Harold S. Goldman

Oxandrolone treatment of short stature: Effect on predicted mature height

Twenty boys and 7 girls aged 3 7/12 to 17 years were treated with oxandrolone during the second 6 months of an 18 or 24 month period. Measurements of length and skeletal age were made at the beginning and at 6 month intervals. The daily dose was 0.05 mg. per kilogram (7 patients), 0.1 mg. per kilogram (13 patients), or 0.2 mg. per kilogram (7 patients). Predictions for mature height at the beginning of the study were compared with those at the end of the treatment period and at 6 to 12 months after termination of treatment. Responses were similar on all 3 doses. In all but 4 children the rate of increase in height age was increased during treatment. Increments in skeletal age were accelerated more than those in height age during the 6 months following treatment. Eight children had a decrease of predicted mature height ranging from 1.5 to 7.5 cm. When oxandrolone medication was given to children whose bone age was at least 9 years, there was no evidence of a deleterious effect on predicted mature height.

Radionuclide scintigraphy for detection of vesicoureteral reflux in children

The use of technetium 99m pertechnetate combined with scintiphotography for thedetection of vesicoureteral reflux in children is described. Forty-seven children have been studied with this method in conjunction with conventional radiographic cystourethrography. Five hundred microcuries of technetium 99m pertechnetate is instilled into the urinary bladder, following which the bladder is distended gradually with saline. With the use of the Anger camera, the distribution of radioactivity in the bladder and renal areas is recorded on Polaroid film during filling and overdistention of the bladder. The study requires an average of 15 minutes to perform and results in an estimated gonadal radiation dosage of 4 or 5 millirads. There is good correlation with conventional cystourethrography. The procedure is recommended as an adjunct to conventional radiographic techniques for the study of vesicoureteral reflux in children.

Hepatic spindle cell tumors in HIV positive children

Spindle cell tumors (leiomyoma, leiomyosarcoma) have been described in HIV infected children involving the gastrointestinal tract, respiratory tract and liver. The same tumor has been reported in immuno-compromised children following liver and renal transplantation. A case of hepatic spindle cell tumor in an HIV infected child is discussed.

Pericardial effusion and cardiac hemangioma in the neonate

In the absence of hydrops or sepsis, a pericardial effusion is a rare occurrence in the neonate. We report a case of a neonate with a pericardial effusion in which there was an associated intracardiac hemangioma. Our literature review found 32 cases of pericardial effusion with-out hydrops in infants under 3 months of age; twelve of these cases were associated with intracardiac and pericardial tumors; 20 others were discovered to be randomly associated with other problems.

Maternal renal insufficiency: A cause of congenital rickets and secondary hyperparathyroidism

We present a case of a newborn with congenital rickets and radiographic evidence of secondary hyperparathyroidism in which the infants mother had severe, longstanding untreated renal insufficiency.

Choledochal cyst imaging by telepaque-enhanced computed tomography

A choledochal cyst is an uncommon anomaly of the biliary system requiring surgical intervention. A case of a choledochal cyst imaged by computed tomography following oral administration of cholangiography contrast material (Telepaque) is reported. Telepaque-enhanced computed tomography is an easy, noninvasive method to demonstrate pertinent preoperative anatomy in cases of choledochal cysts, and is especially useful in the pediatric patient.

Radiographic and radioisotopic methods of evaluation of the kidneys and urinary tract.

A discussion of specific areas, such as infection of the urinary tract, trauma to the kidneys, and renal masses, in which diagnostic approach and interpretation are in a state of change, and in which new diagnostic techniques are available.