bluuebunny/crossref_metadata_2025_split huggingface dataset:
The clinical and financial impact of non‐invasive vascular testing in the USA
Authors: Zwiebel WJ 
Published: March 2008

SUMMARYHealth care costs in the USA have increased dramatically during the past 10 years, and it is widely believed that they have reached crisis dimensions. Vascular laboratories are a segment of the USA health care industry that has experienced particularly rapid growth in the last decade. In 1992, USA Medicare payments (for patients ≥ 65 years) totalled US$304 492 588 for 3 673 695 non‐invasive vascular studies. This figure represents only one segment of USA health care costs and, if all segments were considered, the 1992 total for vascular laboratory services would probably approach one billion USA dollars. The expansion of vascular laboratory utilization is attributed to a number of factors: (i) increased recognition of the clinical value of non‐invasive vascular studies; (ii) replacement of invasive (angiographic) procedures; (iii) expanded surveillance application; (iv) the verification of carotid endarterectomy for treatment of carotid stenosis; (v) widespread, unlimited access; (vi) over‐utilization; (vii) greed. Widespread awareness of the crisis in USA health care funding has imposed cost‐containment pressure where virtually none existed previously. The vascular laboratory is no exception to this trend, and the following measures have been suggested for controlling vascular laboratory costs: (i) demonstration of the clinical and cost effectiveness of non‐invasive vascular studies; (ii) utilization review; (iii) pre‐approval of requests for vascular studies; (iv) linkage of vascular study reimbursement with clinical diagnosis; (v) limitations on self‐referral; (vi) reduced reimbursement; (vii) capitation; (viii) diagnosis‐related reimbursement; (ix) accreditation. This article summarizes the factors that have led to increased utilization of vascular laboratory services, and discusses methods proposed for containing vascular laboratory expenditure.
Brachytherapy in oesophageal carcinoma
Authors: Leung John T , Kuan Richard 
Published: March 2008

SUMMARYPatients with recurrent or locally advanced oesophageal carcinoma have a poor prognosis. Relief of dysphagia is often the goal of any further treatment. Several methods, including laser re‐canalization, prosthetic intubation, dilatation, external beam irradiation (EBI) and intraluminal brachytherapy (IBT) can be used to alleviate dysphagia.In this retrospective review of 11 patients, eight with recurrent tumour and three newly diagnosed patients were treated with low dose rate IBT. Relief of dysphagia was achieved in nine patients, all of whom were able to maintain swallowing of at least a semi‐solid diet until death or last follow‐up. Toxicity was minimal, but survival was poor, with a median survival of only 3 months.IBT presents several advantages over other palliative methods, especially in recurrent tumours where re‐treatment with EBI is often difficult because of normal tissue tolerance. Low dose rate IBT takes only 1–2 days to deliver, is highly effective, has little morbidity and the palliation achieved is relatively durable.
The evolving role of radiation therapy in paediatric oncology, Philadelphia, USA, 19–21 January 1995
Authors: Stevens Graham , Sexton Maree , Gray Alan 
Published: March 2008

SUMMARYA summary of a conference reviewing recent developments and changes in the use of radiation therapy in paediatric oncology is reported. Although the use of radiation therapy has resulted in improved cure rates, the long‐term complications of radiation in a paediatric population are recognised. More intensive systemic therapy and the increasing availability of prognostic data, including biological markers to tailor therapy to the individual patient, has resulted in a more selective use of radiation therapy. Changes in the management of specific tumour types are discussed.
A contrast technique to improve sampling in cavitating lung lesions
Authors: Black JA , Blake MP , Cameron DC 
Published: March 2008

SUMMARYTwelve patients with cavitating lung lesions of uncertain aetiology, who had percutaneous aspiration combined with the instillation of radiographic contrast media, are presented. A diagnosis was made in 11 of the 12 patients (92%). A positive culture was obtained in all patients already receiving treatment for lung abscesses. Cultures of lavage fluid were positive in 89% of infected cavities. The instillation of radiographic contrast media into the lung cavity assists biopsy of the cavity wall, can be used to lavage the cavity, and may facilitate expectoration of sputum.
The value of ultrasound in the assessment of incompetent perforating veins
Authors: Phillips Gwl , Dip US. Grad Cheng 
Published: March 2008

