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Biomedical subjects

E L Effmann

Publications and source records attributed to E L Effmann.

At least 55 records · Page 3Linked to original sources
PubMed1983

Postnatal growth and size of the pulmonary acinus and secondary lobule in man.

The acinus and the secondary lobule are important anatomic, functional, and pathologic units in the human lung; there are, however, few studies that specifically describe their postnatal growth and size. Normal lungs from 15 children and adults dying without evidence of pulmonary disease were fixed and dried using a standardized technique and were radiographed after tantalum or silver nitrate bronchoacinography. The acini and secondary lobules were identified and the diameters of these terminal respiratory units determined. The mean diameter of the pulmonary acinus at 1 month was 1 mm; 1 year, 2.5 mm; and at 2 years, 3 mm. The mean acinar diameter had increased to 6 mm at 12 years and reached a normal adult range of 6-10 mm during late adolescence. Acinar size seemed to be related to both height and age. The mean diameter of the secondary lobule at birth measured 3 mm, increased to 5 mm by the end of the first year of life, and by the fourth year measured 9 mm; at 12 years it measured 15 mm, and in late adolescence and adult life it ranged between 13 and 20 mm. A knowledge of the size of the acinus and secondary lobule has a practical application in radiologic practice and will be important in regional structural analysis of the pulmonary parenchyma with computed tomography.

Adolescent↗
PubMed1983

Comparison of CT localization radiography and high-kilovoltage chest radiography.

Twenty-five patients had localization radiography before chest computed tomography (CT) for evaluation of pulmonary nodules, staging of lung carcinoma, or suspected metastatic disease. Evaluation of the localization radiograph and the 140 k Vp frontal chest radiograph were performed independently and without history by a CT and chest radiologist, respectively. These interpretations were compared to a reference standard compiled from the full CT and chest radiographic reports. Significant abnormalities in the soft tissues, bones, mediastinum, hila, and pleura were detected with about equal frequency by chest and localization radiography. Chest radiography detected all 16 of the lung nodules greater than 1 cm in diameter, while localization radiography detected 12; however, this was not statistically significant. Both the sensitivity and specificity of nodule detection by chest radiography exceeded that of localization radiography. The performance of localization radiography in the detection of chest abnormalities in this and other studies encourages further development of computed chest radiography.

Adolescent↗
PubMed1983

Tracheal compression by mediastinal masses in children: CT evaluation.

Chest computed tomography (CT) was valuable in detecting extrinsic tracheal compression by mediastinal masses in two pediatric patients. This prompted an independent evaluation by CT of 14 children with masses involving the middle mediastinum and possible intrathoracic tracheal narrowing. Computer programs permit precise calculation of tracheal cross-sectional areas. Any apparent decrease in tracheal area may be compared with CT-derived data in normal children. Chest CT not only demonstrates the presence of extrinsic airway compression in pediatric patients with mediastinal masses, but also is capable of precisely measuring the extent of this narrowing. This method identifies children at potential risk for respiratory compromise and may aid in subsequent therapy.

Adolescent↗
PubMed1983

Computed tomography of the lung. Densitometric studies.

This discussion summarizes the physical basis for CT densitometry, the methods used for extracting density information from CT scans, and how the CT scanner has been used to noninvasively monitor the changes in the major mass and volume components that determine lung density (gas, vascular, and extravascular volumes).

Absorptiometry, Photon↗
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

Pulmonary edema: a CT study of regional changes in lung density following oleic acid injury.

Transmission computed tomography (CT) was used to study the global and regional density changes in the dog lung associated with oleic acid induced lung injury. The same level of the lower thorax was scanned (5 s/scan) during suspended ventilation at functional residual capacity prior to and after oleic acid infusion (0.05 ml/kg) into the right atrium. The first signs of edema were usually seen within 15 to 30 min after oleic acid infusion and consisted of patchy areas of increased density primarily in the peripheral and dependent zones. Mean CT density (Hounsfield units + 1,000) of lung cross sections from five dogs was 198 +/- 9 (SEM) during base line; density significantly (p less than 0.05) increased to 243 +/- 14 30 min after infusion and reached an apparent plateau of 294 +/- 31 75 min after oleic acid infusion. Thermal-dye dilution measurements indicated that extravascular lung water increased by 3.8 ml/kg from base line to 75 min after oleic acid infusion.

Absorptiometry, Photon↗
PubMed1981

Control of air flow in bird lungs: radiographic studies.

The complex pattern of air flow in the respiratory system of birds suggests that certain sites function as valves. To examine the possibility of mechanical valving, rather than aerodynamic valving, we recorded radiographic images of the orifices where the medioventral secondary bronchi branch from the primary bronchus in resting Pekin ducks. Analysis of the images indicated that the orifices do not change size or shape during the respiratory cycle, suggesting that they function as aerodynamic rather than mechanical valves in directing air flow through the lung.

Animals↗
PubMed1980

Radiological observations during transpyloric tube feeding in infants of low birth weight. Perforation of the duodenum and variations in normal duodenal anatomy.

Perforation of the duodenum is a serious complication of transpyloric tube feeding in infants of low birth weight. Polyvinyl chloride and (less commonly) silicone tubes have been implicated. Altered radiographic configuration of the tube in the region of the superior or inferior flexure, associated with clinical deterioration, pneumoperitoneum, peritonitis, or a retroperitoneal fistula, is diagnostic of duodenal perforation. The configuration of the tube may vary during uncomplicated transpyloric alimentation and is frequently incompatible with the expected anatomical course. Contrast examination may demonstrate normal anatomy or mobility of the distal duodenal loop as an adaptation to rigidity of the tube. The possibility of perforation appears to be increased at or adjacent to the flexures.

