Radiologist, Pediatric Specialist
40 years of experience

Accepting new patients
1540 E Hospital Dr
Level 3
Ann Arbor, MI 48109
734-936-4500
Locations and availability (2)

Education ?

Medical School
Universidad De Valencia (1970)
Foreign school

Awards & Distinctions ?

Associations
American Board of Radiology

Affiliations ?

Dr. Hernandez is affiliated with 3 hospitals.

Hospital Affilations

Score

Rankings

  • University of Michigan Hospitals & Health Centers
    1500 E Medical Center Dr, Ann Arbor, MI 48109
    • Currently 4 of 4 crosses
    Top 25%
  • University of Michigan Health System
  • C.S. Mott Children's Hospital
    1500 E Medical Center Dr, Ann Arbor, MI 48109
  • Publications & Research

    Dr. Hernandez has contributed to 107 publications.
    Title Age-related Source Memory Deficits Persist Despite Superior Item Memory.
    Date November 2011
    Journal Experimental Aging Research
    Excerpt

    Source and item memory for faces of former United States Presidents were assessed in nondemented older adults over 65 years of age (n = 20) and young adults 18 to 25 years of age (n = 20). During the study phase, a male and a female source each presented pictures of faces to the participant one at a time. To assess source memory, the participant was asked to indicate whether a face from the study phase was presented by the male or female. To assess item memory, a study phase face and distractor face were presented and the participant was asked to indicate which was presented previously. Older adults displayed significantly better item memory for the faces of presidents compared to young adults. However, despite showing superior item memory, source memory still was impaired in older adults compared to young adults. The ability of older adults to efficiently integrate source and item information may be compromised to such a large extent that enhanced item memory does not appear to minimize or negate age-related source memory deficits. The findings demonstrate the robust effects of aging on source memory.

    Title Mri of Legg-calve-perthes Disease.
    Date December 2009
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: Legg-Calvé-Perthes disease is a common cause of hip pain in children that may be initially clinically and radiographically difficult to diagnose and stage. The purpose of this article is to describe and illustrate the various MRI appearances of this condition. CONCLUSION: MRI may show proximal femoral abnormalities before radiography in the setting of Legg-Calvé-Perthes disease, allowing appropriate diagnosis and prompt treatment. MRI can also assess for revascularization, healing, and multiple complications.

    Title Ada-deficient Scid is Associated with a Specific Microenvironment and Bone Phenotype Characterized by Rankl/opg Imbalance and Osteoblast Insufficiency.
    Date October 2009
    Journal Blood
    Excerpt

    Adenosine deaminase (ADA) deficiency is a disorder of the purine metabolism leading to combined immunodeficiency and systemic alterations, including skeletal abnormalities. We report that ADA deficiency in mice causes a specific bone phenotype characterized by alterations of structural properties and impaired mechanical competence. These alterations are the combined result of an imbalanced receptor activator of nuclear factor-kappaB ligand (RANKL)/osteoprotegerin axis, causing decreased osteoclastogenesis and an intrinsic defect of osteoblast function with subsequent low bone formation. In vitro, osteoblasts lacking ADA displayed an altered transcriptional profile and growth reduction. Furthermore, the bone marrow microenvironment of ADA-deficient mice showed a reduced capacity to support in vitro and in vivo hematopoiesis. Treatment of ADA-deficient neonatal mice with enzyme replacement therapy, bone marrow transplantation, or gene therapy resulted in full recovery of the altered bone parameters. Remarkably, untreated ADA-severe combined immunodeficiency patients showed a similar imbalance in RANKL/osteoprotegerin levels alongside severe growth retardation. Gene therapy with ADA-transduced hematopoietic stem cells increased serum RANKL levels and children's growth. Our results indicate that the ADA metabolism represents a crucial modulatory factor of bone cell activities and remodeling.

    Title Role of Ct in the Evaluation of Congenital Cardiovascular Disease in Children.
    Date May 2009
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The purpose of this review is to describe the role of CT in the evaluation of congenital cardiovascular disease in children. Clinical indications, imaging techniques, and illustrations of relevant conditions are presented. CONCLUSION: CT accurately depicts many forms of congenital cardiovascular disease in children. It is particularly valuable in the assessment of extracardiac vascular anomalies and in the evaluation of postoperative complications.

    Title Imaging of Pulmonary Venous Developmental Anomalies.
    Date May 2009
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The purpose of this article is to review pulmonary venous embryology and to present the imaging findings of a variety of pulmonary venous developmental anomalies, including total anomalous pulmonary venous connection, partial anomalous pulmonary venous connection, pulmonary vein stenosis and hypoplasia/atresia, and cor triatriatum. CONCLUSION: There are numerous developmental pulmonary venous anomalies. Although these conditions have traditionally been evaluated with echocardiography and angiography, they can be accurately diagnosed using both MRI and MDCT.

    Title Mr Findings of Endocardial Fibroelastosis in Children.
    Date August 2008
    Journal Pediatric Radiology
    Excerpt

    BACKGROUND: Endocardial fibroelastosis (EFE) is characterized by a diffuse white fibrous tissue lining the endocardium. The diagnosis is difficult to establish because clinical symptoms and electrocardiographic findings are nonspecific. Surgical resection of EFE requires the establishment of the diagnosis and delineation of the extent of the fibrotic changes. OBJECTIVE: To describe the use of MRI in the assessment of EFE in children. MATERIALS AND METHODS: Three children after surgery for aortic stenosis who were suspected of having EFE were evaluated by echocardiography and MRI. The MR evaluation consisted of black-blood, triple IR, bright-blood, perfusion and myocardial delayed-enhancement sequences. EFE was confirmed at surgery in all patients. RESULTS: Echocardiograms demonstrated vigorous systolic function but substantial diastolic dysfunction of the left ventricle in all. Mild endocardial brightening of the anterior septum, anterior wall, or papillary muscles was present in two. No study was thought to be diagnostic of endocardial fibrosis. On MRI EFE manifested at the endocardial surface as a rim of hypointense signal in the perfusion sequences and as a rim of hyperintense signal in the myocardial delayed-enhancement sequences. The black-blood, triple IR, and bright-blood sequences were not diagnostic. CONCLUSION: The diagnosis of EFE is difficult to establish by echocardiography. MRI using perfusion and myocardial delayed enhancement can be useful in establishing the diagnosis.

    Title Effect of Encoding Condition on Source Memory for Odors in Healthy Young and Older Adults.
    Date July 2008
    Journal Gerontology
    Excerpt

    BACKGROUND: Source memory has been shown to be more affected by aging than item memory. Aging also has been shown to result in impairments in odor memory. OBJECTIVE: The aim of the study is to examine the effects of explicit encoding instructions on source memory for olfactory stimuli in healthy older and young adults. METHODS: Source and item memory for odors were assessed in two conditions. In the uninformed condition, young (18-30) and older adults (65+) were presented with 16 odors by two sources (male and female) without instruction at encoding and no warning of a subsequent memory task. In the informed condition, young and older adults were instructed to encode the stimuli and their respective sources. To assess item memory, the participant was presented with an odor from the task and a new odor and was asked to indicate which odor had been presented previously. On source memory trials, the participant was presented with an odor from the task and was asked to indicate whether the male or female presented the odor. RESULTS: A 2 x 2 x 2 analysis of variance revealed that older adults were significantly impaired relative to young adults on the source memory trials in both the uninformed and informed conditions, F(1, 52) = 18.15, p < 0.001. However, older adults matched the performance of young adults on item memory trials, regardless of encoding condition. CONCLUSIONS: Even with conscious effort to encode the sources associated with the odors, older adults show significant source memory impairments. The mnemonic processes used to integrate contextual source information with item memory during encoding may fail to initiate due to the amount of effort required to encode the olfactory stimulus. The difficulty of encoding and subsequently retrieving the source may be increased due to the difficulty of encoding the odors. The results demonstrate the robust effects of aging on source memory for odors.

    Title Interrupted Aortic Arch: Spectrum of Mri Findings.
    Date June 2008
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The objective of this article is to review the types, pathogenesis, MRI appearance, treatment, and prognosis of interrupted aortic arch (IAA). CONCLUSION: IAA is a rare congenital vascular anomaly. Although this entity has been evaluated traditionally with echocardiography and angiography, MRI can accurately diagnose and characterize the various forms of IAA and associated congenital heart defects. MRI can also be used to evaluate for postoperative complications after repair.

    Title The Debittering of Navel Orange Juice Using Polymeric Films.
    Date January 2008
    Journal Journal of Food Science
    Excerpt

    In order to better understand and optimize the sorption of limonin (the major navel orange juice bitter principle) by various plasticized polymeric films, a sorption and plasticizer migration study was carried out using high-performance liquid chromatography (HPLC) and gas chromatography (GC). Low molecular weight (LMW) poly (vinyl chloride) (PVC) plasticized with dioctyl adipate (DOA) gave the best results for both limonin sorption and low DOA migration. Thick films did not significantly sorb more limonin than thin films in the timeframe of our experiments, as the absorption involved rapid surface sorption followed by slow bulk diffusion. The debittering efficiency was a 1000-fold greater than that obtained with current polystyrene divinylbenzene resin beads, with potential for industrial scale debittering.

    Title Ct of Tracheal Agenesis.
    Date April 2007
    Journal Pediatric Radiology
    Excerpt

    BACKGROUND: Tracheal agenesis is a rare and usually lethal anomaly. In the past, opaque contrast medium was injected via the esophagus to demonstrate the anatomy. OBJECTIVE: To demonstrate the utility of helical and multidetector CT in delineating the aberrant anatomy in newborns with tracheal agenesis. MATERIALS AND METHODS: Four newborns with tracheal agenesis were identified from three institutions. Imaging studies and medical records were reviewed. Each child was imaged with chest radiography. One child was imaged on a single-detector helical CT scanner and the other three on multidetector scanners. RESULTS: Helical and multidetector CT with 2D and 3D reconstructions clearly delineated the aberrant tracheobronchial and esophageal anatomy in each infant. Minimum intensity projection reformatted CT images were particularly helpful. One infant each had type I and type II tracheal agenesis. Two infants had type III tracheal agenesis. All four infants died. CONCLUSION: CT is a useful tool for delineating the aberrant anatomy of newborns with tracheal agenesis and thus helps in making rational clinical decisions.