SUMMARYTo determine the value of ultrasound in identifying significant perforator disease we assessed 121 perforators in 90 legs of 61 consecutive patients referred for assessment of varicose veins over a 6 month period. Perforators greater than 4 mm in diameter demonstrated reflux in approximately 60% of cases, perforators 3‐4 mm in diameter demonstrated reflux in approximately 45% and perforators less than 3 mm in diameter demonstrated reflux in approximately 25% of cases.From correlation with previous published data we recommend that all perforators greater than 4 mm in diameter be considered incompetent regardless of whether reflux is demonstrated.
Lymphoscintigraphy pre‐ and post‐surgical lymphatic leak repair
Authors: Andrews John T , Binder Lisa J 
Published: March 2008

SUMMARYThis case report demonstrates the use of lymphoscintigraphy for the localization of a pelvic lymphatic leak. The study was made before and after the operative repair of a lymphatic leak and a marked reduction in the leakage was evident postoperatively. The patient, a 38 year old woman, had a history of adenocarcinoma of the cervix, that was treated by abdominal hysterectomy and pelvic node dissection, and she subsequently developed chylous ascites that required ongoing drainage via a Tenckhoff catheter. This case study illustrates how lymphoscintigraphy aided in the localization of a lymphatic leak and the follow up of surgical repair.
Tropical pulmonary eosinophilia: A comparative evaluation of plain chest radiography and computed tomography
Authors: Sandhu Manavjit , Mukhopadhyay Sima , Sharma Surender K 
Published: March 2008

SUMMARYPlain chest radiography and computed tomography (CT) of the chest were performed on 10 patients with tropical pulmonary eosinophilia (TPE). Chest radiographs revealed bilateral diffuse lesions in the lungs of all the patients with relative sparing of lower lobes in one patient. However, computed tomography revealed bilateral diffuse lung lesions in all of the patients with relative sparing of lower lobes in three patients. In seven (70%) of the 10 patients, CT provided additional information. Computed tomography was found to be superior for the detection of reticulonodular pattern, bronchiectasis, air trapping, calcification and mediastinal adenopathy. No correlation was found between pulmonary function and gas exchange data using CT densities. There was also no correlation between the absolute eosinophil count (AEC) and the radiological severity of lesions. In six patients, high‐resolution CT (HRCT) was performed in addition to conventional CT (CCT), and nodularity of lesions was better appreciated in these patients. It is concluded from this study that CT is superior to plain radiography for the evaluation of patients with TPE. However, more work needs to be done to substantiate the results of the present study.
Computed tomography morphology of the adrenal glands of patients with Addison's disease
Authors: Ammini AC , Gupta R , Mukopadhyay C , Shah P , Sandhu MS , Vijayaraghavan M , Berry M 
Published: March 2008

SUMMARYTo study the morphology of the adrenal glands of patients with Addison's disease an ultrasound and a computed tomographic scan of the adrenal glands were performed in 28 patients with Addison's disease. Thirteen patients had bilateral, asymmetric adrenal enlargement. In six of these patients, areas of necrosis and calcification were also seen. Six patients had atrophic glands with calcification and nine patients had normal/atrophic glands without calcification. After instituting appropriate treatment, computed tomography (CT) was repeated between 6 months and 3 years later in 10 of the 13 patients with adrenal enlargement. A reduction in gland size was noted in all patients and one had functional recovery. We conclude that the appearance of the adrenal glands on CT depends not only on the nature of the underlying disease but also on the duration of the illness and the type of treatment.
Secondary tumours after prophylactic cranial irradiation
Authors: Leung John , Guiney Michael 
Published: March 2008

SUMMARYA 22 year old woman, who at the age of 6 years had prophylactic cranial irradiation for acute lymphoblastic leukaemia, presented with both astrocytoma of the brain and breast carcinoma. The link between the two solid tumours and previous cranial irradiation is discussed.
Bone changes in tuberous sclerosis mimicking metastases
Authors: Pui Margaret H , Kong Hwai Loong , Choo Hui Fen 
Published: March 2008

SUMMARYSclerotic and lytic bone changes of tuberous sclerosis (TS) can mimic bone metastases. We report a case of bone metastases from bronchogenic carcinoma in a patient with TS bone changes. Bone scintigraphy and magnetic resonance imaging are useful in distinguishing the TS bone lesions from bone metastases.
Hook wire localization of inferior lesions in the breast
Authors: Evans Pauline , Champness Peter 
Published: March 2008

