14 results on '"Thomas F. Boulden"'
Search Results
2. C-Reactive Protein in the Diagnosis, Management, and Prognosis of Neonatal Necrotizing Enterocolitis
- Author
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Sheldon B. Korones, Thomas F. Boulden, Henrietta S. Bada, Wenjian Yang, and Massroor Pourcyrous
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Radiography, Abdominal ,medicine.medical_specialty ,Ileus ,medicine.drug_class ,Antibiotics ,Infant, Premature, Diseases ,Gastroenterology ,Enterocolitis, Necrotizing ,Internal medicine ,medicine ,Humans ,Blood culture ,Stage (cooking) ,Pneumatosis intestinalis ,medicine.diagnostic_test ,biology ,business.industry ,C-reactive protein ,Infant, Newborn ,Acute-phase protein ,Infant ,medicine.disease ,digestive system diseases ,Surgery ,C-Reactive Protein ,Pediatrics, Perinatology and Child Health ,Necrotizing enterocolitis ,biology.protein ,medicine.symptom ,business ,Biomarkers ,Infant, Premature - Abstract
Objective. In this prospective, observational study, we determined whether serum C-reactive protein (CRP) correlated with necrotizing enterocolitis (NEC) stages II and III. We hypothesized that serial CRP measurement if used as an adjunct to abdominal radiographs would improve the identification of infants with NEC.Methods. Serum CRP level was measured every 12 hours for 3 measurements and, when abnormal, once daily. When clinical signs persisted and the initial abdominal radiographs were abnormal, follow-up radiographs were obtained.Results. Of 241 infants who were evaluated for gastrointestinal signs, 11 had ileus or benign pneumatosis intestinalis with persistently normal CRP; gastrointestinal manifestations resolved within 48 hours, antibiotics were discontinued in Conclusions. In infants with suspected NEC, normal serial CRP values would favor aborted antibiotic therapy and early resumption of feedings. CRP becomes abnormal in both stage II and stage III NEC. In infants with NEC, persistently elevated CRP after initiation of appropriate medical management suggests associated complications, which may require surgical intervention.
- Published
- 2005
3. Ruptured remnant of urachal diverticulum: an unusual cause of congenital urinary ascites
- Author
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S. K. Chilakala, Massroor Pourcyrous, and Thomas F. Boulden
- Subjects
medicine.medical_specialty ,Voiding cystourethrogram ,medicine.medical_treatment ,Urinary system ,Gestational Age ,Risk Assessment ,Ultrasonography, Prenatal ,Urachus ,Young Adult ,Rare Diseases ,Pregnancy ,Ascites ,medicine ,Paracentesis ,Humans ,Mechanical ventilation ,Fetus ,Urachal Diverticulum ,Rupture, Spontaneous ,medicine.diagnostic_test ,business.industry ,Urinary Bladder Diseases ,Obstetrics and Gynecology ,Surgery ,Diverticulum ,Catheter ,Treatment Outcome ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Urachal diverticulum is an infrequent finding and its perforation as a cause of fetal urinary ascites has not been reported before. This is a case report on an infant with antenatal diagnosis of fetal ascites. This infant was delivered via cesarean section and needed mechanical ventilation owing to a massive ascites that required paracentesis. She did not void for 20 h until a urethral catheter was placed. The biochemical analysis of the ascitic fluid compared with the serum and urine was suggestive of urine ascites. The voiding cystourethrogram (VCUG) showed a leakage at the remnant of urachal diverticulum. The urethral catheter was maintained for 3 weeks until the repeated VCUG confirmed a sealed-off urachal diverticulum. With removal of the catheter, the infant was able to void spontaneously and was discharged home on continued prophylactic antibiotics. As symptomatic urachal remnants have an increased potential for malignant transformation, a close follow-up by a urologist was recommended.
- Published
- 2012
4. Diagnostic utility of color flow Doppler in extracardiac causes of congestive heart failure in infants
- Author
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Carl M. Reed, Bruce S. Alpert, Thomas F. Boulden, Judith A. Becker, Ina L. D. Tonkin, and Thomas G. DiSessa
- Subjects
medicine.medical_specialty ,business.industry ,Color flow doppler ,Internal medicine ,Heart failure ,Pediatrics, Perinatology and Child Health ,Cardiology ,Medicine ,General Medicine ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Abstract
SummarySystemic vascular malformations are a rare cause of congestive heart failure in the infant and newborn infant. Clinical diagnosis is often problematic. Accordingly, this study presents the clinical, radiographic, ultrasound imaging, pulsed and color Doppler features of systemic vascular malformations in six infants. In all cases, color Doppler provided vital information regarding size, location, source of feeding arteries and venous drainage essential for appropriate management of these patients. Color flow Doppler ultrasonography is an accurate and sensitive modality for detecting and evaluating vascular malformations.