    Title Ex Vivo Gene Therapy with Lentiviral Vectors Rescues Adenosine Deaminase (ada)-deficient Mice and Corrects Their Immune and Metabolic Defects.
    Date November 2006
    Journal Blood
    Excerpt

    Adenosine deaminase (ADA) deficiency is caused by a purine metabolic dysfunction, leading to severe combined immunodeficiency (SCID) and multiple organ damage. To investigate the efficacy of ex vivo gene therapy with self-inactivating lentiviral vectors (LVs) in correcting this complex phenotype, we used an ADA(-/-) mouse model characterized by early postnatal lethality. LV-mediated ADA gene transfer into bone marrow cells combined with low-dose irradiation rescued mice from lethality and restored their growth, as did transplantation of wild-type bone marrow. Mixed chimerism with multilineage engraftment of transduced cells was detected in the long term in animals that underwent transplantation. ADA activity was normalized in lymphocytes and partially corrected in red blood cells (RBCs), resulting in full metabolic detoxification and prevention of severe pulmonary insufficiency. Moreover, gene therapy restored normal lymphoid differentiation and immune functions, including antigen-specific antibody production. Similar degrees of detoxification and immune reconstitution were obtained in mice treated early after birth or after 1 month of enzyme-replacement therapy, mimicking 2 potential applications for ADA-SCID. Overall, this study demonstrates the efficacy of LV gene transfer in correcting both the immunological and metabolic phenotypes of ADA-SCID and supports the future clinical use of this approach.

    Title Pigmented Villonodular Synovitis: Mr Imaging in Pediatric Patients.
    Date August 2006
    Journal Pediatric Radiology
    Excerpt

    OBJECTIVES: To describe the usefulness of gradient-echo imaging and contrast-enhanced MR imaging in diagnosing and assessing the extent of pigmented villonodular synovitis (PVNS) in pediatric patients. PATIENTS AND METHODS: Retrospective analysis of five pediatric patients (median age 14 years) with PVNS of the knee examined with a 1.5-T unit. Signal characteristics were obtained comparing T1- and proton-density (PD)-weighted imaging with gradient-echo imaging and enhanced imaging. The extent of the disease was assessed using the arthroscopic approach. Signal intensity ratios were statistically analyzed. RESULTS: Compared to PD- and T1-weighted imaging sequences, gradient-echo imaging provides superior depiction of the extent of the disease due to signal decay (T2*-effect) of hemosiderin-laden thickened synovium and masses. Inflamed synovium with low hemosiderin deposition was identified on enhanced imaging. Beside the suprapatellar bursa and Hoffa's fat pad, the area posterior to the cruciate ligaments is commonly involved. No bony abnormalities were present. CONCLUSION: Gradient-echo imaging together with enhanced imaging is useful in diagnosing and assessing the extent of PVNS in pediatric patients. A low signal mass behind the cruciate ligaments may represent an important diagnostic feature. Bony abnormalities were always absent.

    Title Stage-i Osteochondritis Dissecans Versus Normal Variants of Ossification in the Knee in Children.
    Date February 2006
    Journal Pediatric Radiology
    Excerpt

    BACKGROUND: Juvenile osteochondritis dissecans (OCD) has a better prognosis than the adult type. OBJECTIVE: We postulated that the excellent prognosis of juvenile OCD could be explained, at least in part, by the erroneous diagnosis of some developmental variants of ossification as stage-I OCD. MATERIALS AND METHODS: Knee MRIs of 38 children, ages 7.5-17.7 years (mean and median age 13 years), were retrospectively reviewed to look for features that might separate normal variants of ossification from stage-I OCD. These included age, gender, site, configuration of the lesion, residual cartilaginous model and presence of edema. RESULTS: Twenty-three patients (32 condyles) had ossification defects with intact articular cartilage suggestive of stage-I lesions. No stage-II lesions were seen in the posterior femoral condyles. Accessory ossification centers were seen in 11/16 posterior condyles and 3/16 central condyles. Spiculation of existing ossification was seen in 12/16 posterior condylar lesions and 1/16 central condyles. There was a predominance of accessory ossifications and spiculations in the patients with 10% or greater residual cartilaginous model. No edema signal greater than diaphyseal red-marrow signal was seen in the posterior condyles. Clinical follow-up ranged from 0.5 to 38 months, with clinical improvement in 22 out of 23 patients. CONCLUSION: Inclusion of normal variants in the stage-I OCD category might explain, in part, the marked difference in published outcome between the juvenile and adult forms of OCD. Ossification defects in the posterior femoral condyles with intact overlying articular cartilage, accessory ossification centers, spiculation, residual cartilaginous model, and lack of bone-marrow edema are features of developmental variants rather than OCD.

    Title Myofibromatosis: Imaging Characteristics.
    Date November 2005
    Journal Pediatric Radiology
    Excerpt

    BACKGROUND: Infantile myofibromatosis is the most common fibrous tumor of infancy. It can involve the skin, muscle, bone, and viscera. This uncommon entity is subdivided into solitary and multicentric forms, with or without visceral involvement. Objective: To describe the imaging characteristics of extracranial myofibromatosis. MATERIALS AND METHODS: Six infants, aged 1 day-1 week, were evaluated by imaging. All six patients had evaluation of one of the masses by US; four patients had CT evaluation of at least one of the masses; and five patients had evaluation by MRI. RESULTS: The US appearance of the myofibromas included a mass with a purely anechoic center with a thick wall, a mass with a partially anechoic center, and a mass without anechoic components. On enhanced CT, the masses had lower or similar attenuation compared to adjacent muscle, with some masses exhibiting peripheral enhancement. The MR appearance consisted of low signal on T1-weighted imaging. On T2-weighted imaging, two had low signal of the center and the other three had high signal. All masses showed peripheral enhancement after gadolinium administration. CONCLUSIONS: Myofibromas have variable appearance on US, with a mass with an anechoic center being the most common feature. On CT, the mass can exhibit peripheral enhancement, calcifications, and erosion of adjacent bone. The MR appearance consisted of low signal on T1-weighted imaging and high or low signal of the center on T2-weighted imaging. All masses showed peripheral enhancement after gadolinium administration.

    Title Ethers of 3-hydroxyphenylacetic Acid As Selective Gamma-hydroxybutyric Acid Receptor Ligands.
    Date October 2005
    Journal Bioorganic & Medicinal Chemistry Letters
    Excerpt

    Gamma-hydroxybutyric acid (GHB) is a drug of abuse, a therapeutic, and purportedly a neurotransmitter with a complex mechanism of action in vivo due to direct actions at GABA(B) as well as GHB receptors and because of its metabolism to GABA. Herein, we describe 3-ethers of 3-hydroxyphenylacetic acid, which have relatively high affinity at GHB sites, no significant affinity at GABA receptors, and would not be expected to be rapidly metabolized to GABAergic ligands. The selectivity of these compounds (UMB108, UMB109, and UMB119) could prove to be useful for studying the biology of GHB receptors, free from GABAergic effects.

    Title Comparison of the Behavioral Effects of Gamma-hydroxybutyric Acid (ghb) and Its 4-methyl-substituted Analog, Gamma-hydroxyvaleric Acid (ghv).
    Date July 2005
    Journal Drug and Alcohol Dependence
    Excerpt

    Gamma-hydroxybutyrate (GHB), a metabolite of GABA, is a drug of abuse and a therapeutic. The illicit use of GHB precursors and analogs reportedly has increased worldwide. Gamma-hydroxyvaleric (GHV) is a 4-methyl-substituted analog of GHB that reportedly is abused and is marketed as a dietary supplement and replacement for GHB. The purpose of these studies was to compare the pharmacological and behavioral profiles of GHV and GHB. In radioligand binding studies, GHV completely displaced [(3)H]NCS-382 with approximately 2-fold lower affinity than GHB and did not markedly displace [(3)H]GABA from GABA(B) receptors at a 20-fold larger concentration. In drug discrimination procedures, GHV did not share discriminative stimulus effects with GHB or baclofen. GHV shared other behavioral effects with GHB, such as sedation, catalepsy, and ataxia, although larger doses of GHV were required to produce these effects. Lethality (50%) was observed after the largest dose of GHV (5600mg/kg), a dose that produced less-than-maximal catalepsy and ataxia. To the extent that large doses of GHV might be taken to in an attempt to produce GHB-like effects (e.g., hypnosis) GHV toxicity may pose a greater public health concern than GHB.

    Title Novel Gamma-hydroxybutyric Acid (ghb) Analogs Share Some, but Not All, of the Behavioral Effects of Ghb and Gabab Receptor Agonists.
    Date July 2005
    Journal The Journal of Pharmacology and Experimental Therapeutics
    Excerpt

    gamma-Hydroxybutyrate (GHB), a therapeutic for narcolepsy and a drug of abuse, has several mechanisms of action that involve GHB and GABA(B) receptors, metabolism to GABA, and modulation of dopaminergic signaling. The aim of these studies was to examine the role of GHB and GABA(B) receptors in the behavioral effects of GHB. Three approaches were used to synthesize GHB analogs that bind selectively to GHB receptors and are not metabolized to GABA-active compounds. Radioligand binding assays identified UMB86 (4-hydroxy-4-napthylbutanoic acid, sodium salt), UMB72 [4-(3-phenylpropyloxy)butyric acid, sodium salt], UMB73 (4-benzyloxybutyric acid, sodium salt), 2-hydroxyphenylacetic acid, 3-hydroxyphenylacetic acid (3-HPA), and 4-hydroxy-4-phenylbutyric acid as compounds that displace [(3)H]NCS-382 [5-[(3)H]-(2E)-(5-hydroxy-5,7,8,9-tetrahydro-6H-benzo[a][7] annulen-6-ylidene) ethanoic acid] from GHB receptors at concentrations that do not markedly affect [(3)H]GABA binding to GABA(B) receptors. In rats and pigeons, GHB discriminative stimulus effects were not mimicked or attenuated by UMB86, UMB72, or 3-HPA up to doses that decreased responding. In mice, GHB, GHB precursors (gamma-butyrolactone and 1,4-butanediol) and GABA(B) receptor agonists [SKF97541 [3-aminopropyl(methyl)phosphinic acid hydrochloride] and baclofen] dose-dependently produced hypolocomotion, catalepsy, ataxia, and loss of righting. The GABA(B) receptor antagonist CGP35348 (3-aminopropyl(diethoxymethyl)phosphinic acid) attenuated catalepsy and ataxia that was observed after GHB and GABA(B) receptor agonists SKF97541 and baclofen. UMB86, UMB72, UMB73, and 3-HPA, like GHB, produced hypolocomotion, ataxia, and loss of righting; however, catalepsy was never observed with these compounds, which is consistent with the cataleptic effects of GHB being mediated by GABA(B) receptors. Ataxia that was observed with UMB86, UMB72, UMB73, and 3-HPA was not antagonized by CGP35348, suggesting that ataxia induced by these analogs is not mediated by GABA(B) receptors and might involve GHB receptors.

