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Traumatic abdominal pseudoaneurysm secondary to child abuse [Case Report]

Roche KJ; Genieser NB; Berger DK; Ambrosino MM
Traumatic injury to the descending thoracic and abdominal aorta is uncommon in children and is usually secondary to recognized blunt trauma. Child abuse has not been previously reported as a cause. We report a 3-year-old boy who was kicked in the abdomen by his father. A resulting pseudoaneurysm was successfully resected
PMID: 8577545
ISSN: 0301-0449
CID: 6953

THE EFFECT OF MAGNESIUM ON ISCHEMIC BRAIN-LESIONS IN THE PRETERM INFANT [Meeting Abstract]

FINESMITH, RB; YELLIN, P; AMBROSINO, M; KHAN, A
ISI:A1995RU33300044
ISSN: 0364-5134
CID: 1570362

Acute renal failure in a human immunodeficiency virus-infected child secondary to bilateral fungus ball formation [Case Report]

Papaevangelou V; Lawrence R; Kaul A; Lefluer R; Ambrosino M; Krasinski K; Borkowsky W
PMID: 7638023
ISSN: 0891-3668
CID: 6856

T2-weighted MR imaging of the chest: comparison of electrocardiograph-triggered conventional and turbo spin-echo and nontriggered turbo spin-echo sequences

Haddad JL; Rofsky NM; Ambrosino MM; Naidich DP; Weinreb JC
In 22 patients with a diverse range of thoracic abnormalities, T2-weighted magnetic resonance (MR) images of the chest were obtained with electrocardiograph (ECG)-triggered turbo spin-echo (TSE), ECG-triggered conventional spin-echo (CSE), and nontriggered TSE sequences, and the images were compared. A 5-point rating scale was used by three radiologists experienced in MR imaging of the chest to independently evaluate the images for (a) freedom from ghosting, (b) clarity of heart wall and cardiac chambers, (c) clarity of mediastinal structures, (d) conspicuity of abnormalities, and (e) overall image quality. Evaluations were analyzed with statistical methods. For freedom from ghosting, clarity of heart wall and cardiac chambers, clarity of mediastinal structures, and overall image quality, the ECG-triggered TSE images were rated higher than the TSE images, which, in turn, were rated higher than the ECG-triggered CSE images at the P = .05 level of significance. No significant differences were seen between the pulse sequences in the conspicuity of abnormalities, although some differences were observed in individual cases. Our results suggest that ECG-triggered TSE imaging provides improved, time-efficient T2-weighted images of the chest
PMID: 7633110
ISSN: 1053-1807
CID: 56760

Common bile duct in children: sonographic dimensions

Hernanz-Schulman M; Ambrosino MM; Freeman PC; Quinn CB
PURPOSE: To determine the normal caliber and rate of growth of the extrahepatic biliary ducts in the pediatric population. MATERIALS AND METHODS: The diameter of the common bile duct was measured with sonography in 173 children aged 1 day to 13 years (mean, 6.0 years; median, 5.0 years) who were examined for reasons other than hepatic or biliary tract disease. Results were subjected to regression analysis and compared with similar measurements of the extrahepatic portal vein and hepatic artery. The size of the gallbladder was subjectively estimated as distended, moderately full, and contracted. Differences in the diameter of the common bile duct in these three groups were evaluated with the Mann-Whitney U test. RESULTS: The average diameter of the common bile duct in this population was 1.27 mm +/- 0.67 (< 3.3 mm in all patients and < 1.2 mm in children aged 3 months or less). The slope of the curve describing the growth of the common bile duct was relatively flat, similar to that of the hepatic artery and half that of the portal vein. There was a significant difference in the diameter of the common bile duct between patients with distended gallbladders and those with contracted gallbladder (P = .02). CONCLUSION: The pediatric common bile duct is significantly smaller than adult norms; it is a distensible structure responsive to fluctuations in prandial bile flow
PMID: 7892467
ISSN: 0033-8419
CID: 6641

The antral nipple sign of pyloric mucosal prolapse: endoscopic correlation of a new sonographic observation in patients with pyloric stenosis

Hernanz-Schulman, M; Dinauer, P; Ambrosino, M M; Polk, D B; Neblett, W W 3rd
This study describes the antral nipple sign of pyloric mucosal prolapse, a newly delineated sonographic observation in patients with pyloric stenosis, correlates the endoscopic findings, and examines its prevalence and significance in 31 consecutive patients with pyloric stenosis. Fifty patients who did not have pyloric stenosis served as the control population. The antral nipple sign consists of visualization of prolapsed, hypertrophied pyloric mucosa protruding into the gastric antrum. Using the Wilcoxon scores (rank sums), there was no significant difference among the patients in age, weight, or pyloric muscle dimensions. Although the diagnosis of pyloric stenosis is made on the basis of muscle thickness, we have documented that the pyloric mucosa becomes redundant in infants with pyloric stenosis, permitting a fuller understanding of the anatomic correlate underlying the sonographic images
PMID: 7602686
ISSN: 0278-4297
CID: 124520

