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Biomedical subjects

J H Austin

Publications and source records attributed to J H Austin.

At least 55 records · Page 3Linked to original sources
PubMed1990

The impact of routine chest radiography on the management of patients admitted from an emergency service.

Adult patients entering a hospital usually undergo a routine admission chest radiographic examination (RACXR). Recently, this practice has been questioned. The clinical course of 188 patients admitted to an adult medical service from the emergency area of an inner city hospital was assessed prospectively. Each of these patients underwent RACXR, ie, the only indication for the examination was admission to the hospital. Four subpopulations considered to be at high risk for treatment-altering radiographic abnormalities were defined prospectively: age of 65 years or older, cigarette smokers, altered mental status, and human immunodeficiency virus (HIV) positivity. RACXR abnormalities were significantly more common in the subpopulations at high risk (104/127, 82%) than in the population at low risk (37/61, 61%) (P less than .01). Abnormalities on RACXR led to altered treatment in five (3%) of the 188 inpatients. Each of these five patients was a member of a subpopulation at high risk (5/127, 4%). Because results suggest that various clinical considerations may affect the yield of RACXR, it is proposed that a blanket recommendation to eliminate RACXR is premature.

Adult↗
PubMed1989

Nodular bleomycin toxicity.

Pulmonary interstitial fibrosis, a well-known toxic effect of bleomycin therapy, usually presents radiographically as diffuse reticularity. The authors report an unusual case of biopsy-proven bleomycin toxicity that presented as pulmonary nodules mimicking metastatic tumor. The histologic findings resembled those seen in the diffuse form of toxicity but notably also included foci of bronchiolitis obliterans.

Adult↗
PubMed1989

Pulmonary infection after cardiac transplantation: clinical and radiologic correlations.

Forty-one episodes of radiographically demonstrated pulmonary infection developed in 35 (30%) of 118 cardiac transplant recipients treated with cyclosporine. The most common pathogens were cytomegalovirus (CMV) (13 episodes), Pneumocystis carinii (12 episodes), and Aspergillus (five episodes). Appearance of CMV infection on radiographs was generalized and hazy (n = 9) or limited to one lobe (n = 4). All episodes of P carinii pneumonia, including six combined with CMV infection, appeared diffusely hazy. Aspergillus infection appeared either shaggy and nodular (n = 3) or bibasilar and hazy (n = 2). Aspergillus infection developed only early after transplantation (0.2-2.5 months), whereas CMV infection (1.1-6.1 months) and P carinii pneumonia (2.6-10.3 months) developed later (time ranges for latter two infections exclude three episodes that developed even later in two patients at risk for acquired immunodeficiency syndrome). Nine (8%) patients died of pulmonary infection, eight (7%) within 4.0 months of transplantation. Symptoms or signs were variable; none were found in four (10%) of 41 episodes. The authors recommend frequent chest radiographs in the early months after transplantation.

Adolescent↗
PubMed1988

Radiologic detection of thymoma in patients with myasthenia gravis.

From 1973 through 1986, 154 consecutive patients who had a transsternal thymectomy for myasthenia gravis had preoperative radiologic evaluation for a possible thymoma. Examinations included posteroanterior and lateral (n = 154) and shallow oblique (n = 126) chest radiography, linear tomography (n = 80), and chest CT (n = 96). At surgery, a thymoma was found in 26 patients (17%). Plain film findings, which often were subtle, correctly predicted a thymoma in 15 (58%) of 26 patients. CT findings correctly predicted a thymoma in 17 of 20 patients (sensitivity, 85.0%; specificity, 98.7%; and accuracy, 95.8%). CT findings failed to detect a thymoma in three patients because a small tumor was indistinguishable from adjacent thymus (n = 2) and respirator motion artifacts (n = 1). Four (15%) of the tumors were invasive, and three (12%) were calcified. The likelihood of a thymoma increased with increasing age (3% for 20 years old and under, 12% for 21-45 years old, and 35% for 46 years old and older). In the youngest group, the thymus is densely cellular and normally relatively large, and therefore a small thymoma may be hidden. In patients 21-45 years old, partial fatty involution leaves parenchymal islands that can mimic a thymoma or obscure a small tumor. In patients over 45 years old, fatty involution enhances recognition of even small thymic tumors. For all patients with myasthenia gravis, we recommend that the initial chest radiographic examination include posteroanterior, lateral, and shallow (20 degrees) oblique views. For those patients under 21 years old, we recommend chest CT only when local symptoms, signs, or radiographic findings suggest the presence of thymic abnormality. For those patients 21 years old and older, we recommend routine chest CT.

