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Biomedical subjects

R L Teele

Publications and source records attributed to R L Teele.

89 records · Page 5Linked to original sources

Sonography of infantile polycystic kidney disease.

Sonography was performed on five children, ages 1 day-9 years, who had classic infantile polycystic kidney disease and on one child who had glomerulocystic renal disease. Microcystic involvement of the kidneys in infantile polycystic kidney disease results in renal enlargement, increased echogenicity of renal parenchyma but good transmission of sound through the kidney, and poor definition of renal borders on sonograms. The periportal involvement of the liver in the classic infantile polycystic kidney disease may lead to hepatic fibrosis and portal hypertension. Less typical features include asymmetric renal enlargement and macrocysts in the renal parenchyma.

Child↗

Hepatic arteries and the parallel-channel sign.

The sonographic parallel-channel sign is not pathognomonic of dilatation of the biliary tree. Often, the so-called parallel channel is a hepatic artery. The differentiation between a bile duct and a hepatic artery is usually possible with good sonographic technique.

Bile Ducts↗

An analysis of ultrasound scanning as a guide in determination of "high" or "low" imperforate anus.

The classic upside-down abdominal roentgenogram and the use of pelvic reference points have frequently been inaccurate in assessing the level of the distal pouch in patients with imperforate anus. The ultrasonic study described is different from that previously reported and allows more precise localization of the distal rectal pouch. A review of our experience allows us to make certain definitive statements about this diagnostic modality.

Anus, Imperforate↗

Esophagitis induced by combined radiation and adriamycin.

With the increasing use of combined chemotherapy and radiotherapy in the treatment of certain types of malignancy, a clinically distinct type of esophagitis has been recognized as an undesirable side effect. It occurs with low doses (less than 2,000 rad) of mediastinal radiation in patients who simultaneously or sequentially receive either adriamycin or actinomycin D. Characteristic of this entity is "recall": recurrent episodes of esophagitis with each course of chemotherapy. The radiographic findings are nonspecific, ranging from subtle alterations in motility to severe damage with irreversible stricture formation. The primary differential diagnostic considerations are infectious processes. The radiographic spectrum, clinical aspects, and differential diagnoses in five patients are discussed.

Adolescent↗

Radiographic features of eosinophilic gastroenteritis (allergic gastroenteropathy) of childhood.

The child with eosinophilic gastroenteritis has failure to thrive, a history of allergy or asthma, iron deficiency anemia, and peripheral eosinophilia. This type of eosinophilic gastroenteritis has earned the designation "allergic gastroenteropathy." Pathologic change in the gastric antrum of six children with this disease correlated with an abnormal air-contrast examination of the antrum. The affected children had an irregular, lacy, antral surface rather than the smooth, bald surface seen in normal children. The small bowel in allergic gastroenteropathy is usually abnormal but nonspecific as to etiology. Much more specific is the combination of small bowel and gastric antral abnormalities. Findings encourage air-contrast radiography of the antrum in children with suspected allergic gastroenteropathy.

Asthma↗

Ultrasound of epigastric injuries after blunt trauma.

Blunt trauma to the epigastrum may result in a retroperitoneal hematoma involving the head of the pancreas and descending duodenum. Secondary effects include obstruction of the gastric outlet, obstruction of the biliary tree, and extrinsic compression of the inferior vena cava. Four patients with epigastric trauma were reviewed who had been examined by ultrasound of the abdomen. Ultrasound showed the extent of the retroperitoneal hematoma, its effect on contiguous organs, and was helpful in clinical management.

Abdominal Injuries↗

Gastric volvulus in childhood.

Gastric volvulus, organoaxial or mesenteroaxial, is an uncommon cause of upper gastrointestinal obstruction in childhood. It may be suspected on plain radiographic examination of the abdomen and confirmed by upper gastrointestinal series. Seven affected children are described. In childhood, gastric volvulus often coexists with mesenteric abnormalities or with lesions that lead to distention of the gastrointestinal tract.

Adult↗

The anatomic splenic flexure: an ultrasonic renal impostor.

The anatomic splenic flexure of the colon occupies the left renal fossa in patients with agensis or ectopic of the left kidney. On ultrasonic scans, the colon filled with stool or fluid may simulate a kidney or mass. This mass is often comma shaped on the transverse scans and lacks good definition of its inferior margin on longitudinal scans. An evaluation of a patient with only right renal function should combine radiologic techniques with ultrasonography to establish the correct diagnosis.

