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Biomedical subjects

C E Putman

Publications and source records attributed to C E Putman.

At least 55 records · Page 3Linked to original sources
PubMed1984

Protrusio acetabuli in sickle-cell anemia.

Of 155 adults with sickle-cell anemia (SS, SC), radiographs of the pelvis or hip demonstrated protrusio acetabuli on at least one side in 14 (3 men and 11 women), as indicated by projection of the acetabular line medial to the ilio-ischial line by greater than or equal to 3 mm in men and greater than or equal to 6 mm in women. All 14 patients had bone changes attributable to sickle-cell anemia, including marrow hyperplasia and osteonecrosis; however, the severity of femoral or acetabular osteonecrosis did not appear directly related to the protrusion. The authors conclude that sickle-cell anemia can predispose to development of protrusio acetabuli.

Acetabulum↗
PubMed1984

Obscured aortic arch on the lateral view as a sign of coarctation.

Forty patients with coarctation of the aorta were compared with 80 normal subjects matched by sex and age. The aortic arch was invisible on the lateral radiograph in 84% of patients preoperatively and 88% postoperatively. Only 6 normal subjects (8%) had a similar finding. The authors conclude that an obscured aortic arch on the lateral view could be a clue to the presence of coarctation. Possible explanations for this phenomenon include (a) dilatation of the brachiocephalic arteries (particularly the left subclavian artery), obscuring the superior margin of the arch; (b) hypoplasia and anteromedial displacement of the distal portion of the arch; and (c) diffuse hypoplasia of the arch combined with focal coarctation.

Adolescent↗
PubMed1984

Thoracic cryptococcosis: immunologic competence and radiologic appearance.

Cryptococcosis, a potentially fatal pulmonary infection, is being recognized with increased frequency in both immunologically compromised patients and those without obvious predisposing factors. This review of 24 cases of proven pulmonary cryptococcosis includes 15 immunologically compromised patients and nine noncompromised hosts. The noncompromised hosts tended to have a radiographic pattern of a peripheral nodule or nodules. The compromised hosts demonstrated a wider variety of radiographic abnormalities including single nodules, multiple nodules that progressed to confluence and/or cavitation, segmental consolidation, bilateral bronchopneumonia, or mixed patterns. Adenopathy, cavitation, and pleural effusions were limited to the compromised hosts.

Adult↗
PubMed1984

Diagnostic imaging in acute cardiopulmonary disease.

Optimum use of portable radiography and the newer imaging modalities requires careful coordination between the radiologist and intensivist. This article discusses the current imaging approach to patients with acute pulmonary disease, acute cardiovascular disease, and postoperative and iatrogenic problems.

Acute Disease↗
PubMed1984

Symposium on Nonpulmonary Aspects in Chest Radiology. The diaphragm.

The diaphragm is the main muscle of ventilation and the chief barrier separating the thorax from the abdomen. This article discusses diaphragmatic anatomy, physiology, pathology, and radiology, including hernia, eventration, rupture, tumors, paralysis, weakness, and fatigue. Imaging of the diaphragm involves plain radiography, fluoroscopy, computed tomography, and ultrasonography.

Adult↗
PubMed1983

Adult-onset pulmonary tuberculosis.

Medical records and radiographs of 103 adults with primary tuberculosis were reviewed. The shift toward delayed presentation appears to be related to decreasing childhood exposure and an increasing number of compromised hosts. Compared with classic "childhood" tuberculosis, there is a higher incidence of lower-lobe disease, but infiltrates also commonly involve the upper lobe or upper segments of the lower lobe. Adenopathy, cavitation, and tuberculoma are rare. If a pleural effusion is present and tuberculosis is suspected, pleural biopsy is mandatory. Adult respiratory distress syndrome can be a complication, particularly in miliary tuberculosis, and disseminated intravascular coagulopathy usually follows. A normal chest radiograph or clinical improvement of the patient with bed rest and penicillin does not exclude tuberculosis. Increased awareness of adult-onset tuberculosis on the part of radiologists could lead to a more rapid diagnosis and successful management.

Adolescent↗
PubMed1983

Peripheral middle lobe syndrome.

Classically, the middle lobe syndrome has been described as being caused by a central obstruction. Clinical records and radiologic findings were reviewed in 129 patients examined between 1955-1981 who had chronic disease in the right middle lobe and/or lingula. Fifty-eight patients (45%) had no evidence of a central obstructive lesion. The majority were middle-aged women with histories of chronic cough and chest pain. Bronchoscopic and radiologic evaluation served to exclude central lesions. Surgical confirmation was available in 38 patients. Pathologic study showed varying degrees of chronic inflammation, pneumonia, and bronchiectasis. Surgical results were excellent in isolated disease. Chronic atelectasis and pneumonitis of the right middle lobe and/or lingula do not always imply central obstruction. A lack of collateral ventilation is a plausible theory to explain the pathophysiology in such patients.

Bronchiectasis↗
PubMed1983

Computed tomography of pleural disease.

The computed tomography (CT) scans of 65 cases with histologic and clinical evidence of pleural disease were reviewed. The studies were analyzed according to the following CT features of the lesions: attenuation coefficient, contour, angle of interface with the adjacent pleura, and relationship to the adjacent lung, bone, and extrapleural tissues. The CT feature most helpful in detecting pleural involvement was the angle formed by the interface of the lesion with the adjacent pleura. An obtuse or tapering angle was seen in lesions involving the pleura. The other CT features are useful in identifying the site of origin and the specific nature of a lesion.

