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Biomedical subjects

J E Stark

Publications and source records attributed to J E Stark.

At least 19 recordsLinked to original sources
PubMed1995

Nontraumatic pediatric musculoskeletal MR imaging: comparison of conventional and fast-spin-echo short inversion time inversion-recovery technique.

PURPOSE: To compare conventional short inversion time inversion-recovery (STIR) with fast spin-echo (FSE) STIR techniques to evaluate suspected nontraumatic musculoskeletal abnormalities. MATERIALS AND METHODS: Thirty STIR and FSE-STIR examinations in 26 pediatric patients with suspected nontraumatic musculoskeletal abnormalities were prospectively evaluated. Qualitative (subjective) and quantitative (five-point rank score) analyses of the images were performed. RESULTS: FSE-STIR was faster than STIR (mean, 2 minutes 25 seconds and 6 minutes 35 seconds, respectively). Fat suppression was slightly better with STIR. Image degradation due to motion was judged similar. Lesion contrast to muscle was slightly better with STIR than FSE-STIR, and lesion contrast to fat was equivalent. Qualitatively, lesion conspicuity was similar: All lesions were seen with both techniques. CONCLUSION: FSE-STIR can replace STIR when an inversion-recovery fat-suppression sequence is desired. Considerable imaging time is saved.

Adolescent↗
PubMed1995

Rectal thiopental sodium for sedation of pediatric patients undergoing MR and other imaging studies.

PURPOSE: To determine the efficacy and safety of rectal thiopental sodium as a sedation agent for pediatric imaging. METHODS: Four hundred sixty-two infants and children were sedated with rectal thiopental sodium for MR, CT, or nuclear imaging in 1992 and 1993. Patients received screening histories and physical examinations before sedation, and parents gave informed consent. Sedated patients were monitored by pulse oximetry and direct observation. Twenty-four-hour telephone follow-up to assess delayed side effects was performed successfully in 325 patients. RESULTS: Examinations were successfully completed in 96% of patients. The average time from drug administration to sedation was 12.2 minutes. The average time from sedation to discharge from radiology was 71.1 minutes. Eleven percent of patients had desaturation below the pulse oximetric baseline easily treated with oxygen and head positioning. Twenty-four-hour telephone follow-up in 325 patients revealed a 34% incidence of minor rectal irritation and diarrhea, sleepiness, nausea and vomiting, or ataxia. CONCLUSIONS: Rectal thiopental sodium is a safe and effective drug for pediatric sedation.

Administration, Rectal↗
PubMed1994

Head and neck MR angiography in pediatric patients: a pictorial essay.

Magnetic resonance (MR) angiography is a new, noninvasive imaging method with well-known uses in adults for the evaluation of carotid disease in the neck and cerebral vasculopathy. MR angiography examinations were prospectively studied in 126 children to evaluate the usefulness of MR angiography of the head and neck in children, as well as to correlate its findings with those of conventional angiography. Eleven patients underwent conventional angiography in addition to MR angiography. MR angiography was performed with commercially available pulse sequences and included two- and three-dimensional time-of-flight and phase-contrast techniques. Indications for MR angiography included evaluation of pathologic conditions (aneurysms and arteriovenous malformations, infarcts, venous sinus thrombosis, brain tumors, and cerebritis), screening examinations in sickle cell disease, and follow-up of extracorporeal membrane oxygenation. MR angiography was found to be a useful, noninvasive diagnostic and screening examination for head and neck and cerebral vascular abnormalities in children and had excellent correlation with conventional angiography.

Adolescent↗
PubMed1994

Ovarian torsion in prepubertal and pubertal girls: sonographic findings.

