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Biomedical subjects

N T Griscom

Publications and source records attributed to N T Griscom.

At least 73 records · Page 4Linked to original sources
PubMed1980

Lung growth and airway function after lobectomy in infancy for congenital lobar emphysema.

To characterize the outcome of lobectomy in infancy and the low expiratory flows which persist after lobectomy for congenital lobar emphysema, 15 subjects with this history were studied at age 8-30 yr. Total lung capacity was normal in all, but higher values (P < 0.05) were observed in nine subjects with upper lobectomy than in five subjects with right middle lobectomy. Ratio of residual volume to total lung capacity was correlated (P < 0.05) with the amount of lung missing as estimated from normal relative weights of the respective lobes. Xe(133) radiospirometry in eight subjects showed that the operated and unoperated sides had nearly equal volumes at total lung capacity, but that the operated side was larger than the unoperated side at residual volume. Perfusion was equally distributed between the two sides. Similar findings were detected radiographically in four other subjects. Forced expiratory volume in 1 s and maximal midexpiratory flow rate averaged 72 and 45% of predicted, respectively. Low values of specific airway conductance and normal density dependence of maximal flows in 12 subjects suggested that obstruction was not limited to peripheral airways. Pathologic observations at the time of surgery and morphometry of the resected lobes were not correlated with any test of pulmonary function. These data show that lung volume can be completely recovered after lobectomy for congenital lobar emphysema in infancy. The volume increase occurs on the operated side, and probably represents tissue growth rather than simple distension. The response to resection is influenced by the particular lobe resected and may be associated with decreased lung recoil near residual volume. Low expiratory flows in these subjects could be explained by several mechanisms, among which a disproportion between airway and parenchymal growth in infancy (dysanaptic growth) is most compatible with our data.

Adolescent↗
PubMed1980

Radiography of stillborn fetuses and infants dying at birth.

Twe series of stillborn fetuses and infants dying at birth were radiographed postmortem. Series A was largely unselected; in 18%, radiography showed developmental anomalies of early fetal life. Series B was highly selected; the abnormality rate was 75%. The depicted abnormalities were frequently both severe and diagnostically useful. In many cases the radiologic diagnoses were helpful in family counseling. Radiographic examination in selected cases is recommended, especially when structural abnormalities are evident on external inspection, and specific radiographic techniques are suggested.

Abnormalities, Multiple↗
PubMed1980

Neonatal gastrointestinal masses arising late in gestation.

Gastrointestinal masses arising late in gestation form a small but important subgroup of neonatal abdominal masses. Thirteen infants were seen in the first day of life with abdominal distension or a mass. They had radiographic evidence of a mass and intestinal obstruction, and had masses containing meconium, liquid, or necrotic bowel in association with peritonitis. Results indicated a varied etiology. Six cases seemed to belong to one of three previously described entities: volvulus with pseudocyst formation, cystic meconium peritonitis, or segmental dilatation of the bowel. The other seven had features common to two or more of these entities.

Dilatation, Pathologic↗
PubMed1979

Neonatal intestinal opacification secondary to transplacental passage of urographic contrast medium.

Neonatal intestinal opacification in five infants (one set each of triplets and twins) after maternal excretory urography is described, and mechanisms leading to this phenomenon are discussed. Transplacental passage of urographic contrast medium with subsequent excretion by the fetal kidneys and possibly liver and small bowel seems to explain the radiographic appearance. Although the contrast medium probably does not harm the fetus, it should be distinguished from other more sinister causes of colonic opacification in the neonate.

Adult↗
PubMed1979

Amniography in second trimester diagnosis of myelomeningocele.

Twenty-eight fetuses, at 14-22 gestational weeks, were examined by amniography to identify a thoracic, lumbar, or sacral myelomeningocele. The end point was a fluoroscopic spot film with the fetal back in profile, to show the presence or absence of a bulging midline mass. Fetal irradiation was 0.66 rad +/- 0.36 (SD). There were 26 true negatives and one indeterminate examination. The one true positive was in a patient who had just had negative real-time ultrasonography. It is suggested amniography be used (1) when ultrasonography and amniotic fluid alpha fetoprotein determination disagree about the presence of a neural tube defect, and (2) for further confirmation when both these tests are positive.

Adult↗
PubMed1978

Clue to diagnosis of neonatal urinary ascites. Relative radioluency of liver shadow.

