Biomedical subjects
P Stark
Publications and source records attributed to P Stark.
Identification of internal mammary lymph nodes: value of the frontal chest radiograph.
The article describes eight patients with enlarged internal mammary lymph nodes visualized on the frontal plain chest radiograph. Enlarged internal mammary lymph nodes cast shadows that initially may be mistaken for a mediastinal or pleural abnormality. Although the lateral film alone may suggest these nodes, the findings on the frontal film help lateralize the abnormality.
The radiologic features of cardiac rotation: a pictorial essay.
Rotation of the heart results from enlargement of individual cardiac chambers and influences significantly the configuration of the cardiomediastinal silhouette. Left ventricular enlargement leads to dextrorotation. Conversely, right ventricular enlargement leads to levorotation. The axis of rotation is nearly vertical and extends from the top of the aortic arch through the anterior wall of the left atrium and the proximal interventricular septum. Pericardial defect, deformity of the thoracic skeleton, and lower lobe atelectasis can also lead to cardiac rotation. An understanding of this concept facilitates the interpretation of chest radiographs in patients with heart disease. The terms clockwise and counterclockwise rotation of the heart should be abandoned.
Inflammatory pseudotumor of the heart with vasculitis and venous thrombosis.
Inflammatory pseudotumor (IPT) is a tumor-like reactive lesion of unknown etiology. An unusual case of intracardiac IPT with multisystemic involvement, including leukocytoclastic vasculitis, polyarthritis, and inferior vena cava thrombosis in a 17-year-old boy is reported. This unique combination may suggest that immune/autoimmune factors are important in the pathogenesis of IPT.
Motion artifact simulating aortic dissection on CT.
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Standard imaging in silicosis and coal worker's pneumoconiosis.
Silicosis and coal worker's pneumoconiosis (CWP) are two relatively common occupational diseases. Silicosis is the most common pneumoconiosis in the United States. It results from inhalation of the particulate form of quartz or other crystalline forms of silicon dioxide with a diameter of less than 5 micrograms. CWP is the result of inhalation of carbon particles. Pathologic features of the two diseases differ, yet their radiologic features are identical. Simple pneumoconiosis is characterized by multiple small rounded opacities of 1 to 5 mm in diameter and with a bias for the upper lung zones. Complicated pneumoconiosis results from confluence of small opacities into large opacities that form conglomerate masses or progressive massive fibrosis.
Radiology of thoracic trauma.
Trauma is the leading cause of death in people less than 40 years of age. Blunt and penetrating chest trauma mechanisms and the resultant injuries and complications are reviewed in respect to the chest wall, pleura, lungs, mediastinum, and diaphragm. Recent literature reviewed includes a useful sign of flail chest, the costal "hook sign." New evidence suggests that traumatic aortic rupture may be more common in the pediatric population than was previously reported. The diagnostic evaluation of traumatic aortic rupture continues to be controversial, with imaging modalities ranging from chest radiographs and angiography to CT, MR imaging, and transesophageal echocardiography. Recent integration of these methods has brought to the literature a newly proposed algorithm for the work-up of suspected aortic rupture. Survival and modifying factors in adult respiratory distress syndrome and a comprehensive review of esophageal disease, including trauma, are also presented.
Congressional leaders outline their health agendas. Interview by Marybeth Burke.
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Hemophagocytosis by small cell lung carcinoma.
A 60-year-old woman with disseminated small cell carcinoma of the lung and hemophagocytosis by the metastatic cells in the bone marrow is presented. It is the first clinicopathologic report on phagocytosis of erythrocytes by lung tumor cells in concordance with a recently described evidence of a macrophage origin of small cell carcinoma of the lung.
CT of hemorrhagic lung infarction due to postoperative torsion.
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Magnetic resonance imaging--the evaluation of choice in residual shunt after congenital heart disease surgery?
Accurate anatomic diagnosis presents a dilemma in patients with residual shunt after corrective surgery for congenital heart disease. We describe a patient who, after atrial septal defect repair, developed dyspnea and central cyanosis despite normal pulmonary arterial pressures and right heart chamber size. A role for early MRI is suggested.
A 102-center prospective study of seizure in association with bupropion.
BACKGROUND: This trial was conducted to determine the incidence of seizures associated with the use of bupropion. METHOD: A total of 3341 depressed patients from 102 sites were enrolled in this 8-week, prospective, open trial. Following the 8-week treatment phase, patients could elect to enroll in a humanitarian continuation phase of unlimited duration. Dosing was initiated at 225 mg/day and increased to 450 mg/day as tolerated. Investigators carefully monitored seizure occurrences and rated their patients' response to and tolerance of bupropion. RESULTS: A total of 1986 patients (61%) completed the 8-week treatment phase, and 1616 (81%) of these elected to be maintained on bupropion treatment in the humanitarian continuation phase. The observed seizure rate was 0.24% for the treatment phase and 0.40% for the entire study. An 8-week survival analysis performed on patients with a dosing regimen of 300 to 450 mg/day yielded a cumulative rate of 0.36%. Patients, including those previously resistant to antidepressant treatment, responded to and tolerated bupropion well. CONCLUSION: These rates confirm earlier seizure estimates and fall within accepted parameters for antidepressant drugs. This trial enhances bupropion's position as a valuable alternative for the management of depression.
[Magnetic resonance tomography of Fallot's tetralogy].
We present four patients with tetralogy of Fallot, imaged with magnetic resonance. MRI is useful in clearly depicting the dilated ascending aorta, the infundibular stenosis, ventricular septal defect, right ventricular hypertrophy and dilated bronchial arteries. The pulmonary outflow tract can be visualized better with MR imaging than with ultrasound.
Primary intrathoracic extraosseous osteogenic sarcoma: report of three cases.
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Manifestations of esophageal disease on plain chest radiographs.
The chest film appearances of various esophageal abnormalities are illustrated. Inability to recognize these abnormalities on chest radiographs can result in confusion and misinterpretation. This pictorial essay should assist the radiologist in recognizing esophageal abnormalities on chest films and in recognizing their place in the spectrum of chest film abnormalities.