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Biomedical subjects

L L Barr

Publications and source records attributed to L L Barr.

34 records · Page 2Linked to original sources
PubMed1993

Ultrasonography of acute epitrochlear lymphadenitis.

While the clinical symptomatology and radiographic findings of acute suppurative infection of the epitrochlear lymph nodes of the arm have been previously described, ultrasonographic findings have not been reported. This case report demonstrates that sonographic identification of enlarged epitrochlear lymph nodes immediately confirms the diagnosis. We summarize the clinical, radiological, and sonographic findings of acute suppurative infection of the epitrochlear lymph nodes.

Acute Disease↗
PubMed1992

Intraoperative uses of ultrasound in the pediatric neurosurgical patient.

Ultrasound imaging has become a common method for intraoperative evaluation of the central nervous system. Real-time monitoring aids in guidance for aspiration of fluid collections and placement of catheters as well as the localization and evaluation of masses, and confirmation of their complete removal. Color Doppler is useful in the evaluation of blood flow in arteriovenous malformations, aneurysms, and neoplasms. Consultation among the ultrasound staff, neuroradiologists, and neurosurgeons before the operative procedure maximizes the usefulness of ultrasound, thus aiding in the success of surgery.

Blood Flow Velocity↗
PubMed1992

Conservative management of large ovarian cysts in children: the value of serial pelvic ultrasonography.

BACKGROUND: The management of large ovarian cysts in children is controversial and complicated by a poorly understood natural history. The purpose of this study was to determine the course of sonographically detected large ovarian cysts in a pediatric population. METHODS: All pelvic ultrasonograms in which an ovarian cyst was detected during a 6-year period were reviewed. Large cysts were defined as those of more than 5 cm in any dimension or a volume of more than 13 cc. Clinical data and follow-up was derived from either the hospital chart or by telephone interview. RESULTS: Large ovarian cysts were detected in 92 of 191 patients (48.2%). The average age was 14.9 years (range, 3 to 22 years). Eight patients were premenarchal. In 23 patients, surgery was performed, with findings of neoplasm in 10. In patients managed without surgery and with follow-up, 46 of 51 cysts (90%) decreased in size or completely resolved. Both complex and simple cysts resolved. CONCLUSIONS: Most large ovarian cysts in children (simple or complex) may be safely followed with serial pelvic ultrasonography, because most cysts will either decrease in size or resolve. Neither the character of the cyst nor the size reliably predicted clinical outcome. The decision for surgical intervention should not be based solely on ultrasonographic characteristics, but other factors such as severe symptoms, complications associated with the large mass, other evidence suggestive of neoplasm, ovarian source in doubt, or whether the cyst fails to resolve or decrease in size on follow-up ultrasonography.

Adolescent↗
PubMed1991

Color Doppler US imaging during pediatric neurosurgical and neuroradiologic procedures.

Experience with color Doppler imaging (CDI) during 16 pediatric intraoperative and one percutaneous neuro-radiologic procedures was reviewed to assess whether CDI increased the success rate or decreased the procedure time, thus contributing substantially to procedure performance. Intraoperative CDI was used to rapidly identify abnormal vessels or displacement of normal vessels and correlated with preoperative studies. In six cases (four vascular malformations, one mycotic aneurysm, and one hamartoma), surgical resection was altered on the basis of flow information obtained. In one case of percutaneous embolization of a Galenic malformation, CDI provided information contributing to the cessation of the procedure. In six cases (debulking of three gliomas, resection of one vascular malformation, and two biopsies of nonneoplastic conditions), information was added but did not alter the surgical approach. In the remaining four cases (three cerebrospinal fluid drainage procedures, one posterior fossa decompression), no additional information was obtained. Consultation among the ultrasound staff, neuroradiologists, and neurosurgeons before the operative procedure maximized the usefulness of CDI, thus aiding in the success of surgery.

Adolescent↗
PubMed1991

Sonography of the normal elbow.

Sonography was performed in 30 normal patients, neonatal to 45 years old, to illustrate our technique for complete and rapid examination of the elbow joint. Sonography is an easy, noninvasive method of evaluating the articulating surfaces, tendinous insertions, and supporting soft tissues of the elbow joint. Reliable identification of both normal and diseased anatomy is possible at all ages. Familiarization with the sonographic appearance of the six elbow ossification centers aids in sonographic interpretation.

Adolescent↗
PubMed1990

Enteric duplication cysts in children: are their ultrasonographic wall characteristics diagnostic?

We reviewed eight cases of gastrointestinal duplication cysts to determine whether the combination of an echogenic inner mucosal layer and hypoechoic outer muscular layer could be seen consistently enough to be of diagnostic value. We compared our findings to those seen in twenty-seven other abdominal cysts and conclude that when identified together, the two layers are highly suggestive, if not completely diagnostic of enteric duplication cysts.

Abdomen↗
PubMed1990

Significance of age, duration, obstruction and the dissection sign in intussusception.

A retrospective study of sixty consecutive cases of proven intussusception with attempt at contrast enema reduction was performed to evaluate currently proposed contraindications to such reduction. When patient age, duration of symptoms, presence of small bowel obstruction and presence of a dissection sign were considered alone, none of the findings indicated irreducibility. Our overall reduction rate was 72% with a complication rate of 3%. This is similar to previously reported series and we concur with more recent publications that the only contraindications to non-surgical reduction of intussusception are free intraperitoneal air, peritonitis or evidence of infarcted bowel. Only when we encountered a combination of symptoms being present for greater than 48 hours and the presence of both small bowel obstruction and a dissection sign was reduction likely to be unsuccessful. However, the presence of a prognostic indicator occurring alone should not be considered a contraindication.

Age Factors↗
PubMedDate not supplied

Quantitative sonographic feature analysis of clinical infant hypoxia: a pilot study.

PURPOSE: To determine whether textural features derived from sonographic pixel intensities differ significantly between healthy infants and infants who have had acute clinical hypoxic episodes. METHODS: Neurosonographic and calibration phantom-processed image data were evaluated prospectively from 9 infants (age range, 1 to 163 days) with at least 1 episode of hypoxia and compared with image data from a control population of 16 healthy infants (age range, 1 to 191 days). Custom software was used to make 45 textural feature measurements on 40 x 40-pixel regions of interest within brain parenchyma in the distribution of each major cerebral artery, the thalami, and the cerebellum and in a tissue-mimicking calibration phantom. Means comparison testing was followed by logistic regression to assess statistical variation between the patients and the control group. RESULTS: Nine of 45 textural features showed statistically significant differences between mean values comparing the two groups. Mean gray level was the most sensitive predictor of differences between the two populations (mean gray level for healthy subjects was 46.8; mean gray level for patients was 56.3). An average of mean gray values in areas supplied by the posterior cerebral arteries and the cerebellum was even more sensitive for differentiating healthy subjects from patients. CONCLUSIONS: Quantitative sonographic textural feature analysis showed differences between the brains of healthy infants and those of infants with clinical hypoxia.

Asphyxia Neonatorum↗