Adolescent↗

Ultrasonic evaluation of the obstructed duplex kidney.

The problem of a duplex collecting system associated with an obstructed ectopic ureter or ureterocele is common in pediatric urology. Four such patients were studied by gray scale ultrasound which was useful in demonstrating the dilated upper pole collecting system as well as an ectopic ureter and a ureterocele. Although the diagnosis of a nonfunctioning upper pole unit in a duplex kidney is usually suggested by the urogram, ultrasound provides a noninvasive means of confirmation which is independant of function. Further, ultrasound-guided puncture with antegrade pyelography demonstrates the course of the ectopic ureter, thus providing a more complete preoperative evaluation.

Adult↗

Reflux into the unused ureter.

Reflux occurs into unused ureters in patients with urinary diversion and renal tranplantation, and into the ipsilateral ureter in patients with renal agenesis or dysplasia. Efflux may prevent reflux in patients with normal ureterovesical anatomy. If urine begins to flow down the ureter again the reflux may cease. Thus, in patients undergoing urinary tract reconstruction, undiversion should be done before an antireflux operation is performed. Reimplantation can be done after undiversion on a normal capacity bladder if the reflux persists.

Child↗

A randomized trial of two dexamethasone regimens to reduce side-effects in infants treated for chronic lung disease of prematurity.

OBJECTIVE: Dexamethasone has been widely used to reduce the incidence of chronic lung disease in preterm infants. However side-effects are common, and the ideal dose of dexamethasone has not been identified. We aimed to determine whether an individualized course of dexamethasone given to preterm babies at risk of chronic lung disease reduced the total dose of dexamethasone administered and reduced side-effects compared with a standard 42-day course. METHODS: Thirty-three infants in a regional neonatal unit with a birthweight of < or =1250 g who required mechanical ventilation at 7 days of age were randomly assigned to a 42-day course of dexamethasone or an individualized course tailored to their respiratory status. The primary outcome was linear growth at 36 weeks corrected gestational age. RESULTS: Infants in the individualized course received a 40% lower total dose of dexamethasone. However, there was no difference between the two groups in linear growth or in the incidence of any other side-effects of treatment. There was also no difference in respiratory status or neurodevelopmental outcome. CONCLUSION: The individualized course of dexamethasone used in this study reduced the total dose of dexamethasone administered but did not significantly reduce side-effects of treatment or alter outcome in infants at risk of chronic lung disease.

Anti-Inflammatory Agents↗

Periventricular cavitations in the first week of life.

Eleven infants were encountered (nine premature, two term) in whom well-defined small periventricular cavitations were found by sonography in the first week of life. The sonographic findings bore remarkable similarity to subependymal pseudocysts in neonates previously described in autopsy specimens. The cavitations, which were identified predominantly along the superolateral aspects of the lateral ventricles, did not evolve in the manner of postnatally acquired periventricular leukomalacia. The location of the cavitations differed from the site of previously reported lesions of posthemorrhagic and postinfectious germinolysis along the medial aspect of the caudothalamic groove. Neurosonologists and neonatologists should be alerted to this finding and encouraged to follow these infants as a separate group to learn whether neurodevelopmental sequelae occur in these children.

Cerebral Ventricles↗

Sonographic appearance of callosal agenesis: correlation with radiologic and pathologic findings.

Sonographic features are described in six infants in whom total or partial agenesis of the corpus callosum was confirmed by either computed tomographic or pathologic examination. The six patients demonstrated a range of abnormalities involving the neuraxis as well as other systems, notably cardiovascular, gastrointestinal, and genitourinary. Chromosomal abnormalities were present in two patients. The sonographic features of callosal agenesis seen in these patients included: lack of characteristic acoustic interfaces to define the corpus callosum on both coronal and sagittal sonograms; increased separation and parallelism of the bodies of the lateral ventricles; loss of the characteristic convexity of the medial border of the anterior horns of the lateral ventricles; variable prominence of the occipital horns of the lateral ventricles; variable degree of superior extension of the third ventricle; alteration or absence of the cavum septi pellucidi; and radial arrangement of cerebral sulci about the prominent third ventricle. Cases of partial agenesis may show the dysplastic features found in complete agenesis. However, only some of the callosal echoes are present. The sonographic features of partial agenesis in one infant had not been described before.

Agenesis of Corpus Callosum↗