Application of thin-section low-dose chest CT (TSCT) in the management of pediatric AIDS

Ambrosino MM; Roche KJ; Genieser NB; Kaul A; Lawrence RM
The aim of this study was to evaluate the usefulness of thin-section low-dose computed tomography (TSCT) in the management of children with AIDS, as chest radiographs (CXR) often fail to adequately explain the patients' clinical status. We performed 54 noncontrast TSCTs on 32 children. The patients aged from 3 months to 14.6 years, were diagnosed as having bacterial pneumonia, lumphocytic interstitial pneumonitis (LIP), Pneumocystis carinii pneumonia (PCP), or Mycobacterium avium-intracellulare infection (MAI). The scans were correlated with the clinical diagnosis, T-lymphocyte-subset percentages, and p24-antigen levels. Subsegmental consolidations were seen in patients with LIP, PCP, and MAI, and as an isolated finding in those with only bacterial pneumonia. Ground-glass haziness was seen exclusively with acute PCP. Reticulonodular thickening was identified only in patients with LIP. Mosaic perfusion was seen with MAI, LIP, and pneumonia. The presence of adenopathy correlated with CD4+ T-cell subset percentages. The greatest value of CT in this study was in detecting new disease when chest films failed to correlate with a patient's clinical state, and in demonstrating acute/subacute disease in patients with severe baseline chest-film changes. Recurrent pneumonias may represent progression of 'smoldering' disease, rather than true recurrent disease following complete clearing. Adenopathy with low CD4+ levels should suggest lymphoma or infection with MAI
PMID: 7567277
ISSN: 0301-0449
CID: 6884

Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis

Hernanz-Schulman, M; Sells, L L; Ambrosino, M M; Heller, R M; Stein, S M; Neblett, W W 3rd
PURPOSE: To evaluate the accuracy of sonography for both diagnosis and exclusion of pyloric stenosis in the infant with nonbilious vomiting without a palpable olive and to clarify the relationship between infant age and size and the dimensions of the hypertrophic pylorus. MATERIALS AND METHODS: The sonograms of 152 infants with suspected pyloric stenosis were evaluated. The prospective diagnoses were categorized as pyloric stenosis, normal pylorus, and pylorospasm with potential to progress to pyloric stenosis. Positive findings were confirmed at surgery; negative findings were confirmed by means of chart review. RESULTS: Sensitivity, specificity, and accuracy of sonography in determination of appropriate surgical referral were 100%. A significant (P < .05) correlation was found between the size of the hypertrophied muscle and the age of the patient at initial examination. CONCLUSION: Sonography is highly sensitive and, in this patient population, highly specific, and by virtue of direct visualization of the pyloric muscle, it is the method of choice for both diagnosis and exclusion of pyloric stenosis
PMID: 7972822
ISSN: 0033-8419
CID: 124522

Effect on fetal mouse development of exposure to MR imaging and gadopentetate dimeglumine

Rofsky NM; Pizzarello DJ; Weinreb JC; Ambrosino MM; Rosenberg C
Pregnant mice were exposed to one of five regimens at 9.5 days of gestation: no treatment (group 1), intraperitoneal injection of normal saline (group 2), intraperitoneal injection of gadopentetate dimeglumine (group 3), intraperitoneal injection of gadopentetate dimeglumine and magnetic resonance (MR) exposure (group 4), and MR exposure alone (group 5). At 18 days of gestation, the mice were sacrificed and fetuses were removed and examined for the following end points: litter size, number alive or dead, fetal weight, extremity morphology, eye and ear development, and appearance of the head. A total of 739 fetuses were analyzed: group 1 (n = 161), group 2 (n = 149), group 3 (n = 142), group 4 (n = 136), and group 5 (n = 151). The only statistically significant difference was a lower mean fetal weight in the saline-injection group compared with the control group. The results show that MR exposure with and without gadopentetate dimeglumine had no adverse effect on the end points analyzed
PMID: 7865940
ISSN: 1053-1807
CID: 56700

Monitoring of girls undergoing medical therapy for isosexual precocious puberty

Ambrosino MM; Hernanz-Schulman M; Genieser NB; Sklar CA; Fefferman NR; David R
We evaluated the use of sonography in monitoring the efficacy of suppressive therapy with a gonadotropin releasing hormone analogue in girls being treated for isosexual precocious puberty. Ten girls 5 to 9 years of age underwent serial sonography and hormonal stimulation tests on the same day. Sonographic trends of decreasing ovarian volume and uterine length indicated early suppression even when absolute values were above threshold. Changes in ovarian volume were the most sensitive predictor of pituitary-gonadal suppression. Sonography is a sensitive and accurate method of monitoring medical therapy; ovarian volume and analysis of interval change are the most sensitive barometers of change
PMID: 7933011
ISSN: 0278-4297
CID: 6566