Humans↗
PubMed1983

Solitary pulmonary metastases in high-risk melanoma patients: a prospective comparison of conventional and computed tomography.

A prospective comparison of chest radiography, conventional tomography, and computed tomography (CT) in the detection or confirmation of solitary pulmonary nodules was made in 42 patients with high propensity for pulmonary metastases due to advanced local (Clark level IV or V) or regional malignant melanoma. Unequivocal nodules were revealed by chest radiography in 11 patients, conventional tomography in 16, and computed tomography in 20 patients. Both plain films and tomography in three of these 20 were normal, but follow-up verified pulmonary metastases. Computed tomography detected more pulmonary nodules than conventional tomography in 11 patients in addition to identifying lesions in extrapulmonary sites. Therefore, chest CT is recommended before institution of immunotherapy or surgical removal of a solitary pulmonary melanoma metastasis. Once chemotherapy had been instituted for bulky regional or cutaneous involvement, however, the findings of either conventional or computed tomography were comparable in this study.

Adult↗
PubMed1982

Comparison of plain radiography, conventional tomography, and computed tomography in detecting intrathoracic lymph node metastases from lung carcinoma.

Forty-two patients with T2 bronchogenic carcinoma were evaluated with plain radiography, conventional 55 degrees oblique hilar and anteroposterior mediastinal tomography, and computed tomography (CT) to compare their accuracy in assessing mediastinal and hilar nodal metastases. Definitive staging was achieved by thoracotomy and histopathological evaluation of resected specimens. All modalities demonstrated about the same accuracy; however, in the 25 patients with hilar and/or mediastinal lymphadenopathy, CT of the mediastinum was more sensitive but not more specific than the other two and conventional tomography was no more accurate than CT for hilar evaluation. Overall, no technique was accurate enough for routine staging; their value may lie in directing biopsy or in treatment planning in patients with inoperable disease.

Carcinoma, Bronchogenic↗
PubMed1982

Scintigraphic perfusion patterns in patients with diffuse lung disease.

Perfusion scintigrams of 55 patients with radiographic evidence of diffuse lung disease were reviewed. Thirty-nine had acute and/or chronic changes caused by congestive heart failure, and 16 had diffuse reticulonodular disease. A normal or near-normal perfusion pattern was seen in 40/55 (73%), and this finding was equally common in the two groups. The authors conclude that perfusion scintigraphy is useful in excluding pulmonary embolism in patients with radiographic evidence of diffuse, symmetrical lung disease.

Adolescent↗
PubMed1982

The efficacy of full-lung tomography in the detection of early metastatic disease from melanoma.

In a prospective study, 62 patients with proved melanoma and negative chest radiographs underwent full-lung tomography. Of 109 examinations performed, 12 patients had positive findings on tomography; nine were false-positive and three were true-positive. Of the true-positive examinations, two patients already had widespread metastatic disease and one had an advanced local lesion. Clinical staging and therapy were changed in only one patient as a result of information provided by full-lung tomography. It appears from these results that full-lung tomography is of limited use in detection of metastases from melanoma in the presence of a negative chest radiograph.

Adult↗
PubMed1982

Distinguishing benign from malignant pulmonary nodules by computed tomography.

Investigators have been able to distinguish benign pulmonary nodules from malignant ones in about two-thirds of the cases studied by detecting high computed tomography (CT) numbers (attributed to microscopic calcifications) within many benign nodules. This paper reports a similar analysis on a series of 22 benign and 14 malignant pulmonary nodules. Although about one-third of the benign nodules gave high CT numbers, all but one of the nodules diagnosed as benign by CT could also be diagnosed by detection of calcification on plain radiographs or conventional tomograms.

Calcinosis↗
PubMed1982

Two methods for isolating the lung area of a CT scan for density information.

Extracting density information from irregularly shaped tissue areas of CT scans requires automated methods when many scans are involved. We describe two computer methods that automatically isolate the lung area of a CT scan. Each starts from a single, operator specified point in the lung. The first method follows the steep density gradient boundary between lung and adjacent tissues; this tracking method is useful for estimating the overall density and total area of lung in a scan because all pixels within the lung area are available for statistical sampling. The second method finds all contiguous pixels of lung that are within the CT number range of air to water and are not a part of strong density gradient edges; this method is useful for estimating density and area of the lung parenchyma. Structures within the lung area that are surrounded by strong density gradient edges, such as large blood vessels, airways and nodules, are excluded from the lung sample while lung areas with diffuse borders, such as an area of mild or moderate edema, are retained. Both methods were tested on scans from an animal model of pulmonary edema and were found to be effective in isolating normal and diseased lungs. These methods are also suitable for isolating other organ areas of CT scans that are bounded by density gradient edges.

Animals↗
PubMed1982

Thymoma detection by mediastinal CT: patient with myasthenia gravis.

The precise role of computed tomography (CT) in evaluating the mediastinum for thymomas in patients with myasthenia gravis is not defined. The only published CT accuracy assessment reports a false-positive rate of 90%. Mediastinal CT was performed in 23 consecutive unselected patients with myasthenia gravis who underwent thymectomy independent of their neurologic status or diagnostic imaging results. Four patients had discrete thymomas; all were detected by CT. Conventional chest radiography and tomography were positive in three and falsely negative in one. In the remaining 19 patients with a normal or atrophic thymus or microscopic hyperplasia, CT was falsely positive in two; conventional chest radiography and tomography were falsely positive in three. Mediastinal CT is an accurate technique for evaluation of thymoma in patients with myasthenia gravis.

Adolescent↗