SUMMARYInferior lesions in the breast can be difficult to localize pre‐operatively using the hook wire technique as the equipment does not readily allow an approach from below. Distorting the breast by rolling it against the cassette holder displaces an inferior lesion into a lateral position. The lesion can then be easily localized by the shortest needle path.
Wildervanck syndrome
Authors: Kumar A , Chaudhary D , Gupta SK 
Published: March 2008

SUMMARYWe report a case of the Wildervanck (cervico‐oculo‐acoustic) syndrome exhibiting Klippel–Feil anomaly, congenital sensorineural deafness and bilateral sixth nerve palsy. Associated anomalies included short stature, microcephaly, mental retardation, and cleft palate.
Construction of an ultrasound biopsy phantom
Authors: Patel AS , Harrington TJ , Saunt KS , Jones WK 
Published: March 2008

SUMMARYThe technique for construction of an agar‐based ultrasound biopsy phantom is described. Features include tissue equivalent reflectivity, long life and non‐shadowing targets. The phantom is useful for learning the necesary co‐ordination between needle and probe for ultrasound needle guidance. This skill should initially be practised in vitro, on a device such as this.
Diagnosis of renal artery branch stenosis using captopril intervention scintirenography
Authors: Prakash R , Gupta SK 
Published: March 2008

SUMMARYA case of renovascular hypertension in a young male is presented. The patient had a small size right kidney with reduced differential function on the baseline [99mTc]‐DTPA renal study. Captopril intervention scintigraphy demonstrated a dramatic reduction in renal perfusion and cortical uptake in the upper and mid‐poles of the affected kidney. Time‐activity curves of the [99mTc]‐DTPA studies using segmental regions of interest corroborated visual findings. The presence of renal artery branch stenosis was confirmed on renal angiography.
Role of transabdominal pelvic ultrasound and computed tomography in the detection of bladder involvement in advanced cancer of the cervix
Authors: Deo SVS , Shukla NK , Sandhu M , Thakur KK , Goel S , Mohanti BK , Rath GK 
Published: March 2008

SUMMARYThe imaging data of 125 advanced cancer cervix patients attending the Institute Rotary Cancer Hospital between June 1992 and June 1994 was reviewed. The aim of the study was to assess the role of transabdominal pelvic ultrasound (TAPUS) and computed tomography (CT) in the detection of bladder involvement. TAPUS was performed in 65 patients (group I) and CT in 60 patients (group II). With respect to clinical stage, both groups were comparable. Cystoscopy was performed in all patients and the findings were taken as the gold standard for comparison of imaging data. The sensitivity, specificity and accuracy of TAPUS were 65, 94 and 75%, respectively, while those for CT were 80, 92 and 85%, respectively. Results of the present study reveal that the accuracy of TAPUS is comparable to the accuracy of other imaging modalities in the detection of bladder involvement in cervical cancer and that it should be used more frequently in developing countries that deal with a large number of cervical cancer patients in view of its easy availability, low cost and absence of exposure to radiation.
Common bile duct stones in non‐dilated bile ducts? An ultrasound study
Authors: Hunt David R 
Published: March 2008

SUMMARYIn a consecutive series of 870 patients having cholecystectomy performed by the laparoscopic technique in a single surgical unit, prospective data collection has permitted analysis of the relationship between common bile duct (CBD) diameter, as measured pre‐operatively by ultrasound (US) examination, and the frequency of CBD stones. Overall, 85 patients (9.8%) have been shown to have CBD stones; the interval frequency for CBD size 0–4, 4.1–6, 6.1–8, 8.1–10 and > 10mm, was 3.9, 9.4, 28, 32 and 50%, respectively. Because most patients have small ducts (736 with CBD size < 6.1 mm) almost half (42) of those with CBD stones came from this group. In reporting CBD size as ‘not dilated', radiologists should remind clinicians that this does not equate with ‘no CBD stones'.
Occlusive arterial disease of the upper extremity: Colour Doppler as a screening technique and for assessment of distal circulation
Authors: Taneja Karuna , Jain Rajiv , Sawhney Sukhpal , Rajani Mira 
Published: March 2008

