Radiologic assessment of temporal lobe epilepsy.

Neuroimaging plays an important and increasing role in assessing patients with epilepsy. This article focuses on procedures used to evaluate patients who have failed medical treatment for epilepsy but may benefit from resective surgery. Radiologic assessment and use of the intracarotid amobarbital procedure are described.

Ultrasonography of pylorospasm: findings may simulate hypertrophic pyloric stenosis.

We compared sonographic images and measurements of patients diagnosed as having hypertrophic pyloric stenosis and pylorospasm among infants with projectile vomiting. Thirty-seven patients with hypertrophic pyloric stenosis had an unchanged pyloric length (mean, 22.5 mm) and muscle wall thickness (mean, 5.3 mm). Thirty-four pylorospasm patients had considerable variability in measurement or image appearance during their studies. Means of their longest or largest measurements were 14.4 mm for pylorus length and 3.8 mm for muscle wall thickness. Among these, 53% had muscle wall thickness of 4 mm or greater and 18% had pyloric length of 18 mm or greater during some portion of their study. We concluded (after clinical follow-up study confirmed our ultrasonographic diagnoses) that pylorospasm may mimic hypertrophic pyloric stenosis for at least a portion of a sonographic study. Muscle wall thickness or pyloric length measurements may overlap those accepted as positive for hypertrophic pyloric stenosis. Image or measurement variability is an important clue for diagnosing pylorospasm.

The gastrointestinal manifestations of pediatric AIDS.

The manifestations of AIDS in the gastrointestinal tract in children are mainly secondary to opportunistic infections and AIDS-related neoplasms. This article reviews the radiologic and pathologic findings seen throughout the gastrointestinal tract and within the abdomen in children afflicted with AIDS. Although many radiologic findings are not specific for a particular infection or neoplasm, the radiologist can narrow the differential diagnosis with a good knowledge of the imaging findings and pathologies specific for children with AIDS.

Neonatal goiter: imaging findings in two children.

Neonatal goiter is a rare cause of a neck mass and stridor. Often, the diagnosis can be made on clinical grounds exclusively, but there may be times when a neck mass becomes a diagnostic dilemma. There are several different imaging modalities available to the clinician that are useful in the rapid diagnosis of neonatal goiter. Presently, however, there is no definite algorithm for the workup of a neonatal neck mass. The two cases presented here demonstrate the imaging findings of plain film radiography, sonography, scintigraphy, and CT in neonatal goiter.

Panner's disease: X-ray, MR imaging findings and review of the literature.

Panner's disease, avascular necrosis of the capitellum, was first described on X-ray examination of the elbow. It represents a major threat to the elbow joint integrity, and it is important to diagnose early. Panner's disease occurs most commonly in young children who play baseball, and in competitive gymnasts. Although considered a rare entity, it probably is underdiagnosed. We present the X-ray and MR imaging findings in a young boy with Panner's disease. The MR imaging findings in Panner's disease have not been previously reported.

Desensitization to follicle-stimulating hormone in cumulus cells is coincident with hormone induction of oocyte maturation in the rat follicle.

The objective of the present studies was to assess whether hormone induction of oocyte maturation in isolated intact follicles may be linked to desensitization of follicle-stimulating hormone (FSH) in the oocyte-cumulus complex (OCC). Incubation of follicles with chorionic gonadotropin (hCG), FSH or epidermal growth factor (EGF) produced a marked inhibition of FSH-dependent cyclic AMP accumulation in OCC with a time-course coincident with the onset of germinal vesicle breakdown (GVBD). These effects were evident within 3 h for both hCG and FSH, but with EGF a reduced response to FSH was seen within 1 h of treatment followed by an increase in GVBD. In contrast, no inhibition of cyclic AMP accumulation was seen in response to cholera toxin, forskolin or LH in OCC derived from follicles incubated with hCG for 3 h. The time-course for induction of oocyte maturation by incubation of the intact follicle with hCG was also coincident with production of prostaglandin (PG) F2 alpha, an indirect marker of cyclooxygenase induction. No effect on metabolic coupling between the oocyte and cumulus cells was seen until 9 h after hCG treatment. Retinoic acid caused a marked decrease in metabolic coupling between the oocyte and cumulus cells but inhibited oocyte maturation both in denuded oocytes and OCC. Since FSH desensitization in OCC, the resumption of meiosis, and production of arachidonic acid-derived products were coincident, it is suggested that abrogation of FSH action in cumulus cells by the ovulatory surge of gonadotropins may initiate oocyte maturation.