Adolescent↗
PubMed1988

Permanent subcutaneous acupuncture needles: radiographic manifestations.

Metallic acupuncture needles are occasionally placed permanently in subcutaneous tissues. We report the radiographic appearances of these needles in two patients, each showing many dorsal subcutaneous needles in parallel longitudinal lines along traditionally delineated meridians between the neck and buttocks.

Acupuncture Therapy↗
PubMed1987

Bleomycin-associated pulmonary fibrosis: rapidly fatal progression without chest radiotherapy.

Two patients with carcinoma of the tonsil were treated with bleomycin (396 and 224 units, respectively) but not with radiotherapy. Respiratory insufficiency led to death 45 and 52 days, respectively, after onset of therapy. Chest radiographs before bleomycin therapy revealed no evidence for lung disease. Postmortem examinations showed severe interstitial and intraalveolar pulmonary fibrosis. Comparably rapid progression from radiographically normal pulmonary parenchyma to fatal fibrosis has been documented previously only in patients with thoracic neoplasia as well as, in all but one instance, either prior or concurrent chest radiotherapy. These two cases indicate that chest radiotherapy is not a necessary cofactor for the development of rapidly progressive, fatal, diffuse interstitial pulmonary fibrosis after bleomycin therapy.

Aged↗
PubMed1986

Moiré topography in scoliosis. Correlations with vertebral lateral curvature as determined by radiography.

The backs of 42 subjects were examined using moiré topography; 22 of these subjects had scoliosis (range of lateral curvature, 6 degrees-95 degrees; mean, 31 degrees) and had recent radiographs of the spine. Two experienced observers, each an orthopedic surgeon, determined moiré angles and number of fringe deviations for each subject. Two radiologists assessed radiographic Cobb angles for each scoliotic subject. For major curves superior to T10 (n = 9), significant correlations were found between Cobb angles and fringe deviations in the W1 region (r = .64, p less than .05). Cobb and moiré angles were correlated in the upper O1 region (r = .60, p less than .05) and in the lower O1 region (r = .78, p less than .01). For major curves at or inferior to T10 (n = 13), the angles were correlated in the W region (r = .57, p less than .05). After one hour of training, three physical therapists averaged 87% accuracy in analyzing moiré fringe deviations. Complex moiré patterns, as observed in obese subjects or those with severe curvature, made fringe-deviation analysis unreliable. The most accurate moiré data were obtained at the approximate level of the apex of the scoliotic curve.

Adolescent↗
PubMed1986

The left minor fissure.

A left minor fissure (LMF) has been described anatomically as being present in 8%-18% of left lungs. Analogous to the right minor fissure (RMF), the LMF separates the anterior segment of the left upper lobe from the lingula. Two thousand consecutive normal radiographic examinations of the adult chest (posteroanterior, left lateral views with the subjects in the erect position) were reviewed prospectively. A definite LMF was identified in 32 of the subjects (1.6%). The fissure was dome-shaped (convex superior) on at least one projection in 26 (81%) of 32 subjects. The position of the LMF was usually more cephalad than that of the RMF (25 of 31 subjects, or 81%). The lateral end of the LMF was usually superior to the medial end (25 of 32; 78%) and rarely inferior to the medial end (three of 32; 9%). The LMF infrequently was horizontal (four of 32; 12%). In a number of additional patients whose control chest radiographs showed no evidence of an LMF, subsequent radiographs revealed an LMF outlined by active pulmonary or pleural disease.

Adolescent↗