Dr. William E. Shiels II

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  www.lancastereaglegazette.com/article/20090825/NEWS01/9 - [Cached Version]
  Published on: 8/25/2009    Last Visited: 8/26/2009  

  LANCASTER -- Dr. William Shiels of Nationwide Children's Hospital will be a speaker at the Sherman Rotary Club at 7 a.m. Wednesday at Elks Lodge, 129 E. Main St., Lancaster.
  
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  Shiels, a leading expert in pediatric interventional radiology, will discuss how Rotary is teaming up with his staff to make procedures available to radiologists around the world.

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  www.portlandtribune.com/us_world_news/story.php?story_i - [Cached Version]
  Published on: 2/15/2009    Last Visited: 2/15/2009  

  "We identified a group of 10 patients over a three-year period of time that have this pattern of self-inflicted injury," said Dr. William Shiels, chief of radiology at Nationwide Children's Hospital in Columbus, Ohio. He presented his findings at the Radiological Society of North America meeting in Chicago.
  
  "It's cutting gone to the next level," Shiels said in a telephone interview.
  
  Shiels, who is developing a minimally invasive surgical technique for removing objects accidentally embedded in the skin, saw his first case of what he called self-embedding in 2005, and recently has seen a cluster of cases.
  ...
  Shiels said nine of the patients were female and one was male, all were between 15 and 18 and most had significant psychiatric problems, including depression.
  
  He said the teens described being in an agitated state and said embedding offered a measure of comfort.
  
  "The consistent theme is one of being angry and upset. Some of the patients have had very recent sexual abuse encounters, and they feel no one is taking them seriously," Shiels said.
  
  "Patients will usually have reported behavior that includes cutting and even ingesting things like battery acid and Drano (drain cleaner) before they engage in self-embedding," he said.

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  www.time.com/time/health/article/0,8599,1865995,00.html - [Cached Version]
  Published on: 12/13/2008    Last Visited: 12/13/2008  

  All of Nationwide's patients were young females, but when the researchers, including Dr. William Shiels II, the hospital's chief of radiology, turned to medical literature for other examples of self-embedding, they found very few — and those were among adults, primarily males. Shiels and his colleagues asked around at the hospital, but not even mental-health specialists had heard of it, nor had many of their colleagues outside the hospital. "As a profession in general, psychologists were not aware that this was happening," Shiels says. (See pictures of self-injury in Japan.)
  
  At the time of the conference, however, a Chicago Tribune reporter uncovered two more instances of self-embedding in an Illinois town — two teen girls had deliberately inserted pencils into their skin and broken off the tips — lending credence to the possibility that self-embedding was a growing trend, albeit off the radar. "We know it's elsewhere," says Shiels, who is creating a protected database for medical professionals worldwide to track the behavior.
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  Part of his responsibilities included maintaining a database of patients who had been treated by the hospital's radiology department using Image Guided Foreign Body Removal, a technique that was developed by Shiels during his Army days to help remove foreign objects like shrapnel from soft tissue. Shiels' method was less invasive than surgery, which often requires an incision of 2 to 3 inches and can lead to damage in surrounding tissues or organs; the new method requires a quarter-inch incision and uses a combination of ultrasound and fluoroscopy — live X-ray — to carefully guide forceps to the object, steering clear of the body's vital structures during extraction. The scar is also much smaller, "about the size of a freckle," Shiels says. (See pictures from an X-ray studio.)
  
  While Young was cataloging the hospital's data on procedures involving Shiels' technique, which Shiels first introduced to the hospital in 1995, Young realized that some of the patients hadn't injured themselves accidentally.
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  "I started to think it was a little strange and mentioned it to Dr. Shiels."
  ...
  For Shiels and Young, it became clear that they were on to something.
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  The following summer, Shiels, Young (who graduated from Miami University in Ohio) and three others worked their way through the data, unearthing cases of self-embedding going back to 2005.
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  Once they were aware of the trend, Shiels and his colleagues analyzed the patients' medical records, finding consistent histories of self-injury and mental-health problems.
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  Characterizing it as a disorder rather than a symptom of one may miss the mark, says Dr. John Campo, chief of child and adolescent psychiatry at Nationwide Children's and one of the specialists consulted by Shiels.
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  "The infections aren't just at the site," Shiels says. "You can get a deep muscle infection or a bone infection," or if you hit arteries, veins, nerves or tendons while driving something into the soft tissue, you can cause tears or other damage. Beyond those risks, there is also the possibility that objects can travel once inside the body, approaching vital organs. "They pose significant risk, not only during insertion, but also if they're not removed," Shiels says.

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  www.jsonline.com/features/health/35482489.html - [Cached Version]
  Published on: 12/3/2008    Last Visited: 12/3/2008  

  "This is not a local phenomenon," said lead author William Shiels II, a radiologist at Nationwide Children's Hospital in Columbus, Ohio.
  
  Since the disorder was identified two months ago, at least six other hospitals have reported similar cases, Shiels said, and a national registry is being set up to monitor the cases.
  
  Self-embedding disorder was defined as using objects to puncture the skin or inserting them into a wound after cutting.
  
  "Our children have progressed to the point where cutting doesn't work," he said.
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  A 17-year-old girl had embedded 11 objects, including two unfolded paperclips about 6 inches long that were inserted into each bicep, said Shiels, chairman of the department of radiology at the hospital.
  
  "Every time she flexed her muscle, she would feel a twinge of pain," Shiels said.
  
  Another patient came back to the hospital 10 days ago, this time with four more objects that she had embedded, he said.
  
