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Biomedical subjects

C O Ovenfors

Publications and source records attributed to C O Ovenfors.

At least 19 recordsLinked to original sources
PubMed1988

Evaluation of intrathoracic extent of lung cancer by plain chest radiography, computed tomography, and magnetic resonance imaging.

A comparison was made of the ability of plain chest radiography, computed tomography (CT), and magnetic resonance imaging (MRI) to detect and assess the intrathoracic extent of lung cancer in 46 patients. The chest radiographs (CXR) were obtained with a high kilovoltage phototimed technique. The CT scans were obtained with a GE 9800 machine and the MRI studies with a 0.3 Tesla permanent magnet imaging system. The primary tumor was well demonstrated by all 3 imaging techniques; however, the configuration of lesions was best demonstrated by CT. MRI was superior to CXR and CT for demonstrating hilar involvement in 4 cases. CT and MRI were generally comparable for demonstrating mediastinal involvement but were superior to CXR. In 2 cases, small normal size nodes seen on CT were considered to be a single large abnormal node on MRI. Because of the paucity of signal from flowing blood, compression and displacement of vessels were easier to identify with MRI. In 1 case, a small pleural effusion was better seen with CT than with CXR or with MRI. Direct chest wall involvement in 1 case was not seen by CXR. Vertebral body abnormality in another case was seen only by MRI and not by CXR or CT. At present, MRI, with its long scanning time, motion degradation of the image, and poor spatial resolution, is inferior to CT for imaging lung cancer. For evaluation of intrathoracic extent of lung cancer, CT remains the procedure of choice after performing plain chest radiography.

Adult↗
PubMed1987

Efficacy and complications of transthoracic needle biopsy of lung in patients with Pneumocystis carinii pneumonia and AIDS.

Transthoracic needle biopsy of lung was performed under fluoroscopic guidance in 16 patients with AIDS or suspected AIDS for diagnosing 18 episodes of possible P carinii infection. Diagnostic information was obtained in 15 of 18 cases. P carinii (10) and other infections agents (5) were diagnosed by TNB. The complications were pneumothorax in 44% (17% requiring chest tube drainage) and minor hemoptysis in 11%. Our incidence of pneumothorax following TNB in patients with diseases other than AIDS is 17% with 4.8% requiring chest tube drainage. Although TNB under fluoroscopic guidance is a cost-effective, rapid procedure with a high diagnostic yield, it is frequently complicated by pneumothorax in AIDS patients with diffuse pulmonary disease. This procedure should therefore only be performed in AIDS patients when transbronchial biopsy has failed to provide the diagnosis and prior to considering such patients for open lung biopsy.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Iatrogenic trauma to the thorax.

With more sophisticated medical procedures and treatment for the critically ill patient, iatrogenic damage to the thorax has become increasingly common. But simple radiologic procedures, such as chest radiography and fluoroscopy, permit diagnosis of unsuspected and clinically silent complications. A very important iatrogenic trauma to the lung depends on the increasing use of overpressure ventilation. Experimental evidence shows that the lung can be damaged with interstitial emphysema at peak pressures as low as 40 cm H2O. The chest radiograph may show and early pathognomonic finding of perivascular air collections. The respirator treatment should then be modified to avoid pneumomediastinum and pneumothorax. The placement of catheters, chest tubes, endotracheal tubes, and feeding tubes as well as pacemaker electrodes and counterpulsation balloons may cause serious complications. Follow-up chest radiography after these procedures is therefore important.

Barotrauma↗
PubMed1985

Percutaneous needle lung aspiration for diagnosing pneumonitis in the patient with acquired immunodeficiency syndrome (AIDS).

Fourteen patients with acquired immunodeficiency syndrome (AIDS) or suspected AIDS underwent percutaneous needle lung aspiration (PNLA) for evaluation of 16 occurrences of acute pneumonitis. A 22-gauge spinal needle was passed 2 to 3 times in the area of greatest radiographic involvement under fluoroscopic guidance. The specimen was immediately placed on microscope slides for Gomori's methenamine silver and Papanicolaou staining. The needle was then flushed with sterile water for bacterial, Legionella, viral, mycobacterial, and fungal cultures, and for Legionella immunofluorescent staining. Diagnostic information was provided by 14 of the 16 procedures. Of 11 patients ultimately found to have P. carinii pneumonitis, PNLA specimens were diagnostic in 10 (91%). Infectious agents other than P. carinii also were identified by PNLA, including cytomegalovirus (4 cases), M. avium-intracellulare (1 case), and pyogenic bacteria (3 cases). Complications of PNLA were: pneumothorax in 7 cases (44%), 3 (19%) of which required chest tube evacuation; and minor hemoptysis (less than 50 ml) in 2. The PNLA can be a useful diagnostic procedure in the patient with AIDS and pneumonitis. It has the advantages of being less costly and time-consuming than fiberoptic bronchoscopy. It is, however, frequently complicated by pneumothorax, making it an inappropriate approach for patients with significant respiratory compromise.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Parathyroid imaging: comparison of high-resolution CT and high-resolution sonography.

