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Biomedical subjects

J L Westcott

Publications and source records attributed to J L Westcott.

At least 19 recordsLinked to original sources
PubMed1991

Bronchiectasis.

Bronchiectasis is important because (1) it predisposes the patient to infection; (2) it may be accompanied by increased bronchial blood flow and hemoptysis; (3) when widespread, it may be associated with significant airway obstruction; and (4) when focal, it may simulate neoplasms and other diseases. The widespread use of computed tomography (CT) for evaluation of lung diseases has revealed that bronchiectasis is common--even in patients who do not have clinical or plain radiographic suspicion of bronchiectasis. The pathology, pathogenesis, and radiographic findings are presented herein.

Bronchiectasis↗
PubMed1987

Transthoracic needle biopsy of the hilum and mediastinum.

TNB of hilar and mediastinal masses is both safe and useful. It has a high diagnostic yield, can be performed in practically all areas of the mediastinum, and appears to be no more hazardous than needle biopsy of the lung. In healthy patients, it can be performed as an outpatient procedure. TNB makes it possible to avoid surgery and mediastinoscopy in patients with unresectable malignant neoplasms and in many patients with innocuous benign mediastinal lesions. The ease and safety of TNB may make it the preferred initial procedure for diagnosing and staging patients with mediastinal masses of unknown etiology.

Biopsy, Needle↗
PubMed1987

Intrathoracic Kaposi sarcoma in AIDS patients: radiographic-pathologic correlation.

The chest radiographs and postmortem pathologic findings in 24 patients with acquired immunodeficiency syndrome (AIDS) and autopsy-proved intrathoracic Kaposi sarcoma were reviewed. Premortem radiographic visualization of pulmonary lesions of Kaposi sarcoma depended on the extent of involvement and the presence of concomitant disease. In three patients (13%) the radiographs showed nodular opacities that corresponded in size and configuration to nodules seen at autopsy. In 21 patients (87%) the lesions were not radiographically identifiable, in some cases because they were obscured by infection. The positive and negative predictive values of four radiographic findings for intrathoracic Kaposi sarcoma were evaluated, using a control group of 14 AIDS patients without intrathoracic Kaposi sarcoma at autopsy. Findings with a high positive predictive value were parenchymal nodular and reticular opacities (100%), pleural effusions (89%), and hilar and/or mediastinal lymphadenopathy (92%). None of these findings is specific, but the presence of any one in a patient with AIDS should increase the possibility of intrathoracic involvement by Kaposi sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Clinical applications of magnetic resonance imaging (MRI) of the heart.

The rapid progress of MRI has been remarkable, and it is clear that it will become an important method for cardiac imaging. Its major advantages are the lack of ionizing radiation and the ability to obtain excellent global images of the cardiac walls and chambers without the need for contrast injection or cardiac catheterization. High resolution surface coil imaging, tissue spectroscopy, and other improvements and applications should be rapidly forthcoming.

Coronary Disease↗
PubMed1979

Pulmonary lesions due to Dirofilaria immitis (dog heartworm). Report of four cases with radiologic findings.

Chest radiographs of 4 patients with Dirofilaria immitis (dog heartworm) revealed solitary, small, peripheral, noncalcified nodular lesions. The pulmonary lesions were apparently produced secondary to lodging of the parasite in peripheral pulmonary vessels. None of the patients had symptoms referable to the heartworm lesions. Needle aspiration in 2 patients revealed a nonspecific inflammatory lesion.

Adult↗
PubMed1978

Cardiopulmonary effects of intravenous fluid overload: radiologic manifestations.

Large volumes of normal saline were infused intravenously in 6 dogs until obvious pulmonary edema was observed radiographically. Following volume overload, statistically significant increases occurred in the size of the heart, left atrium, pulmonary arteries and veins, and systemic veins, without the development of congestive heart failure (CHF). The left ventricular end-diastolic pressure remained normal, and cardiac output and stroke volume increased. The results suggest that, in the absence of left ventricular failure, acute volume overload may simulate the radiographic changes produced by CHF. Pulmonary edema may have occurred at least partly from a marked decrease in serum colloid osmotic pressure.

Animals↗
PubMed1978

Malformation of bronchopulmonary foregut with systemic and pulmonary arterial blood supply.

A case of congenital malformation of the bronchopulmonary foregut with communication between the esophagus and sequestered lobe is reported in a six-month-old boy. Only 29 similar cases have been reported previously, and this case was especially unusual in that the communication was from the middle portion of the esophagus to a right apical sequestration. Another unusual feature was that the sequestered segment was supplied by four systemic arteries from the thoracic aorta, as well as by branches from the right pulmonary artery. Within the sequestration, there was shunting of blood from the systemic to pulmonary arterties with reversal of flow in the pulmonary arterial branches.