Duodenal Diseases↗
PubMed1980

Neonatal gastrointestinal masses arising late in gestation.

Gastrointestinal masses arising late in gestation form a small but important subgroup of neonatal abdominal masses. Thirteen infants were seen in the first day of life with abdominal distension or a mass. They had radiographic evidence of a mass and intestinal obstruction, and had masses containing meconium, liquid, or necrotic bowel in association with peritonitis. Results indicated a varied etiology. Six cases seemed to belong to one of three previously described entities: volvulus with pseudocyst formation, cystic meconium peritonitis, or segmental dilatation of the bowel. The other seven had features common to two or more of these entities.

Dilatation, Pathologic↗
PubMed1979

Hyperimmunoglobulinemia E syndrome: radiographic observations.

Susceptibility to recurrent staphylococcal cutaneous and respiratory infections beginning in infancy associated with extreme hyperimmunoglobulinemia E is a recently described primary immunodeficiency syndrome. Other clinical features include depressed cellular immunity and deficient antibody formation. Recurrent pneumonia and cyst formation with variable persistence and expansion characterized the radiographic couse in 11 patients. Five cysts resolved with continuous antistaphylococcal therapy; 2 were resected without recurrence; and 4 persisted after surgery and/or antibiotics (2--8 years). The cysts had dense, necrotic surfaces with fibrous walls, eosinophilic and other inflammatory cell infiltrates, and frequent, persistent, bronchial connections. Sinusitis (9/9) and mastoiditis (3/4) were also observed radiographically.

Adolescent↗
PubMed1978

Ether cystitis.

Two children are reported in whom chemical cystitis developed when ether was used to dissolve a Foley catheter balloon that would not deflate. The irritative effects of ether and preventive measures are discussed.

Child↗
PubMed1978

Radiographic aspects of total parenteral nutrition during infancy.

In a retrospective radiographic study the authors reviewed the position of 82 central venous catheters in 57 consecutive infants receiving total parenteral nutrition between 1972 and 1976. Sixteen of the 82 catheters (19%) were initially not positioned within the superior vena cava and 11 (14%) migrated from a satisfactory position during therapy; peripheral edema, pleural effusion, and vascular thrombosis occurred more frequently in this group than in those infants with the catheter remaining in the superior vena cava. Unusual complications of intersititial pulmonary edema, hydrocephalus, and cardiac arrhythmia were noted in three different patients. An increased incidence of clinical complications is associated with catheter malposition or migration during total parenteral nutritional therapy. Radiographic monitoring with repositioning or removal of a malpositioned catheter may reduce the number of clinical complications.

Catheterization↗
PubMed1977

The radiographic features of early onset Group B streptococcal neonatal sepsis.

The clinical and radiographic features of 27 newborn infants with early onset Group B streptococcal infection as documented by blood culture have been reviewed. Initial chest radiographs revealed a wide spectrum of patterns. These included changes usually associated with the respiratory distress syndrome, extensive pneumonia, and small infiltrates as well as a normal appearance. Premature birth and a fatal outcome were associated with extensive radiographic changes. At autopsy some of the infants with a radiographic appearance of respiratory distress syndrome had pathologic features of Group B streptococcal infection with no apparent evidence of coexisting respiratory distress syndrome.

Humans↗
PubMed1977

Renal growth.

Application of the renal growth chart may yield considerable information on longitudinal growth of normal and diseased kidneys. Its systematic use in following patients with urinary tract infection and vesicoureteral reflux is established, and application to other forms of renal disease in childhood may increase current knowledge of the natural history of these diseases.

Child, Preschool↗
PubMed1977

Traumatic perforation of the pharynx in the newborn.

Two newborn, low-birth-weight infants with traumatic perforation of the pharynx and an additional 18 previously reported cases are presented. Injury produced by pharyngeal suction catheters and nasogastric and endotracheal tubes is generally unrecognized until the baby develops signs of esophageal obstruction or radiographic evidence of pharyngeal perforation, usually in the posterior mediastinum. The catheter may enter the pericardial space. Conservative management with intravenous antibiotics and a feeding gastrostomy is favored, except in instances that require mediastinal decompression. The key to prevention is the use of soft-tipped suction catheters and nasogastric tubes and careful visualization of the cords during endotracheal intubation. The use of metal stylets to direct the endotracheal tube is condemned. Pediatrics, 56:1019-1022, 1977, PHARYNX, PERFORATION, SUCTION CATHETER, NASOGASTRIC TUBE, ENDOTRACHEAL TUBE, METAL STYLET.

Esophagus↗
PubMed1976

A comparison of early-onset group B streptococcal neonatal infection and the respiratory-distress syndrome of the newborn.

In attempting to differentiate early-onset Group B streptococcal infection from hyaline-membrane disease we found features of severe Group B infection to be rupture of the membranes for more than 12 hours before delivery (four or eight versus one of nine), gram-positive cocci in the gastric aspirate (four or four versus none of one), apnea and shock in the first 24 hours of life (seven of eight versus none of nine), and the generation of lower peak inspiratory pressures on avolume-cycled respirator (mean of 36.5 +/- 2.8 versus 63.9 +/- 6.2 cm of water; P = 0.005). In eight fatal cases of Group B infection, four patients had radiographic features indistinguishable from hyaline-membrane disease whereas the other cases were consistent with neonatal pneumonia. Seven of the eight infected infants had no histologic evidence of coexisting hyaline-membrane disease. Microscopical features of Group B infection included cocci in unevenly distributed hyaline membranes and minimal atelectasis. Group B streptococcal infection differs clinically and pathologically from hyaline-membrane disease. Differentiating clinical features include early apnea and shock and lower inspiratory pressures on mechanical ventilation.

Diagnosis, Differential↗