- Published
- 1993
5. MR imaging of infradiaphragmatic lymphadenopathy in children and adolescents with Hodgkin disease: Comparison with lymphography and CT
- Author
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Soheil L. Hanna, Thomas F. Boulden, Barry D. Fletcher, Larry E. Kun, Melissa M. Hudson, and Carol A. Greenwald
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Computed tomography ,Newly diagnosed ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Child ,Lymph node ,medicine.diagnostic_test ,business.industry ,Lymphography ,Magnetic resonance imaging ,Hyperplasia ,equipment and supplies ,medicine.disease ,Hodgkin Disease ,Magnetic Resonance Imaging ,Mr imaging ,medicine.anatomical_structure ,Paraaortic Region ,Female ,Lymph Nodes ,Lymph ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
The ability of short-inversion-time inversion recovery (STIR) magnetic resonance imaging to depict infradiaphragmatic lymphadenopathy was evaluated in 25 consecutive patients with newly diagnosed Hodgkin disease. All patients underwent computed tomography (CT) and multiplanar STIR imaging prior to lymphography (LAG). The STIR and CT images were evaluated for paraaortic and parailiac node enlargement. Findings were compared with LAG findings, which showed the architectural pattern of the opacified lymph nodes. In the upper paraaortic region, STIR imaging showed more abnormal nodes than did CT or LAG. In the lower paraaortic and parailiac regions, lymph node enlargement was shown equally well with STIR and LAG, whereas CT showed fewer enlarged lymph nodes. LAG showed paraaortic or parailiac focal tumor infiltration in three patients with normal-size nodes, and hyperplasia in two patients with enlarged nodes. STIR imaging showed more abnormal infradiaphragmatic nodes than did CT because of improved lymph node conspicuity. STIR imaging may be a useful addition to CT for staging pediatric Hodgkin disease.
- Published
- 1993
6. Classical Wind Sock sign of duodenal web on upper gastrointestinal contrast study
- Author
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Virendersingh K Sheorain, Thomas F Boulden, and Harris L. Cohen
- Subjects
medicine.medical_specialty ,Duodenum ,business.industry ,media_common.quotation_subject ,Radiography ,MEDLINE ,Surgery ,Text mining ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Contrast (vision) ,Upper gastrointestinal ,Duodenal Obstruction ,Duodenal Web ,Radiology ,Child ,business ,Digestive System Abnormalities ,media_common ,Sign (mathematics) - Published
- 2013
7. Efficacy and toxicity of multiagent chemotherapy and low-dose involved-field radiotherapy in children and adolescents with Hodgkin's disease
- Author
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Minnie Abromowitch, Paul W. Mackert, Judith A. Wilimas, Neyssa Marina, William Kauffman, Larry E. Kun, Melissa M. Hudson, Paula M. Bozeman, Jesse J. Jenkins, Carol A. Greenwald, Diane L. Fairclough, Thomas F. Boulden, and Elizabeth D. Thompson
- Subjects
Adult ,Male ,Cancer Research ,Vincristine ,medicine.medical_specialty ,Cyclophosphamide ,Adolescent ,Dacarbazine ,medicine.medical_treatment ,Procarbazine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Child ,Chemotherapy ,Radiotherapy ,business.industry ,Radiotherapy Dosage ,Combined Modality Therapy ,Hodgkin Disease ,Survival Analysis ,Vinblastine ,Surgery ,Regimen ,Treatment Outcome ,Oncology ,ABVD ,Child, Preschool ,Female ,business ,medicine.drug - Abstract
PURPOSE Between May 1980 and September 1990, 85 patients with Hodgkin's disease were treated with a regimen designed to increase cure rates while reducing late toxicity. PATIENTS AND METHODS Therapy consisted of five cycles of cyclophosphamide, Oncovin (vincristine; Eli Lilly and Co, Indianapolis, IN), and procarbazine (COP), alternated with four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and low-dose (20 Gy) regional radiotherapy. Vincristine and cyclophosphamide were administered as tolerated during irradiation and during the 2- to 4-week rest period between radiation volumes. The need for staging laparotomy was defined by clinical presentation. RESULTS The median age at diagnosis was 14 years (range, 4 to 20), and 56% of patients were male. The majority (67%) had stage III or IV disease and 68% (19 of 28) of stage II patients had bulky mediastinal disease. Nodular sclerosing histology predominated (67%). Ninety-three percent of patients were alive without disease with a median follow-up of 4.1 years. Abnormalities were detected on chest roentgenograms and/or pulmonary function tests in 58% and 25% of clinically asymptomatic patients who were tested at least 1 year after completion of therapy. The only symptomatic patient had pulmonary fibrosis after treatment with bleomycin (20 U/m2) and mantle (20 Gy)/lung (13 Gy) irradiation, and developed multiple spontaneous pneumothoraces that required cortical stripping. One patient had congestive heart failure 19 months post-treatment, and two had abnormalities on echocardiograms. Thyroid abnormalities occurred in 21 (27%) patients who were assessable for late toxicity. The majority of female patients have had regular menstrual cycles. Six developed ovarian failure, and 10 have had a total of 17 pregnancies. Other than one documented case of oligospermia, information was not available on male fertility. CONCLUSION The results demonstrate excellent disease control for the COP/ABVD regimen, with acceptable toxicity.
