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Biomedical subjects

M Oliphant

Publications and source records attributed to M Oliphant.

At least 19 recordsLinked to original sources
PubMed2000

Palpable spongy mass over the clavicle, an underutilized sign of clavicular fracture in the newborn.

This prospective study emphasizes the importance of an early physical finding of neonatal clavicular fracture, termed "the palpable spongy mass sign." Of the 1,661 term neonates examined at our tertiary center over a 20-month period, 24 had clinical signs of a clavicular fracture. In 22 of the 24 neonates, the fractures were documented by positive radiographs or callus formation. None of the fractures was recognized because of an asymmetric Moro reflex, visible swelling, or bruising. The palpable spongy mass was present in 18 of the 22 fractures (82%), crepitus in 10 (45%), angulation deformity in two (9%), and localized tenderness in one (5%). Any combination of crepitus, deformity, and localized tenderness was detected in 11 of the 22 (50%) fractures. When the palpable spongy mass sign was added to these three signs, all but one fracture was clinically detected (95%), emphasizing the importance of using all physical findings. We conclude that "the clavicular spongy mass sign" is highly sensitive and predictive of neonatal clavicular fractures.

Adolescent↗
PubMed1996

The dilemma of Saussurean communication.

A Saussurean communication system exists when an entire communicating population uses a single 'language' that maps states unambiguously onto symbols and then back into the original states. This paper describes a number of simulations performed with a genetic algorithm to investigate the conditions necessary for such communication systems to evolve. The first simulation shows that Saussurean communication evolves in the simple case where direct selective pressure is placed on individuals to be both good transmitters and good receivers. The second simulation demonstrates that, in the more realistic case where selective pressure is only placed on doing well as a receiver, Saussurean communication fails to evolve. Two methods, inspired by research on the Prisoner's Dilemma, are used to attempt to solve this problem. The third simulation shows that, even in the absence of selective pressure on transmission, Saussurean communication can evolve if individuals interact multiple times with the same communication partner and are given the ability to respond differentially based on past interaction. In the fourth simulation, spatially organized populations are used, and it is shown that this allows Saussurean communication to evolve through kin selection.

Algorithms↗
PubMed1996

Renal oncocytomatosis.

Renal oncocytoma is an uncommon benign renal neoplasm of unknown etiology. Bilateral, multicentric renal oncocytomas are rare and diffuse renal oncocytomas are even rarer. We report a patient with incidentally detected marked bilateral nephromegaly due to innumerable oncocytomas. The term "oncocytomatosis" should be strictly applied to cases in which oncocytomas diffusely infiltrate the kidneys.

Adenoma, Oxyphilic↗
PubMed1995

Nontuberculous Mycobacteria subcarinal lymphadenitis and severe airway obstruction.

This report has emphasized the importance of a careful evaluation of the chest roentgenogram for lymphadenopathy in children with wheezing, cough, or other symptoms of lower airway disease. This patient report also illustrates that intrathoracic lymphadenitis caused by nontuberculous mycobacteria should be considered in children with unexplained airway obstruction.

Airway Obstruction↗
PubMed1995

Chronic pneumonitis of infancy. A unique form of interstitial lung disease occurring in early childhood.

We describe nine infants with a rare form of interstitial lung disease that is characterized by marked alveolar septal thickening, striking alveolar pneumocyte hyperplasia, and an alveolar exudate containing numerous macrophages and foci of eosinophilic debris. Primitive mesenchymal cells predominate within the widened alveolar septa; inflammatory cells are scant. This entity occurs exclusively in infants and very young children and differs from other types of interstitial pneumonia occurring in either children or adults. The histologic findings suggest that it may reflect slowly resolving or recurrent pneumonia superimposed on immature or abnormally developed lungs. The term chronic pneumonitis of infancy was chosen to reflect the unique occurrence of this lesion in young children and to emphasize its distinction from adult forms of interstitial pneumonia.

Age Factors↗
PubMed1994

Demyelinating and gliotic cerebellar lesions in Langerhans cell histiocytosis.

PURPOSE: To describe the involvement of the cerebellum by a gliotic and demyelinating process in Langerhans cell histiocytosis. METHODS: A retrospective analysis of all (N = 30) cases of Langerhans cell histiocytosis followed at our institution since 1975 yielded four patients with CT and/or MR evidence of cerebellar abnormalities. RESULTS: Four patients manifested strikingly similar findings of symmetric nonenhancing hypodensities in the dentate nuclei region of the cerebellum, which were hypointense on short-repetition-time/short-echo-time MR and hyperintense on long-repetition-time/long-echo-time MR. Biopsy in one patient yielded areas of demyelination, cell loss, and gliosis without histiocytic infiltration. CONCLUSION: Langerhans cell histiocytosis involves the cerebellum in a specific and poorly understood manner. Lesions on imaging may precede clinical findings by years. Lesions may occur in patients who have never experienced radiation therapy and may act as a marker for eventual central nervous system deterioration.

Biopsy↗
PubMed1993

Inflammatory myofibroblastic tumor in children.