    Title Uptake of Polychlorinated Biphenyls (pcbs) from an Aqueous Medium by Polyethylene, Polyvinyl Chloride, and Polystyrene Films.
    Date March 2005
    Journal Journal of Agricultural and Food Chemistry
    Excerpt

    The sorption of selected polychlorinated biphenyl (PCB) congeners (from tri to deca chlorinated) by three food-packaging plastic films [polyethylene, polyvinyl chloride (PVC), and polystyrene] from an aqueous solution was investigated. From the data generated, PCB uptake, partition, and diffusion coefficients were calculated for the various films. Polyethylene exhibited the highest PCB uptake, diffusion, and partition coefficients when compared to the other materials. Although PVC indicated larger sorption diffusion and partition coefficients for the lower chlorinated congeners than polystyrene, a reversal of this trend was observed for the higher congeners. For polyethylene and PVC, the PCB uptake decreased as the chlorine numbers in the congeners increased, confirming the correlation between increasing chlorination and increasing cohesive density within the PCB molecules. For polystyrene, the uptake decreased from tri to penta congeners, but showed an increase for the hexa, and then a decreased uptake until the deca chlorination. A comparison of the molecular sizes of the PCB congeners showed that the partition (Ke) and sorption diffusion (Ds) coefficients generally decreased with their increasing molar volumes. The resulting Ke values were used to determine the extent of sorption because these values indicate the affinity of PCBs for the plastic films. Results from this study can be of practical importance for cases of product quality related to the transfer of contaminants from the product to the packaging materials.

    Title 3-chloropropanoic Acid (umb66): a Ligand for the Gamma-hydroxybutyric Acid Receptor Lacking a 4-hydroxyl Group.
    Date November 2004
    Journal Bioorganic & Medicinal Chemistry
    Excerpt

    Gamma-Hydroxybutyric acid (GHB) has gained in notoriety in recent years due to its association with sexual assaults. GHB is an endogenous ligand for GHB receptors, but its complete pharmacological mechanism of action in vivo remains unclear due to apparent GABAergic components. It has been proposed that the hydroxyl group in the 4-position acts as a hydrogen bond donor to the GHB receptor. Herein we show that 3-chloropropanoic acid possesses significant affinity for the GHB receptor, has no affinity for GABA receptors, and cannot undergo metabolism to GABAergic compounds. UMB66 is thus a selective agent for the study of GHB in vivo. These results, in combination with data from quantum mechanical calculations, suggest that the hydroxyl group of GHB actually acts as a hydrogen bond acceptor in contrast to the currently accepted model. This finding is anticipated to facilitate the rational design of novel agents with selectivity for GHB receptors that may be used to elucidate the mechanism of action of this common drug of abuse.

    Title A Tertiary Alcohol Analog of Gamma-hydroxybutyric Acid As a Specific Gamma-hydroxybutyric Acid Receptor Ligand.
    Date May 2003
    Journal The Journal of Pharmacology and Experimental Therapeutics
    Excerpt

    gamma-Hydroxybutyric acid (GHB) shows great promise as a treatment for sleeping disorders but is also increasingly abused. The exact mechanism of action of GHB is yet to be delineated, but it is known to interact with specific GHB binding sites or receptors, to act as a weak agonist at GABA(B) receptors, and that GHB undergoes metabolism to GABA. In drug discrimination studies, GABA(B) agonists, and to a lesser extent GABA(A)-positive modulators, substitute for GHB. To delineate the relative contributions of each receptor system to the profile of GHB, tertiary alcohol analogs of GHB and its homolog, 5-hydroxypentanoic acid (UMB58), were prepared (UMB68 and UMB75, respectively), which cannot be metabolized to GABA-active compounds. Binding studies against [(3)H]NCS-382 [(2E)-(5-hydroxy-5,7,8,9-tetrahydro-6H-benzo[a][7]annulen-6-ylidene) ethanoic acid] showed that the tertiary alcohol analog of GHB (UMB68) has similar affinity to GHB, with the longer chain analogs possessing lower affinity. Against [(3)H]GABA, UMB68 showed no affinity (IC(50) >100 microM) at GABA(A) or GABA(B) receptors. In vivo studies showed that, at behaviorally active doses, rats trained to discriminate GHB did not recognize the novel ligands as GHB. Thus, UMB68 is a selective GHB receptor ligand in binding assays, will not undergo metabolism to GABA-active compounds, and does not show the same effects as GHB in vivo. These data suggest that, although UMB68 binds to the GHB receptor, it does not have the observed GABA receptor-mediated effects of GHB in vivo and could provide a novel tool for studying the pharmacology of the GHB receptor in the absence of complicating GABAergic effects.

    Title Magnetic Resonance Imaging of Mediastinal Vessels.
    Date January 2003
    Journal Magnetic Resonance Imaging Clinics of North America
    Excerpt

    Advances in technology have led to a changing role for MRI in the evaluation of the thoracic vasculature in children. MRI, especially with 3D gadolinium-enhanced MR angiography, can clearly demonstrate the morphology of the aortic and pulmonary vascular supply. In patients with nonvalvar obstructive lesions of the aorta (i.e., coarctation, interruption of the aortic arch, and supravalvar stenosis), MRI can reliably assess the site and extent of the obstruction. Similarly, MRI can depict the morphology of the central pulmonary arteries and aortopulmonary collateral vessels in patients with obstructive lesions of the pulmonary artery. MRI is also useful in assessing the course of the aorta and pulmonary arteries in patients with suspected vascular rings. The result is that MRI can supplement information obtained from echocardiography and angiography and reduce the need for angiography.

    Title Focal Pyomyositis of the Perisciatic Muscles in Children.
    Date November 2002
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The purpose of this report is to describe the role of MR imaging in the diagnosis of focal pyomyositis surrounding the sciatic nerve in children. CONCLUSION: In the absence of joint effusion on sonography, MR imaging should be considered in pediatric patients who present with a febrile illness and incapacitating pelvic pain.

    Title Staging of Neuroblastoma at Imaging: Report of the Radiology Diagnostic Oncology Group.
    Date June 2002
    Journal Radiology
    Excerpt

    PURPOSE: To compare the accuracies of computed tomography (CT), magnetic resonance (MR) imaging, and bone scintigraphy in staging disease in patients with neuroblastoma. MATERIALS AND METHODS: Ninety-six children with newly diagnosed neuroblastoma were enrolled in a multicenter prospective cohort study. CT, MR, and bone scintigraphy were used to evaluate tumor stage. Sensitivity and specificity values and receiver operating characteristic (ROC) curve analyses were used to compare the accuracy of CT, MR, and scintigraphy for tumor staging. RESULTS: Eighty-eight patients were eligible for staging analysis, and 45 patients who underwent surgery at initial diagnosis were eligible for analysis of local tumor extent. CT and MR had sensitivities of 43% and 83%, respectively (P <.01), and specificities of 97% and 88%, respectively (P >.05), for detection of stage 4 disease. Areas under the ROC curves for CT and MR were 0.81 and 0.85, respectively (P =.06); that for scintigraphy was 0.83. Addition of scintigraphy to both CT and MR increased the areas under the ROC curves to 0.90 and 0.88, respectively. Accuracy of CT and MR for staging disease confined to the chest or abdomen (stages 1, 2, and 3) was poor. CONCLUSION: MR alone and CT and MR combined with bone scintigraphy enable the accurate detection of stage 4 disease. Both CT and MR perform poorly for local tumor staging.

    Title Gadolinium-enhanced Mr Angiography (gd-mra) of Thoracic Vasculature in an Animal Model Using Double-dose Gadolinium and Quiet Breathing.
    Date January 2002
    Journal Pediatric Radiology
    Excerpt

    OBJECTIVE: To evaluate a gadolinium-enhanced MR angiography (Gd-MRA) imaging protocol for the assessment of thoracic vessels using double-dose gadolinium and quiet breathing. An animal model was used to simulate imaging in infants and young children. MATERIAL AND METHODS: Six baboons (Papio anubis), mean weight 5.7 kg, were sedated and intubated. After the injection of double-dose Gd-DTPA (0.2 mmol/kg) through a peripheral vein, a coronal spoiled 3D gradient-echo volume acquisition was obtained during quiet breathing. Two radiologists reviewed the images for visualization of aortic arch, brachiocephalic vessel origins, pulmonary arteries (central, upper lobe and descending branches), and pulmonary veins (upper and lower). RESULTS: Visualization was excellent for the aortic arch, brachiocephalic vessel origins, and pulmonary arteries, including the hilar branches. Visualization was excellent for the lower and right upper pulmonary veins and fair for the left upper pulmonary vein. There was excellent agreement between radiologists. CONCLUSION: Imaging of thoracic vessels with Gd-MRA using double gadolinium during quiet breathing was effective in our animal model. The advantages of this technique include a short imaging time and depiction of vascular segments--branches of pulmonary arteries and intraparenchymal segments of pulmonary veins--not optimally visualized with other non-invasive imaging techniques.

    Title Basic Science of Articular Cartilage Repair.
    Date October 2001
    Journal Clinics in Sports Medicine
    Excerpt

    As the ability to understand the peculiarities of successful healing of articular cartilage defects moves forward, it becomes clear that this complex orthopaedic problem soon will be successfully addressed. A multidisciplinary approach, combining clinical experience, cogent biomaterial designs, new cell biologic processes, biomechanical assessment, and modern molecular biology, clearly is leading toward clinically acceptable, viable, and consistent articular cartilage regeneration.

