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Biomedical subjects

J P Kuhn

Publications and source records attributed to J P Kuhn.

At least 19 recordsLinked to original sources
PubMed2001

Congenital surfactant protein B deficiency--emphasis on imaging.

BACKGROUND AND OBJECTIVES: Surfactant protein B deficiency has become increasingly recognized as a cause of severe prolonged respiratory distress. Little has been written about the imaging appearance and the role of imaging in diagnosis. MATERIALS AND METHODS: Three newborn infants with severe respiratory distress exhibited prolonged diffuse pulmonary opacification radiographically. RESULTS: Diffuse ground-glass opacity and markedly prominent interlobular septa suggesting alveolar proteinosis were present on early thin-section chest computed tomographic (CT) images. Fibrotic changes with prominent interlobular septal thickening were present on a later CT. Surfactant protein B deficiency was confirmed by alveolar lavage and peripheral blood DNA analysis. CONCLUSION: Thin-section chest CT imaging contributes important information when this diagnosis is considered.

Extracorporeal Membrane Oxygenation↗
PubMed1996

CT scan of bowel trauma in the pediatric patient.

In the CT evaluation of children with blunt abdominal trauma, bowel injury may represent the most problematic condition that the radiologist encounters. In cases where there is a large, unexplained pneumoperitoneum or extravasation of oral contrast, the diagnosis is straightforward. Significant, potentially life-threatening injuries, however, may be manifest only by focal bowel wall thickening and peritoneal fluid accumulation. Meticulous attention to detail with regard to scanning, administration of contrast, and review of the images along with the recognition of patterns and sites of more common injuries can improve the sensitivity of the radiologist in the detection of bowel trauma.

Child↗
PubMed1994

Morphologic changes following endoscopic and two-portal subcutaneous carpal tunnel release.

This study describes the morphologic changes that occur following single incision endoscopic and two-portal subcutaneous carpal tunnel release. Seventeen patients were studied preoperatively and an average of 24 weeks postoperatively. Canal volume, carpal arch width, and median nerve palmar displacement and cross-sectional area were measured by use of multiplanar reformation and three-dimensional reconstruction of magnetic resonance images. Both methods produced a marked increase in canal volume and median nerve cross-sectional area; neither resulted in a significant change in carpal arch width. These data provide a morphologic basis for the belief that endoscopic or subcutaneous carpal tunnel release will produce clinical relief equivalent to open carpal tunnel release.

Carpal Tunnel Syndrome↗
PubMed1993

High-resolution computed tomography of pediatric pulmonary parenchymal disorders.

The role of CT in the diagnosis of pediatric lung disease is still evolving, but certain indications are already well established. In immunocompromised or other high-risk children who have fevers or respiratory symptoms but normal or nonspecific chest radiographs, HRCT can detect and localize disease, thus allowing earlier therapy. It also has been shown that HRCT can assess the severity of disease in bronchiectasis and cystic fibrosis and that it may provide a more sensitive means of evaluating therapy in these conditions. Areas for research include the effects of infection on the developing lung, quantification of bronchopulmonary dysplasia, the prevalence of complications in asthma, and the use of HRCT in pulmonary edema of all types. As CT scan times decrease, the use of CT will expand to younger, sicker, and less cooperative children. Dynamic scanning probably will develop to provide a more accurate assessment of the focal and generalized air trapping that accompanies many common pediatric diseases.

Child↗
PubMed1992

Aberrant thymus--MR assessment.

Aberrant thymic tissue, particularly when it is located posteriorly, can present a diagnostic dilemma. Once a mediastinal "lesion" is defined on the plain film, MR is the most efficient and best diagnostic test for defining the nature of the mass and showing its relationship to other mediastinal structures. Two cases of aberrant thymic tissue, one on the right side and one on the left, are presented to elucidate the unique role of MRI.

Choristoma↗
PubMed1992

Coexistence of bronchial atresia and bronchogenic cyst: diagnostic criteria and embryologic considerations.

We report a case in a neonate of concurrent bronchial atresia and bronchogenic cyst. An accurate, noninvasive, preoperative diagnosis of this unusual combination of anomalies was made by ultrafast computed tomography (UFCT). This case supports the hypothesis that bronchial atresia results from an event occurring in the 5th-6th week of embryological development, rather than after the 16th week as previously believed.

Bronchi↗
PubMed1992

Bronchiolitis obliterans-organizing pneumonia (BOOP) in children with malignant disease.

Four patients who had completed chemotherapy for malignant disease are presented. Unexpected findings of pulmonary infiltrates on chest radiographs of two patients and solitary and/or confluent nodules on CT in all four led to open lung biopsy. Histologic diagnosis in each case was bronchiolitis obliterans-organizing pneumonia (BOOP). This usually innocuous disorder can be differentiated histologically from the more severe pure bronchiolitis obliterans and should be considered in the differential diagnosis of pulmonary lesions associated with malignant disease.

Adolescent↗
PubMed1991

Ultrafast computerized tomography of the chest in cystic fibrosis: a new scoring system.

