Facial cosmetics have little effect on attractiveness judgments compared with identity.

The vast majority of women in modern societies use facial cosmetics, which modify facial cues to attractiveness. However, the size of this increase remains unclear--how much more attractive are individuals after an application of cosmetics? Here, we utilised a 'new statistics' approach, calculating the effect size of cosmetics on attractiveness using a within-subjects design, and compared this with the effect size due to identity--that is, the inherent differences in attractiveness between people. Women were photographed with and without cosmetics, and these images were rated for attractiveness by a second group of participants. The proportion of variance in attractiveness explained by identity was much greater than the variance within models due to cosmetics. This result was unchanged after statistically controlling for the perceived amount of cosmetics that each model used. Although cosmetics increase attractiveness, the effect is small, and the benefits of cosmetics may be inflated in everyday thinking.

A useful radiologic sign for the diagnosis of Turner's syndrome.

A new X-ray sign of gonadal dysgenesis is described. In this series nine out of ten patients with Turner's syndrome have a coarse, reticular pattern of the carpal bones. A comparison with other previously described roentgenographic characteristics on hand and wrist films of these children leads to the conclusion that the new sign is more reliable and specific.

Methacholine-induced temporal changes in airway geometry and lung density by CT.

PURPOSE: Electron-beam CT (EBCT) was utilized to assess the time course of changes in airways cross-sectional area (CSA) and lung density during methacholine-induced bronchoconstriction. MATERIALS AND METHODS: EBCT scans (200 ms, 3-mm thickness, 2 mm increments) were obtained before (baseline) and 30 s, 2 min, and 4 min after bolus IV injection of methacholine to pigs receiving mechanical ventilation. A total of seven experiments were analyzed using custom-made image analysis software. With each challenge, five different airways and 50 lung regions of interest were studied. RESULTS: The time course of lung density changes paralleled the time course for CSA changes. The maximal response to methacholine, measured in terms of both CSA and lung density changes, occurred 30 s after injection. Lung density changes were unaffected by reconstruction algorithm, normal (standard) or sharp (high resolution). Overall, there was increased air content in the lung during bronchoconstriction. This effect was significantly greater at the dependent lung regions. CONCLUSIONS: EBCT is an effective tool to assess temporal and regional changes in the lung during bronchoconstriction. Measurements of lung density during bronchoconstriction allow for assessment of peripheral changes that are beyond the CT spatial resolution of airways anatomy.

The pediatric tracheostomy: III). An appraisal of xerography.

Comparatively new in the roentgen evaluation of infants and children, xerography would appear to be ideal for portraying the pediatric airway. Since the radiation dose of xerography is higher than conventional radiography, its image quality is the subject of careful scrutiny in a pediatric setting here described in 23 infants and children with tracheostomies. In this appraisal three pediatric radiologists independently compared each child's xeroradiograph with an accepted control, conventional radiography. The principal conclusion: the xerographic image of the pediatric airway is slightly superior to standard radiography in most studies (40 of 47 paired studies, 85.1%). In all but two comparisons, however, the tracheal morphology is correctly perceived, described, and interpreted in both the standard radiograph and the xeroradiograph. The main role of xerography, then, is its verification of tracheal detail as first depicted by the preliminary radiography. This confirmation is important in this particular pediatric problem, the tracheostomy, which has inherent difficulties in correct roentgen diagnosis.

Airway growth after pediatric lung transplantation.

BACKGROUND: Lung transplantation (LT) has been successfully offered to pediatric patients. Very little is known about the growth of the transplanted lung, especially in the infant population. Computerized tomography (CT) scanning is a simple method for studying pediatric patients who have undergone LT. We evaluated the use of CT scans to assess airway growth after pediatric LT, compare airway diameter indexed to somatic growth between LT patients and normals, and compare the growth of pre-anastomotic and post-anastomotic airways indexed to somatic growth in pediatric LT patients. METHODS: We reviewed CT scans on all pediatric patients who underwent primary LT before their fifteenth birthday between January 1995 and September 1998. Uniform measurements of diameter were made in pre-anastomotic (trachea, and proximal right and left bronchi) and post-anastomotic (distal right and left bronchi) sites. These measurements were then correlated with height and compared to previously published normal values. RESULTS: Of the 16 patients who underwent LT during the study period, 11 had at least 2 sequential CT scans (LT age 3 months to 14 years, median 2 years). Thirty-one CT scans were reviewed. Inter-observer variability was within 1 standard deviation (2 mm) in 93% of the measurements and inter-observer reliability was 0.91 by analysis of variance. Tracheal transverse diameter plotted against body height (slope 0.0072, correlation coefficient 0.88) was virtually identical to previously published norms. A similar relationship between airway diameter and height was observed in pre-anastomotic and post-anastomotic segments. CONCLUSION: CT scanning is a reliable method for assessing airway growth in pediatric LT recipients. Tracheal growth in pediatric LT recipients is similar to that of normal children. Post-anastomotic large airways grow similarly to native, pre-anastomotic airways.