    Title Characterizing the Migration of Antioxidants from Polypropylene into Fatty Food Simulants.
    Date August 2001
    Journal Food Additives and Contaminants
    Excerpt

    The migration (diffusion and equilibrium) processes of antioxidants (AOs) from polypropylene (PP) films of different thicknesses into n-heptane and 95% ethanol as fatty food simulants were analysed at 20, 37 and 60 degrees C. Heptane fully extracted the AOs from the polymer while a partition equilibrium described the migration to ethanol. The kinetics of migration were also studied via the diffusion coeffcients. As expected, diffusion was found to be faster when the polymer was in contact with heptane, due to polymer swelling by the solvent. The kinetics of the process in ethanol was described by different theoretical expressions which are discussed. Equations disregarding partition equilibrium failed to describe the process and the diffusion coefficient values obtained through them were much smaller than the actual ones and dependent on film thickness. The results also showed the significance of food simulant selection in the analysis of food-packaging interactions and migration variability with thickness.

    Title Vomiting in Infants Up to 3 Months of Age. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Imaging of the Pediatric Patient with Seizures. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title The Limping Child. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Imaging the Child with Suspected Physical Abuse. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Sinusitis in the Pediatric Population. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Developmental Dysplasia of the Hip. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Fever Without Source. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Imaging Evaluation of Acute Right Lower Quadrant and Pelvic Pain in Adolescent Girls. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Hematuria. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Urinary Tract Infection. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Headache. American College of Radiology. Acr Appropriateness Criteria.
    Date November 2000
    Journal Radiology
    Title Mr Imaging Differentiation of Soft-tissue Hemangiomas from Malignant Soft-tissue Masses.
    Date June 2000
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The purpose of this study was to determine whether MR imaging features can reliably distinguish hemangiomas from malignant soft-tissue masses. MATERIALS AND METHODS: We retrospectively reviewed MR imaging studies of 22 patients with soft-tissue hemangiomas and 22 patients with malignant soft-tissue masses. Images were reviewed and agreement reached by a consensus interpretation of two observers and by an independent observer. Masses were evaluated for signal intensity on T1- and T2-weighted images, for enhancement with gadolinium administration, and for morphology (lobulation, septation, central low-intensity dots). Lesion T2 signal and lesion enhancement with gadolinium administration were also objectively measured using regions of interest and comparison with skeletal muscle. RESULTS: Signal intensity on T1-weighted imaging of hemangiomas and malignant soft-tissue masses was similar. Subjective analysis showed greater T2 signal and gadolinium enhancement in hemangiomas; however, the differences were not statistically significant on objective analysis. Lobulation, septation, and central low-signal-intensity dots were all more common in hemangiomas, with statistical significance achieved; the combination of all three findings was specific for hemangioma. CONCLUSION: Although no single MR imaging feature was diagnostic in this study, analysis of lesion morphology, signal intensity, and enhancement with gadolinium allowed MR imaging differentiation of hemangiomas from malignant soft-tissue masses.

    Title Development of an Analytical Method for the Determination of Congener Specific Pcbs in Selected Polymeric Packaging Materials.
    Date September 1998
    Journal Bulletin of Environmental Contamination and Toxicology
    Title Diffuse Marrow Disorders in Children.
    Date August 1998
    Journal Magnetic Resonance Imaging Clinics of North America
    Excerpt

    This article describes MR imaging findings in neoplastic processes affecting the marrow of children. Differentiation from non-neoplastic processes, such as edema and hematopoietic marrow is described.

    Title Images in Cardiovascular Medicine. Correlative Imaging of Aortopulmonary Window: Demonstration with Echocardiography, Angiography, and Mri.
    Date September 1997
    Journal Circulation
    Title Assessment of Central Pulmonary Arteries in Patients with Obstructive Lesions of the Right Ventricle: Comparison of Mr Imaging and Cineangiography.
    Date December 1996
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: MR imaging and cineangiography were compared in the evaluation of central pulmonary arteries in patients with obstructive lesions of the right ventricular outflow tract. SUBJECTS AND METHODS: Prospectively, we obtained multiplanar spin-echo cardiac-gated MR images and cineangiograms in 29 patients who had obstructive lesions of the right ventricular outflow tract (31 examinations). Blinded first observers evaluated the presence, size, confluence, and stenoses of the pulmonary artery and the presence of aortopulmonic collaterals. Blinded second observers evaluated the presence and size of the pulmonary artery. RESULTS: Each imaging technique revealed pulmonary arteries that were not shown by the other technique. We measured pulmonary arteries as being smaller on MR images; however, we found good correlation between the two techniques (r value for right pulmonary arteries = .82, r value for left pulmonary arteries = .88). MR imaging revealed five of six stenoses in the left pulmonary artery, but our observers falsely identified five right pulmonary arteries as stenotic from MR images. Interobserver variability and intraobserver variability in estimating size of the pulmonary artery on MR images and cineangiograms were similar and were less than variability when paired estimations in the same patient with both imaging techniques were compared. CONCLUSIONS: MR imaging and cineangiography should be viewed as complementary techniques.

    Title Reduction of Radiation Dose in Pediatric Patients Using Pulsed Fluoroscopy.
    Date December 1996
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE: The purpose of this study was to determine if pulsed fluoroscopy reduces radiation exposure to pediatric patients undergoing conventional fluoroscopy. SUBJECTS AND METHODS: Four hundred one consecutive patients were nonrandomly divided into pulsed fluoroscopy and conventional fluoroscopy study groups. Two control groups were also assembled: 474 patients evaluated with conventional fluoroscopy before the study and 138 patients evaluated with pulsed fluoroscopy after the study. RESULTS: We found no difference in fluoroscopy times across the groups. Although the number of digital spot films was slightly higher for the pulsed fluoroscopy study group than for the conventional fluoroscopy study group, we found no difference in the number of digital spot films for the pulsed fluoroscopy study group and for the conventional fluoroscopy control group. Furthermore, the difference in the number of digital spot films was also insignificant for the pulsed fluoroscopy control group and the conventional fluoroscopy study group. The radiation exposure in the pulsed fluoroscopy study group was 50% lower (mean, 0.6 R) than in the conventional fluoroscopy study group. When using pulsed fluoroscopy in the 7.5 pulses-per-second mode, we were able to reduce radiation exposure by 75% of that from conventional fluoroscopy. CONCLUSION: Pulsed fluoroscopy reduces fluoroscopic radiation exposure to pediatric patients undergoing conventional fluoroscopy. Despite minor image degradation, pulsed fluoroscopy is the technique of choice at our institution.

    Title Development of a Gas-phase Oxygen Biosensor Using a Blue Copper-containing Oxidase.
    Date December 1996
    Journal Enzyme and Microbial Technology
    Excerpt

    A gas-phase oxygen biosensor based on blue copper-containing oxidases was developed. Blue-oxidase enzymes, including laccase and ascorbate oxidase, have a blue chromophore prosthetic group, type 1 Cu+2, which can be reduced and decolorized with reducing substrates. When the enzyme is reoxidized with molecular oxygen, there is a concomitant return of the blue color. The oxygen biosensor consisted of the Rhus vernicifera laccase and ascorbate as substrate enclosed in pouches of low-density polyethylene under nitrogen gas. Operational stability of the biosensor was established by exposing it to different oxygen/nitrogen gas mixtures at 5 degrees C. Gas-phase oxygen concentrations were measured by keeping it under nitrogen gas and subsequently recording the rate of reappearance of the enzyme blue color, both visually and spectrophotometrically at 610 nm. The oxygen biosensor was able to detect a wide range of oxygen concentrations. The time required to recover the blue color, namely the biosensor response time, at the optimized assay conditions of 5 degrees C and a high-water activity level, was determined. This research describes the development of an oxygen biosensor with adequate activity and stability to measure gas-phase oxygen concentrations at 5 degrees C and high-water activity levels. The oxygen biosensor could be used to indicate oxygen concentrations above acceptable levels in headspace oxygen concentration which could affect the quality and safety of products packaged under initial low levels of oxygen concentration.

    Title Magnetic Resonance Imaging in Congenital Heart Disease in Children.
    Date December 1996
    Journal Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
    Title Cardiovascular Mr Imaging of Children.
    Date December 1996
    Journal Magnetic Resonance Imaging Clinics of North America
    Excerpt

    The role of MR imaging in the evaluation of congenital heart lesions is described. Emphasis is placed on those indications where MR imaging complements other imaging modalities, i.e., evaluation of the great vessels. Advantages and disadvantages of different MR imaging techniques (i.e., spin echo, segmented k-space acquisition, and gadolinium-enhanced angiography) are illustrated.

    Title Mr Visualization of Aortic Valve Vegetations.
    Date September 1996
    Journal Journal of Computer Assisted Tomography
    Excerpt

    PURPOSE: The purpose of this report is to describe the MR findings of aortic vegetations in two patients. METHOD: MR imaging using SE and fast GE (Fastcard) sequences was performed in the axial and coronal planes. RESULTS: The vegetations were not visible with SE MRI, but were clearly visible with fast GE imaging (Fastcard). The vegetations appeared as areas of low signal at valve leaflets in contrast to the bright flowing blood. CONCLUSION: MR evaluation in patients with infective endocarditis is useful in clarifying echocardiographic findings and establishing the diagnosis in previously undiagnosed patients.

    Title Improved Ejection Fraction and Flow Velocity Estimates with Use of View Sharing and Uniform Repetition Time Excitation with Fast Cardiac Techniques.
    Date May 1995
    Journal Radiology
    Excerpt

    PURPOSE: To improve the accuracy of ventricular volume estimates and effective temporal resolution in fast cardiac acquisitions. MATERIALS AND METHODS: Data sets at intermediate temporal phases were generated by means of sharing of views from two temporally adjacent data sets. A simulated model was used, and studies with patients and volunteers were conducted. View sharing was implemented in both fast gradient-echo and fast phase-contrast cine acquisitions; breath holding was used when possible. RESULTS: Uniform repetition time (TR) radio-frequency (RF) excitation allowed a better assessment of the end-diastolic ventricular volume. In addition, view sharing provided a better estimate of end-systolic ventricular volume in cases in which rapid changes in volume occurred at or about the temporal boundary of the source images. View sharing also provided a much smoother representation of dynamic cardiac motion when viewed in a cine loop. CONCLUSION: View sharing and uniform TR RF excitation improve the accuracy of end-systolic and end-diastolic ventricular volume measurements by improving the effective temporal resolution.