Bronchopulmonary Sequestration↗
PubMed1977

Dissecting hematoma of the aorta secondary to blunt chest trauma.

Two types of dissecting aortic hematoma occasionally follow blunt chest trauma. Localized subadventitial dissecting may occasionally accompany aortic laceration or transection. This subadventitial hematoma may itself rupture, or it may compress the true aortic lumen. In the presence of arteriosclerosis, classical (medial) dissecting hematoma may occur following blunt trauma. The trauma may be considerably less than that required to cause aortic rupture. Differentiation of the two forms may have practical significance. The treatment of aortic laceration is surgical repair, whether or not there is an associated subadventitial dissection. However, medial dissection following trauma is indistinguishable from spontaneous aortic dissection, and medical therapy may sometimes be the preferred method of treatment.

Adolescent↗
PubMed1977

Intra-arterial lidocaine: an effective analgesic for peripheral angiography.

Intra-arterial lidocaine was found to be an effective and safe method for reducing pain associated with peripheral angiography. A convenient method for delivery is to directly mix 2% lidocaine and contrast material in a ratio of 1:10 by volume. In a comparative evaluation, 25 of 29 patients experienced significantly less discomfort when the lidocaine-contrast mixture was used as compared to contrast material alone. There were no apparent complications from the use of intra-arterial lidocaine.

Angiography↗
PubMed1977

"Blind" femoral angiography.

Analysis of a series of 352 femoral angiograms revealed that "blind" cannulation of the femoral artery distal to an occluded aorta or iliac artery is technically feasible in most patients. The vessel is usually patent even when the pulse is absent. Blind cannulation is not necessary for satisfactory peripheral angiography in all cases, but it is useful whenever visualization of the peripheral circulation is unsatisfactory following aortic injection. There were no apparent complications from the use of the technique.

Aortography↗
PubMed1976

The right pulmonary artery-left atrial axis line. A method for measuring left atrial size on lateral chest radiographs.

Based on the relationships of the aorta, right pulmonary artery (RPA), and left atrium (LA), a method for directly measuring the LA diameter is described. A line drawn downward from the anterior wall of the RPA, parallel to the barium-filled esophagus, will approximate the anterior wall of the LA and enable a direct measurement of the anteroposterior LA diameter. This radiological measurement correlated well with the echocardiographic determination of LA size in 82 adult patients. In some patients, direct measurement of LA size made it possible to detect chamber enlargement before other signs appeared. The major disadvantage of this method is the inability to clearly see the RPA in infants and in approximately 10-15% of adults.

Cardiomegaly↗
PubMed1976

Pulmonary edema and respiratory insufficiency in acute pancreatitis.

Pulmonary edema, cardiac enlargement, and respiratory insufficiency may occur in patients with acute pancreatitis. The mechanisms are complex and incompletely understood, but probable etiologic factors include fluid overload, left ventricular failure, impaired respiratory excursion and microatelectasis, and a nonspecific response of the lung to various types of pulmonary injury including hypotension, intravenous crystalloids, and the effects of circulating pancreatic enzymes. Recognition of the association of pulmonary edema and respiratory insufficiency with pancreatitis is importance because early treatment with positive pressure breathing, careful fluid management and diuretics, and corticosteroids may prevent the development of irreversible respiratory failure.

Acute Disease↗
PubMed1976

Lipoma of the diaphragm. Report of a case.

A lipoma of the diaphragm was found at surgery in a 69-year-old man. Postmortem examination offered an unusual opportunity for radiological/pathological correlation. Diaphragmatic lipomas are usually asymptomatic and present radiographically as smooth, rounded masses which generally arise from the posterolateral portion of one hemidiaphragm. They may appear less radiopaque than would be expected of a lesion that size. Certain features of this case suggest that the lipoma may have been the result of chest trauma.

Aged↗
PubMed1976

Portal vein visualization during intravenous cholangiography.

The portal vein (PV) was frequently visualized during infusion intravenous cholangiography with tomography. Although visualization was usually faint, the PV was occasionally seen as well as or better than the common duct (CD). Occasionally, there is sufficient periportal fat to enable PV visualization without contrast material, but PV visualization is probably usually due to a combination of faint venous opacification and surrounding periportal and omental fat. If unrecognized, the opacified portal vein may occasionally be mistaken for a dilated common duct.

Cholangiography↗