- Published
- 1993
8. Arteriovenous fistula after biopsy of renal transplant kidney: diagnosis and treatment
- Author
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Douglas G. Matsell, Ina L. D. Tonkin, Scott Baum, Deborah P. Jones, Thomas F. Boulden, and Edward M. Burton
- Subjects
Nephrology ,medicine.medical_specialty ,Fistula ,medicine.medical_treatment ,Biopsy ,Arteriovenous fistula ,urologic and male genital diseases ,Renal Veins ,Renal Artery ,Internal medicine ,Medicine ,Humans ,Embolization ,Child ,Kidney ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Embolization, Therapeutic ,Kidney Transplantation ,Surgery ,Transplantation ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Arteriovenous Fistula ,Female ,Radiology ,Renal vein ,business - Abstract
An 11-year-old renal transplant recipient was noted to have a bruit over her transplant graft 26 months post transplant and 17 months following percutaneous renal biopsy during an episode of rejection. Diagnosis of an arteriovenous (AV) fistula was made by ultrasound examination with Doppler flow and was confirmed with arteriography. The AV fistula was occluded by transcatheter embolotherapy with placement of a steel coil into the fistula from the renal vein approach. This procedure allowed nonsurgical closure of the AV shunt without significant change in renal function.
- Published
- 1992
9. Bronchial arteriography and embolotherapy for hemoptysis in patients with cystic fibrosis
- Author
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Robert Gold, Aram S. Hanissian, Warren J. Green, Ina L. D. Tonkin, Scott Baum, Thomas F. Boulden, Morris L. Gavant, and Phillip George
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hemoptysis ,Adolescent ,Cystic Fibrosis ,medicine.medical_treatment ,Femoral artery ,Bronchial Arteries ,Cystic fibrosis ,Pseudoaneurysm ,Recurrence ,medicine.artery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Embolization ,Child ,medicine.diagnostic_test ,business.industry ,Respiratory disease ,Reflux ,Angiography, Digital Subtraction ,Digital subtraction angiography ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Follow-Up Studies - Abstract
Bronchial arteriography and embolotherapy were performed to control hemoptysis in 11 patients with advanced stages of cystic fibrosis. Two patients suffered massive, 1 moderate, and 8 mild but recurrent hemoptysis. The embolization procedures were performed with Gelfoam, Ivalon, and coils in one to four separate procedures. Altogether, 19 of 20 procedures were successful, with follow-up periods ranging from 9 months to 8 years. No serious complications were encountered except for one femoral artery pseudoaneurysm which required surgical repair. Rapid digital subtraction angiography and “roadmapping” were considered helpful in avoiding the complication of reflux embolization and expediting the procedures. Bronchial embolization is a life-saving procedure for severe hemoptysis in patients with cystic fibrosis and is considered safe enough to include the indications of moderate and mild/recurrent hemoptysis to improve the quality of life in these patients.
