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Biomedical subjects

J D Godwin

Publications and source records attributed to J D Godwin.

At least 73 records · Page 4Linked to original sources
PubMed1986

Opportunistic lung infection caused by Rhodococcus (Corynebacterium) equi.

Rhodococcus (formerly Corynebacterium) equi, a common animal pathogen, can cause a slowly evolving pneumonia in humans, particularly immunocompromised people. The authors describe two patients; one with acquired immunodeficiency syndrome. On chest radiographs, R. equi produces chronic, localized pulmonary opacities that can cavitate. The main differential diagnoses are tuberculosis and fungal infection.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Imaging of the axillary subsegment of the right upper lobe.

The bronchial supply of the lateral or axillary area of the right upper lobe is variable. In 16 percent of normal subjects, an independent ramus of the posterior right upper lobe bronchus supplies an axillary subsegment. Airspace disease in the axillary subsegment has a characteristic appearance on radiographs. The CT appearance of disease in the axillary subsegment correlates closely with classic anatomic studies. Recognizing that disease is located in the axillary subsegment can help in directing bronchoscopy or biopsy.

Bronchial Diseases↗
PubMed1985

CT of obstructive lobar collapse.

The varied computed tomographic (CT) appearance of obstructive lobar collapse is described in 25 cases. CT is helpful in understanding the morphology and mechanisms of lobar collapse and in diagnosing atypical cases. The final shape of the collapsed lobe is dependent on the size and location of the obstructing tumor and on the amount of retained lung fluid. Focal bulging of the fissure (S-sign) is the most helpful sign in identifying the obstructing tumor. Differential enhancement could not separate the tumor from collapsed lung in six of eight (75%) of the cases studied with intravenous contrast, a finding at variance with previous reports. The limitations of CT in evaluating mediastinal or pleural invasion in the presence of lobar collapse are discussed.

Adult↗
PubMed1985

Noninvasive assessment of exercise cardiac function before and after pectus excavatum repair.

Surgical correction of pectus excavatum frequently results in subjective improvement of exercise tolerance. Whether or not cardiac function improves after repair remains controversial and has primarily been limited to isolated case reports. The purpose of this investigation was to assess changes in cardiac function during rest and exercise associated with the surgical correction of this deformity. First-pass radionuclide studies during upright rest and bicycle exercise were performed on 13 patients before and at least 6 months after pectus excavatum repair. Operation did not change left ventricular ejection fraction or cardiac index at rest or during exercise. However, the left ventricular end-diastolic volume index and stroke volume index increased at rest after surgical correction. The estimated resting right ventricular end-diastolic volume also increased markedly after operation and was associated with a decrease in right ventricular ejection fraction. These data show no limitation in exercise cardiac function that could be relieved by pectus repair. However, the increase in right and left ventricular volume after operation suggests that some cardiac compression is relieved by operative repair.

Adolescent↗
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

CT identification of bronchopulmonary segments: 50 normal subjects.

A systematic evaluation of the fissures, segmental bronchi and arteries, bronchopulmonary segments, and peripheral pulmonary parenchyma was made from computed tomographic (CT) scans of 50 patients with normal chest radiographs. Seventy percent of the segmental bronchi and 76% of the segmental arteries were identified. Arteries could be traced to their sixth- and seventh-order branches; their orientation to the plane of the CT section allowed gross identification and localization of bronchopulmonary segments.

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

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

Clinical value of coronary bypass graft evaluation with CT.

Computed tomography (CT) has a reported accuracy of 45%-97% in assessment of patency of coronary artery bypass grafts. Dynamic CT was done in 26 patients (47 grafts) with recurrent cardiac symptoms after graft surgery. Although CT was 79% accurate (with selective angiography as the standard), the authors do not believe that it provides sufficient information for the assessment of symptomatic patients. Four patients had high-grade stenoses in their grafts, and 50% of patients had significant progression of atherosclerosis in their native coronary arteries. Neither of these conditions could be detected by CT. The clinical contribution of CT will probably be greatest for routine screening of asymptomatic patients soon after operation. Technical problems with CT scanning for graft patency are discussed.

Angiography↗