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R L Teele

Publications and source records attributed to R L Teele.

At least 37 records · Page 2Linked to original sources
PubMed1993

Renal findings in 40 individuals with Williams syndrome.

We tabulated the frequency of renal abnormalities in 40 Williams syndrome individuals presenting for medical and/or developmental assessment to a multi-disciplinary Williams syndrome program. The average age at time of assessment was 7 2/12 years. Seven individuals (7/40 = 18%) had abnormalities detected, including nephrocalcinosis = 2; marked asymmetry in kidney size = 2; small kidneys = 1; solitary kidney = 1; and pelvic kidney = 1. Renal function was also assessed. Two individuals had evidence of renal dysfunction, one secondary to nephrocalcinosis and the second due to hypercalcemia and interstitial nephritis of unclear pathogenesis. We examined the frequency of renal artery stenosis in 9 individuals who underwent abdominal angiography during cardiac catheterization. We found unilateral or bilateral mild renal artery narrowing in 4 individuals and normal renal arteries in the remaining 5. Persistent hypertension occurred in only 2 individuals and did not correlate with renal artery status. We conclude that intrinsic renal anomalies, as well as problems secondary to hypercalcemia, occur with sufficient frequency to warrant baseline renal screening in all individuals with Williams syndrome.

Abnormalities, Multiple↗
PubMed1993

Joint effusion in children with an irritable hip: US diagnosis and aspiration.

Ninety-six children with an irritable hip possibly representing septic arthritis underwent clinical and laboratory evaluation, radiography, and ultrasonography (US). Forty had normal US scans; none were later shown to have septic arthritis, although three had osteomyelitis. Fifty-six children had effusion at US. Thirty-one of these underwent US-guided aspiration, two unsuccessfully. On the basis of results of aspirate analysis, 15 of these 31 patients underwent surgical drainage, and septic arthritis was diagnosed in all 15. The mean peripheral white blood cell (WBC) count was not significantly higher in patients with septic arthritis (n = 21) than in patients with toxic synovitis (n = 24) (P = .44). However, the erythrocyte sedimentation rate and synovial fluid WBC count were significantly greater in those with septic arthritis than in those with toxic synovitis (P = .002 and P < .0001, respectively). Clinical evaluation, radiographs, and sonograms together determined the need for US-guided aspiration. US-guided aspiration allowed selection of only those with septic arthritis for operative drainage and shortened that procedure. Negative sonograms allow exclusion of septic arthritis but not osteomyelitis.

Adolescent↗
PubMed1992

Scrotal ultrasonography in Henoch-Schönlein purpura.

The vasculitis of Henoch-Schönlein purpura may involve the scrotum and clinically mimic diseases requiring surgical intervention, such as testicular torsion or an incarcerated inguinal hernia. The ultrasonographic features include marked edema of the scrotal skin and contents with intact vascular flow in the testicles. These findings may suggest the correct diagnosis and prevent unnecessary surgical exploration.

Child, Preschool↗
PubMed1992

Juvenile granulosa cell tumor of an intraabdominal testis.

Juvenile granulosa cell tumor of the testis is a distinct form of sex cord-stromal tumor of neonates and infants [1]. This tumor comprises a significant percentage of testicular tumors in baby boys. We present a patient who had preoperative imaging studies.

Cryptorchidism↗
PubMed1992

The antegrade colonogram: extending the small bowel follow through for children suspected of having colonic disease.

Fifty pediatric patients suspected of having colonic disease were evaluated by antegrade barium study ("antegrade colonogram") and by colonoscopy with multiple biopsy specimens. Radiographic patterns of mucosal irregularity, nodularity, or ulceration, haustral asymmetry or edema, and narrowing of the colonic lumen were easily recognized. Correlation between colonographic patterns, biopsy findings, and gross appearance at colonoscopy showed the colonogram to have an overall accuracy of 77-88%. The antegrade colonogram is easily performed and often provides information regarding areas of the colon not seen by the endoscopist. In some cases it may also be useful in the evaluation of response to therapy for inflammatory bowel disease.

Adolescent↗
PubMed1992

Urolithiasis in a children's hospital: 1985-1990.

We performed a retrospective study of patients who had urinary tract stones and were seen at our hospital from 1985-1990. The study was intended to determine the prevalence of urolithiasis and optimal approaches to imaging. Clinical data and imaging studies of 87 patients were reviewed. The mean age was 15.7 years with a range of 3 months to 44 years. Fifty-four percent of patients were male. Most patients had a known predisposing cause for urolithiasis; patients with myelodysplasia and structural urologic problems predominated. Plain films were performed in 77 patients; 57% showed stones. Ultrasonograms were performed in 71 patients; 77% showed stones. Excretory urograms (EU) were performed in 49 patients; 84% showed either stones or their effect on the urinary tract. Computed tomographic (CT) scan was performed in 25 patients; all showed stones.

Adolescent↗
PubMed1992

Echogenic material in the fetal gallbladder: sonographic and clinical observations.

Obstetric sonograms of 26 fetuses with echogenic material in the gallbladder were reviewed to describe the sonographic findings and clinical significance. Gestational age at the time of diagnosis ranged from 28 to 42 weeks (mean, 36.2 weeks). The echogenic foci were associated with distal shadowing in eight fetuses (30%), comet-tail artifact in nine (35%), and no distal artifact in nine (35%). No hemolytic anemias, other predisposing risk factors, or clinical sequelae associated with biliary tract disease were identified in any of the infants. Postnatal sonographic or pathologic follow-up studies were available in 17 cases. In nine of these 17 infants, the echogenic foci had resolved. In three, the foci have persisted, but none of the children have become symptomatic; the longest period of follow-up with stones still present is 4 1/2 years. Whether all echogenic foci in the fetal gallbladder represent true gallstones remains unknown. Echogenic foci may be seen in the fetal gallbladder during the third trimester. No predisposing fetal risk factors or clinical sequelae were evident in our series. Many echogenic foci, but not all, will resolve.