Assessing the presence and severity of bronchiectasis (BR) and mucoid impaction (MI) of the airways in cystic fibrosis (CF) is difficult by non-invasive methods. We hypothesized that scoring ultrafast computerized tomograms (UFCT) of the chest for BR and MI could be useful in detecting early lung changes in 28 patients with CF. To do this, UFCT scores were compared to established clinical and chest X-ray (CXR) scores. Results showed that UFCT scores correlated highly with clinical (r = 0.88) and CXR (r = 0.93) scores, and several pulmonary function tests. Regression analysis indicated that BR influenced clinical and CXR scores more than MI. Both BR and MI were found in all areas of the lungs without a major propensity for one region, although there was significantly more BR in the right upper lobe than the right lower lobe. In patients with CXR score greater than or equal to 21 BR was present in 8/9 and MI in 3/9, while in those with CXR score less than 21 UFCT showed BR in 19/19 and MI in 17/19. We conclude: 1) scored UFCTs correlate well with CXR and clinical scores; 2) BR influences clinical and CXR scores more than MI; 3) UFCTs detect BR and MI in CF patients with minimal evidence of pulmonary disease; and 4) CXR scores less than 21 reflect the presence of both BR and MI.

Adolescent↗
PubMed1991

Common causes of low back pain in children.

Low back pain in children and adolescents is often caused by a serious problem. The diagnostic investigation should begin with a complete patient history, complete physical examination, laboratory testing, and plain radiography. These results should be used to direct further imaging studies. Although most of the painful injuries that children sustain in recreational activities are mild, back pain that lasts for extended periods may be due to various disorders, including spondylolysis and spondylolisthesis, disk herniation, Scheuermann disease, or neoplasms. Low back pain can also be caused by diskitis and osteomyelitis, most commonly found in children younger than 10 years old. Primary osseous neoplasms of the lumbar spine are uncommon, with Ewing sarcoma, aneurysmal bone cyst, benign osteoblastoma, and osteoid osteoma being the most common followed by primary lymphoma. These lesions occur more often between the ages of 5 and 20 years. Other causes of low back pain include spinal cord tumors (eg, ependymoma), congenital disorders of the spine (eg, scoliosis), and systemic disease (eg, sickle cell disease).

Adolescent↗
PubMed1991

Airway evaluation in children with use of ultrafast CT: pitfalls and recommendations.

Ultrafast computed tomographic (CT) evaluation of the airway can be performed with either 50-msec low-resolution images (cine CT) or 100-msec high-resolution images (high-resolution CT). To determine the best imaging strategy for ultrafast CT of the pediatric airway, the authors prospectively compared ultrafast CT and endoscopy in 20 children. Both studies were performed in 11 patients; cine CT alone was performed in six and high-resolution CT alone in three. Six patients had normal anatomy. Six patients had focal tracheal stenoses, four had tracheomalacia or laryngomalacia, one had a laryngoesophageal cleft, one had irregularity and narrowing in the subglottic area, one had laryngeal papillomas, and one had focal stenosis with stoma granuloma. Cine CT results agreed with those of endoscopy in 10 of 17 cases. In five cases focal stenosis was misinterpreted with cine CT as tracheomalacia. High-resolution CT results agreed with those of endoscopy in 10 of 14 cases. The results of a technique that combined high-resolution CT for the entire airway and cine CT at selected areas agreed with those of endoscopy in 10 of 11 cases; only a tracheoesophageal cleft was missed with the combined technique. For the greatest diagnostic accuracy with ultrafast CT in evaluation of the pediatric airway, both cine and high-resolution modes should be used.

Child↗
PubMed1991

John Caffey Award paper. Avascular necrosis: early MR imaging and histologic findings in a canine model.

To examine the early MR and histologic changes of avascular necrosis, we surgically devascularized the distal femur of adult beagle dogs and performed short TR/short TE MR imaging and histologic examinations. MR showed increasing areas of low signal, and histologic examination showed changes of fat necrosis, inflammatory infiltrate, and fibrocytic and bony repair. These processes were divided into four stages. Stage 1 is seen in the first days after surgery and consists of homogeneous high signal on MR and only subtle histologic changes of early fat necrosis. Stage 2, seen by 7 days after surgery, shows linear low-signal areas within the high-signal marrow on MR and fat necrosis and an inflammatory infiltrate on histologic sections. Stage 3, seen by 16 days after surgery, shows patchy low signal occupying more of the marrow on MR with a fibrocytic infiltrate on histologic sections. Stage 4, seen by 23 days after surgery, shows a more homogeneous low and intermediate signal on MR and histologic findings of more organized fibrocytes and the onset of new bone formation. Using this model, we have proved that MR imaging can show marrow changes as soon as 1 week after the onset of avascular necrosis. Whereas MR imaging showed a progression of increasing areas of low signal, the histologic findings seen during this time were diverse, including inflammatory infiltration (a previously unreported finding), fat necrosis, and fibrocytic and osseous repair.

Animals↗
PubMed1990

Glomerulocystic kidney disease: case report.

A newborn infant with abdominal masses was found to have Glomerulocystic Kidney Disease. Imaging showed markedly enlarged kidneys with multiple macroscopic cysts. Radiographic and clinical findings are discussed.

Humans↗
PubMed1990

Correlation between clinical, endocrinologic and nuclear magnetic resonance findings in women with suspected pituitary adenomas.

Twenty-nine women with suspected pituitary adenomas were evaluated with nuclear magnetic resonance (NMR). Twenty-six had prolactin levels less than 100 ng/mL, and three had levels greater than 100. We tried to correlate the clinical findings with the prolactin levels and NMR findings. Pituitary adenomas were detected on NMR even with prolactin levels less than 100 ng/mL.

Adenoma↗