Parathyroid computed tomographic (CT) scanning using a specially designed patient positioning harness, bolus contrast administration, and dynamic scanning significantly improved localization of parathyroid tumors from 45% (19/42) to 76% (35/46) (p less than 0.01) over conventional CT scanning. High-resolution sonography with a 10 MHz transducer localized 65% (57/88) of these tumors. Average tumor size was 15 X 10 X 9 mm. Patients undergoing reoperation for hyperparathyroidism had similarly small tumors localized by CT in 63% (12/19) and high-resolution sonography in 47% (9/19) of cases. High-resolution sonographic equipment suitable for parathyroid imaging is not widely available. Since high-resolution CT is more generally available and more effective, it is recommended as the procedure of choice for localizing cervical parathyroid tumors.

Adenoma↗
PubMed1982

Localization of parathyroid adenoma by computed tomography.

Sixteen consecutive patients with the clinical diagnosis of hyperparathyroidism, nine with and seven without previous surgery, had computed tomography (CT) examinations preoperatively to evaluate the use of CT in localizing parathyroid adenomas. The patients were scanned at 5 mm intervals from the level of the hyoid bone to the lung apex. Scanning of the mediastinum was performed at 10 mm intervals from apex to lung base. Computed tomography correctly identified prospectively the site of the adenoma in 10 of 13 patients (77%), with surgically proven adenomas. In retrospect, all 13 adenomas could be identified. One false positive diagnosis of adenoma was made. Our study suggests that CT may be beneficial in the preoperative localization of parathyroid tumors, particularly in ectopic locations.

Adenoma↗
PubMed1981

Diagnosis of peripheral pulmonary emboli by computed tomography in the living dog.

Computed tomography (CT) provides a noninvasive alternative to arteriography in detecting central pulmonary thromboembolism. It is uncertain, however, if smaller, more peripheral clots can be diagnosed by means of CT because of the low spatial resolution and the possible motion artifacts that result from long exposure time. The peripheral pulmonary arteries of five dogs were embolized with boiled autologous clots. The location and size of the thromboemboli were then determined using arteriography. One dog died after embolization. In three of the four remaining dogs, CT scans, after slow intravenous injection of contrast material, showed the emboli as filling defects in the appropriate lobar and segmental arteries.

Animals↗
PubMed1981

Bronchographic features of chronic bronchitis in normal men.

As part of a study of mucous transport in the airways, tantalum bronchography was performed on 13 normal, asymptomatic men who had normal findings on pulmonary function studies. Most of the subjects demonstrated some of the bronchographic features which have been regarded as specific for chronic bronchitis. Eight men showed opacification of the ducts of mucous glands; 12 had visible secretions in the airways; three had moderate-to-marked irregularity of airways. The clearance of tantalum from the airways in all but two subjects was more rapid than anticipated and thus could not be correlated with the bronchographic features of chronic bronchitis. Two subjects who previously had symptoms of respiratory tract infection showed markedly delayed peripheral airway clearance of tantalum. The bronchographic features of chronic bronchitis can be seen in normal subjects or may indicate airway abnormalities that are not manifested functionally.

Adult↗
PubMed1980

Compensation examination of the cervical and lumbar spines: critical disagreement in radiographic interpretation.

Radiographic interpretation is often the major factor in the decision to award compensation for job-related complaints, especially in the Veterans Administration system. Three board-certified radiologists reviewed 200 consecutive lumbar and cervical spine examinations and assigned each case to one of three categories: normal, normal for age (not compensable), or degenerative disease (compensable). A critical disagreement, in which at least one radiologist considered the examination compensable and another not compensable, occurred in interpretation of 31% of the cervical and 46% of the lumbar spine examinations. Although the overall detection of radiographic findings was similar among all three radiologists, diagnostic interpretation of the findings varied greatly. Although most radiologists and orthopedists agree that the use of plain radiography of the spine as a deciding factor in awarding compensation is unjustified and inappropriate, until the regulations are changed there is a pressing need for strict, objective, radiographic criteria for determining "normal aging" of the cervical and lumbar spines so that interpreatations can be more uniform.