The authors presented the cases of two children with inflammatory myofibroblastic (IMF) tumor and reviewed the literature to facilitate the preoperative recognition, delineate the clinical features, and describe the natural history of this entity. The first child had IMF tumor arising from the mesentery of the small intestine. He presented with an abdominal mass associated with severe inflammatory response manifested by fever, impaired growth, thrombocytosis, and microcytic, hypochromic anemia. After surgical resection, his fever resolved and his growth rate and the laboratory abnormalities normalized. Five months after initial diagnosis, the fever, anemia, and thrombocytosis recurred along with two tumors arising from the omentum and the abdominal soft tissue. After the second surgery, he remains free of recurrent disease for 30 months. The second child presented with a lung mass that was radiologically indistinguishable from pulmonary sequestration. After surgical resection, she remains free of recurrent disease for 18 months. IMF tumor should be considered in any solid tumor that occurs in association with a chronic inflammatory response. IMF tumor should also be considered in the differential diagnosis of pulmonary sequestration.

Child↗
PubMed1993

Spread of disease via the subperitoneal space: the small bowel mesentery.

The designation of the subperitoneal space emphasizes the continuum of the potential space of extraperitoneal and intraperitoneal areolar tissue traversed by blood vessels, lymphatics, and nerves. Across its root, the subserous connective tissue of the small bowel mesentery is anatomically continuous with that deep to the posterior parietal peritoneum. There is thereby provided an avenue of spread from multiple sites to and from the small bowel mesentery and its relationships. These include perforated lesions of the bowel, pancreatitis, lymphoma, neuroblastoma, leiomyosarcoma of small bowel, and hemorrhage of retroperitoneal and pelvic origin.

Female↗
PubMed1993

Bidirectional spread of disease via the subperitoneal space: the lower abdomen and left pelvis.

In early fetal life a persistent interconnection between the peritoneum and retroperitoneum of the abdomen and pelvis is formed--the subperitoneal space (SS). This paper serves to complete the description of the specific anatomical nuances of the SS as they relate to the bidirectional direct spread of disease in the left lower abdomen and pelvis. Described are the two avenues of communication (central and lateral pathways) within this portion of the SS. Selected cases illustrating the bidirectional spread of disease processes within this portion of the SS are reported.

Abdominal Neoplasms↗
PubMed1992

Zinc-induced copper deficiency in an infant.

OBJECTIVE: To describe the case of a 13-month-old girl who developed copper deficiency as a result of excessive zinc gluconate ingestion. SETTING: Tertiary care hospital in Syracuse, NY. INTERVENTIONS: Cessation of zinc ingestion followed by intravenous and oral copper chloride therapy. MEASUREMENTS/MAIN RESULTS: Ingestion of zinc gluconate, 120 mg/d for 6 months, and thereafter 180 mg/d for 1 month, preceded the clinical presentation of listlessness, anemia, neutropenia, poor weight gain, abnormal sparse hair, and scorbuticlike bone changes. Findings on a bone marrow examination included ring sideroblasts and suggested copper deficiency. Plasma zinc level was 36.7 mumol/L, serum ceruloplasmin level was 20 mg/L, and serum copper level was undetectable. Clinical and laboratory abnormalities resolved shortly after initiation of copper therapy. CONCLUSIONS: This case demonstrates the reciprocal relationship of copper and zinc metabolism and exemplifies the important interrelationships of dietary trace minerals.

Bone Diseases, Metabolic↗
PubMed1990

Prenatal sonographic evaluation of short-limbed dwarfism: an algorithmic approach.

Prenatal sonographic evaluation of short-limbed dwarfism is initiated when a significantly shortened femur is found or by referral of a patient with a family history of skeletal dysplasia. If a short femur is demonstrated, all the long bones are measured and evaluated for bowing, fractures, and mineralization. The bone dysplasia is categorized according to whether it is mesomelic, rhizomelic, or micromelic and whether bowing or fractures are present. The fetal spine, head, thorax, hands, and feet are carefully evaluated to differentiate the type of bone dysplasia and to determine whether it is lethal. Serial examinations may be necessary. This approach will provide sufficient information to counsel the family, manage the pregnancy, and direct the postnatal evaluation.

Algorithms↗
PubMed1990

Fetal central nervous system abnormalities.

The advances in the sonographic imaging of the fetus have made the detailed examination of the fetal central nervous system (CNS) a routine part of the prenatal sonogram. A logical sonographic approach to the diagnosis of fetal CNS abnormalities is presented, based on the normal sonographic anatomy and the understanding of CNS pathology. This approach results in a classification of CNS abnormalities derived from ultrasound findings. The main categories are (1) hydrocephalus, (2) entities that mimic hydrocephalus, and (3) neural tube defects. Once a disorder is classified and all ultrasound abnormalities identified, a differential diagnosis can be developed.

Brain↗
PubMed1989

Grey Turner's sign and Cullen's sign in acute pancreatitis.

Four patients with acute pancreatitis presenting with Grey Turner's sign or Cullen's sign have been studied by computed tomography (CT). These observations help confirm the precise anatomic pathways by which the extravasated pancreatic enzymes and their effects lead to these cutaneous discolorations. Grey Turner's sign is produced by spread from the anterior pararenal space to between the two leaves of the posterior renal fascia and subsequently to the lateral edge of the quadratus lumborum muscle. Communication may be established to the posterior pararenal space and to the structures of the flank wall. The lumbar triangle, a site of anatomic weakness on the flank wall, may serve as a structural predisposition. Cullen's sign can be seen to be secondary to the tracking of liberated pancreatic enzymes to the anterior abdominal wall from the inflamed gastrohepatic ligament and across the falciform ligament. Another more direct pathway may be extension from inflammatory changes of the small mesentery or greater omentum to the round ligament, and then to properitoneal fat deep to the umbilicus.

Abdomen↗