- Published
- 1991
10. Neurenteric cyst: surgery and diagnostic imaging
- Author
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Edward M. Burton, A. Paige Whittle, Olga P. Edwards, Eduardo T. Fernandes, Earle L. Wrenn, Thomas F. Boulden, and Monford D. Custer
- Subjects
medicine.medical_specialty ,Spina Bifida Occulta ,Ultrasonography, Prenatal ,Pregnancy ,medicine ,Medical imaging ,Humans ,Cyst ,medicine.diagnostic_test ,Respiratory distress ,business.industry ,Infant, Newborn ,Mediastinum ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Spinal cord ,Spinal column ,Magnetic Resonance Imaging ,Surgery ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Female ,Neurenteric cyst ,business ,Tomography, X-Ray Computed - Abstract
Neurenteric cysts are rare, with fewer than 30 cases noted in the literature. We report the case of a newborn infant with respiratory distress caused by a large neurenteric cyst that was identified by prenatal ultrasound. Treatment consisted of excision of the mass through a right posterolateral thoracotomy. The cyst adhered to the spine at the level of the first thoracic vertebra and communicated with the jejunum through a posterior diaphragmatic defect. Postoperative studies with magnetic resonance imaging (MRI) and computed tomography (CT) disclosed an anterior meningocele and tethering of the spinal column. This is the second reported case of a neurenteric cyst demonstrated by prenatal ultrasound. The presence of an intrathoracic cyst associated with spinal abnormalities is characteristic of this anomaly. With imaging techniques such as MRI and CT, we may detect residual intraspinal disease associated with neurenteric cysts.
- Published
- 1991
11. Orbital Sinus Histiocytosis
- Author
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Royce E. Joyner, Michael B. Tierney, Thomas F. Boulden, Edward M. Burton, and Michael P. Hickman
- Subjects
medicine.diagnostic_test ,business.industry ,Sinus histiocytosis ,Magnetic resonance imaging ,Computed tomography ,Middle cranial fossa ,medicine.disease ,Magnetic Resonance Imaging ,Lymphatic disease ,medicine.anatomical_structure ,medicine ,Enhancing Lesion ,Humans ,Orbital Neoplasms ,Female ,Radiology, Nuclear Medicine and imaging ,Child ,business ,Proton density ,Nuclear medicine ,Lymphatic Diseases - Abstract
This case report describes the appearance of orbital sinus histiocytosis by magnetic resonance (MR) imaging. Four years after the remission of unilateral cervical adenopathy due to sinus histiocytosis, a 6-year-old girl developed orbital sinus histiocytosis with extension into the middle cranial fossa. Computed tomography demonstrated a homogeneously enhancing lesion; on MR, this tumor was isointense to gray matter on T1-weighted, proton density, and T2-weighted images. Vascular embarrassment was clearly shown by MR.
- Published
- 1989
12. Congenital pancreatic cyst
- Author
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Robert S. Hollabaugh, Thomas F. Boulden, Monford D. Custer, Olga P. Edwards, S. Douglas Hixson, and Eduardo T. Fernandes
- Subjects
medicine.medical_specialty ,Pathology ,business.industry ,General Medicine ,Congenital pancreatic cyst ,medicine.disease ,medicine.anatomical_structure ,parasitic diseases ,Pediatrics, Perinatology and Child Health ,Pediatric surgery ,medicine ,Surgery ,Cyst ,Pancreatic cysts ,Presentation (obstetrics) ,Pancreas ,business - Abstract
True congenital pancreatic cysts are extremely rare, with less than 20 cases reported in the literature. A 3-month-old infant with a giant congenital cyst of the pancreas is reported. The cyst, located in the head and body of the pancreas, was diagnosed by ultrasound and completely excised. The clinical presentation and treatment of this anomaly are discussed.
- Published
- 1989
13. Diagnosis and treatment of intrapericardial teratoma
- Author
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Abdul W. Aldousany, Robert A. Price, June C. Joyner, Donald C. Watson, Thomas F. Boulden, and Thomas G. DiSessa
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Male ,medicine.medical_specialty ,medicine.diagnostic_test ,Critically ill ,business.industry ,Infant, Newborn ,Teratoma ,Mediastinal tumor ,Computed tomography ,Diagnostic accuracy ,Vascular surgery ,medicine.disease ,Mediastinal Neoplasms ,Cardiac surgery ,Intrapericardial teratoma ,Echocardiography ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Pericardium - Abstract
Intrapericardial teratoma is a rare mediastinal tumor that originates from aberrant clusters of multipotential cells from three germinal layers. Previous reports have used the combination of cardiac angiography, CT scan, and echocardiogram to establish the diagnosis prior to surgery. We report a case of intrapericardial teratoma diagnosed noninvasively and removed surgically within the first three days of life. Furthermore, we compare the diagnostic accuracy of echocardiography and computerized tomography (CT), and discuss the superiority of noninvasive evaluation in the management of these critically ill infants.
- Published
- 1987
14. Diagnostic Imaging in Children With Urinary Tract Infection Reply
- Author
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H Lynn Magill, Webster Riggs, Thomas F. Boulden, Sarah J. Fitch, and Clifford J. Meservy
- Subjects
General Medicine - Published
- 1988
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