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Biomedical subjects

C E Ravin

Publications and source records attributed to C E Ravin.

At least 127 records · Page 7Linked to original sources
PubMed1979

Air crescent sign of invasive aspergillosis.

Pulmonary infection in immunocompromised patients is frequently difficult to diagnose. Therapy for the more common pathogens differs greatly from that for infection with unusual opportunistic organisms. However, neither of these infectious agents offers specific radiographic signs. The authors report on 4 patients with acute leukemia and invasive aspergillosis whose radiographs demonstrated a distinctive feature of one or more air crescents within an area of pulmonary infiltrate. Autopsy studies correlated the radiographic changes with an infection due to Aspergillus species fungi. While the sign is not pathognomonic for Aspergillus infection, seen in a suitable host, it would suggest the possibility of invasive aspergillosis.

Aspergillosis↗
PubMed1979

Intercostal artery laceration during thoracocentesis: increased risk in elderly patients.

Two cases of intercostal artery laceration following thoracocentesis are reported. Subsequent analysis of 29 thoracic aortograms demonstrated a definite trend toward increasing tortuosity of intercostal arteries with advancing age. Consequently, the amount of space available for safe insertion of the thoracocentesis needle tends to decrease with advancing age. As a result, elderly patients are more prone to intercostal artery laceration during thoracocentesis, and careful attention must be paid to the proper technique for performing this examination in such patients.

Age Factors↗
PubMed1979

Primary mediastinal seminoma.

Four new cases of primary mediastinal seminoma are presented, and the 103 previously reported cases reviewed. All of the tumors occurred in the anterior mediastinum, and generally appeared as lobulated noncalcified masses on chest radiography. Most patients were in the third and fourth decades, and about 30% were asymptomatic at the time of initial diagnosis. Although mediastinal seminoma is not commonly considered a cause of superior vena caval obstruction, about 10% of patients experience it. The tumors are radiosensitive and potentially radiocurable. A striking reduction in size of the tumor may be noted after radiation therapy. Prognosis is generally good, with a 5-year survival rate of 75%. The controversy surrounding histogenesis of this tumor is reviewed, and the pathologic criteria for making the diagnosis presented.

Adult↗
PubMed1978

Benign pneumoperitoneum following median sternotomy incision.

Because of the close anatomic relationship of the pericardium, diaphragm, and peritoneal cavity, a benign pneumoperitoneum may occur following median sternotomy incision and cardiac surgery. The pneumoperitoneum results from inadvertent opening of the peritoneal cavity during the initial surgical incision or during the subsequent cardiac surgery. It is generally of no significance to the patient, although it must be distinguished from pneumoperitoneum occuring secondary to intraabdominal pathology or to retrograde dissection of extraalveolar air in patients on ventilatory support. Two illustrative cases are presented.

Aged↗
PubMed1978

Chest pain in the nontraumatized patient.

The radiologist plays an important role in the examination of nontraumatized patients with chest pain presenting in the emergency room. In some instances, a diagnosis can be made on the basis of the initial radiograph. In others, consultation with the referring physician may either make the diagnosis or indicate a need for additional view or other imaging procedures. In this discussion, medical conditions associated with various radiographic appearances of the chest have been considered. We have not attempted to be encyclopedic, but have confined ourselves to the more common or distinctiive radiographic findings. Obviously, chest pain can occur from many other causes including primary disease in the neck, abdomen, and skeletal system.

Cardiomegaly↗
PubMed1978

Mediastinal masses of vascular origin. A review.

Vascular lesions must be considered in the differential diagnosis of mediastinal masses. Knowledge of the vascular anatomy of the mediastinum and the clinical setting, as well as an awareness of key radiographic features, should suggest the vascular origin and guide appropriate diagnostic imaging. Although angiography is used most often, radionuclide flow studies and computed tomographic scanning may also be useful.

Aneurysm↗
PubMed1977

Concentration of 99mTechnetium polyphosphate in fibrothorax following pneumonectomy.

Following the injection of 99mTechnetium-polyphosphate for bone scanning, a diffuse accumulation of radioactivity in post-pneumonectomy fibrothorax was demonstrated in 3 patients. This substantiates the nonspecificity of the localization of 99mTc-phosphorus compounds, and underlines the need for close clinical correlation in the accurate interpretation of such scans.

Aged↗
PubMed1977

Reuse of disposable catheters and guide wires.

Recent government directives and manufacturers' warnings have strongly cautioned against reuse of angiographic catheters and guide wires following cleaning and sterilization. Though it is theoretically possible that complications might result from reuse, actual documentation is lacking. Complete sterility can be achieved by standard procedures even when the devices are intentionally infected. Survey data indicate no increased incidence of mechanical malfunction when these devices are reused.

Angiography↗
PubMed1977

Cytomegaloviral infection presenting as a solitary pulmonary nodule.

