Percutaneous needle aspiration of neonatal lung abscesses.

Three premature infants (mean gestational age 27 weeks) ranging in age from 3 to 11 weeks, were treated for lung abscesses, with a combination of antibiotics and percutaneous needle aspiration under either ultrasound or fluoroscopic guidance. Antibiotics, to which microorganisms cultured from aspirated pus were sensitive, were continued for a further period of two weeks, with no relapse in any of the patients. The lung abscesses resolved in all cases without the need for catheter drainage or surgery. In conclusion, needle aspiration under either ultrasound or fluoroscopic guidance is a simple and effective diagnostic and therapeutic method of managing neonatal lung abscesses. Its early use allows selection of the most appropriate antibiotics and may hasten recovery, prevent further complications and obviate the need for surgery. The use of a drainage catheter does not appear to be necessary for resolution of the abscesses. The procedure appears reasonably safe, since complications arising from the procedure were benign.

A digital video image splitting device for microvascular measurements.

An improved video image splitting device for the measurement of vessel lumen diameter and wall thickness has been developed. The use of digital electronics allows a split image to be displayed on a standard CCTV monitor with image shifting allowed to both the right and left. Testing of the device shows it to be linear to within 1% and accurate to 0.5% of full screen.

Ultrasonic diagnostic system for interactive interrogation of adult brain through intact skull.

An integrated ultrasonic system has been developed employing static gray scale imaging, digital image processing, and analyses of quantitative ultrasonic backscatter for interactive interrogation of brain through the adult human skull. Operating at 750 kHz, to avoid severe spatial and temporal pulse distortion which accompany ultrasonic transkull transmission at higher frequencies, storage and image processing of successive images taken at selected gain settings in the same image plane allow the reconstruction of a composite cross-section of the brain and skull and enable visualization of internal brain structure. Analyses of digitized backscatter data obtained with the visualization transducer over selectable interrogation paths referenced to the cross-sectional image permit quantitative classification of tissue type independent of qualitative visual image analysis, such that enhanced diagnostic potential is provided. A previous paper described in detail the modifications of the commercial ultrasound diagnostic unit which serves as the core of this system. The present paper presents the rationale for the integrated system design approach, as well as a description of graphics display and tissue classification features which have been incorporated into the instrumentation configuration and are deemed necessary for successful transkull ultrasonic imaging and diagnosis.

Sinus histiocytosis with massive lymphadenopathy. Report of its occurrence in two siblings with retropharyngeal involvement in both.

Sinus histiocytosis with massive lymphadenopathy (SHML) was found in two siblings, both of whom had retropharyngeal involvement. In one of the children the retropharyngeal swelling appeared to produce obstructive symptoms, requiring excision of the involved lymph nodes. These cases appear to constitute not only the first proven familial occurrence of SHML but also the only reported instances of retropharyngeal involvement. SHML is an uncommon disease of unknown etiology that must be distinguished from other diseases associated with marked lymphadenopathy, particularly as its course is generally benign and not altered by any known form of medical treatment.

Polyarteritis nodosa in older children.

Polyarteritis in the older child is thought to be a rare disease. This study describes 11 children, 3 to 12 years of age, with polyarteritis seen over a five-year period. Fever, abdominal pain, hypertension, and leukocytosis were found in almost all. Renal disease occurred in eight. Examination of muscle, gut, or kidney tissue was an effective means of diagnosis. The pathological changes were the same as those seen in adults. There seemed to be an association between polyarteritis and group A streptococcal infection. Ten patients had a salutary response to high-dose prednisone administration.