SUMMARYA prospective study was performed to evaluate the sensitivity of colour Doppler flow imaging (CDFI) in the detection of occlusive arterial disease in the upper limb (using angiography as the standard) and to quantify the severity of the disease. Twenty‐one ischaemic and 15 healthy limbs were studied by intra‐arterial digital subtraction angiograms (IADSA) and CDFI. Selective subdavian digital subtraction angiograms were performed by the percutaneous transfemoral route. CDFI was performed from the brachial artery superiorly to the subdavian artery origin. Special attention was paid to the study of spectral waveforms and peak systolic velocities at various levels. In each subject, IADSA and CDFI were performed by different radiologists without knowledge of the results of the other investigation. In normal limbs, all arteries demonstrated a characteristic sharp triphasic spectral pattern with mean peak systolic velocity of 105, 80 and 57 cm/s for the subdavian, axillary and brachial arteries, respectively. In ischaemic limbs, reduction in peak systolic value and broadening of the spectral trace with filling in of the spectral window were noted. More characteristic was the finding of a loss of diastolic flow reversal, which was the earliest sign of significant arterial stenosis. The pattern of diastolic blood flow correlated well with the degree of collateral formation and distal vascular runoff. In conclusion, CDFI has a high sensitivity and specificity in the detection of significant arterial stenosis and is thus an ideal, inexpensive screening procedure. Analysis of the diastolic wave‐form distal to the stenosis is an indicator of the degree of collateral circulation and distal runoff and thus acts as a prognostic indicator, guiding further investigation and management.
Small gauge gelfoam plug liver biopsy in high risk patients: Safety and diagnostic value
Authors: Fandrich Christian A , Davies Roger P , Hall Pauline de la M 
Published: March 2008

SUMMARYThe performance of a percutaneous core biopsy of the liver may be contraindicated in patients at higher risk of haemorrhage. In this clinical setting, gelfoam plug embolization of the needle track has been proposed to minimize haemor‐rhagic complications of biopsy. In the present study, gelfoam plug liver biopsy was performed in 51 consecutive patients at increased risk of haemorrhage. An 18 gauge spring‐loaded disposable cutting needle was used through a 4 French sheath. The biopsy track was embolized by three to four gelfoam pledgets. In every patient, the cores of hepatic tissue were adequate for histopathological diagnosis. There were no fatalities and no serious complications. Gelfoam plug liver biopsy using this needle and sheath in combination appears to be a safe procedure and produces diagnostic cores for histological analysis. This method represents an alternative to transjugular liver biopsy and is technically more straightforward to perform.
Primary small‐cell carcinoma of the oesophagus with spontaneous oesophageal perforation following chemotherapy
Authors: Clark Timothy , Lee Mark J , Munk Peter L 
Published: March 2008

SUMMARYThe authors describe a 66 year old woman with small‐cell carcinoma of the oesophagus who developed a perforation following chemotherapy. Small‐cell carcinoma of the oesophagus is a rare neoplasm, varying in appearance from a small mucosal lesion to a larger fungating mass, which in our patient presented as a bulky soft‐tissue mass causing stricture. Pleural fluid collections which developed via a spontaneous oesophageal‐pleural fistula were subsequently drained using percutaneously placed catheters. Radiologic management of this condition provided a successful and cost‐effective means of patient care.
Dense middle cerebral artery computed tomography sign: Confirmation by magnetic resonance (MR) imaging and MR angiography
Authors: Marsman JWP , Feenstra‐Holtkamp M 
Published: March 2008

SUMMARYIn acute ischaemic stroke, the dense middle cerebral artery sign on computed tomography indicates occlusion of the middle cerebral artery. A case is described in which the sign was confirmed by magnetic resonance (MR) imaging and MR angiography.
Role of a psychiatry liaison clinic in the management of breast cancer
Authors: Pendlebury SC , Snars J 
Published: March 2008

