writing multiple-choice questions in radiology courses.

Objective evaluation of students frequently includes the utilization of multiple-choice test questions. Due to constraints on faculty time, however, the writing of these questions is usually completed quickly and somewhat haphazardly. The guidelines contained in this article were written to help radiologists produce better test questions for the purpose of improving the evaluation of clerkship students. The guidelines include choosing an item that is worth testing and has one definite answer, asking a single, clearly formulated question, avoiding true-false stems, being concise when writing the question, avoiding the use of negatives in the stem, avoiding using "all of the above" or "none of the above" as a response, avoiding subtle clues toward the keyed answer or away from the distractors, avoiding one-word definitions as responses, and placing the responses in logical or numerical order. A definition of terms used in the educational literature and a discussion of a quantitative evaluation of test questions are included.

Educational Measurement↗
PubMed1986

Splenic trauma in the pediatric patient: the integrated roles of ultrasound and computed tomography.

Seven children who sustained splenic trauma were scanned by ultrasound and computed tomography (CT) or ultrasound and nuclear liver/spleen scan. All patients were managed conservatively and did not need abdominal surgery. On the initial sonogram, the majority of children had multiple areas of both increased and decreased echogenicity. Hematomas were followed to resolution in five of seven children and were usually multiple and hypoechoic prior to complete disappearance. On contrast-enhanced CT scans, areas of splenic hemorrhage appeared as low attenuation. Our small patient population demonstrates that, following an initial CT scan, sonography is helpful for sequential splenic imaging to show when the appearance of the spleen returns to normal. When correlated with the clinical information, such data are helpful to the clinician in determining when a child who has sustained splenic trauma may resume normal activity.

Adolescent↗
PubMed1986

Constructing pre- and post-tests in a medical student elective.

The importance of evaluating medical student performance has been widely addressed in the medical education literature. Multiple-choice examinations are the preferred method of testing because they are easy to administer and score. Development of parallel or equivalent pre- and post-examinations provides objective information regarding actual knowledge gains by the students during the elective and points to strengths and weaknesses in the elective. This article provides information for developing the parallel multiple-choice questions for effective pre- and post-tests.

Education, Medical, Graduate↗
PubMed1985

Imaging of Burkitt lymphoma in pediatric patients.

The imaging procedures utilized at presentation in the diagnostic work-up of 19 children with Burkitt lymphoma were reviewed. The distribution of disease was compared to other tumors of childhood so that the most valuable modalities could be identified. Burkitt lymphoma is a rapidly growing tumor in the child, making it essential to suggest the diagnosis as quickly as possible so that biopsy and treatment can be instigated. The primary area of involvement was abdominal (15 of 19), gastrointestinal, intraperitoneal adenopathy, hepatic and pancreatic without retroperitoneal adenopathy. Pleural effusions were common without hilar and mediastinal adenopathy. This is in contrast to other tumors of childhood where mediastinal and hilar disease in the chest and retroperitoneal node involvement in the abdomen are common. Thus sonography is an excellent imaging modality, easily identifying the extent of the disease and so suggesting the diagnosis.

Abdominal Neoplasms↗
PubMed1985

Gastrointestinal complications of gastroschisis.

The mortality of infants with gastroschisis has been reduced markedly in the last decade with the application of new surgical techniques, improved metabolic monitoring, and total parenteral nutrition. The late complications of repaired gastroschisis are now emerging. In this series of 30 infants with gastroschisis (20% mortality) significant gastroesophageal reflux was identified in seven of 10 infants with the appropriate barium study. The clinical symptom complexes of dysmotility, a recognized problem in gastroschisis, and gastroesophageal reflux can be easily confused. In addition, 11 episodes of necrotizing enterocolitis were identified in seven infants, four with perforations. The children with necrotizing enterocolitis had a deceptively benign clinical presentation, which was easily misinterpreted in these ill infants. Awareness of these two significant gastrointestinal complications and close cooperation of clinicians and radiologists to detect them should insure better survival in the infant with gastroschisis.

Enterocolitis, Pseudomembranous↗
PubMed1985

Sonographic standards for normal infant kidney length.

Standards for kidney length in relation to size were derived from measures of 34 normal, full-term, healthy infants aged 2-56 weeks. Of six general size variables (age, weight, length, head circumference, abdominal circumference, and C7 to coccyx length), net kidney length correlated best with a combination of infant length and weight. A nomogram has been generated from these data for use by the radiologist.

Female↗
PubMed1985

Primitive cystic hepatic neoplasm of infancy with mesothelial differentiation: report of a case.

