Faculty Bibliography

Twelve children with laboratory evidence of human immunodeficiency virus (HIV) infection underwent diagnostic flexible bronchoscopy with washings or bronchoalveolar lavage at Bellevue Hospital Center from October 1987 to April 1989. The patients included 7 boys and 5 girls ranging from age 3.5 months to 10 years 5 months. Indications for bronchoscopy included respiratory distress with or without focal changes on chest radiograph in 11 patients, and persistent but asymptomatic right middle lobe collapse in one child. The etiology of pneumonia was diagnosed in 7 children and included Pneumocystis carinii, (PCP) (17%), Streptococcus viridans (17%), mechanical obstruction (17%) and cytomegalovirus (CMV) (8%). Bronchoscopy was non-diagnostic in 5 cases. Techniques for maximal yield of information using flexible bronchoscopy in HIV-positive children are discussed

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

A 15-year-old boy presented with a short history of right-sided flank pain was found to have bilateral duplex renal systems with obstructed upper poles. Sonographic examination and contrast-enhanced delayed computed tomography (CT) performed at the conclusion of the excretory urography (EU) demonstrated termination of both obstructed ureters in the seminal vesicles. These noninvasive studies allowed accurate preoperative diagnosis of this abnormality

A retrospective examination of brain tumors in infants less than a year of age was undertaken by reviewing their charts and CT scans. In contradistinction to brain tumors found in older children, most tumors were supratentorial in location. The most common histologic types included: astrocytoma, ganglioglioma and primative neuroectodermal tumors. Apart from their larger size at the time of presentation, these tumors were radiologically and pathologically similar to analogous tumors found in adults

Magnetic resonance imaging utilizing spin echo sequences was used to demonstrate cor triatriatum in an 18-year-old boy. Phase map images aided the diagnosis by demonstrating the presence of slowly flowing blood in the accessory atrial chamber. Magnetic resonance is an excellent modality for the noninvasive diagnosis of cor triatriatum

A 7-year-old male presented with a triple A syndrome, a tirad of ACTH insensitivity, achilasia and alacrima. His clinical course is followed and the literature reviewed