OBJECTIVE: The purpose of this study is to report the range of gray-scale and color Doppler findings of ovarian torsion in prepubertal and pubertal girls to determine whether there is a difference in appearance between the two age groups. MATERIALS AND METHODS: The study population consisted of 20 patients, 11 who were prepubertal (ages 2 days to 6 years) and nine who were pubertal (ages 12-16 years), who had gray-scale sonograms and surgical confirmation of ovarian torsion. Color Doppler studies were obtained in 14 of 20 patients. All sonograms were reviewed retrospectively by two radiologists with attention to location of the twisted ovary, internal characteristics, and evidence of color Doppler flow. The results were then compared in the prepubertal and pubertal groups. RESULTS: Sonographic findings of torsion in 11 prepubertal patients included complex mass with septations and debris (6/11), cystic mass (1/11), and solid mass with peripheral cysts (4/11). The masses were located in the right lower quadrant (5/11), left lower quadrant (3/11), right adnexa (2/11), and right inguinal canal (1/11). Eight of nine pubertal patients had solid masses, and one had a thick-walled cystic mass. Torsion involved the right ovary in nine patients and the left in 11. Color patterns included central flow (3/14), peripheral flow (6/14), and absence of flow (5/14) and did not correlate with age or gray-scale findings. CONCLUSION: Sonographic findings of ovarian torsion vary with age. Neonates and young children have extrapelvic cystic or complex cystic masses, whereas pubertal girls have predominantly solid masses in an adnexal location. In both groups of patients, color Doppler signal can be documented in many twisted ovaries.

Adolescent↗
PubMed1994

Cerebral artery Doppler ultrasonography for prediction of outcome after perinatal asphyxia.

Perinatal asphyxia is the most common cause of neurologic injury and neurodevelopmental delay. The signs of injury are nonspecific at birth, and most indicators take hours to days before they become manifest. Early recognition of the injury is important in guiding management during those critical first days of life. Over a five-year period, we investigated 16 term neonates with a history of asphyxia on the first day of life who demonstrated on intracranial Doppler sonography cerebral vessel high diastolic flow with a resistive index below 60. Two infants died and one was lost to follow-up. Three of the remaining 13 patients were normal at 8 months to 1 year follow-up. The remaining 10 patients had severe neurodevelopmental delay with profound handicaps at follow-up periods from 3 months to 32 months. This study has confirmed earlier reports that in the first days of life, a very low resistive index combined with history of asphyxia is associated with an adverse outcome and may be considered one of the earliest markers for poor neurodevelopmental outcome. Only 50% of these patients demonstrated abnormal sonographic imaging.

Asphyxia Neonatorum↗
PubMed1991

Osteomyelitis in children with sickle cell disease: early diagnosis with contrast-enhanced CT.

Two children with sickle cell disease and osteomyelitis were treated. In one child, definitive treatment was delayed until computed tomography (CT) revealed a subperiosteal abscess. Early performance of CT in the other child resulted in prompt diagnosis and treatment. Before the appearance of the characteristic plain radiographic findings, diagnosis of osteomyelitis in patients with sickle cell disease can be difficult because the clinical manifestations of infarction and osteomyelitis can be similar. Radionuclide scans have yielded mixed results. In equivocal cases, early performance of CT can help establish the diagnosis of osteomyelitis to avoid significant morbidity.

Abscess↗
PubMed1983

COPD--or is it?

Explore the source record for details and available documents.

Animals↗
PubMed1982

Localised airway narrowing in sarcoidosis.

Four patients developed multiple narrowings or occlusions of bronchi during the early stages of sarcoidosis when the chest radiograph showed no evidence of pulmonary fibrosis. Three of the patients had symptoms of breathlessness and wheezing and all had an obstructive defect of ventilation. Bronchography showed stenoses that were not apparent at bronchoscopy. It is concluded that the possibility of bronchial narrowing should be considered in patients who develop breathlessness or wheezing at any stage of sarcoidosis, and that bronchoscopy should be supplemented by bronchography.

Adult↗
PubMed1981

Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma.