    Title Assessing Renal Function in Children Prior to Administration of Contrast Material.
    Date February 1995
    Journal Ajr. American Journal of Roentgenology
    Title Neoplasms in a Pediatric Population: 2-[f-18]-fluoro-2-deoxy-d-glucose Pet Studies.
    Date February 1995
    Journal Radiology
    Excerpt

    PURPOSE: To assess the uptake of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) in common and uncommon tumors in children and to develop a method for performing positron emission tomography (PET) studies in children with malignant neoplasms. MATERIALS AND METHODS: Twenty-two pediatric patients with known or suspected malignancies (27 scans) underwent FDG PET. Tumor uptake of FDG was measured on PET scans. RESULTS: Tumor uptake of FDG was detected in 17 of 21 patients with malignant disease. Neuroblastomas and their metastases (including those that did not absorb metaiodobenzylguanidine) intensely accumulated FDG. In a patient with Ewing sarcoma, FDG PET showed two foci of metastatic disease not evident on bone scans. In two patients, PET showed that large areas of the tumor were necrotic. CONCLUSION: FDG PET is feasible, is useful in the study of tumors in children, and may provide unique, clinically important information.

    Title Ultrasound Diagnosis of Neonatal Congenital Dislocation of the Hip. A Decision Analysis Assessment.
    Date August 1994
    Journal The Journal of Bone and Joint Surgery. British Volume
    Excerpt

    Routine ultrasound evaluation of neonates and young infants for congenital dislocation of the hip has been recommended. We have used the methods of decision analysis to determine whether every neonate should be examined by ultrasound or just those at increased risk. We have also studied the reliability and accuracy of ultrasound in following infants during observation and treatment, using published data. We find that ultrasound is not the preferred strategy for the screening of neonates, and that its role in evaluating high-risk patients depends on the point of view. For an individual, when third parties are bearing the cost, ultrasound is useful. For society as a whole, the routine ultrasound evaluation of the high-risk patient is not advantageous. For follow-up, ultrasound using the methods of Graf has a low reliability and there are no adequate data for methods using dynamic assessment.

    Title Radiation Dose Reduction in Ct of the Pediatric Pelvis.
    Date March 1994
    Journal Radiology
    Excerpt

    PURPOSE: To determine whether a lower radiation dose technique can be used for computed tomography (CT) of the pediatric pelvis without significant loss of diagnostic image quality. MATERIALS AND METHODS: Thirty-six pediatric patients underwent CT at 80 mAs (experimental group), and 42 underwent CT at 240 mAs (control group). Anatomic details, image quality, and the degree of confidence in reaching a diagnosis were graded on a scale of 1 (poor) to 4 (excellent). RESULTS: The difference in perceived image quality between the experimental and control groups was not statistically significant. The mean scores for scans evaluated by the first reader were 3.88 for the experimental group and 3.92 for the control group (P = .2804). The mean scores for the second reader were 3.78 and 3.77 for the experimental and control groups, respectively (P = .8131). CONCLUSION: A substantial dose reduction can be achieved if pelvic CT is performed at 80 mAs, without a recognizable deterioration of diagnostic image quality.

    Title Thoracic Cardiovascular Anomalies in Children: Evaluation with a Fast Gradient-recalled-echo Sequence with Cardiac-triggered Segmented Acquisition.
    Date September 1993
    Journal Radiology
    Excerpt

    A fast gradient-recalled-echo sequence with cardiac-triggered segmented acquisition (fastcard) was compared with a standard T1-weighted spin-echo sequence with cardiac gating and respiratory compensation in the evaluation of pediatric patients with thoracic cardiovascular anomalies. Twenty patients aged 1 week to 24 years (median age, 9 months) with various abnormalities underwent magnetic resonance (MR) imaging. In 18 patients, MR imaging was performed with both gated spin-echo and fastcard. Two observers rated the clinical utility of each sequence. Fastcard images were superior to spin-echo images in 10 patients, equivalent in seven, and inferior in one. Two additional patients with suspected pulmonary vascular lesions were accurately evaluated with the fastcard technique. The fastcard technique provides superior demonstration of thoracic cardiovascular structures and turbulent flow and enables imaging in multiple phases of the cardiac cycle.

    Title Mr Imaging in Children with Dermatomyositis: Musculoskeletal Findings and Correlation with Clinical and Laboratory Findings.
    Date August 1993
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    OBJECTIVE. The purpose of this study was to describe the musculoskeletal MR findings in childhood dermatomyositis and to correlate MR findings with indicators of disease activity such as muscle strength and serum levels of muscle enzymes. SUBJECTS AND METHODS. This prospective study included 24 children: 19 children with dermatomyositis and five control subjects. The diagnosis of dermatomyositis was established by clinical findings and serum levels of muscle enzymes in all patients, electromyography in six patients, and biopsy in four patients. At the time of the initial MR evaluation, patients were classified on the basis of clinical findings as having active (n = 15) or inactive (n = 4) disease. A total of 44 MR evaluations of patients with dermatomyositis were included in the study: 19 initial MR examinations and 12 examinations repeated after 4-6 months of therapy in patients with active disease. An additional 13 examinations were performed on five patients. Conventional T1-weighted (SE 600/20) and T2-weighted (SE 2500/80) spin-echo and fat-suppressed MR images were obtained. The T2-weighted images (TE = 80) were used for comparison. In addition to the visual assessment, ratios between the signal intensity of muscles (gluteus, adductors, quadriceps, and hamstrings) and the signal intensity of subcutaneous fat in the same tomographic section were calculated. RESULTS. All patients with clinically active disease (n = 15) had abnormal findings on MR studies, whereas those with inactive disease (n = 4) had normal MR findings. Signal-intensity ratios of patients with active disease were greater than those in control subjects, whereas the ratios in patients with inactive disease were not different from those in control subjects. After 4-6 months of therapy, the average signal-intensity ratios of treated patients with repeated MR evaluations (n = 12) differed from ratios obtained before therapy in the same patients, but were not different from the ratios in control subjects. Other MR findings observed were perimuscular edema, enhancement of the chemical-shift artifact, and inflammatory changes of subcutaneous fat. Fat-suppressed imaging enhanced visualization of abnormalities. Markedly abnormal signal intensities of muscle were associated with marked elevations of serum levels of muscle enzymes; however, abnormal MR findings were visualized with normal serum levels of muscle enzymes. CONCLUSION. Findings of active childhood dermatomyositis on T2-weighted MR images include increased signal intensity in affected muscle, perimuscular edema, enhanced chemical-shift artifact, and increased signal intensity in subcutaneous fat. After therapy, signal intensity of muscle returns to normal. These MR findings are enhanced on fat-suppressed images.(ABSTRACT TRUNCATED AT 400 WORDS)

    Title Renal Imaging in Children with Persistent Hypertension.
    Date January 1993
    Journal Pediatric Clinics of North America
    Excerpt

    The role that imaging plays in the evaluation of the child with hypertension depends in large part on the results of thorough historical, physical, and laboratory examinations. How aggressively one searches for an underlying renal parenchymal or renovascular disorder must be individualized in each child. An individualized approach to renal imaging in children with hypertension is presented.

    Title Diseases of the Musculoskeletal System in Children: Imaging with Ct, Sonography, and Mr.
    Date April 1992
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    We reviewed the applications of CT, sonography, and MR imaging in diseases of the musculoskeletal system in children. Unique advantages of each technique are discussed, and common disease entities and practical applications of the three imaging methods are stressed. Evaluation of congenital dysplasia of the hip, hip effusion, and soft-tissue foreign bodies with sonography are emphasized. The role of CT in imaging patients with congenital dysplasia of the hip, tarsal coalition, osteomyelitis, and benign and malignant bone tumors is stressed. Common applications of MR that are emphasized include imaging of osteomyelitis, musculoskeletal tumors, normal bone marrow, and avascular necrosis. Innovations are briefly discussed, including evaluation of dermatomyositis with MR and imaging sternoclavicular dislocation, congenital vertical talus, and fractures and dislocations with sonography.

    Title Fat-suppressed Mr Imaging of Myositis.
    Date January 1992
    Journal Radiology
    Excerpt

    A hybrid fat-suppression sequence in magnetic resonance (MR) imaging was used to evaluate inflammatory muscle disorders in seven children: five patients with dermatomyositis, one patient with vasculitis, and one patient with viral myositis. Fat-suppressed multisection axial images obtained with the same repetition and echo times as those used to obtain standard spin-echo (SE) images enabled direct comparison of images, with little variation of T1 and T2 weighting. In six patients, the contrast on images obtained with T2 fat suppression was 15%-20% greater than contrast on conventional T2-weighted SE images. In all seven patients, the subjective judgment was that T2-weighted fat-suppression sequences improved visualization of muscle abnormalities. It is concluded that T2 fat suppression is useful in evaluation of inflammatory muscle disorders in children because it increases contrast and eliminates fat as a cause of muscle abnormality.

    Title Serial Magnetic Resonance Imaging in Juvenile Dermatomyositis.
    Date January 1992
    Journal Arthritis and Rheumatism
    Excerpt

    Magnetic resonance imaging (MRI) was used to follow the course of juvenile dermatomyositis from the onset of disease through resolution of a primary relapse. The signal intensity of the T2-weighted image of involved muscles was elevated during periods of disease activity, and returned to approximately normal levels with effective suppression of disease activity. T1-weighted images of involved muscles remained approximately normal despite disease activity.

    Title "dilatation" of the Left Renal Vein on Computed Tomography in Children: a Normal Variant.
    Date September 1991
    Journal Pediatric Radiology
    Excerpt

    Compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta is thought to be a cause of hematuria, periureteral and gonadal varices, and varicocele ("Nutcracker phenomenon"). Previous investigators have suggested that this diagnosis can be made on computed tomography when the LRV ratio greater than or equal to 1.5 (the diameter of the LRV proximal to the aorto-mesenteric angle divided by the diameter of the LRV distal to the aorto-mesenteric angle). This study was designed to establish the normal range for the LRV ratio on CT in children. The LRV ratio was measured in thirty-nine consecutive children undergoing intravenously enhanced CT of the abdomen. None of the children had hematuria on urinalysis immediately before or after the CT. Children with any known abnormality involving the kidneys, adrenal glands, IVC, or renal or gonadal veins were excluded. The patients ranged in age from 3.4 to 18.5 years (mean = 10.6 years). LRV ratio ranged from 0.78 to 2.00 (mean = 1.46; S.D. = 0.312). Twenty of the 39 children (51.3%) had a LRV ratio greater than or equal to 1.50. The conclusion is that the normal range for the LRV ration is too wide for it to be useful in diagnosing LRV entrapment and that a LRV ratio greater than or equal to 1.5 on CT is normal in children.

