A5021451028- Vascular Malformations and Hemangiomas
- Fetal and Pediatric Neurological Disorders
- Congenital Diaphragmatic Hernia Studies
- Advanced MRI Techniques and Applications
- Vascular Tumors and Angiosarcomas
- Radiology practices and education
- Tracheal and airway disorders
- Prenatal Screening and Diagnostics
- Tumors and Oncological Cases
- Appendicitis Diagnosis and Management
- Vascular Malformations Diagnosis and Treatment
- Vascular anomalies and interventions
- Congenital Anomalies and Fetal Surgery
- Tuberous Sclerosis Complex Research
- Muscle Physiology and Disorders
- Orthopedic Infections and Treatments
- Musculoskeletal synovial abnormalities and treatments
- Atomic and Subatomic Physics Research
- Intestinal Malrotation and Obstruction Disorders
- Spinal Dysraphism and Malformations
- Esophageal and GI Pathology
- Histiocytic Disorders and Treatments
- Teratomas and Epidermoid Cysts
- Soft tissue tumor case studies
- Clinical Reasoning and Diagnostic Skills
Cincinnati Children's Hospital Medical Center
2012-2023
University of Cincinnati Medical Center
2018-2023
University of Cincinnati
2019-2023
Hudson Institute
2018
John Wiley & Sons (United Kingdom)
2018
Rady Children's Hospital-San Diego
2017
Texas Children's Hospital
2016
Nemours Children's Health System
2016
Children's of Alabama
2010-2016
University of Alabama at Birmingham
2009-2016
Complicated vascular anomalies have limited therapeutic options and cause significant morbidity mortality. This Phase II trial enrolled patients with complicated to determine the efficacy safety of treatment sirolimus for 12 courses; each course was defined as 28 days.Treatment consisted a continuous dosing schedule oral starting at 0.8 mg/m(2) per dose twice daily, pharmacokinetic-guided target serum trough levels 10 15 ng/mL. The primary outcomes were responsiveness by end 6 (evaluated...
The growth plates, or physes, are visible on virtually all images obtained in skeletally immature children. proper function of these plates depends an intricate balance between chondrocyte proliferation, which requires nourishment from the epiphyseal vessels, and death, integrity metaphyseal vessels. Therefore, injury to plate (ie, direct insult) vascular compromise either side indirect can cause dysfunction. Direct insults occur most commonly with Salter-Harris fractures, injuries that...
In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," which it was recommended that "health care organizations should adopt policies and practices promote nonpunitive culture values open discussion feedback on diagnostic performance." It may seem counterintuitive addressing highly technical skill such as medical diagnosis would be focused organizational culture. The wisdom becomes clearer, however, when examined light recent...
The standard treatment for Langerhans cell histiocytosis (LCH) is chemotherapy, although the failure rates are high. Since MAP-kinase activating mutations found in most cases, BRAF- and MEK-inhibitors have been used successfully to treat patients with refractory or relapsed disease. However, data on long-term responses children limited there no use of these inhibitors as first-line therapy. We treated 34 (26 LCH, 2 juvenile xanthogranuloma, Rosai-Dorfman disease, 4 presumed single...
Blue rubber bleb nevus syndrome (BRBNS) is a rare multifocal venous malformation involving predominantly the skin and gastrointestinal tract. Traditional treatment modalities include corticosteroids, interferon-α, sclerotherapy, aggressive surgical resection. Sirolimus has been used in several single case reports.We performed single-institution retrospective review of four children with BRBNS, who received sirolimus as part their regimens. A diagnosis BRBNS was based on clinical, radiologic,...
We describe a child initially diagnosed with multi-focal infantile hemangioma (cutaneous, hepatic, pulmonary), benign vascular lesion, which underwent malignant transformation to angiosarcoma. The use of anti-angiogenic agents, such as bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, has been reported in adults Treatment chemotherapy (gemcitabine and docetaxel) bevacizumab resulted disease response progression free survival 12 months. This report describes the...
The purpose of this study is to validate the use MR spectroscopy (MRS) in measuring muscular fat and compare it with T2 maps differentiating boys Duchenne dystrophy (DMD) from healthy boys.Forty-two DMD 31 were evaluated MRI (1)H-MRS maps. Grading muscle edema on conventional images, calculation fractions ([fat / fat] + water) MRS, values gluteus maximus vastus lateralis muscles performed. Group comparisons made. 95% reference interval (RI) fraction for control group was applied compared map...
Gorham-Stout disease is a life-threatening disorder often manifested by lymphatic malformation and osteolysis. Unfortunately, available therapies are not uniformly effective carry substantial morbidity. We report an 18-year-old male with lytic rib lesions intractable pleural effusion that responded dramatically to the combination of mammalian target rapamycin (mTOR) inhibitor sirolimus aminobisphosphonate zoledronic acid after failing interferon therapy. This tolerable therapeutic has...
Kaposiform hemangioendothelioma (KHE) is a rare aggressive vascular tumor of skin and deep soft tissues that typically presents in infancy may be associated with potentially life-threatening coagulopathy known as Kasabach–Merrit phenomenon (KMP). Recent advances medical therapy have successfully treated many patients. However, our knowledge regarding the natural history these lesions optimum surveillance strategies remains rudimentary. We report two young women who had KHE KMP presented...
The purpose of this study was to validate derived T2 maps as an objective measure muscular fat for discrimination between boys with Duchenne dystrophy (DMD) and healthy boys.Forty-two DMD (mean age, 9.9 years) 31 11.4 were included in the study. Age, body mass index, clinical function scale grade evaluated. T1-weighted MR images without suppression obtained. Fatty infiltration graded 0-4 on images, values (difference mean from suppression) gluteus maximus vastus lateralis muscles calculated....