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Biomedical subjects

L R Goodman

Publications and source records attributed to L R Goodman.

At least 91 records · Page 5Linked to original sources
PubMed1983

Multiple infectious esophageal fistulae.

Acquired fistulous communication between the respiratory tract and the esophagus in the adult are most often posttraumatic or secondary to malignant disease. Infectious fistulae, although uncommon, have been described secondary to primary esophageal, mediastinal, or pulmonary processes. Because of better mucosal definition, double contrast esophagography may help determine the origin of the communication and therefore aid in the differential diagnosis. In addition, near-maximal esophageal distension may demonstrate additional fistulae, which if widely separated, suggest an infectious etiology. To our knowledge, no examples of multiple esophagopulmonary communications have been reported in the English literature. We report two such cases in which the barium study correctly predicted an infectious etiology.

Adult↗
PubMed1982

The right mid-lung window.

On conventional chest radiographs, an area of diminished vascularity usually indicates focal disease. On CT scans of the chest, however, there is often a focal vascular deficiency in the right mid-lung that appears to be normal. In a study of 50 patients, diminished vascularity was noted at the level of the bronchus intermedius on 92% of the scans. The anatomical basis for this finding is discussed.

Adolescent↗
PubMed1982

Iatrogenic esophageal-pleural fistula: subtlety of diagnosis in the absence of mediastinitis.

Seven patients with iatrogenic esophageal-pleural fistulas are described, and the differences in radiographic and physical findings in these patients and in patients with esophageal perforation with mediastinitis are emphasized. Radiographic findings in patients with esophageal pleural fistulas are pneumothorax, hydropneumothorax and localized pneumonitis. These fistulas can mimic other inflammatory supradiaphragmatic or infradiaphragmatic processes. Clinical and radiographic signs may be subtle, and active investigation is needed to establish the diagnosis of esophageal-pleural fistula in patients who have undergone esophageal manipulation.

Adult↗
PubMed1982

Radiographic detection of mobilizable lung water: the gravitational shift test.

A radiographic method for detecting excessive lung water in patients with pulmonary infiltrates of uncertain cause is described. The gravitational shift test uses bedside frontal films before and after prolonged lateral decubitus positioning. Excess lung water is identified by detecting a shift in infiltrate to the dependent lung while the opposite side clears or remains stable. The test was evaluated in 33 patients with infiltrates of well defined etiology. Twelve patients had heart failure or fluid overload (edema): 14 had pulmonary infection or parenchymal damage (inflammation); and seven had inflammation plus edema. Infiltrates shifted to the dependent lung in 85% of patients with lung edema, but did not shift in 78% of patients with inflammatory disease. The test also detected excess lung water in six of seven patients with underlying inflammatory disease. Each patient with a positive test showed clinical, physiologic, and radiographic improvement after therapy directed at mobilizing excessive lung water. When the differential diagnosis of a diffuse infiltrate is in question, a positive test represents a strong indication for a trial of diuretic therapy.

Body Water↗
PubMed1982

In vitro dissolution of gallstones: comparison of monooctanoin, sodium dehydrocholate, heparin, and saline.

A new gallstone solvent, monooctanoin, was tested in vitro on gallstones from 43 patients and compared with heparin, sodium dehydrocholate, and saline. Monooctanoin proved to be an excellent solvent, far superior to the other agents. It can completely dissolve or substantially reduce the size of most gallstones (except those composed of bilirubinate) in a relatively short time. Monooctanoin has been used on the bile duct stones in humans with favorable results. It can often eliminate the need for basket extraction of retained bile duct calculi. Potentially, it may be used to dissolve bile duct or gallbladder calculi in patients who are poor surgical risks.

Caprylates↗
PubMed1982

Normal tracheal bifurcation angle: a reassessment.

The tracheal bifurcation angle was measured in 100 normal adult patients. A wide range of normal values was found. There was no relation of the bifurcation angle to age or gender. There was only a weak correlation between bifurcation angle and height or width or the thorax. Thus, absolute measurements of the tracheal bifurcation angles are of little diagnostic value. In addition, when the angle was measured on two successive films, large changes (greater than 20%) were noted about 20% of patients.

Adult↗
PubMed1982

Tracheobronchial compression in Hodgkin lymphoma in children.

Tracheobronchial compression was observed in 55% of 20 consecutive newly diagnosed children with Hodgkin lymphoma at Children's Hospital of Philadelphia. In most reports of Hodgkin lymphoma, no mention is made of tracheobronchial compromise. This radiographic finding may explain respiratory symptoms, aid in initial therapy planning, prevent sudden deterioration, and help guide intubations for anesthesia or respiratory support. At times, fluoroscopy and tomography were helpful in confirming the plain film findings.

Adolescent↗
PubMed1981

Lightweight cassette for mobile-unit radiography.

The authors have developed a cassette system for mobile-unit radiography, using a soft-vinyl cassette in a Lucite housing faced with aluminum. This system performs as well as conventional radiographic cassettes and weighs approximately one-half to one-third as much.

Evaluation Studies as Topic↗
PubMed1980

Postoperative chest radiograph: I. Alterations after abdominal surgery.

Postoperative cardiopulmonary complications remain a major cause of mortality and morbidity despite recent advances in intra- and postoperative management. The chest radiograph is a valuable aid in evaluating them. This paper reviews the major chest radiographic alterations after abdominal surgery and attempts to place them in clinical perspective.

Abdomen↗
PubMed1980

Postoperative chest radiograph: II. Alterations after major intrathoracic surgery.

Major radiographic changes almost always occur after surgery for pulmonary resection and adult acquired heart disease. With careful attention to the timing and clinical setting of these alterations, their significance can be evaluated and their management planned. This paper reviews the expected postoperative changes as well as those indicating a potential complication of surgery.

Bronchial Fistula↗
PubMed1979

Effect of mechanical ventilation and positive end-expiratory pressure (PEEP) on chest radiograph.

The effect of differing ventilator settings and positive end-expiratory pressure (PEEP) on the chest radiograph was studied in 12 patients with acute respiratory failure. Changing ventilator settings produced dramatic variations in the appearance of pulmonary infiltrates in technically identical radiographs exposed over a 10-15 min period. PEEP had the greatest effect on radiographic appearance. In seven patients, the diagnosis or estimation of severity of pulmonary infiltrates would have been altered if only the film during PEEP had been available. Knowledge of ventilator settings is vital in evaluating the severity of infiltration and radiographic diagnosis in patients with acute respiratory failure.

Humans↗
PubMed1977

Kepone-induced scoliosis and its histological consequences in fish.

Scoliosis in fish is caused by several diverse agents that possibly act on the central nervous system, neuromuscular junctions, or ionic metabolism. The organochlorine pesticide Kepone induces scoliosis in the sheepshead minnow. Some effects associated with Kepone-induced scoliosis in these fish are disruption of myotomal patterns, inter- and intramuscular hemorrhage, fractured centra of vertebrae, and death. The histological syndrome of Kepone poisoning in fish and the clinical syndrome in humans suggest that the nervous system is a primary target for Kepone and that scoliosis is a secondary effect of Kepone poisoning in fish.

Animals↗