    Title Approach to Skeletal Maturation.
    Date July 1991
    Journal Hand Clinics
    Excerpt

    Skeletal maturation is marked by an orderly and reproducible sequence of recognizable changes in the appearance of the skeleton during childhood. Such changes include the timing and sequence of the appearance of the centers of ossification, specific alterations in the contours of the bones, and the timing and sequence of the ultimate closure of the growth plates. Radiographically, skeletal maturity can be assessed by comparing the radiographic appearance of portions of an individual child's skeleton with the standardized appearance in a comparable population of children at various stages in their progress toward maturity. Radiographic assessment of skeletal maturity in the child is most frequently based on the appearance of the hand and wrist. Considerable normative data are available for this examination. The Greulich-Pyle atlas is the system which is most frequently used in the United States. Assessment of skeletal maturity can be useful in the evaluation and management of children with various endocrinopathies (especially those involving the pituitary, thyroid, and gonads) and in children with malformation syndromes. Skeletal maturity assessment is also frequently requested as part of the evaluation of children who are either too tall or too short for their chronologic age and can be used to predict height at maturity. Such assessment can also be useful in planning orthopedic procedures in which the outcome may be influenced by subsequent growth of the child (e.g., surgical management of scoliosis or leg-length discrepancy).

    Title Interobserver and Intraobserver Variations in Sonographic Renal Length Measurements in Children.
    Date May 1991
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    Sonographic measurement of renal length is used commonly to evaluate growth of the kidneys in children. However, no previous studies have been performed to determine the degree of interobserver and intraobserver variability in such determinations. We measured the interobserver and intraobserver error in sonographic measurements of renal length obtained independently by three experienced imagers in 21 children (41 kidneys). The mean interobserver variation between any two imagers ranged from 3.87 to 5.49 mm. The mean intraobserver variation was 0.87 to 3.61 mm. The observed variability in sonographic measurement of renal length is comparable to the expected annual increase in length of the kidneys during childhood (2.2-5.7 mm per year). Therefore, caution is suggested when using sonography to evaluate renal growth in children during a year's time.

    Title Congenital Heart Disease: Applications of Computed Tomography and Magnetic Resonance Imaging.
    Date April 1991
    Journal Seminars in Ultrasound, Ct, and Mr
    Title Association of Increased Cardiothoracic Ratio and Intrauterine Growth Retardation.
    Date February 1991
    Journal American Journal of Perinatology
    Excerpt

    Clinical observation suggested an association between an increased cardiothoracic ratio (CT) and growth retardation (IUGR) in the premature neonate. To investigate this hypothesis, a case-control study was performed. Study subjects included 23 cases (IUGR) and 55 control (appropriate for gestational age [AGA]) premature infants with birthweights 2000 gm or less; Apgar scores greater than 5 at 5 minutes; no congenital heart disease; no polycythemia; no toxoplasmosis, rubella, cytomegalovirus, or herpes infection. In random order, the first chest radiograph of each infant (less than 24 hours) was reviewed by a single radiologist, unaware of the infant's growth status. The CT ratio was computed after measuring the widest internal width of the bony thorax and the cardiac diameter. Mean birthweight (+/- 1 SD) of the IUGR infants was 1161 +/- 289 g and of AGA infants was 1401 +/- 401 g (p less than 0.002); the mean gestational ages (+/- 1 SD) were 33.2 +/- 2.8 and 30.8 +/- 2.5 weeks (p less than 0.001). Mean CT for IUGR infants was 0.57 +/- 0.07 (+/- 1 SD) versus AGA infants, 0.51 +/- 0.04 (+/- 1 SD), p less than 0.001. When the infants were stratified by growth status and CT ratio, 11 of 23 IUGR and 1 of 55 AGA infants had an increased CT ratio p less than 0.0001. When birthweight and gestational age were covaried, growth status remained the best predictor of CT, p = 0.005. There is a strong association of increased CT and growth retardation in premature infants with birthweights 2000 gm or less.

    Title Mr Imaging of Double Chambered Left Ventricle.
    Date February 1991
    Journal Journal of Computer Assisted Tomography
    Excerpt

    Double chambered left ventricle is a very rare anomaly within the broader category of "subdivision of the left ventricular cavity," which includes the relatively more common congenital aneurysms and diverticulae. We report a case of an adolescent with double chambered left ventricle that MR clearly delineated, resulting in successful surgical correction.

    Title Pseudoascites: Unusual Presentation of Omental Cyst.
    Date November 1990
    Journal Pediatric Radiology
    Excerpt

    An unusual case of omental cyst is described. The child initially presented with a unilocular intraperitoneal fluid collection on CT. After paracentesis, CT showed freely layering peritoneal fluid, with eventual complete resolution of fluid. CT eight months later demonstrated re-appearance of a multi-septated cystic mass. At surgery, an omental cyst was found.

    Title Magnetic Resonance Imaging Appearance of the Muscles in Childhood Dermatomyositis.
    Date November 1990
    Journal The Journal of Pediatrics
    Excerpt

    Documentation of muscle involvement in a child thought to have dermatomyositis may require the performance of invasive procedures such as electromyography and/or muscle biopsy. We describe four patients with dermatomyositis in whom magnetic resonance imaging (MRI) demonstrated the muscle involvement. The involved muscles had increased signal intensity on the T2-weighted images (SE 2500/80) and normal appearance on the T1-weighted images (SE 600/20). The involvement of the muscles was not uniform. There was good correlation between the distribution of muscle involvement by MRI and functional testing. Follow-up MRI scans in patients with favorable outcome demonstrated that the affected muscles had returned to normal signal intensity. Although the MRI findings are not specific, in the proper clinical context they may be helpful in establishing the diagnosis of dermatomyositis. MRI may also be used in establishing an appropriate muscle biopsy site. In addition, MRI may be used for monitoring the progress of the disease.

    Title Radiographic Imaging of Airway Obstruction in Pediatrics.
    Date September 1990
    Journal Otolaryngologic Clinics of North America
    Excerpt

    The authors review techniques available to image the airway, normal radiographic airway anatomy, pitfalls in imaging the airway, and radiographic findings in various pathologic processes that may cause airway obstruction. A brief discussion of the application of imaging in the child with sleep apnea is included.

    Title Intracapsular Osteoid Osteoma of the Proximal Femur: Findings on Plain Film and Ct.
    Date June 1990
    Journal Ajr. American Journal of Roentgenology
    Title Mri of Surgically Created Pulmonary Artery Narrowing in the Dog.
    Date February 1990
    Journal Pediatric Radiology
    Excerpt

    Narrowing of the pulmonary arteries was created surgically in twelve dogs. In six of the dogs the narrowing was central (main pulmonary artery), and in the remaining six the narrowing was located peripherally at the hilar level of the right pulmonary artery beyond the pericardial reflection. MRI and angiography were performed in all dogs. MRI clearly delineated the site of the pulmonary band and the caliber of the pulmonary artery at the site of the band in all dogs (N = 6). MRI was not able to visualize any of the stenosis of the right pulmonary arteries at the hila, beyond the pericardial reflection. In addition, optimal imaging planes to depict each segment of the central pulmonary arteries were determined. The capability to image in oblique planes is essential in evaluating the morphology of the central pulmonary arteries.

    Title Pedicled Right Atrial-pericardial Tissue Conduit for Bypass of the Obstructed Superior Vena Cava in Children.
    Date September 1989
    Journal The Journal of Thoracic and Cardiovascular Surgery
    Excerpt

    Surgical relief of superior vena caval obstruction with flaps constructed from pedicled right atrium and pedicled pericardium has been performed successfully in 2 children aged 1 and 13 years. Long-term conduit patency 43 and 24 months after the operation has been achieved with this technique, despite continued growth of both patients.

    Title Case Report 511: Fibroblastic Rheumatism.
    Date May 1989
    Journal Skeletal Radiology
    Title Ct Evaluation of the Shoulder in Children with Erb's Palsy.
    Date August 1988
    Journal Pediatric Radiology
    Excerpt

    The majority of children with traumatic injuries of the brachial plexus recover with only minor sequelae. Some patients develop residual deformity, however. This deformity may consist only of internal rotation contractures, but in some patients subluxation of the humeral head may be present. CT is useful in the evaluation of: the presence or absence of subluxation, deformity of the glenoid and the proper placement of the humeral head in plaster or orthotic devices.

    Title Bolus Dynamic Computed Tomography in the Evaluation of Pulmonary Sequestration.
    Date April 1988
    Journal The Journal of Computed Tomography
    Excerpt

    Three cases of pulmonary sequestration evaluated by bolus dynamic computed tomography are described. The computed tomography appearance and the differential diagnosis are discussed. It is important to recognize the advantages of the bolus dynamic technique in the evaluation of pulmonary sequestration as it may eliminate the need for further studies.

    Title Ct and Mr of Congenital Heart Disease.
    Date March 1988
    Journal Radiologic Clinics of North America
    Excerpt

    CT and MR join echocardiography in the noninvasive evaluation of the child with congenital heart disease. This article discusses the uses of these modalities in the assessment of the cardiovascular system in children.

    Title Mr Evaluation of Liver Iron Overload.
    Date February 1988
    Journal Journal of Computer Assisted Tomography
    Excerpt

    Children and young adults with hemolytic anemias requiring frequent transfusions develop increased liver iron content. We evaluated 15 chronically transfused children with sickle cell disease to determine whether spin-echo magnetic resonance (MR) imaging was useful in assessing the degree of iron overload. Quantitative MR parameters were correlated with liver biopsy iron determinations and serum ferritin levels. The best predictor of liver iron was the ratio of the intensities between the liver and paraspinal musculature on somewhat T1 weighted sequence (repetition time 0.5 s, echo time 28 ms), R2 = 0.58. Magnetic resonance was able to separate those patients with liver iron levels greater than 100 micrograms/mg (intensity ratios approximately 0.4), from those with levels less than 100 micrograms/mg (intensity ratios near 1). However, MR was unable to quantitate liver iron in patients with values ranging from 100 to 400 micrograms/mg since similar intensity ratios were present in this range. Thus, MR provides a qualitative rather than quantitative assessment of liver iron overload.

    Title Gastrointestinal Hemangiomatosis in Children: Demonstration with Ct.
    Date December 1987
    Journal Radiology
    Excerpt

    The presence of gastrointestinal (GI) tract hemangiomatosis was demonstrated by computed tomography in two children who presented with lower GI tract bleeding. Marked vascular enhancement of the bowel during rapid intravenous administration of contrast material and dynamic scanning is characteristic, similar to that seen with hemangiomas elsewhere in the body. Barium examinations demonstrate submucosal lesions within the bowel and are useful to approximate the length of bowel involvement.