Adult↗
PubMed1980

Computed tomography of pulmonary embolism.

Computed tomography (CT) can provide a noninvasive alternative to pulmonary arteriography for pulmonary embolism in selected circumstances. Three cases that demonstrate the technique and initial clinical experience are reported. Illustrated are: (1) CT detection of massive central pulmonary thromboembolism in a critically ill girl in whom the risk of complications from pulmonary arteriography was considered especially high; (2) the use of CT for serial examinations for follow-up of central thromboembolism, avoiding repeat angiography; and (3) preoperative CT delineation of organized thrombus in the proximal right pulmonary artery, an area not adequately evaluated on selective pulmonary artery injections. CT effectively displayed emboli and thrombi in central pulmonary arteries in each patient. Its application to embolus detection in peripheral arteries was not investigated.

Adolescent↗
PubMed1980

Muscular hyperplasia of the lung: a clinical, radiographic, and histopathologic study.

The clinical, radiographic, and histopathologic characteristics of pulmonary muscular hyperplasia were analyzed in 13 patients who were seen over a 13 year period. The average follow-up period was 7.2 years (range, 1-13). Eight patients initially demonstrated interstitial disease radiographically and the radiographic diagnosis was "interstitial fibrosis." The radiographs of the other five patients exhibited only localized infiltrates initially--produced by bronchiectasis in three, inflammatory mass in one, and bronchial carcinoma in one. Histologic features were consistent with desquamative interstitial pneumonia in eight, usual interstitial pneumonia in one, and unspecified interstitial pneumonia in four. When tuberous sclerosis is absent, pulmonary muscular hyperplasia is probably an end stage of interstitial pneumonia.

Adult↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: I. General methodology and application to chest examination.

A major goal of the radiologist is to devise methods to decrease health care costs and radiation exposure without sacrificing diagnostic accuracy. In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for chest disease or injury claimed to be service-related. Three separate readings of every chest radiographic assessment could have been made from a single posteroanterior view. In eight cases, granulomas or mild hyperexpansion of the lungs were only appreciated using the lateral projection, but these findings were not clinically significant and did not affect decisions as to whether compensation sould be awarded. The only potentially serious lesion missed (a possible pulmonary nodule) using the posteroanterior view alone was also missed using the lateral and only suggested by the oblique views. Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examination of the chest to a single posteroanterior view would eliminate 150,000 radiographs in the evaluation of 190,000 applicants and yield an annual savings of almost $900,000.

Accidents, Occupational↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: II. Cervical and lumbar spines.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for cervical and lumbar spine disease or injury claimed to be service-related. Results show that the final radiographic assessment could be made in 100% (245) of cervical spine examinations using two views (anteroposterior and lateral) and in 99.3% (699/704) of lumbar spine examinations using two views (anteroposterior and a single well centered lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the cervical and lumbar spines to these views would eliminate 193,000 radiographs in the evaluation of 100,000 applicants and yield an annual savings of about $1,000,000.

Accidents, Occupational↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: III. Knee, hand and foot.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for knee, hand, and foot diseases or injury claimed to be service-related. Results show that the final radiographic assessment could be made in all 535 (100%) of the knee examinations using two views (anteroposterior and lateral), all 181 (100%) of the hand examinations using one view (anteroposterior), and all 223 (100%) of the foot examinations using two views (anteroposterior and lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the knee, hand, and foot to these views would eliminate 91,000 radiographs in the evaluation of 119,000 applicants and yield an annual savings of about $500,000.

Accidents, Occupational↗
PubMed1978

Intensive care unit radiology. Problems of interpretation.

The radiographic examination of the chest plays an important role in the evaluation of patients in the intensive care unit. The maximum diagnostic value of the radiographs can be achieved only if the films are frequently reviewed, preferably in a daily working conference of the radiologist with the clinicians. Without detailed knowledge of the patient's clinical status, the radiologist will be severely limited in the precision with which the radiographs can be used to evaluate the status of a patient in the intensive care unit.

Adult↗
PubMed1976

Patch grafts or tubular grafts in the repair of coarctation of the aorta. A follow-up study.

The occurrence of aneurysms after repair of aortic coarctation with patch graft and tubular graft techniques was studied. In the patch graft group, 3 out of 6 re-investigated patients developed aneurysms; 2 of them after several years. It is suggested that the causes of aneurysms originate from mechanical factors. In the tubular graft group, 2 out of 18 patients developed aneurysms. In this group, the aneurysms seemed to be due to infection.

Adolescent↗