Marie A. Capitanio

Lymphoid Hyperplasia of the Colon in Children: Roentgen Observations

Lymphoid hyperplasia of the colon has been identified in aircontrast studies of the colon in 19 infants and children, the majority of whom presented with rectal bleeding. In each, multiple umbilicated polypoid lesions have been observed. Umbilication in multiple polyps in the colon appears to be diagnostic of lymphoid hyperplasia and differentiates it from juvenile and other polyps in children. This benign lesion probably represents the normal response of lymphoid tissue in children to a variety of stimuli. There is no evidence that the rectal bleeding is caused by the lymphoid hyperplasia.

Obstructions of the Upper Airway in Children as Reflected on the Chest Radiograph

Abstract Alterations in the appearance of the heart and lungs that should lead one to suspect the possibility of upper airway obstruction in children are: distension of the hypopharynx, underaeration of the lungs, cardiac enlargement, cardiac enlargement with passive congestion, and pulmonary edema without cardiac enlargement.

Immune deficiency syndromes.

S INCE 1952, following Bruton’s report of a patient with agammaglobulinemia,’ efforts have been made to gain insight into the complexities of the immune system. The growing list of recognizable immunodeficiency states is a testimonial to the achievements reached that established the importance of the immune system in protecting the individual against infections and the development of certain neoplasms.6 The lymphocytes, the phagocytic cells of the blood, and reticuloendothelial system, comprise the major components of an active and complete immune system. Because the thymus is now known to play a major role in the ultimate activation of the lymphocyte, a consideration of its role in normal function must precede the discussion of the various abnormal states.

The Lateral Decubitus Film

Abstract The lateral decubitus chest film is helpful and convenient in detecting air trapped in infants and young children of whom satisfactory expiration chest films are difficult to obtain.

Persistent Localized Intrapulmonary Interstitial Emphysema: An Observation in Three Infants

Persistent intrapulmonary interstitial emphysema confined to a single lobe was observed in 3 premature male infants as a complication of pulmonary hyaline membrane disease. Following resolution of the clinical and roentgen findings of the respiratory distress syndrome, each infant again experienced respiratory distress as a result of enlarging cystic collections of intrapulmonary interstitial air. In each instance, a lobectomy was necessary to alleviate respiratory distress. Age at time of lobectomy was 7 months, 33 days, and 7 weeks, respectively.

Nasopharyngeal Lymphoid Tissue Roentgen Observations in 257 Children Two Years of Age or Less

Abstract Lateral radiographs of the nasopharynx in 257 children two years of age or less were evaluated to determine the age at which lymphoid tissue in the posterior nasopharynx becomes visible radiographically. Soft tissue was observed in the nasopharynx in all infants over six months old but in only half of those under six months. In no infant less than one month old was a soft-tissue mass seen in the posterior nasopharynx on lateral films of that area. These findings suggest that in children over six months of age, absence of this lymphoid tissue may be significant and imply an immune deficiency; its absence in infants under six months may be normal.

Widening of the Cranial Sutures: A Roentgen Observation During Periods of Accelerated Growth in Patients Treated for Deprivation Dwarfism

An increase in the width of the cranial sutures is a common manifestation of increased intracranial pressure in infants and children. However, separation of the sutures has been observed during treatment for “failure to thrive” in three children who had no signs or symptoms of increased intracranial pressure. The clinical evaluation and course of each patient fulfilled the diagnostic criteria outlined by Barbero and Shaheen for the clinical syndrome of growth failure not secondary to organic causes (1). While in the hospital, the patients responded rapidly to emotional support and proper nutrition. Marked acceleration in growth and social and emotional development occurred during their hospital stay, and at this time the cranial sutures were noted radiographically to widen. Deprivation dwarfism or emotional failure to thrive occurs in children who have experienced emotional and psychological deprivation (4). As described by Barbero and Shaheen, the syndrome is characterized by: “(1) weight below the 3rd p...

Carbenicillin in patients with cystic fibrosis: Clinical pharmacology and therapeutic evaluation

Carbenicillin, a new semisynthetic penicillin (alpha-carboxybenzylpenicillin) with activity against Pseudomonas aeruginosa , has been studied. Forty per cent of 110 strains of P. aeruginosa and most strains of Proteus mirabilis and Proteus morganii were susceptible to 62.5 μg per milliliter or less of carbenicillin. Of strains of Staphylococcus aureus tested, the majority were inhibited by 6.25 μg per milliliter of less of carbenicillin. Concurrent administration of probenecid is necessary to maintain effective serum levels for 2 to 4 hours after an intravenous dose. About 80 per cent of an intravenous dose is excreted in urine within 4 hours. Only 1 per cent of the antibiotic inhaled as an aerosol is recovered in urine. Fifty-four patients with cystic fibrosis, during 85 episodes of acute exacerbations of their pulmonary infections, had favorable clinical and radiologic responses to carbenicillin therapy. Transient elimination of P. aeruginosa was achieved in a small number of patients, but there was a striking increase in isolation of Klebsiella pneumoniae in end-treatment cultures. A rise of serum glutamic oxaloacetic transaminase activity was found in 40 per cent of the patients treated.

Infantile hypertrophic pyloric stenosis--congenital or acquired?

Three cases of IHPS are presented in which an ulcer or a local irritant was an associated factor. Mucosal irritation leading to pyloric and antral spasm and then to muscular hypertrophy and obstruction is a possible explanation for the pathogenesis of the disease observed in these three infants. A review of the literature also leads us to conclude that IHPS is an acquired disease with a genetic or familial predisposition. Peptic ulcer may be an etiologic factor in some instances; however, the presence of a small ulcer is difficult to demonstrate in the majority of clinical cases.

Dilatation of the descending aorta: a radiologic and echocardiographic diagnostic sign in arteriovenous malformations in neonates and young infants

Eleven infants with arteriovenous malformations were admitted to St. Christophers Hospital for Children between 1970 and 1978. Dilatation of the descending aorta was seen in the chest roentgenogram in 8 of the 11 patients. Echocardiography used in the two most recent cases revealed approximation of the descending aorta to the posterior left atrial and left ventricular wall in association with generalized cardiomegaly. The most frequently reported radiologic findings in infants with arteriovenous malformations are cardiomegaly, increased pulmonary vasculature and a widened superior mediastinum. These findings can accompany other congenital malformations of the heart, but the radiographic and echocardiographic findings of a dilated descending aorta appear to be more specifically associated with arteriovenous malformations in the neonate and infant.