    Title Role of Ct in the Evaluation of Children with Foregut Cyst.
    Date July 1987
    Journal Pediatric Radiology
    Excerpt

    The presentation of a foregut cyst may vary from an asymptomatic mass discovered as an incidental finding in a chest radiograph, to signs or symptoms secondary to airway compression by the cyst. The radiographic evaluation of a child with a possible foregut cyst usually consists of a chest radiograph and barium esophagogram. Although this approach is often sufficient, in other instances delay of treatment occurs or unnecessary workups are performed due to the inadequacy of the approach. CT is useful for depicting cryptic foregut cysts, clarifying abnormal radiographs, avoiding unnecessary workup of patients by establishing the precise location of the mass, and defining the cystic nature of the mass and excluding other etiologies.

    Title Radiographic Manifestations of Experimental Aluminum Toxicity in Growing Bone.
    Date July 1987
    Journal Skeletal Radiology
    Excerpt

    To evaluate the effect of aluminum on growing bone in the presence of normal renal function, the following experiment was performed. Eight littermate pair-fed pigs (5 weeks old) were randomly assigned to one of two study groups: control C, n = 4, or aluminum treated Al, n = 4. Daily intravenous injections of either aluminum 1.5 mg/kg/day (Al group) or vehicle only (C group) were given during the 8-week duration of the study. The radiographic findings which appeared in the aluminum-treated group and not in the controls consisted of areas of sclerosis in the submetaphyseal regions and the periphery of epiphyses. In addition there was separation of the anterior tibial tubercle. The growth plates did not increase in width despite the presence of osteomalacia and histologic evidence of extensive deposition of aluminum in bone. The area of sclerosis visualized in the radiographs correlated histologically with thickened bony trabeculae. The increased width of these trabeculae is attributable to an increase in primary spongiosum and broadened seams of osteoid.

    Title Congenital Tracheal Stenosis: Role of Ct and High Kv Films.
    Date June 1987
    Journal Pediatric Radiology
    Excerpt

    Congenital tracheal stenosis is an intrinsic narrowing of the tracheal lumen due to complete cartilaginous rings. We evaluated the role of the chest radiograph, high kV films, CT and bronchoscopy in five patients with congenital tracheal stenosis. CT was superior to chest radiography and high kV films in the evaluation of the presence and extent of the stenosis. CT was superior to bronchoscopy in the evaluation of the distal extent of the stenosis in two patients. In addition, CT is useful in ruling out external compression of the trachea by a mass or associated vascular anomaly.

    Title Comparative Evaluation of the Pulmonary Arteries in Patients with Right Ventricular Outflow Tract Obstructive Lesions.
    Date June 1987
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    The purpose of this prospective study was to assess and compare the roles of CT, sonography, and cineangiography in the evaluation of the central pulmonary arteries. Twenty patients with severe cyanotic congenital heart disease were evaluated. In six patients, cineangiography failed to identify pulmonary arteries (four right, two left) that were seen by CT. Narrowing within the right pulmonary artery was seen more clearly by CT and sonography than by cineangiography in one-third of patients. By contrast, narrowing of the origin of the left pulmonary artery shown by cineangiography was not detected by either CT or sonography in four of four patients. CT has a complementary role and should be performed when the pulmonary arteries are not well seen by cineangiography or sonography, confirmation of the patency and adequacy of the pulmonary arteries is necessary before complete repair, or documentation of interval growth of the pulmonary arteries is desired after palliative surgery.

    Title Coarctation of the Aorta in Children Undergoing Angioplasty: Pretreatment and Posttreatment Mr Imaging.
    Date January 1987
    Journal Radiology
    Excerpt

    Twelve children (aged 4-15 years) with suspected coarctation of the aorta or restenosis of the aorta after previous coarctation repair were considered for balloon angioplasty. Gated magnetic resonance (MR) imaging and cineangiography of the aorta were performed before angioplasty in all 12 children. In six of the nine children treated with angioplasty, MR imaging was performed between 1 day and 4 months later. Correlation with cineangiography showed that MR imaging accurately delineated the site and characteristics of the coarctation before balloon angioplasty. After balloon dilation, MR demonstrated a significant increase in the diameter of the aorta at the coarctation site in four patients and no change in two patients. No complications such as aneurysm formation, dissection, or hematoma were detected as a result of balloon angioplasty in the follow-up MR studies. A decrease in the number and size of collateral vessels was identified in successfully treated patients. MR was useful in identifying patients who were unlikely to benefit from angioplasty, determining the appropriate balloon size for angioplasty, and noninvasively monitoring patients who underwent angioplasty.

    Title Ct Evaluation of Pediatric Hip Disorders.
    Date August 1985
    Journal The Orthopedic Clinics of North America
    Excerpt

    CT plays an important role in the management of children with congenital dislocation of the hip and torsional abnormalities of the femur. In addition, CT is also useful in evaluating children with inflammatory, neoplastic, and traumatic abnormalities of the pelvis.

    Title Visualization of Small Sequestra by Computerized Tomography. Report of 6 Cases.
    Date July 1985
    Journal Pediatric Radiology
    Excerpt

    The diagnosis of osteomyelitis is usually clear by a constellation of clinical, radiographic, and/or scintigraphic findings. Computed tomography may be used to clarify the nature of a bony process. In addition to the CT findings already described, an additional finding is reported, consisting of the visualization of a small sequestrum. This finding has to be differentiated from the similar appearance in osteoid osteoma, intraosseous lipoma, fibrous dysplasia, and osteogenic sarcoma.

    Title The Role of Computed Tomography and Radionuclide Scintigraphy in the Localization of Osteomyelitis in Flat Bones.
    Date May 1985
    Journal Journal of Pediatric Orthopedics
    Excerpt

    The combined use of radionuclide scintigraphy and computed tomography is recommended for evaluating children with laboratory and clinical data suggestive of flat bone osteomyelitis despite normal conventional radiographs. In addition, computed tomography may be helpful in the presence of abnormal radiographs in determining the exact location of the focus of osteomyelitis and the most suitable route for appropriate drainage or to obtain culture material.

    Title Computed Tomography Diagnosis of Bronchial Compression by the Spine After Surgical Correction of Scoliosis.
    Date October 1984
    Journal Pediatric Radiology
    Excerpt

    Compression of the bronchi by vertebral bodies is an uncommon cause of atelectasis. This report describes a patient with such a compression and the important role of CT in establishing the etiology.

    Title Evaluation of Tarsal Coalition by Computed Tomography.
    Date August 1984
    Journal Journal of Pediatric Orthopedics
    Excerpt

    Three cases of talocalcaneal and two calcaneonavicular tarsal coalitions were evaluated with plain radiography and computed tomography (CT). Four of five of the patients' plain films were read as normal. Two of three patients had a Harris view performed for the talocalcaneal middle facet coalitions. One was read as negative, the second as positive after five attempts at obtaining the correct angle. In addition, two of three patients with talocalcaneal middle facet coalition had conventional tomography. One was read as positive, the other as negative. Arthrography was done in one case of calcaneonavicular coalition and was suspicious for the coalition. CT was diagnostic in all five cases. It provided an accurate depiction of the coalition site. In addition, the width of the bony bar at the coalition site could be determined to help plan surgical treatment. In patients presenting with painful feet, in whom tarsal coalition is suspected, plain radiographs should be the initial screening procedure. If secondary signs are present, CT is recommended as the best imaging modality to investigate further for tarsal coalition. Also, if plain films are normal but the index of suspicion is high, CT is thought to be the next most valuable test for diagnosing tarsal coalition.

    Title Case Report 262: Dysplasia Epiphysealis Hemimelica (deh)--trevor Disease.
    Date April 1984
    Journal Skeletal Radiology
    Title Concentric Reduction of the Dislocated Hip. Computed-tomographic Evaluation.
    Date January 1984
    Journal Radiology
    Excerpt

    Concentric reduction of a dislocated hip can be evaluated by anteroposterior views or linear tomography. Anterior relationships, however, may be difficult to evaluate from a frontal radiograph despite good visibility. Computed tomography (CT), because of its cross-sectional imaging capabilities, is superior in demonstrating these relationships. The CT appearance of two types of dislocations (posterior and lateral) is described. A posterior dislocation should be suspected if the femoral metaphysis approximates the acetabulum, a mass projects behind the ischium, or the fat plane anterior to the gluteus maximus is deformed or displaced posteriorly.

    Title Computed Tomography in the Evaluation of the Gluteal Region.
    Date December 1983
    Journal Journal of Pediatric Orthopedics
    Excerpt

    The role of computed tomography (CT) in the evaluation of the gluteal region was assessed. Six cases of gluteal masses were studied preoperatively by CT; several were also studied with conventional radiographic methods, including barium enema, cystogram, and intravenous urogram. Our case material included an epithelioid sarcoma, Ewing's sarcoma, endodermal sinus tumor, cystic hygroma, neurofibromatosis, and a normal variant. The conventional radiologic studies were normal or demonstrated nonspecific soft tissue density mass effect. By comparison, CT, with its cross-sectional imaging capability, provided unique diagnostic information. CT depicted the presence and origin of a mass, provided tissue characterization, and showed the extent of the lesion, often demonstrating the gluteal mass as an extension of an intrapelvic lesion. CT was valuable in monitoring tumor response to therapy, detecting recurrences, and excluding normal variants as the cause for a gluteal mass. The information provided by CT was important in treatment planning.

    Title Evaluation of Congenital Hip Dysplasia and Tibial Torsion by Computed Tomography.
    Date July 1983
    Journal The Journal of Computed Tomography
    Excerpt

    We have performed over 200 examinations in children with congenital dislocation of the hip during a 3-year period. From this experience, we conclude that computed tomography is useful in the evaluation of: (a) concentricity of closed reduction; (b) obstacles to closed reduction, such as infolding of the capsule, secondary to a tight iliopsoas tendon; (c) femoral torsion; (d) intraarticular obstacles contributing to persistent subluxation, such as (1) hypertrophy of the pulvinar, (2) intraarticular soft-tissue interposition, and (3) iatrogenic obstacles, such as metallic pins penetrating into the joint space; and (e) acetabular configuration, specifically (1) anterior or posterior lip of the acetabulum, (2) capacity of the acetabulum, and (3) acetabular torsion.

