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Biomedical subjects

R C Brasch

Publications and source records attributed to R C Brasch.

At least 181 records · Page 10Linked to original sources
PubMed1981

Ossification in a soft tissue embryonal rhabdomyosarcoma.

We describe the previously unreported finding of ossification within a rhabdomyosarcoma of the extremity in the absence of bone destruction. Rhabdomyosarcoma is a highly malignant tumor but could not be radiographically differentiated from benign or other malignant causes of soft-tissue masses containing calcium. Definitive diagnosis and thus appropriate therapy requires prompt pathologic examination.

Female↗
PubMed1981

Utility of computed tomography in the diagnosis of thoracic aneurysm in childhood.

For an unusual case of saccular aneurysm of the thoracic aorta in a child, the computed tomographic demonstration of a totally vascular mass led directly to the definitive diagnosis by angiocardiography and eliminated the need for many additional imaging or chemical tests. This case illustrates how computed tomography can be beneficial in the potentially difficult diagnostic evaluation of pediatric medistinal masses.

Aorta, Thoracic↗
PubMed1981

Endotracheal tube orifice abutting the tracheal wall: a cause of infant airway obstruction.

Effects of endotracheal tube and infant head positions upon the orientation of the beveled tube orifice to the tracheal wall were studied in living infants receiving ventilatory assistance and in infant cadavers. Radiographs of infant cadavers showed that when the endotracheal tube orifice faces one direction and the infant's head faces the opposite direction, the tube orifice can abut the tracheal wall and thus obstruct the airway. This obstructive relationship was more readily produced with relatively high tube positions (above the level of T1) and/or with full neck flexion. Measurement of mean pulmonary resistance in living infants showed a position-dependent increase above the baseline of up to 487% (from 31 to 182 cm H2O/l/sec) when the tube orifice abutted the tracheal wall. The radiologist who observes the tube orifice against the tracheal wall should alert the clinician immediately so that endotracheal tube alignment can be adjusted to relieve obstruction.

Airway Obstruction↗
PubMed1981

Abdominal pseudotumor in childhood: distended gallbladder with parenteral hyperalimentation.

Two children receiving total parenteral hyperalimentation had palpable upper abdominal masses. Sonography showed these masses to be distended gallbladders. Sonograms of four other children receiving parenteral hyperalimentation were examined to determine if gallbladder distension in these cases was coincidental or common; three of four also had gallbladder distension. Follow-up sonograms after initiation of oral feedings in two children showed reduced gallbladder dimensions. Children can have palpable, distended gallbladders while fasting and receiving parenteral hyperalimentation. Sonography can differentiate distended gallbladders from other abdominal masses.

Abdominal Neoplasms↗
PubMed1981

Medially deployed thoracostomy tubes: cause of aortic obstruction in newborns.

It was observed that severe aortic displacement, narrowing, and obstruction can occur when thoracostomy tubes abut the mediastinum. To further investigate this previously undescribed phenomenon, aortography was performed with intraluminal pressure measurements in newborn puppies and aortograms obtained in two infant cadavers. In the puppies, when the tube tip pressed against the descending thoracic aorta, aortic pressure below that site decreased and aortic arch pressure rose. When the tube tip pressed against the ascending aorta, pressures in the aortic arch and abdominal aorta decreased. Aortography in the puppies and infant cadavers demonstrated aortic displacement, narrowing, and obstruction when the thoracostomy tubes abutted the mediastinum. The clinical consequences of malpositioned thoracostomy tubes were observed in two premature infants. When the posteromedially deployed tubes were partially withdrawn, systolic arterial pressures, which had been exceptionally low, suddenly and significantly increased distal to the tube tip. Medially deployed thoracostomy tubes may represent a potential hazard to the newborn infant.

Animals↗
PubMed1981

Follow-up of Wilms tumor: comparison of CT with other imaging procedures.

In a retrospective review, computed tomography (CT) was compared to a "routine" combination of other diagnostic imaging procedures used for follow-up evaluations of 13 children being treated for Wilms tumor. The examined variables were diagnostic accuracy, expense, and duration of examination. Results from 13 patients indicated that CT most accurately answers diagnostic queries pertinent to follow-up evaluation of Wilms tumor: the presence and extent of bilateral renal tumors, local recurrence, contralateral renal hypertrophy, and metastasis to liver or lungs, For diagnosing pulmonary metastases, CT was superior to conventional chest radiography both in sensitivity (4/4 vs. 2/4) and specificity (9/9 vs. 6/9). In depiction of liver metastases, CT (3/3) was superior to liver scintigraphy (2/3). The extent of bilateral Wilms tumors was better defined by CT than by urography. In no instances were the alternative diagnostic imaging studies found to be more accurate than CT for detection of recurrent tumor. Average cost for a CT examination ($344) is considerably less than the cost for a routine combination of the other imaging studies ($594). Examination time and diagnostic radiation does are also reduced using CT. Pending larger comparison studies, CT is recommended as the primary diagnostic method for follow-up evaluation of patients with Wilms tumor.