About 25 per cent of neonatal ascites is caused by urinary tract disease. Opacification of the ascitic fluid by leakage of contrast material during cystography or intravenous urography may lead to striking relative radioluency of the liver. This phenomenon may be an important clue to the differential diagnosis of the etiology of neonatal ascites.

Ascites↗
PubMed1978

Protrusion of the lung apex through Sibson's fascia in infancy.

Apical 'herniation' of the lung is an unusual protrusion of the lung and its pleural coverings through the superior aperture of the thorax. It is supposedly caused by weakness of Sibson's fascia. The phenomenon is an anatomical variation and not a disease entity; however, it must be recognised in order to avoid inappropriate surgery. The condition apparently disappears spontaneously with growth.

Fascia↗
PubMed1978

Lower respiratory infections: how infants differ from adults.

Largely for anatomic reasons, the peripheral airways of infants are more susceptible to inflammatory narrowing than are those of adults. When infection occurs in the lower respiratory tract of an infant, the primary effect is likely to be on the smaller airways, not the alveoli. The results are airtrapping and atelectasis. This airway obstruction often causes severe respiratory embarrassment. It is recognized on chest films by generalized hyperinflation and irregularity of aeration. Small airway obstruction is a common and important manifestation of lower respiratory infection in infancy. True consolidative pneumonia is much less frequent.

Adolescent↗
PubMed1977

The lung following repair of congenital diaphragmatic hernia.

To determine the effects of the pulmonary hypoplasia present at birth in infants with congenital diaphragmatic hernia upon subsequent development of the lung, 19 patients who had undergone surgical repair before the age of one year were studied at ages 6 to 18 years. Total lung capacity and vital capacity averaged 99% of predicted value. Diffusing capacity for carbon monoxide was normal. Forced expiratory volume in one second averaged 89% of predicted value and 80% of vital capacity. Total respiratory system conductance and maximum expiratory flow volume curves obtained during air and helium-oxygen breathing were normal. Xenon 133 radiospirometry performed in nine patients revealed equal distribution of lung volumes on the two sides. Ventilation to the hernia side was reduced in only two patients. Blood flow to the hernia side was reduced in all nine patients. Chest radiographs supported the physiologic observations. These findings are consistent with the persistence of a reduction in the number of branches or generations of pulmonary arteries and bronchi on the side of the hernia. Since a substantial part of the vascular resistance resides in peripheral vessels, this developmental abnormality influences the distribution of pulmonary blood flow, although it has little effect on tests reflecting airway resistance or the distribution of ventilation.

Adolescent↗
PubMed1977

Diagnostic aspects of neonatal ascites: report of 27 cases.

Review of 27 cases of massive ascites found in the first month of life, usually immediately after delivery, revealed a broad spectrum of causes. Seven newborns had urinary ascites, five had bowel disease, three had cardiac arrhythmias, two had liver disease, and one each had toxoplasmosis, ovarian cyst, and chylous ascites. In seven cases the cause was never established. Physical examination, a planned sequence of radiologic examinations, and paracentesis for fluid analysis when necessary are the major steps in differential diagnosis. A systematic approach to the problem is proposed.

Ascites↗
PubMed1977

Huge splenic cyst in a newborn: comparison with 10 cases in later childhood and adolescence.

Radiographic, sonographic, and histologic findings in a case of a huge splenic cyst in a newborn are presented. The patient had the characteristic findings, particularly the visceral displacement, associated with splenic cysts in a series of 10 older children and adolescents. The occurrence in a newborn of a large splenic cyst histologically similar to those found in older children supports the hypothesis that they are developmental rather than traumatically acquired.

Cysts↗
PubMed1977

Neonatal hydronephrosis: 146 cases.

Recognition and precise etiologic diagnosis of neonatal hydronephrosis is worthwhile since, although often severe, it is usually treatable with at least partial success. This relatively favorable prognosis, despite dilatation that may be marked, suggests a greater regenerative capacity at this age, or may be due to the relative infrequency or short duration of the infection.

Abdominal Muscles↗
PubMed1976

The medial pneumothorax.

The intrapleural air of a pneumothorax may largely collect medial to the anterior aspect of the lung in supine infants. The mechanical basis for this phenomenon is presented with supporting experimental evidence. This distribution of intrapleural air poses problems in recognition of the pneumothorax radiographically, in differentiation of the pneumothorax from pneumomediastinum, in estimation of the true volume of intrapleural air, and in the proper placement of drainage tubes. The importance of horizontal-beam lateral radiographs and of careful attention to the position of intrapleural tubes is emphasized, especially in supine, immobile newborns.

Diagnosis, Differential↗