    Title Postnatal Development of High Affinity Neuronal Recognition Sites for 3h-5-ht in Rat Brain.
    Date April 1983
    Journal Developmental Neuroscience
    Excerpt

    The postnatal development of 3H-5-HT specific binding sites has been studied in rat brain. Experimental conditions allowed the characterization of the class of sites corresponding to the synaptosomal receptor for 5-HT. The related affinity constant and maximal binding were measured at various ages after birth. During the second week after birth, the serotonin receptor system developed explosively, the maximal number of sites increasing from a nonsignificant value to that observed in adult rats. Lesion of the presynaptic neurons using 5,6-DHT led to a significant increase of the number of sites.

    Title Cystic Nephroma: Morphologic Spectrum and Implications.
    Date October 1982
    Journal Urology
    Excerpt

    Among 216 primary renal tumors collected from a pediatric population in metropolitan Chicago, 6 instances corresponded in multiloculated cystic masses conforming to the diagnostic criteria of so-called cystic nephroma. Histopathologically, the component tissues were entirely mature in 2 cases, but in the remaining 4 the septa between cysts contained variable amounts of primitive or embryonic tissues; in one of these, a grossly visible mass formed a nodule of typical Wilms tumor. Our experience agrees with previous reports that favor closer structural similarity of these lesions to nephroblastoma than to any known form of cystic malformation. This concept has important consequences on the therapeutic approach to preoperatively diagnosed multilocular cystic masses of the kidney, and supports the idea that nephrectomy is the treatment of choice. Metastases or local recurrence have not been reported in cases of cystic nephroma.

    Title Hip Ct in Congenital Dislocation: Appearance of Tight Iliopsoas Tendon and Pulvinar Hypertrophy.
    Date August 1982
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    The iliopsoas tendon can interpose between the femoral head and the acetabulum, preventing reduction or stability of reduction of a dislocated hip by a closed method. The tendon produces an infolding of the capsule and labrum. This infolding of the capsule and labrum creates an "isthmus" between the capital and the acetabular parts of the capsule. This deformity of the capsule was recognizable on computed tomography (CT) in 10 patients, all of whom had surgical confirmation of the findings. The presence of hypertrophied pulvinar can also be recognized by CT.

    Title Ct Determination of Femoral Torsion.
    Date August 1981
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    Femoral torsion has been measured in infants and children by computed tomography. The method requires two scans, one through the femoral neck, another through the femoral condyles. A specially designed device and packing about the knees assures immobilization of the legs. Slight variations in the positions of the sections in the neck and condyles do not alter the measurement significantly. Intraobserver and interobserver errors are low, 2 degrees and 3 degrees mean error, respectively. The radiation required involves small tissue volumes at about 1.7 R (4.4 x 10(-4) C/kg). Measurements are more difficult when the femoral necks are short or vertically oriented. The method appears to have sufficient accuracy for clinical purposes.

    Title Case Report 120, Probable Bone Infarcts in Long Bones Secondary to Pheochromocytoma.
    Date May 1981
    Journal Skeletal Radiology
    Title Calcification in the Soft Tissues of the Chest After Thoracotomy.
    Date July 1980
    Journal Skeletal Radiology
    Excerpt

    We have observed soft-tissue calcification of the chest in 4 of 54 patients following thoracotomy in the neonatal period for a Blalock-Taussig or a Blalock-Hanlon procedure. The time of appearance ranged from 2 weeks to 11 months. This calcification is similar to myositis ossificans in having a traumatic origin. In one of the patients, it resolved spontaneously.

    Title Large Skull Defect in a Headbanger.
    Date February 1980
    Journal Pediatric Radiology
    Excerpt

    A mentally retarded self-mutilating child developed a large skull defect at the site of repeated trauma. The bony defect involved only the outer table and had smooth bony margins.

    Title Pulmonary Lymphangiectasis in Noonan Syndrome.
    Date February 1980
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    This report describes the course and prognosis of four patients with Noonan syndrome and associated pulmonary lymphangiectasia. All patients had (1) superior deviation of the QRS axis in the frontal plane of the electrocardiogram; (2) moderate to severe valvular pulmonary stenosis, with an additional atrial septal defect secundum type present in two and a small ventricular septal defect in one; and (3) bilateral prominence of the pulmonary interstitial markings (dilated lymphatics), with or without accompanying pleural effusions on the chest radiographs. Surgical repair of the cardiac lesion may cause undue morbidity because of the interruption of the engorged pleural or mediastinal lymphatics.

    Title Capacity of the Colon in Children.
    Date November 1979
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    The capacity of the colon was determined in 49 children during filling of the colon under fluoroscopic control. The data were evaluated by regression analysis and a mean from the sample was obtained. The capacity of the colon may be determined in milliliters by the formula: V = 233 + 83.87 X (X being the age of the child in years).

    Title Size and Skeletal Maturation of the Hand in Children with Hypothyroidism and Hypopituitarism.
    Date September 1979
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    Hypothyroidism affects linear growth less than it affects skeletal maturation, while hypopituitarism linear growth is more severely affected. By determining the mean age for the length of the second metacarpal and dividing by the skeletal age, a ratio R was obtained in 15 hypothyroid children and in 33 with hypopituitarism. R was more than 1 in most hypothyroids and less than 1 in most children with hypopituitarism. Thus, a distinction between these two entities can be made simply from a hand radiograph and appropriate reference sources for determining second metacarpal length age and skeletal age.

    Title Distinctive Appearance of the Distal Phalanges in Children with Primary Hypothyroidism.
    Date August 1979
    Journal Radiology
    Excerpt

    An osseous projection from the midportion of the metaphysis of the distal phalanges of the digits was seen in 79% of untreated children with primary hypothyroidism. There is a significant difference (p less than .0005) in the incidence of this projection between children with primary hypothyroidism and those with idiopathic hypopituitarism or psychosocial dwarfism. The presence of this projection together with delayed skeletal should suggest primary hypothyroidism.

    Title The Effect of Synthetic Androgens on the Hypothalamic-pituitary-gonadal Axis in Boys with Constitutionally Delayed Growth.
    Date June 1979
    Journal The Journal of Pediatrics
    Excerpt

    Serial concentrations of basal serum LH, FSH, testosterone, and LH and FSH responses to intravenous gonadotropin-releasing hormone were measured before and during six months of administration of fluoxymesterone or oxandrolone in 14 boys with constitutionally delayed growth and adolescence, in order to assess the effects of these androgens on maturation of the hypothalamic-pituitary-gonadal axis. Before therapy all boys had normal hormonal responses based on bone age. At the end of six months therapy 10 of the 14 boys had lower LH responses (34 to 89% reduction) to GnRH without consistent changes in FSH responses. With both androgens, there there was significant suppression of both basal serum FSH and testosterone. Eleven boys were restudied six months after completion of therapy; basal serum LH, FSH, and testosterone and responses to GnRH were equal to or greater than pretreatment levels, indicating recovery or progressive maturation of the HPGA. All boys had increased growth velocity and imporved weight gain without excessive bone age advancement; all had improved psychosocial adjustment.

    Title Factors Affecting the Measurement of Renal Length.
    Date May 1979
    Journal Radiology
    Excerpt

    The variation in kidney length between the 1-minute radiograph (centered over the kidney) and the 5-minute study (centered over the mid-abdomen) was evaluated on 100 random excretory urograms. When both kidneys were measurable, the change in kidney size was discordant in 40%. Most such changes are due to changes in geometry, differences in centering, or changes in the angle of the kidney with respiration. These alterations are of much greater magnitude than the reported swelling of the kidney due to contrast medium. Since there is practically no relation between the time of injection and changes in renal image size, it makes no difference whether the 1-minute or 5-minute radiograph is selected for measurement.

    Title Carpal Length in Children--a Useful Measurement in the Diagnosis of Rheumatoid Arthritis and Some Concenital Malformation Syndromes.
    Date February 1979
    Journal Radiology
    Excerpt

    The distance between the midpoint of the distal radial epiphyseal growth plate and the proximal end of the third metacarpal offers a useful measure for determining wrist size. Standards of this distance as compared to intermetacarpal width and second metacarpal length are presented. These measures (or ratios) should be useful in evaluating patients with juvenile rheumatoid arthritis and a number of congenital malformation syndromes, particularly when the carpals are still not fully ossified. Shortening of the carpus occurs in multiple epiphyseal dysplasia, the otopalatodigital syndromes, Turner syndrome, arthrogryposis, and in juvenile rheumatoid arthritis. A relatively large carpus is present in achondroplasia.

    Title Incidence of Growth Lines in Psychosocial Dwarfs and Idiopathic Hypopituitarism.
    Date October 1978
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    The presence of growth lines in the distal radius was evaluated prior to treatment in 23 psychosocial dwarfs and 25 patients with idiopathic hypopituitarism. The lines were very common in the psychosocial dwarfs and rare in the pituitary dwarfs (P = .0005). This finding can be explained by the fluctuating adverse environment to which the psychosocial dwarf is exposed and the constant lack of growth in hypopituitary patients. Therefore, in the absence of systemic disease, when growth lines are present in a patient with short stature or failure to thrive, a thorough review of the patient's psychosocial environment should be made.

    Title Developmental Pattern of the Serotonin Synthesizing Enzyme in the Brain of Postnatally Malnourished Rats.
    Date March 1974
    Journal Experientia
    Title Unexpected Mri Findings in Clinically Suspected Legg-calvé-perthes Disease.
    Date
    Journal Pediatric Radiology
    Excerpt

    In the setting of clinically suspected Legg-Calvé-Perthes (LCP) disease and negative/equivocal radiographs, contrast-enhanced MRI can be performed to confirm the diagnosis.


    Similar doctors nearby

    Dr. Moon-Chul Kim

    Radiology
    30 years experience
    Ann Arbor, MI

    Dr. Kathleen Gebarski

    Radiology
    32 years experience
    Ann Arbor, MI

    Dr. Gary Luker

    Radiology
    19 years experience
    Ann Arbor, MI

    Dr. Peter Strouse

    Radiology
    21 years experience
    Ann Arbor, MI

    Dr. Maria Ladino Torres

    Radiology
    7 years experience
    Ann Arbor, MI

    Dr. Ethan Smith

    Radiology
    5 years experience
    Ann Arbor, MI
    Search All Similar Doctors