Biomedical subjects
Publications and source records attributed to J L Strife.
We describe a technique wherein an endotracheal tube is used as a sheath for a feeding tube, which has been placed through the wall of a gastrostomy catheter, to allow selective intubation of the duodenum.
Percutaneous aspiration, drainage, and biopsy techniques can be performed safely and effectively in infants and children. Over the past 4 years we performed 11 aspiration, nine drainage, and 14 biopsy procedures in patients aged 1 day to 17 years. Success was achieved in 88% and 93% of drainages and biopsies, respectively. Our experience suggests that aspiration and drainage procedures are effective in the diagnosis and management of fluid collections and are often the only procedure required and that percutaneous biopsy techniques are applicable to the pediatric population.
The authors describe a new technique for dilatation of an esophageal stricture in a child. Under fluoroscopic control, a small guide wire is passed through the narrowed area. Dilation is accomplished with the Grüntzig balloon catheter.
We describe the use of the inferomedial approach in hip arthrography in children and review the technical aspects of the procedure and its complications.
Tc-99m diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, seven hips in seven patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in three patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more months following internal fixation, three children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.
Newborn infants with severe respiratory distress syndrome have an increased incidence of pulmonary interstitial emphysema, pneumomediastinum, and pneumothorax. A chest tube inserted for treatment of a pneumothorax may inadvertently perforate the lung. Recognition of chest tube perforation can be suggested by the occurrence of: (1) persistent or repeated pneumothoraces despite the presence of a chest tube and (2) atelectasis and/or infiltrate near the end of the chest tube.
The authors evaluated the normal radiographic anatomy of the innominate (brachiocephalic) artery in children. Review of 1,000 randomly selected lateral chest radiographs demonstrated anterior tracheal indentation in 30% of the children under the age of 2 years. In addition, 172 angiograms in children with congenital heart disease revealed that the innominate artery normally originates either completely or partially to the left of the trachea and crosses in front of it.
Bone scintigraphy and radiography were performed in seven children with back pain. Six of the children with radiographic evidence of a pars interarticularis defect also had abnormal scintigrams. Increased uptake of the bone imaging agent occurred at six of the ten sites of radiographic pars interarticularis defects, implying increased bone metabolic activity. However, the location of scintigraphic abnormalities did not correspond to the location of radiographic abnormalities in several cases. Possible explanations for the discordant findings are: (a) normal bone metabolism at the site of an old spondylolysis and (b) radiographically inapparent stress fractures. Measurements of absorbed radiation dose indicate that plain radiography, including oblique views where appropriate, has a lower absorbed radiation dose than scintigraphy or tomography and should be performed prior to these studies.
Chest radiographs obtained at birth in two neonates with absent pulmonary valve and tetralogy of Fallot demonstrated asymmetrical lung aeration. This finding was attributed to delay in resorption of fetal lung fluid. It is postulated that in the initial hours of life, the dilated pulmonary artery compressed the bronchus and delayed egress of fetal lung fluid. Over a 24-hour interval, the fluid was resorbed, resulting in the more typical pattern of hyperinflated lung and markedly dilated pulmonary artery. These cases are presumably the first of their kind to be reported.
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While congenital malformed and malpositioned livers are rare, they are relatively common in patients with omphaloceles. A malpositioned, malformed liver causing pyloroduodenal deformity and apparent pyloric obstruction in an infant or child with an omphalocele has not been previously reported. Thee such cases are described in which symptoms of upper gastrointestinal obstruction developed shortly after primary closure of the omphaloceles. Recognition of this condition at the time of primary closure of an omphalocele may allow consideration of additional procedures to prevent postoperative pyloric obstruction.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Two children, one with an internal laryngocele and the other with a lateral saccular cyst are described. The anatomy, classification, and history of these unusual lesions are described. The diagnosis and management are discussed. An external approach is suggested for the more persistent cases.