  Parents and even emergency room doctors often are unaware of the injuries, he said. Often the girls will lie and say the objects got embedded when they fell down.
  
  Using ultrasound or fluoroscopy, a type of X-ray that provides moving images, doctors were able to detect both metallic and non-metallic objects, which then could be removed by through small incisions in the skin. The approach left little scarring and did not cause the objects to fragment.
  
  Ultrasound proved especially useful because it could detect non-metal objects that did not show up on X-ray, Shiels said.
  
  Sharing on Internet
  
  In recent years, hundreds of messages boards, blogs and other Internet sites have sprouted up, allowing adolescents to solicit and share information about self-injury, sometimes glorifying it. Most of the sites are used by girls between the ages of 12 and 20, according to a study in Developmental Psychology.
  
  Shiels said he is concerned that children will use the Internet to coach other kids on self-embedding. Because of that, he said, it is important that doctors recognize the problem.
  
  "This is the most severe form of self-injury," he said.
  
  While none of the self-embedding episodes was part of a suicide attempt, about 90% of the girls had suicidal thoughts, he said.

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  derrenbrownart.com/blog/?cat=10 - [Cached Version]
  Published on: 1/4/2009    Last Visited: 1/6/2009  

  Dr. William E. Shiels II, chief of radiology at Nationwide ChildrenÂÂ's Hospital in Columbus, Ohio, shows an X-ray of a girl who has a straightened paper clip embedded in her arm.

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  www.rt-image.com/News_from_RSNA_Making_headlines_in_rad - [Cached Version]
  Published on: 12/9/2008    Last Visited: 12/9/2008  

  "Radiologists are in a unique position to be the first to detect self-embedding disorder, make the appropriate diagnosis, and mobilize the healthcare system for early and effective intervention and treatment," says the study's principal investigator, William E. Shiels II, DO, chief of the radiology department at Nationwide Children's Hospital in Columbus, Ohio.
  
  Self-injury, or self-harm, refers to a variety of behaviors in which a person intentionally inflicts harm to his or her body without suicidal intent.
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  Shiels and colleagues studied 19 episodes of self-embedding injury in 10 adolescent girls, ranging from ages 15 to 18.

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  www.eurekalert.org/pub_releases/2008-12/rson-rda112508. - [Cached Version]
  Published on: 11/25/2008    Last Visited: 12/4/2008  

  "Radiologists are in a unique position to be the first to detect self-embedding disorder, make the appropriate diagnosis and mobilize the healthcare system for early and effective intervention and treatment," said the study's principal investigator, William E. Shiels II, D.O., chief of the Department of Radiology at Nationwide Children's Hospital in Columbus, Ohio.
  
  Self-injury, or self-harm, refers to a variety of behaviors in which a person intentionally inflicts harm to his or her body without suicidal intent. It is a disturbing trend among U.S. adolescents, particularly girls. Prevalence is unknown because many cases go unreported, but recent studies have reported that 13 to 24 percent of high school students in the U.S. and Canada have practiced deliberate self-injury at least once. More common forms of self-injury include cutting of the skin, burning, bruising, hair pulling, breaking bones or swallowing toxic substances. In cases of self-embedding disorder, objects are used to puncture the skin or are embedded into the wound after cutting.
  
  Dr. Shiels and colleagues studied 19 episodes of self-embedding injury in 10 adolescent girls, age 15 to 18.

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  www.newsmax.com/us/teens_scarring/2008/12/03/157903.htm - [Cached Version]
  Published on: 1/1/2008    Last Visited: 12/5/2008  

  "We identified a group of 10 patients over a three-year period of time that have this pattern of self-inflicted injury," said Dr. William Shiels, chief of radiology at Nationwide Children's Hospital in Columbus, Ohio. He presented his findings at the Radiological Society of North America meeting in Chicago.
  
  "It's cutting gone to the next level," Shiels said in a telephone interview.
  
  Shiels, who is developing a minimally invasive surgical technique for removing objects accidentally embedded in the skin, saw his first case of what he called self-embedding in 2005, and recently has seen a cluster of cases.
  
  "We had never seen this prior to 2005." he said.
  ...
  Shiels said nine of the patients were female and one was male, all were between 15 and 18 and most had significant psychiatric problems, including depression.
  
  He said the teens described being in an agitated state and said embedding offered a measure of comfort.
  
  "The consistent theme is one of being angry and upset. Some of the patients have had very recent sexual abuse encounters, and they feel no one is taking them seriously," Shiels said.
  
  "Patients will usually have reported behavior that includes cutting and even ingesting things like battery acid and Drano (drain cleaner) before they engage in self-embedding," he said.

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  www.columbuschildrens.com/gd/applications/controller.cf - [Cached Version]
  Published on: 4/5/2007    Last Visited: 4/5/2007  

  William E. Shiels II, DO, is the Chief of the Department of Radiology, Children's Hospital and President of The Children's Radiological Institute, Inc.He also is a Clinical Associate Professor of Radiology & Pediatrics and Category M on the graduate faculty in Biomedical Engineering, The Ohio State University College of Medicine.His primary radiological areas are interventional radiologyand ultrasound, with his greatest clinical focus in treating infants and children with vascular

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  www.lakehighlandsymca.org/index.cfm?FuseAction=Page&Pag - [Cached Version]
  Published on: 12/3/2008    Last Visited: 1/2/2009  

  "Radiologists are in a unique position to be the first to detect self-embedding disorder, make the appropriate diagnosis, and mobilize the health-care system for early and effective intervention and treatment," principal investigator William E. Shiels II, chief of the department of radiology at Nationwide Children's Hospital in Columbus, Ohio, said in a news release issued by the conference organizer.

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