SUMMARYPsychological factors contribute to morbidity in the management of breast cancer. This study assesses the role of a psychiatric liaison clinic in the management of such problems. Fifty‐seven patients with breast cancer seen by the liaison psychiatrist within the radiation oncology clinic from May 1989 to March 1991 were retrospectively reviewed. This population was assessed for pattern of referral, concordance between oncologist and psychiatrist regarding diagnosis, compliance with referral and treatment patterns.The most frequent times of referral were during initial treatment or at the time of metastatic or recurrent disease. Compliance with referral was 90%. There was concordance of psychiatric diagnosis between the oncologist and the psychiatrist in only 23%, with the oncologist failing to diagnose a major depression in a significant number of patients. Antidepressants were prescribed by the psychiatrist in all patients in whom a major depression was diagnosed.Our conclusions are that there is a high incidence of major depression in this outpatient breast cancer population. Oncologists frequently fail to recognize a major depression in this patient population with resultant psychological morbidity. Compliance with referral to a liaison psychiatric clinic located within an oncology department is high. The psychiatric management of these patients is an important part of their overall treatment.
Postoperative radiotherapy for DukesB ‘ and C rectal cancer: Peter MacCallum Cancer Institute experience
Authors: Guiney Michael J , Smith Jennifer G , Worotniuk Valentina , Ngan Sam , Blakey David 
Published: March 2008

SUMMARYThis retrospective study reviews the outcome of patients with DukesB ‘ and C rectal cancer treated with adjuvant postoperative pelvic radiotherapy at the Peter MacCallum Cancer Institute from 1981 to 1990. Sixty‐one patients (22 DukesB ‘, 36 DukesC ‘ and 3 unknown stage) received a median dose of 50 Gy of pelvic irradiation.Locoregional relapse occurred in 33% of patients. Estimated median progression‐free survival was 1.7 years with 46% surviving without progression at 2 years and 30% at 5 years. There was no difference according to Dukesstage ‘. The estimated median survival was 2.6 years, with no difference according to disease stage. These results with postoperative radiotherapy alone are inferior to results achievable by combination chemotherapy and radiotherapy as adjuvant therapy which should now be considered standard therapy following surgical resection for DukesB ‘ and C rectal cancer.
Midline interhemispheric fusion associated with atypical callosal dysgenesis: A mild type of holoprosencephaly
Authors: Sener R Nuri , Jones Andrew O , Roebuck Derek J , Silva Merl de 
Published: March 2008

SUMMARYWe report the imaging findings in a 3 year old girl with a mild form of holoprosencephaly. The malformation is of interest because it may contribute to our understanding of brain development. The relatively mild clinical features are emphasized.
Migration and lymphatic spread of calcified paraffinomas after breast augmentation
Authors: Ooi GC , Peh WCG , Ip M 
Published: March 2008

SUMMARYA 62 year old Chinese woman presented 25 years after having both breasts augmented with paraffin injections. Development of paraffinomas and multiple episodes of paraffin‐related mastitis eventually resulted in bilateral mastectomies. The unusual distribution of migrated calcified paraffinomas in the thoracic wall and its lymphatic system is documented on computed tomography.
Duplex ultrasound in the pre‐operative assessment of varicose veins
Authors: Dixon Peter M 
Published: March 2008

SUMMARYA technique for the pre‐operative localization of sites of incompetence using B mode and Doppler ultrasound (duplex) is described. The reliability of this investigation was compared with the clinical assessment of a group of surgeons experienced in varicose vein surgery, and with the subsequent surgical findings.Duplex scans were found to be over 98% sensitive and 93‐97% specific compared with the surgical findings. Clinical techniques were much less sensitive and specific, and in addition there was uncertainty about incompetence in up to 52% of cases.The place of ultrasound and comparison with other techniques is discussed. While this technique is widely used, especially in vascular laboratories, the technique has not previously been reported in detail.
Pneumomediastinum: An acute presentation of the superior mesenteric artery syndrome
Authors: Ooi GC , Crundwell M , Ferrando J 
Published: March 2008

SUMMARYThe authors report a case of the superior mesenteric artery syndrome presenting acutely with a Boerhaave‐type syndrome. Pneumomediastinum was seen on the chest X‐ray. There were no known predisposing factors or previous history typical of this syndrome.
Opsismodysplasia: A case report
Authors: Zeman J , Baxova A , Houstkova H , Kozlowski K 
Published: March 2008

SUMMARYA 6‐month‐old boy with opsismodysplasia is reported. The purpose of this paper is to draw attention to severe ureteric reflux and incidence of pseudo‐obstruction, findings not previously reported in opsismodysplasia. They are most likely the result of an intrinsic neuromuscular defect which also affects the skeletal muscles. Another new feature, not reported in opsismodysplasia, was dilatation of ventricles probably secondary to brain atrophy.