Assessment of methacholine-induced airway constriction by ultrafast high-resolution computed tomography.

Assessment of changes in airway dimensions during bronchoconstriction is conventionally based on measurements of respiratory mechanics. We evaluated the efficacy of ultrafast high-resolution computed tomography (UHRCT) to directly determine the dynamic changes in cross-sectional area (CSA) of airways in response to methacholine (MCh). UHRCT scans were obtained at functional residual capacity before (baseline) and after intravenous bolus injections of MCh (10(-8.5)-10(-7.0) mol/kg) to seven mechanically ventilated pigs. Changes in CSA of bronchi of varying baseline size (1-10 mm diam) were determined by using a customized image processing software package (VIDA) based on a user-directed computer-adjusted edge-finding algorithm. MCh induced dose-dependent decreases in CSA, which were paralleled by increases in airway opening pressure at higher doses of MCh; at lower doses of MCh, decreases in CSA of smaller airways were detected without concomitant changes in airway opening pressure. Changes in CSA were heterogeneous and variable, especially in the smaller airway ranges. The results of the present study support the concept that UHRCT can be used in conjunction with bolus challenges to effectively determine dose-response changes in airway caliber in both large and small airways. This technique provides data that may not be reflected by conventional lung function measurements and, hence, is a useful tool to study airway reactivity.

Physiologic imaging of the lung with volumetric high-resolution CT.

The combination of high-resolution computed tomography (HRCT), rapid volumetric scanning, and advanced image display and analysis applications software is a powerful potential tool for the evaluation of physiologic and pharmacologic events in the lung. Currently employed in the experimental setting, this tool can provide verifiable and quantifiable information about regional responses in the lung, which were previously impossible to demonstrate. This is particularly true when physiologic or pharmacologic effects result in an anatomic change that can be directly imaged and measured within the limits of CT resolution. However, information about events occurring beyond resolution limits is potentially available indirectly from lung density and pulmonary blood flow measurements using CT techniques. The results of animal airway reactivity experiments making use of i.v. methacholine and CT imaging tools are presented as an example of "physiologic imaging."

The pediatric airway.

Accurate diagnosis is important in the evaluation of airway disorders of infants and children. Today, multiple imaging techniques are available to evaluate the pediatric airway. In general, it is best to start with simple and readily available examinations, which may provide a diagnosis in most cases, and progress to more sophisticated studies only in cases where needed.

Bronchial diseases and lung aeration in children.

Bronchial diseases are common in children, and are usually associated with disturbances of aeration. This article briefly summarizes the embryological development and respiratory physiology pertinent to pediatric bronchial diseases. Current diagnostic imaging tools are discussed, with an emphasis on CT, which can demonstrate bronchial pathology such as bronchial obstruction and bronchiectasis in larger bronchi, as well as indirectly show the peripheral physiologic consequences of bronchial disease, such as alterations in aeration. Computed tomography measurements of lung attenuation may aid in diagnosis in problematic cases. Diseases that affect the pediatric airways at different ages are reviewed. Knowledge of these entities is important for accurate interpretation of imaging studies.

Bronchiectasis in children.

Bronchiectasis (BR) is a descriptive term for abnormal, irreversibly dilated, and often thick walled bronchi, usually associated with inflammation. Causes are varied but include cystic fibrosis, aspiration, post infectious airway obstruction, immune abnormalities, immotile cilia, posttransplantation states, and congenital bronchial lesions. Although BR is uncommon in children, it causes significant mortality when present. Following a period of presumed decline due to antibiotics and vaccines, BR may increase in prevalence because of AIDS, organ transplantation complications, and changing patterns of childhood immunization. As with adults, high resolution CT (HRCT) is the most useful imaging tool for diagnosis and evaluation of bronchiectasis in children.

Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report.