Cytomegaloviral infection presenting in an immunologically compromised host as a solitary pulmonary nodule has not previously been reported. A patient with a renal transplant and with no pulmonary symptoms was noted to have a single nodule on a chest roentgenogram. At autopsy, this proved to be secondary to cytomegaloviral infection. Differential diagnostic considerations in the immunosuppressed patient are discussed.

Adult↗
PubMed1977

Thoracocentesis of loculated pleural effusions using grey scale ultrasonic guidance.

Six patients with either malignant pleural effusion or empyema, in whom multiple conventional attempts at thoracocentesis were unsuccessful, were evaluated by ultrasound. In each case, a subsequent thoracocentesis guided by ultrasound produced sufficient fluid to enable a diagnosis to be established. In no case was pneumothorax produced.

Drainage↗
PubMed1977

In vitro effects of lidocaine on anaerobic respiratory pathogens and strains of Hemophilus influenzae.

Lidocaine is commonly employed as a topical anesthetic agent during fiberoptic bronchoscopic procedures or transbronchial brushing. Previous studies have demonstrated an inhibitory effect of lidocaine on the growth in culture media of gram-positive and gram-negative organisms, as well as several species of Mycobacterium and various fungi. The current in vitro investigation demonstrates an inhibitory, as well as a bactericidal, effect of lidocaine hydrochloride (in concentrations identical to those encountered during fiberoptic bronchoscopic procedures) on the common anaerobic respiratory pathogens and on multiple strains of Hemophilus influenzae. The finding helps to explaint the difficulty in producing proof via culture of the specific etiologic agent in inflammatory lesions from specimens obtained by fiberoptic bronchoscopic procedures or transbronchial brushing.

Anesthesia↗
PubMed1977

Intraaortic counterpulsation balloon: radiographic considerations.

The intraaortic counterpulsation balloon is being used with increasing frequency in the setting of cardiogenic shock and/or high risk cardiac surgery. The radiologist should be aware of the normal function of this cardiac assist device, as well as its potential complications. The principal complications apparent on the plain chest radiograph are related to improper positioning of the balloon catheter.

Aortic Aneurysm↗
PubMed1977

PEEP: radiographic features and associated complications.

Positive and expiratory pressure (PEEP) has been used for several years in the treatment of acute respiratory failure. Dramatic improvement in the chest radiograph may occur with institution of PEEP; the degree of change parallels the levels of positive and expiratory pressure used. Conversely, weaning from mechanical ventilation may be associated with deterioration in the radiographic picture despite improvement in arterial blood gases and lung compliance. Serial chest films of representative patients with adult respiratory distress syndrome are reviewed and changes in the radiographic pattern are correlated with the amount of PEEP. The efficacy of PEEP in reducing intrapulmonary shunting and improving arterial oxygenation is related to increasing functional residual capacity, with improvement of diffuse atelectasis and associated shift of pulmonary water from the alveoli to the interstitial space and pulmonary capillaries. The changing radiologic manifestations reflect these physiologic phenomena. Pulmonary barotrauma is a frequent complication of PEEP therapy. Pneumothorax, pneumomediastinum, and interstitial emphysema may lead to rapid deterioration of a patient maintained on mechanical ventilation with an already compromised respiratory status.

Acute Disease↗
PubMed1977

Radiographic manifestations of acute smoke inhalation.

Acute smoke inhalation may lead to serious pulmonary injury and contribute significantly to mortality of fire victims. The chest radiographic findings in 21 patients with acute smoke inhalation are analyzed, and possible pathophysiologic mechanisms responsible for the radiographic abnormalities noted are discussed. Patients with surface injury burns were intentionally eliminated from this study. Our findings indicate that the standard chest radiograph is an insensitive means of determining pulmonary injury by smoke inhalation. The importance of blood carboxyhemoglobin levels and arterial blood gas determinations in the clinical evaluation of patients with acute smoke inhalation is stressed.

Acute Disease↗
PubMed1976

Post-traumatic pneumatocele in the inferior pulmonary ligament.

Pneumatocele localized to the inferior pulmonary ligament is an uncommon sequel of blunt chest trauma. Three such cases are reported and the characteristic location and appearance of the pneumatocele, as well as its benign course, are discussed. A similar radiographic appearance has been produced in cadavers by injecting air into the inferior pulmonary ligament.

Adolescent↗
PubMed1976

Hazards of the intensive care unit.

Complications arise in the introduction, maintenance, and use of devices for life support and monitoring in an intensive care unit. Since recognition of such complications is frequently difficult in this clinical setting, the radiologist is often in a position to be the first to detect complications associated with the use of endotracheal and tracheostomy tubes, Swan-Ganz catheters, subclavian catheters, central venous pressure catheters, and intra-aortic balloons.

Cardiac Catheterization↗