The accuracy of diagnosis in 656 patients with the four common histopathological types of primary lung cancer has been assessed by comparing the cell type diagnosis made on cytological and histological investigation with that determined by examination of the surgically resected or necroscopy specimen. The accuracy of diagnosis achieved by cytological examination of sputum and bronchial aspirate, and by bronchial biopsy histology was over 85%. The least accurate diagnostic procedure was percutaneous needle biopsy (62%). Squamous and small cell tumours were accurately diagnosed by all four investigations but errors were made in the diagnosis of large cell and adenocarcinomas. Nearly half the number of patients (43%) with large cell carcinoma were later reclassified as having squamous carcinoma and of the patients with adenocarcinoma 32% had been predicted to be squamous and 18% large cell carcinoma. We consider such quality control of pretreatment diagnosis mandatory in management of individual patients and before enrollment in clinical trials.

Adenocarcinoma↗
PubMed1979

Diagnostic accuracy of cytology and biopsy in primary bronchial carcinoma.

The accuracy of diagnosis of cell type obtained from sputum cytology, bronchial aspirate, bronchial biopsy, or percutaneous lung biopsy in 161 cases of confirmed primary lung cancer has been examined and the pretreatment histological diagnosis has been compared with the final diagnosis made after surgical resection or necropsy. The yield of positive diagnoses of malignancy obtained by each method of investigation in each cell type showed that cytological examination of sputum was the most accurate method, but a high degree of accuracy was also obtained by bronchoscopic aspiration and bronchial biopsy. Percutaneous lung biopsy was the most effective, but the least accurate, means of obtaining carcinoma cells. The level of diagnostic accuracy was highest in patients with squamous cell carcinoma. Accurate pretreatment diagnosis of patients with adenocarcinoma was particularly difficult, and only 20% of these cases were correctly diagnosed by investigation. Of seven patients with adenocarcinoma and a positive diagnosis of malignancy made on percutaneous lung biopsy, none was correctly diagnosed. The causes of error in diagnosis of cell type of primary lung cancer are discussed.

Adenocarcinoma↗
PubMed1979

Tuberculosis in renal transplant recipients.

Of more than 400 patients who received renal transplants in Cambridge, five subsequently developed tuberculosis. All had pulmonary involvement. Radiological abnormalities included miliary opacities, bilateral lower zone shadowing or typical upper zone shadowing with cavitation. Lung biopsy was required for diagnosis in two cases. Three patients recovered after treatment with antituberculosis drugs and none has relapsed. One died during chemotherapy despite drug-susceptible organisms. The problems encountered during chemotherapy are discussed.

Adult↗
PubMed1978

Unilateral pulmonary collapse in asthmatics.

Five asthmatic patients developed collapse of one lung. Three of the patients were children and three of the five had repeated episodes of atelectasis. Episodes of atelectasis were usually associated with localised chest pain, which was not pleuritic in character, and with breathlessness, but without wheezing. The were not related to clinically apparent respiratory infections or to deterioration of the underlying asthma. The cause is obscure, but re-expansion seems to be hastened by oral corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1975

The use of isoniazid as a marker to monitor the self-administration of medicaments.

1. Isoniazid was used as a marker to monitor the regularity of drug self-administration in a trial of chemoprophylaxis against natural influenza infection. Two hundred and sixty-two volunteers were treated for five weeks with a synthetic isoquinoline compound (U.K. 2371) or a matching placebo. 2. Five marker tablets containing isoniazid (150 mg) were incorporated into each regimen and their ingestion monitored by testing for acetylisoniazid in the urine. 3. Positive evidence of marker tablet consumption was obtained on 75% of the occasions on which urine samples were requested. The results obtained among the volunteers from each treatment group who returned urine specimens as requested (92%) indicated that they had swallowed at least 81% of their prescribed tablets. 4. The findings of the study suggest that when used in this way isoniazid is a very suitable compound for use on a few occasions for monitoring the self-administration of drugs in clinical trials.

Adolescent↗