A malignant cystic neoplasm in the liver of a 6-month-old girl is reported. The neoplasm has unique clinical and morphological features, and despite ultrastructural and immunohistochemical studies, the tumor could not be clearly classified as any known primary hepatic neoplasm of infancy. A differentiated cystic component of the neoplasm had features of cystic peritoneal mesothelioma. Alpha-1-antitrypsin and alpha-fetoprotein were demonstrated in solid, anaplastic portions of the recurrent tumor by immunohistochemistry. The neoplasm recurred after surgical resection and proved fatal 11 months following diagnosis, despite multiple courses of chemotherapy.

Female↗
PubMed1984

CT findings in hepatoblastoma.

Hepatoblastoma is the third most common intraabdominal malignant neoplasm in infants. Computed tomography of six patients with surgically proven hepatoblastoma was reviewed; abnormalities included large, diffuse, or multifocal liver masses with lower attenuation values than normal hepatic parenchyma after contrast enhancement. In three patients, areas of speckled or amorphous calcifications within the tumor were evident on CT, whereas calcification was present on conventional radiography in only one patient. In four of the six infants, CT demonstrated unresectable tumor by virtue of massive pansegmental involvement. Computed tomography is a useful tool for screening patients with suspected hepatoblastoma and for determining the anatomic extent of tumor and thus selecting a group of children for aggressive surgical excision.

Carcinoma, Hepatocellular↗
PubMed1984

Patterns of calcification in childhood dermatomyositis.

The radiographs of 40 patients with childhood dermatomyositis, an uncommon inflammatory disease, were reviewed. Four distinct patterns of calcification were identified: deep calcareal masses, superficial calcareal masses, deep linear deposits, and a lacy, reticular, subcutaneous deposition of calcium encasing the torso (not emphasized in recent literature). This linear reticular pattern of calcification was associated with a severe unremitting clinical course. Soft-tissue calcification was identified in 40% of cases, a lower incidence than previously reported. No patient in this series had acroosteolysis or pulmonary parenchymal disease, radiographic findings more commonly associated with childhood scleroderma.

Adolescent↗
PubMed1984

Arthrography in the posttraumatic elbow in children.

Radiographic interpretation of children's elbows after trauma can be perplexing because of the large proportion of unossified cartilage relative to bone. The numbers of ossification centers appearing at different ages also complicate the interpretation. This study summarizes arthrographic experience in 10 children who sustained elbow trauma. Nine children had arthrography performed 5-24 months after injury. Seven patients had supracondylar or condylar fractures, one patient had a proximal radial fracture, and two patients had suspected osteochondritis dissecans. Arthrography was useful in delineating the integrity of the joint surfaces and in identifying healed rotated fracture components, cartilaginous spurs, nonunion of unossified fragments, and the normal physis. A small scarred joint and intraarticular loose bodies also were demonstrated. Elbow arthrography, though clearly not indicated for all pediatric elbow trauma, can contribute valuable information in the complex elbow fracture.

Adolescent↗
PubMed1984

An analysis of bowel perforation in patients with intussusception.

A barium colon examination is recommended for the diagnosis and reduction of intussusception in children, except when bowel perforation is evident either radiographically or clinically. In our experience and contrary to recent reports neither radiographic evidence of bowel obstruction nor an age of less than six months is a contraindication. We reviewed 40 patients diagnosed as having had intussusception and found five children aged more than six months with perforations discovered at operation. Three of the five children had plain radiographic findings of small bowel obstruction as did nine other children. In four of the 12 children with evidence of small bowel obstruction a successful hydrostatic reduction of the intussusception was carried out. Barium studies were performed for diagnosis and therapy in eight children with ileo-colic intussusception aged six months or less, four of whom had evidence of small bowel obstruction. In five, including two with obstruction, reduction of the intussusception was successful. The major contraindication to barium examination is radiographic or clinical evidence of perforation.

Adolescent↗
PubMed1983

Childhood dermatomyositis: factors predicting functional outcome and development of dystrophic calcification.

The medical records of 47 children with dermatomyositis who were seen in the pediatric rheumatology clinic at the University of Michigan between 1964 and 1982 were reviewed. Although most children with dermatomyositis have a good prognosis, the best predictor of both good functional recovery and minimal calcinosis is early treatment after the onset of symptoms, using high doses of prednisone for an adequate length of time. Of the children given such treatment, 78% had good functional outcomes, and disabling calcinosis was seen in 20% or less. Children given treatment late in the course of disease and with low doses of steroids are more likely to be functionally limited and have a greater amount of dystrophic calcium salt deposition. In our study, only 33% of patients given such treatment had a mild disease course with good functional outcome. We have identified a subgroup of children with dermatomyositis who appear to do poorly despite optimal therapeutic regimens. These patients are distinguished by a severe disease course responding minimally to corticosteroid therapy and manifested by persistent muscle weakness, elevations of muscle enzyme activity, and severe generalized cutaneous vasculitis. These children are at high risk for the development of exoskeleton-like calcification; consideration should be given to combined immunosuppressive therapy early in the course of disease.

Adolescent↗