A pectus index can be derived from dividing the transverse diameter of the chest by the anterior-posterior diameter on a simple CT scan. In a preliminary report, all patients who required operative correction for pectus excavatum had a pectus index greater than 3.25 while matched normal controls were all less than 3.25. A simple CT scan may be a useful adjunct in objective evaluation of children and teenagers for surgery of pectus excavatum.

N-type anorectal malformations.

Three cases of N-type anorectal malformations have been encountered. Two girls with anorectal-vestibular fistulas (one with a normal anus and the other with mild stenosis) were typical of 15 other such cases in the literature. A boy with an anorectal-urethral fistula and covered anus had a lesser variant than most of the other 8 males in the literature. The frequently accompanying esophageal, renal, and skeletal anomalies were not present, nor did he have anterior urethral hypoplasia. The constellation of other major associated anomalies in the boys, but not in the girls, follows the pattern of other types of anorectal malformations and suggests an earlier and/or more severe teratogenic insult in the boys. Anterior perineal resection of the fistula is appropriate for girls with N-type fistulas and for those boys with normal anterior urethras. An additional urethroplasty is necessary for boys with anterior urethral hypoplasia. Our experience and that from the literature suggest that N-type anorectal malformations constitute a rare but real entity, akin to N-type tracheoesophageal fistulas. A plea is made that they be included in classifications of anorectal anomalies.

Life-threatening airway obstruction as a complication to the management of mediastinal masses in children.

Life-threatening airway obstruction from large mediastinal masses in children poses a difficult diagnostic and therapeutic dilemma, requiring the close coordination of a pediatric surgeon, anesthesiologist, radiologist, and oncologist. To focus on this problem, the anesthetic and surgical management of 50 consecutive children with mediastinal masses treated between 1978 and 1984 were reviewed. Thirty children presented with respiratory symptoms; nine had life-threatening respiratory compromise with dyspnea, orthopnea, and stridor. Thirteen of these symptomatic children had marked compression of the trachea and/or mainstem bronchi on radiographic studies. The tracheal cross-sectional area which was measured by computed tomography was decreased by 35% to 93% of the normal tracheal dimensions in these children. Nonresectable malignant neoplasms including lymphoma, Hodgkin's disease, rhabdomyosarcoma, and neuroblastoma were the eventual diagnoses in 10 of these patients. The other 3 patients were less than 4 years old and had benign lesions. General anesthesia was judged to be prohibitively risky in 5 of 13 patients. The diagnosis was established by node or needle biopsy under local anesthesia, and general anesthesia was deferred until the compromised airway was alleviated by radiation and chemotherapy. General anesthesia with endotracheal intubation was administered to 8 patients, 5 of whom developed total airway obstruction. Using a variety of maneuvers, ventilation was reestablished in all 5 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Three-dimensional imaging of the pediatric airway.

Accurate imaging of the pediatric tracheobronchial tree is indicated for the evaluation of congenital or acquired abnormalities. Conventional axial computed tomography (CT) is now considered the best imaging modality for evaluation of the trachea and major bronchi, and has almost completely replaced the former gold standard of tracheobronchography. Preliminary results indicate that CT scan performance is further enhanced through the application of spiral technology and two-dimensional (2D) and 3D representation of the tracheobronchial tree. Spiral CT scans with 3D surface rendering offers an opportunity to replace traditional tracheobronchography with a safer, less invasive modality.

Pulmonary tuberculosis in children.

TB is no longer the scourge it once was, but it remains an important cause of morbidity and mortality worldwide. Fueled by increasing poverty, homelessness, immigration, drug abuse, declining prevention programs, and the HIV epidemic, its incidence in the United States has increased dramatically. The complex natural history of pulmonary TB in children is reflected in its varied radiographic manifestations. Strict distinction between "adult" and "childhood" patterns of TB should be avoided (Fig 16). In general, adenopathy is the footprint of childhood primary pulmonary TB, with or without a readily apparent primary parenchymal focus or pleural effusion. Infants and young children are more likely to present with adenopathy only than their older counterparts. The pediatric tracheobronchial tree is particularly susceptible to compression by surrounding nodes, producing segmental atelectasis, or less commonly, obstructive emphysema. Self-limited lymphohematogenous dissemination is the rule, but actual miliary disease is the exception. Pediatric postprimary TB, when it occurs, is usually observed in adolescents. It is characterized by parenchymal disease with an anatomic bias for the upper lung zones. Proper image interpretation is inextricably dependent on an understanding of the pathogenesis of this fascinating and often baffling illness whose appearance widely varies depending on host age and immunity as well as the virulence of the organism itself.