Child↗
PubMed1980

Resection of distal tracheal stenosis in a baby with agenesis of the lung.

A newborn infant with agenesis of the left lung and critical distal tracheal stenosis required tracheal resection and reanastomosis. This case illustrates the combined use of flow-volume curves, radiology and endoscopy in the diagnosis and management of airway obstruction in infants. It also establishes the feasibility of complete tracheal reconstruction in small babies.

Female↗
PubMed1980

Abdominal disease in children: a comparison of computed tomography and ultrasound.

Diagnoses from computed tomographic (CT) and ultrasonic examinations of the abdomen in 29 pediatric patients were reviewed retrospectively to compare the sensitivity and specificity of the two methods for detection of abnormalities and to assess their differential diagnostic accuracies. No difference in sensitivy (87%) and specificity (100%) was observed between the two imaging methods. However, the differential diagnostic accuracy in abnormal cases was greater with CT than ultrasound. The combined information from CT and ultrasound allowed for correct diagnoses in all but three instances. Findings from each technique considered separately would have resulted in erroneous diagnoses in four instances using CT and nine instances using ultrasound. Diagnostic information obtained from CT and ultrasound examinations were complementary in many instances.

Abdomen↗
PubMed1980

Allergic reactions to contrast media: accumulated evidence.

The allergic, antibody-mediated hypothesis of contrast medium reactivity, a nearly abandoned theory, is reconsidered in light of recently available clinical and laboratory data which support it. Anti-contrast-medium antibodies have been observed in patients suffering severe reactions and the triiodinated contrast medium moeity has been shown to be an effective hapten in experimental animals. Acceptance of an allergic hypothesis for contrast medium reactivity does not exclude alternative mechanisms for certain reactions.

Animals↗
PubMed1980

Computed tomography in the evaluation of pediatric genitourinary disease.

Traditionally, urography has been the diagnostic imaging technique of choice in children with renal and retroperitoneal diseases. However, ongoing experience with abdominal CT in the pediatric patient suggests that CT may be superior to more conventional modes of evaluation for certain urologic conditions, including renal masses and blunt abdominal trauma.

Child↗
PubMed1979

Gastrointestinal complications of renal transplantation in children.

Twenty episodes of serious gastrointestinal complication occurred in 14 of 85 (16%) consecutive patients less than 17 years old who underwent renal homograft transplantation. These complications consisted of small-bowel obstruction, ulceration, pancreatitis, hepatitis, ascites, and severe gastroenteritis. Only 1 patient died as a consequence of the complication--a much lower mortality rate than that reported for gastrointestinal complications of renal transplantation in adults. Radiographic findings were diagnostic in the majority of cases and aided in the prompt administration of therapy.

Ascites↗
PubMed1978

Radiologic evaluation of the thymus in juvenile myasthenia gravis.

Clinical records and chest radiographs of nineteen patients with juvenile myasthenia gravis treated by thymectomy were reviewed retrospectively. Correlation of radiographic findings, clinical data, and pathologic observations were sought to determine the value of radiography in the pre-operative assessment of juvenile myasthenia gravis patients. Although the vast majority of patients had normal plain films and tomographic chest radiographs the thymuses in seventeen of the nineteen patients were pathologically abnormal. The pathologic abnormalities consisted of hyperplasia and/or the presence of germinal centers within the glands. Despite these histologic abnormalities, the weights of the surgically removed thymuses were generally in the range of normal for patients of this age. None of the nineteen patients had a thymoma. In our series, there was no apparent benefit from radiographic examination of the thymus gland in consideration of thymectomy for patients with juvenile myasthenia gravis.

Adolescent↗
PubMed1978

Extragonadal endodermal sinus (yolk sac) tumor. Angiographic findings and literature review.

The angiographic and pathologic features of an endodermal sinus tumor (EST) arising from the retroperitoneum in a 19-month-old boy are presented. Although rare instances of extragonadal origin of EST have been reported, this is the first detailed description of the angiographic abnormalities. The angiographic appearance was that of a primarily retroperitoneal tumor with parasitized feeding arteries from the liver and right kidney, early filling venous radicles, sinusoidal pooling of contrast material, and inferior vena caval obstruction.

Aortography↗