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1.
J Pediatr Orthop B ; 27(1): 77-81, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28379910

ABSTRACT

The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the skeletal development of the talus. LEVEL OF EVIDENCE: prognostic level III.


Subject(s)
Foot/physiopathology , Gait/physiology , Movement Disorders/physiopathology , Toes , Weight-Bearing/physiology , Adolescent , Ankle/physiopathology , Biomechanical Phenomena , Case-Control Studies , Child , Female , Foot/diagnostic imaging , Humans , Male , Movement Disorders/diagnostic imaging , Range of Motion, Articular , Retrospective Studies , Talus/physiology
2.
Tex Heart Inst J ; 44(2): 138-140, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28461801

ABSTRACT

A male neonate presented with CHARGE syndrome, a multiorgan genetic disorder involving the Coloboma of the eyes, congenital Heart defects, nasal choanal Atresia, growth and development Retardation, Genitourinary disorders, and Ear anomalies and deafness. Moreover, he had a rare case of vascular ring-consisting of a right aortic arch with retroesophageal brachiocephalic artery-combined with coarctation of the mid-aortic arch. He underwent both vascular ring and aortic arch repair at our institution. To our knowledge, this is the 4th documented case of this exceedingly rare type of aortic arch anomaly combined with aortic arch obstruction. Moreover, it is the first confirmed case of these combined disorders occurring in CHARGE syndrome. This report describes a truly rare case and reveals the limitations of echocardiography in detecting complex aortic arch anomalies while illustrating the benefits of advanced imaging prior to surgical intervention.


Subject(s)
Abnormalities, Multiple , Aortic Coarctation/complications , CHARGE Syndrome/complications , Vascular Ring/complications , Aortic Coarctation/diagnostic imaging , Aortic Coarctation/physiopathology , Aortic Coarctation/surgery , Aortography/methods , CHARGE Syndrome/diagnosis , Computed Tomography Angiography , Humans , Infant, Newborn , Male , Treatment Outcome , Vascular Ring/diagnostic imaging , Vascular Ring/physiopathology , Vascular Ring/surgery
3.
Pediatr Surg Int ; 33(7): 817-821, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28417152

ABSTRACT

Association of unilateral severe pulmonary atresia or agenesis and esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) and dextrocardia is a rare and highly lethal combination. We report a case of a full-term female infant who had EA with TEF, right lung agenesis, and dextrocardia. Repair of the fistula took place on day of life 3. We describe anesthetic and surgical concerns of this patient's case which are keys to a good operative outcome as well as follow-up for the patient.


Subject(s)
Abnormalities, Multiple/diagnostic imaging , Dextrocardia/diagnostic imaging , Esophageal Atresia/surgery , Lung Diseases/diagnostic imaging , Lung/abnormalities , Tracheoesophageal Fistula/surgery , Cardiotonic Agents/administration & dosage , Dopamine/administration & dosage , Enteral Nutrition , Female , Gastrostomy , Humans , Infant, Newborn , Intraoperative Care , Lung/diagnostic imaging
4.
Echocardiography ; 34(2): 250-256, 2017 Feb.
Article in English | MEDLINE | ID: mdl-27996161

ABSTRACT

PURPOSE: To evaluate the feasibility and correlation of 3D echocardiography (echo) and cardiac biomarkers with cardiac MRI, in surveillance of cardiac function for cancer survivors. METHODS: Subjects ≥10 years of age who have survived >2 years after completion of cancer treatment from a single center were enrolled. Cardiac MRI and 3D echo images were obtained on the same day when routine echo was obtained. On the same day, along with annual routine blood test, cardiac biomarkers N-terminal pro-B-type natriuretic peptide levels (NT-proBNP) and troponin-I levels were also measured. RESULTS: Cardiac MRI was feasible in all 50 subjects. Three-dimensional echo and 2D echo images were of poor quality in four subjects. With a median duration of remission of 10 years, there were four subjects with mild LV dysfunction (cardiac MRI LV EF of<53%). None had MRI EF <50%, and nine subjects had LVEF <55%. M-mode echo overestimated EF more than 2D and 3D echo. Two-dimensional and 3D echo methods had much tighter limits of agreement for LV EF. For measurement of LVEF, 3D echo had a lower % error than 2D echo or M-mode echo. One subject had an abnormal troponin-I level and another one had an elevated NT-proBNP. CONCLUSIONS: Three-dimensional echo can be performed in most adolescent cancer survivors, and it correlates well with MRI. Further large-scale research is required in assessing utility of cardiac biomarkers in pediatric cancer survivors.


Subject(s)
Echocardiography, Three-Dimensional/methods , Heart/diagnostic imaging , Magnetic Resonance Imaging/methods , Neoplasms/blood , Adolescent , Biomarkers/blood , Child , Child, Preschool , Feasibility Studies , Heart/physiopathology , Humans , Infant , Male , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Survivors , Troponin I/blood
5.
AJR Am J Roentgenol ; 190(4): 984-92, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18356446

ABSTRACT

OBJECTIVE: The concepts of biliary tract inflammation are changing. Some previously common entities are now rare. New autoimmune conditions are being recognized, and imaging has continued to advance, resulting in better and in many areas less-invasive techniques for examination of the biliary tract. CONCLUSION: Radiologists should be aware of the etiologic factors of biliary tract inflammation being proposed. They should also understand new approaches to imaging of the biliary tract.


Subject(s)
Biliary Tract Diseases/diagnosis , Diagnostic Imaging , Biliary Tract Diseases/etiology , Diagnosis, Differential , Humans , Inflammation/diagnosis , Inflammation/etiology
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