Ultrasound diagnosis of multiple anomalies associated with prenatal oral contraceptives.
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Biomedical subjects
Publications and source records attributed to J J Cunningham.
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This article proposes an estimate of the daily caloric recommendation for individual adults as 50 kcal per kilogram lean body mass (LBM). This estimate is calculated for light activity, one the basis of the typical activity patterns of a reference man and woman, as listed in the 1980 Recommended Dietary Allowances (RDAs). The proposed individual and the 1980 RDA group energy estimates are compared for adults of various ages. Metabolic ward data are examined to compared the prediction accuracy of the LBM method and other existing methods. Adjustments for individual variation in activity are suggested. The authors believes that the proposed method provides the best current individual caloric guide to complement the group table of the 1980 RDAs.
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A multiple regression analysis of several factors influencing basal metabolic rate (BMR) was performed using data for 223 subjects from the classic metabolism studies published by Harris and Benedict in 1919. These data had previously been analyzed by Kleiber using metabolic body size, the three-fourths power of body mass, as a predictor of BMR. His prediction equations were separated by sex and each contained components for age and height. Factors in the present analysis included sex, age, height, body mass, and estimated lean body mass (LBM). Lean body mass was found to be the single predictor of BMR. A best estimate prediction equation: BMR(cal/day) = 500 + 22 (LBM) is proposed. The previously presumed influences of sex and age are shown to add little to this estimation.
When renal echograms are made, the central renal pyelocalyceal complex (CRPC) is seen as a strongly echogenic oval confluence surrounded by echo-poor renal parenchyma. Fragmentation of the CRPC is abnormal, and this fragmentation is widely known in association with urinary obstruction. But, there are a variety of nonobstructive causes for dispersion of the CRPC; renal duplication, postobstructive atrophy, chronic pyelonephritis, renal sinus lipomatosis, nephrocalcinosis, and renal cystic disease. Patterns of CRPC fragmentation may be correlated with renal parenchymal status to determine the cause of abnormal renal echograms.
The performance of lighting timers in animal rooms was tested with a portable light-level recorder. The instrument monitored the light and dark phases under various degrees of illumination. This inexpensive method of electronic surveillance ensured the validity of experiments dependent on photoperiodicity.
Most cases of ventral hernias are easily diagnosed by palpation, but palpation is a subjective examination that may be difficult or even misleading, especially in obese patients. In cases of diagnostic uncertainty, ultrasonic examinations offer an objective means of distinguishing between a mass in the abdominal wall and one actually deep to the peritoneum. In addition, if such a mass is detected, these studies provide information that can characterize its physical nature.
B mode gray scale echography is not useful in evaluation of the normal lung and pleural space. The presence of abnormal fluid collections in the chest change the acoustic properties of the thorax and pleural fluid collections may be detected and localized with precision. Lesions abutting the chest wall may be characterized as cystic or solid. Echography can be used to assess the motion and morphology of the diaphragms. Sonographic examination of the thorax is particularly useful in determining whether a large area of radiographic opacification such as an opaque hemithorax is due to fluid, tumor, or intrinsic pulmonary disease such as atelectasis or consolidation.
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Excellent methods are available to produce quality images of the liver and kidneys. Gray scale echography is the only suitable method of simultaneously showing hepatic and renal anatomic detail in addition to the instantaneous relationship of these organs to each other. Gray scale echography may be used to determine (1) if normal liver and a normal right kidney have interacted to give the false clinical impression of disease, (2) when renal lesions simulate hepatic disease, (3) when hepatic lesions mimic renal disease, and (4) if structural hepatic and structural renal disease are related or unrelated.
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Hepatic metastases or mass lesion near the head of the pancreas are usually found when echograms are performed on patients with malignant diseases of the biliary tract. Atypical cholesonograms may result when the gall bladder itself is deformed or invaded by tumor, when tumor obstructing the bile duct is plaquelike and not detectable as a mass lesion, or when gall stones coexist as a purely incidental finding.
Dynamic physiologic and psychological changes occur in patients awaiting excretory urography. A total of 2,000 patients were studied to see if rates of reaction to urographic contrast materials are influenced by the time of day such injections are given. Examinations performed between 7:00 A.M. and 2:00 P.M. were evaluated. The data suggest that reactions to radiographic contrast medium occur randomly and that a "safe" or "safer" time of day cannot be defined.
A 63 year old man underwent lymphography because of anemia, splenomegaly, and fever. Nodes in the high para-aortic region had the appearance of involvement with malignant lymphoma. Subsequent biopsy showed that these changes were due to the partial replacement of nodal tissue with extramedullary hematopoiesis.
Four patients with angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) had lymphograms that did not show a consistent radiographic pattern. Instead, a spectrum of radiologic changes ranging from a moderate increase in lymph node size with slight "foaminess" to total nonopacification was observed. One patient with this disorder had gray-scale echograms that showed enlarged anechoic lymph nodes. The findings in this small group of patients with AILD are indistinguishable from the radiologic and echographic changes seen in malignant lymphoma.
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Two patients had convincing mass lesions demonstrated with gray-scale echography and strongly supporting clinical evidence for intra-abdominal abscesses. Neither patient had a lesion at the time of surgery. Although modern echography is an accurate diagnostic method for intra-abdominal abscess, false-positive results can occur.