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Biomedical subjects

R S Boyer

Publications and source records attributed to R S Boyer.

31 records · Page 2Linked to original sources
PubMed1990

Multiple sclerosis in adolescents: CT and MR findings.

The MR and CT findings in 12 adolescents with multiple sclerosis were compared with reported findings in adults. The adolescent group showed a more striking female predominance, more severe disease characteristics, and more frequent infratentorial involvement. Cortical atrophy and abnormal iron accumulation in the basal ganglia were uncommon in the adolescents. Neither group demonstrated a correlation between symptom severity and either extent or location of disease as delineated by MR imaging. MR was more sensitive than CT in detecting demyelinating plaques.

Adolescent↗
PubMed1989

Band heterotopias: a newly recognized neuronal migration anomaly.

Five patients with a continuous band of heterotopic neurons between the lateral ventricles and the cerebral cortex are described. All patients presented with intractable seizures and moderate-to-severe developmental delay. The identification of this anomaly is difficult because of its symmetry and the minimal abnormality of the gyral pattern of the cortex. The possible embryogenesis of the anomaly is discussed. The identification of these band heterotopias is important because of the intractable nature of the seizure disorder and the poor prognosis for the patient.

Brain Neoplasms↗
PubMed1988

Disorders of histogenesis: the neurocutaneous syndromes.

MRI is uniquely suited to demonstration of the wide array of brain abnormalities in the neurocutaneous syndromes, due to its ability to provide previously unattainable neuroanatomic information on T1-weighted images and its extreme sensitivity to changes in water content of brain structures on T2-weighted images. It therefore is assisting physicians in better understanding the full expression of these heritable disorders, such as the extent of optic pathway involvement in optic nerve glioma, the presence of hamartomas in TS, and abnormal myelination in Sturge-Weber syndrome. It may in the future have a role in genetic counseling in TS. CT provides complimentary information to MRI in the evaluation of intracranial pathology in the neurocutaneous syndromes. Bone abnormalities and abnormal states of calcification may at times still be better evaluated by CT. Additionally, CT is a less expensive means of following existent abnormalities over time.

Angiomatosis↗
PubMed1986

Trampoline fracture of the proximal tibia in children.

Seven children (aged 2-5 years) sustained fractures of the proximal tibial metaphysis while jumping on a trampoline with a heavier child or adult. Most impaction fractures were transverse and neither angulated nor displaced. None of the children developed permanent disability or impairment. Parents and physicians should be aware of the possible danger to small children while tandem jumping on a trampoline with a heavier partner.

Athletic Injuries↗
PubMed1980

Acute monoarticular arthritis. A diagnostic approach.

A group of adult patients with acute nontraumatic monoarticular arthritis was studied. Using only the traditional clinical tools of history, physical examination, joint x-ray films, and synovial fluid culture, Gram's stain, and examination for crystals, 74% of the diagnoses made were achieved either immediately or within two to three days. Overall, 64% of the cases were diagnosed during follow-up. Other tests were not found to be helpful in the acute situation and should be utilized only if the tests already mentioned fail to yield a diagnosis. The prognosis of patients with acute monoarthritis that remains undiagnosed after thorough evaluation is generally good.

Acute Disease↗
PubMedDate not supplied

Factors associated with stroke following the Fontan procedure.

We reviewed the results of 68 consecutive Fontan procedures from 1978 to 1993 to determine the frequency of late central neurologic complications of the Fontan procedure in patients living at a mean altitude of 4500 feet. Two surviving patients had transient neurologic symptoms or signs with no corresponding evidence of brain injury by magnetic resonance imaging (MRI), whereas six surviving patients had strokes defined by sustained neurologic symptoms or signs with areas of brain injury identified by MRI [8.8% (6.0-13.0%; 70% confidence limits)]. Collectively, patients with neurologic symptoms had normal hemoglobin values, platelet counts, partial thromboplastin times, and prothrombin times at the onset of clinical neurologic findings. Two patients were taking antiplatelet agents, and one patient was taking warfarin. One of the patients with transient neurologic findings and all of the stroke patients had residual right-to-left shunts. Thus strokes were not uncommon in our patients after the Fontan procedure. Brain injury may result from thromboembolic events associated with residual right-to-left shunts, but our total number of asymptomatic patients with a residual shunt or brain abnormalities by MRI is not known.

Adolescent↗
PubMedDate not supplied

Successful therapy in a child with a congenital peripheral medulloepithelioma and disruption of hindquarter development.

PURPOSE: Medulloepithelioma is an embryonal multipotential neuroepithelial tumor with a striking potential for divergent differentiation. It is usually intraocular or intracerebral and associated with a good prognosis only if completely surgically excised. Data regarding therapy in children with incompletely resected tumors are limited. PATIENT AND METHODS: A girl was born with a large, peripheral, congenital medulloepithelioma associated with complete absence of the left hindquarter and anus. Plain film, ultrasonography, and magnetic resonance imaging demonstrated complete absence of the left kidney and hemipelvis. A subtotal resection of the mass and reconstruction of the tumor-related anatomical defects were performed. RESULTS: Pathologic examination showed neuroglia and pseudostratified neuroectoderm diagnostic of medulloepithelioma. She was treated with multiagent chemotherapy including vincristine, cisplatin, cyclophosphamide, carboplatin, and etoposide. She is now 50 months of age and developing normally without recurrent disease. CONCLUSIONS: A child with an incompletely resected congenital peripheral medulloepithelioma who has experienced long-term disease-free survival after treatment with chemotherapy is described. This report supports a role for adjuvant chemotherapy in the treatment of children with peripheral medulloepithelioma.

Abdominal Neoplasms↗
PubMedDate not supplied

Sedation in pediatric neuroimaging: the science and the art.

Sedation of infants and children for neuroimaging is a "necessary evil" that will be with us for the foreseeable future. Sedation must be accompanied safely in all patients with a high frequency of success on the first attempt. A carefully-considered written sedation plan that addresses the issues raised in this review will assure maximum safety and success in sedating infants and children at each facility involved in pediatric neuroimaging. An affirmative approach and careful attention to both the science and the art of pediatric sedation by all concerned professionals will produce excellent results and facilitate application of current imaging technology in the diagnosis of pediatric neurologic disease.

Child↗
PubMedDate not supplied

Immunoperoxidase staining of the choroid plexus in systemic lupus erythematosus.

Immune deposits in the choroid of patients with systemic lupus erythematosus (SLE) are thought to relate to the pathogenesis of central nervous system (CNS) SLE. Using an immunoperoxidase technique, we found the presence of immunoglobulin heavy and light chains in the choroid stroma and/or in the ependymal cells in all of 7 patients with SLE, 2 of 4 with rheumatoid arthritis, but not in 3 subjects without autoimmune disease. The occurrence, pattern or intensity of the immunoglobulin deposits did not distinguish the patients with or without clinical neuropsychiatric manifestations. Thus, the presence of immune deposits in the choroid plexus is not specific for CNS involvement in SLE.

Antibodies, Antinuclear↗