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Biomedical subjects

J E Takasugi

Publications and source records attributed to J E Takasugi.

At least 19 recordsLinked to original sources
PubMed1998

Radiology of chronic obstructive pulmonary disease.

This article reviews the radiologic manifestations and complications of chronic obstructive pulmonary disease, particularly those seen in association with emphysema. Current concepts on the pathogenesis of chronic obstructive pulmonary disease are discussed and related to findings on high-resolution CT scan and histologic examinations. Controversial issues concerning the detection and grading of emphysema using radiologic and physiologic tests are also addressed.

Acute Disease↗
PubMed1998

Lung-volume reduction surgery for diffuse emphysema: radiologic assessment of changes in thoracic dimensions.

Patients with severe, diffuse emphysema may be candidates for pneumectomy (lung-volume reduction surgery, LVRS) to improve lung and respiratory muscle function. To identify candidates who might benefit from this surgery, it is necessary to understand how lung volumes and respiratory function are effected. In this article, the authors demonstrate a significant difference in lung size on chest radiographs obtained before and after surgery. Thirty-five of 71 consecutive patients undergoing LVRS had both preoperative and postoperative chest radiographs and pulmonary function tests available for retrospective review. Preoperative and postoperative measurements of lung height, transthoracic diameters, mediastinal width, heart size, diaphragmatic arc, and intercostal spaces were compared using paired t-tests. Radiographic measurements where also correlated with changes in lung volumes as measured by pulmonary function tests. Lung heights (right, left, mean lateral) and coronal diameter at the aortic arch were reduced after surgery (all p < 0.05). Forced vital capacity, forced expiratory volume in 1 second (FEV1), and vital capacity increased, and total lung capacity and residual volume decreased after surgery (all p < 0.05). Left lung height showed a significant correlation (p = 0.025) with FEV1; all other correlations between radiographic changes and pulmonary function test changes were not significant. The explanation for improved lung function in patients after LVRS is not completely clear and is probably multifactorial. Radiologic alterations reflect anatomic changes caused by surgery and support the theory that modifications of chest wall configuration occur and are likely responsible, in part, for improved symptomatology and respiratory function.

Adult↗
PubMed1996

Intrathoracic granulocytic sarcomas.

Recent trends in the treatment of intrathoracic granulocytic sarcoma (IGS) call for an overview of its radiographic manifestations. Nine patients from our institution and a review of 41 from the literature provide the basis of our conclusions on the typical and atypical appearance of IGS. Of the nine patients with IGS, all had chest radiographs, five had computed tomographic (CT) scans, and one had magnetic resonance (MR) scans. Radiographic studies and medical records were examined to establish the site and appearance of IGS. Three cases were histologically proved; in the others, the diagnosis was based on clinical presentation and response to chemotherapy. The mediastinum was the most common site of involvement (six of nine cases). A focal mass or mediastinal widening was visible on chest radiographs, and a focal mass or diffuse infiltration or replacement of fat was visible on chest CT. Less common sites of involvement were the lungs (two cases), the pleura (two), the pericardium (two), and the hilar (two). Mediastinal or hilar mass or mediastinal widening is the characteristic finding in IGS. Less common manifestations such as pleural and pericardial effusions and lung opacities should be confirmed histologically, since fluid or tissue is readily accessible.

Adult↗
PubMed1994

Diagnostic use of inadvertent pneumothorax after CT-guided percutaneous lung biopsy.

Previous studies using artificially induced pneumothorax and post-pneumothorax computed tomography (pCT) have shown that 100% of cancers that fall away from the mediastinum or chest wall are contained within the visceral pleura at that site. This patient demonstrates how an unintentional, postbiopsy pneumothorax can be used to show that a peripheral carcinoma of the lung does not invade the mediastinum.

Aged↗
PubMed1994

The implantable pace-maker-cardioverter-defibrillator: radiographic aspects.

Safer and easier placement, recent approval by the U.S. Food and Drug Administration of several models, and increasing availability have expanded the use of implantable cardioverter-defibrillators (ICDs) for treatment of life-threatening ventricular tachyarrhythmia. Modern ICDs generally use a combination of two transvenously placed electrodes and one subcutaneous electrode; therefore, they do not require a thoracotomy for placement. The authors evaluated the radiographic aspects of one particular ICD--the pacemaker-cardioverter-defibrillator (PCD)--including the normal appearance and variations, confusing findings, and such complications as deformity of the subcutaneous patch electrode, lead fracture, and electrode malposition and migration. The PCD can also be combined with a preexisting, surgically placed automatic ICD or with a pacemaker. Familiarity with the PCD and other ICDs is essential, since the radiologist may be the first to recognize a complication that can render the device inoperative and leave the patient vulnerable to sudden death.

Defibrillators, Implantable↗
PubMed1994

Radiographic changes in acute exacerbations of cystic fibrosis in adults: a pilot study.