Anemia, Hemolytic↗
PubMed1992

Ultrasonography of the female pelvis in childhood and adolescence.

The age of the patient is crucial in the consideration of differential diagnoses for pelvic disease. This is especially true in the pediatric population. Ultrasonography is the first, and often only, imaging required for female babies, children, and young adults who present with signs and symptoms referable to the pelvis. Usually, children come to attention because of pelvic mass, pelvic pain, ambiguous genitalia, or abnormal sexual development. It should be remembered that congenital anomalies may not become apparent until the onset of puberty. In all cases, good practice requires that adnexal and uterine anatomy and screening views of each kidney are documented on hard copy. Further evaluation, which consists of MR or CT scanning, depends on the results of the ultrasonograms, the clinical examination, and acuity of the problem.

Adolescent↗
PubMed1991

Antenatal ultrasonography in Dunedin: one year's data.

Two thousand and forty-five pregnancies were registered during one calendar year, at the two hospitals in Dunedin. One thousand five hundred and ninety-four liveborn infants and 15 stillborn infants resulted from 1585 pregnancies. Of this group of pregnant women, 74% had one or more ultrasonographic studies (mean number of scans = 1.5). Of the 1609 infants delivered, 0.4% had a major anomaly of the central nervous system, and 0.7% had hydroenphrosis. Four hundred and sixty pregnancies resulted in spontaneous or therapeutic abortion. Ten point nine percent of those women undergoing therapeutic abortion had ultrasonographic studies. It is apparent from this retrospective audit, that antenatal ultrasonography has become almost routine in those women carrying an infant to term. The relative rarity of fetal anomalies is similar to other, larger, series.

Abortion, Spontaneous↗
PubMed1990

Unsuspected hepatic injury in the neonate--diagnosis by ultrasonography.

Three cases of severe neonatal hepatic injury were investigated with ultrasonography. The injury is often associated with antenatal factors (fetal hepatic enlargement, maternal trauma), perinatal factors (breech presentation, pre- or post-maturity, difficult delivery), or postnatal factors (resuscitation).

Birth Injuries↗
PubMed1990

Pitfalls in pediatric urinary sonography.

Our review of pediatric urinary tract ultrasonograms over a period of two and one-half years resulted in a catalog of pitfalls. Cases included normal scans mistaken for abnormal and vice versa. These erroneous diagnoses stemmed from the inappropriate selection of the primary imaging test, improper timing of the ultrasonogram, errors of commission or omission in performance of the scans, and improper interpretation of the findings. For ease of reference, the pitfalls are grouped under bladder, ureters, and kidney with emphasis on the first two which are common sources of error.

Child↗
PubMed1990

Pictorial essay. Current evaluation of the patient with abnormal visceroatrial situs.

Patients suspected of having derangement of solitus asymmetry should be evaluated individually to determine abdominal visceral and vascular arrangement and to investigate associated problems. This evaluation should begin with plain films to assess cardiac and gastric positions and pulmonary vascularity. Assessment of the bronchial branching patterns should be attempted in all cases. Sonography will delineate the presence or absence of splenic tissue and the anatomy and relationships of the cava and the portal vein. When no spleen is found and the pulmonary vascularity appears congested, a subdiaphragmatic total anomalous pulmonary venous connection should be suspected and verified. If there are splenuli in the retrogastric area, particular attention should be paid to the status of the gallbladder, especially in children who do not have congenital heart disease. Selective spleen scans can confirm the presence of splenic tissue. The high cost and sedation requirement of MR would suggest that it be reserved for cases in which sonography is unable to answer the pertinent questions.

Heart↗
PubMed1989

Septo-optic-dysplasia-schizencephaly. Radiographic and clinical features.

The anatomical anomalies that characterize septo-optic-dysplasia (deMorsier Syndrome) are variable and often subtle. We report imaging studies of nine patients with septo-optic-dysplasia which provide radiologic and ultrasonographic clues to this disorder. In addition, we propose that cerebral schizencephaly may be a component of the dysmorphogenesis that results in septo-optic-dysplasia. Septo-optic-dysplasia-schizencephaly complex is frequently associated with endocrinologic, ophthalmologic, and neurologic symptoms and signs.

Adolescent↗
PubMed1989

Sonography of testicular microlithiasis.

The sonographic appearance of testicular microlithiasis detected in a patient presenting with torsion is described. A "speckled" pattern of multiple, tiny bright echoes is produced by calcific concretions in the seminiferous tubules and seems to be characteristic of microlithiasis. Although this condition is not treatable, it should be recognized because it is often associated with extratesticular abnormalities and can obscure superimposed testicular disease.

Adolescent↗
PubMed1989

Sonography of the simple and complicated ipsilateral fused kidney.

Anomalies of renal fusion and their sonographic findings can be straightforward or quite complex. Sonograms of eight cases of simple and complicated anomalies of renal fusion in pediatric patients are reviewed to determine characteristic sonographic findings in such cases. The correct diagnosis can be suspected by evaluation of the following parameters: (1) the echoic texture of the renal "mass"; (2) the differential orientation of the renal pelves; (3) the content of the contralateral renal fossa; (4) the size of the ipsilateral kidney; (5) extension of the isthmus medially anterior to the spine; and (6) presence of a deep anteroposterior notch. Utilizing these parameters, a rationale for diagnosis and for selecting the appropriate sequence of further studies is suggested.

Child↗