OBJECTIVE: We set out to determine whether specific findings can be seen on chest radiographs of adult patients with cystic fibrosis who are having acute exacerbation of respiratory disease. MATERIALS AND METHODS: Over a 2-year period, 22 adults with cystic fibrosis had both a baseline chest radiograph and a radiograph obtained either because of acute exacerbation or for some other reason (nonexacerbation). Fourteen radiographic features, including mucous plugs, air-space disease, peribronchial thickening, bronchiectasis, fluid levels, and lymphadenopathy, were scored retrospectively by two radiologists, who did not have knowledge of the patient's clinical condition, as being present, absent, increased, decreased, or unchanged. An overall assessment (better, worse, or no change) was also given for each radiograph. Data were analyzed in two ways (per individual episode and per individual patient) by using contingency tables, with statistical significance determined by exact permutation testing. RESULTS: Of the 22 patients, 13 had 29 exacerbations and eight had 11 nonexacerbations. The remaining patient had radiographs showing both an exacerbation and a nonexacerbation. With the exception of overall change (p = .06), none of the radiographic variables showed a statistically significant association with exacerbation (mean p value, .66; range, .19-.90). CONCLUSION: The 14 specific radiographic findings studied, including peribronchial thickening, mucous plugs, air-space disease, and fluid levels, were not useful in determining whether an adult patient with cystic fibrosis was having acute exacerbation of the disease. With regard to these individual variables, chest radiographs are not helpful in the management of acute exacerbation of cystic fibrosis in adults. However, overall change approached statistical significance (p = .06). The value of chest radiography lies more in excluding the rare major complication, such as pneumothorax, than in diagnosing the usual exacerbation.

Acute Disease↗
PubMed1991

The airway.

Explore the source record for details and available documents.

Bronchial Diseases↗
PubMed1991

Lung abscess caused by Rhodococcus equi.

In the immunocompromised patient, early diagnosis of a lung cavity is essential for appropriate treatment. Rhodococcus equi (formerly Corynebacterium equi) is a variably acid-fast bacterium that can produce cavitary disease in an immunocompromised host. The two cases presented here demonstrate the clinical and radiographic features of R equi lung abscess. The first patient was on long-term corticosteroid therapy for rheumatoid arthritis. The second patient had AIDS. The correct diagnosis in both cases was delayed because acid-fast bacilli seen on smears of sputum were presumed to be Mycobacterium tuberculosis.

Actinomycetales Infections↗
PubMed1991

The extrapleural fat in empyema: CT appearance.

Pleural empyema can be accompanied by changes in the adjacent chest wall. We examined the chest wall on computed tomographic scans in 24 patients with pleural effusions. Eighteen patients had pleural empyema and six had transudative effusions. Of the 18 empyema patients, 13 had abnormally high attenuation in the extrapleural tissues. In 12 of these 13, the high attenuation was probably caused by reaction to the pleural infection. In two, it was probably caused by haematoma (one patient had haematoma and empyema). In five patients there was either no clear abnormality in the extrapleural space or an insufficient amount of fat to permit detection of an abnormality, or the parietal pleura could not be distinguished from the pleural fluid because intravenous contrast medium was not given. Of the six patients with proven transudative pleural effusions, all had extrapleural fat which appeared normal. Abnormally high attenuation in the extrapleural tissues can be expected to accompany exudative pleural effusion, particularly empyema, but not transudative effusion.

Adipose Tissue↗
PubMed1991

Computed tomography of air-space disease.

Although computed tomography (CT) has not been used as often in air-space diseases as in interstitial ones, it often provides useful information. Diseases such as early opportunistic pneumonia may be detected by CT before becoming visible on plain radiographs. Also, extent and location are often better defined by CT than by plain radiographs. Accompanying abnormalities such as abscess, lymphadenopathy, and pleural effusion are often clearly demonstrated by CT. This article reviews the CT findings in a variety of air-space diseases, including pneumonia and other infections, radiation pneumonitis and fibrosis, embolism, eosinophilic pneumonia, alveolar proteinosis, bronchioloalveolar carcinoma, lipoid pneumonitis, sarcoidosis, and trauma.

Air↗
PubMed1990

CT appearance of the retroaortic anastomoses of the azygos system.

The terminations of the hemiazygos and accessory hemiazygos veins can be mistaken for normal or enlarged posterior mediastinal lymph nodes on CT scans of the chest. These terminations are termed the retroaortic anastomoses by anatomists. We studied the CT appearances of these veins on scans of one cadaver and seven patients. We found that the retroaortic anastomoses usually were clearly recognizable because of their continuity with the hemiazygos or accessory hemiazygos vein. However, it is sometimes possible to mistake these vessels for lymph nodes, especially when only short segments of the vessel are visible on a CT image or when the vessel is not clearly opacified by contrast material. Familiarity with the CT appearances of the hemiazygos and azygous veins can prevent their being mistaken for normal or enlarged lymph nodes.

Azygos Vein↗
PubMed1989

Superior sulcus tumors: the role of imaging.

Advances in the treatment of stage 0 to III superior sulcus tumors mandate greater accuracy in establishing tissue diagnosis, assessing tumor extent, and staging. Currently, this is best accomplished by a combination of PA chest radiography, MRI, and needle biopsy. MRI is superior to other single imaging modalities for the overall assessment of local tumor extent, bone invasion, mediastinal invasion, and perhaps in the future, determining radiosensitivity. In patients with superior sulcus tumors, evaluation of the brain, liver, and skeleton for metastases may be advisable prior to treatment with preoperative radiation and radical surgical resection.

Diagnostic Imaging↗
PubMed1989

Inadvertent bucrylate pulmonary embolization: a case report.

Detection of small, dense, rectangular opacities that follow the course of pulmonary vessels on chest radiographs should raise the suspicion of a prior therapeutic occlusion of the blood supply of a mass or of an arteriovenous fistula elsewhere with embolization of the occlusive material to the lungs. This article demonstrates the radiographic findings of such an occurrence in an asymptomatic woman.

Adult↗
PubMed1989

Left azygos lobe.

Left azygos lobe is much rarer than right azygos lobe, but cases have been reported. Computed tomography proved more reliable than plain radiography in the diagnosis of left azygos lobe in a 10-year-old girl.

Azygos Vein↗
PubMed1989

Pulmonary histiocytosis X: comparison of radiographic and CT findings.

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.

Adult↗