bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retroperitoneal sarcoma: Time for a change in attiude?
Authors: Spillane Andrew J. 
Published: March 2003

Background: Retroperitoneal sarcoma (RPS) is considered a disease with poor prognosis partly because of the difficulty with diagnosis at an early stage. This review assesses the current best practice principles for RPS and finds evidence suggesting a better outlook for appropriately managed cases. Recommendations are made for improving diagnostic certainty before laparotomy and inappropriate transperitoneal biopsy occur. Methods: A critical review of the English language literature was conducted using MEDLINE software and searching the terms ‘retroperitoneal sarcoma’ alone or in combination with ‘prognosis’, ‘surgery’ and ‘adjuvant therapy’. Conclusions: Retroperitoneal sarcoma is a rare disease but when appropriately managed the disease‐free survival can be improved and may even approach that of extremity soft tissue sarcoma. One of the greatest barriers to improving outcome is the misinterpretation of clinical signs and an over‐reliance on ultrasound diagnosis in pelvic presentations, or misinterpretation of clinical signs and/or computer tomography (CT) scans in abdominal masses. Physicians referring patients with a retroperitoneal mass should consider more frequently the less common differential diagnoses of an abdominopelvic mass including retroperitoneal sarcoma. This is especially true in circumstances where there is a circumscribed, predominantly solid tumour, with clinical or radiological signs of vascular or rectal displacement, ureteric obstruction and/or classic renal rotational displacement. The more frequent use of CT scans with intravenous and oral contrast with referral prior to inappropriate transperitoneal biopsy is recommended. In atypical cases where preoperative biopsy is necessary, extraperitoneal routes are preferable. Complete en bloc surgical excision at the first laparotomy is the treatment of choice in RPS. Macroscopic clearance may necessitate resection of adjacent viscera, neurovascular structures or abdominopelvic walls but, if achieved, may lead to long‐term survival depending on individual tumour biology.
An epidemiological view of vascular trauma in Western Australia: A 5‐year study
Authors: Gupta Robin , Rao Sudhakar , Sieunarine Kishore 
Published: March 2003

Background: Although Australia encounters vascular injury less frequently than countries such as the USA, the predominance of blunt trauma with associated complex injuries continues to pose problems for clinicians. The present paper reviews Royal Perth Hospital’s experience of vascular trauma epidemiology. Methods: All individuals who presented to the Royal Perth Hospital (RPH) with a vascular injury between August 1994 and January 2000 were identified from a prospective trauma database. Injuries were classified using the Abbreviated Injury Score (AIS 90 code). The five major vascular injury groups as defined by AIS 90 (neck, thorax, abdomen, upper limb and lower limb) were analysed in turn to determine which injuries were most frequent, what the common causes were, effects of alcohol and drugs, common associated injuries, investigations performed, mortality, proportion of rural vascular trauma with transfer details and lengths of hospital stay. Results: During the study period, 153 patients (1% of total trauma workload) sustained 175 vascular injuries. The commonest causes of injury for each group were stabbing (neck and lower limb), motor vehicle accident (thorax and abdomen) and work machinery (upper limb). Mortality was highest for thoracic injury (14/32; 44%) followed by abdominal injury (10/29; 34%). The ratio of blunt to penetrating vascular trauma is high and is increasing, as is the ratio of truncal to extremity vascular trauma. The most common artery–vein combination injury was to the femoral vessels. Conclusions: The injury patterns emerging from the present study will hopefully help all medical personnel to recognize the potential for vascular injury in a trauma setting.
Diagnostic value of preoperative RT‐PCR‐based screening method to detect carcinoembryonic antigen‐expressing free cancer cells in the peritoneal cavity from patients with gastric cancer
Authors: Yonemura Yutaka , Endou Yoshio , Fujimura Takashi , Fushida Sachio , Bandou Etsurou , Kinoshita Kazuo , Sugiyama Kazuo , Sawa Toshiharu , Kim Byung‐Sik , Sasaki Takuma 
Published: March 2003

Background: At present the most reliable method for the diagnosis of peritoneal micrometastasis of gastric cancer is peritoneal wash cytology, but the sensitivity of this method is low. The aim of the present study was to verify whether carcinoembryonic antigen (CEA) reverse transcriptase–polymerase chain reaction (RT‐PCR) assay can enhance the sensitivity and specificity of conventional cytology, and to determine how this technique can improve the accuracy of peritoneal recurrence. Methods: The present study included 230 patients with gastric cancer. Preoperative peritoneal wash was done by a paracentesis, followed by conventional cytology, CEA measurement, and CEA RT‐PCR of recovered fluid. Results: The CEA RT‐PCR assay yielded 40 (17%) positives, which included none of the 26 patients with benign disease. The incidence of positive cytology and CEA level in wash fluid was 19% and 15%, respectively. Logistic stepwise regression analysis revealed that lymph node status, depth of invasion, venous invasion, and the results of peritoneal cytological examination, and CEA RT‐PCR assay were independently related to peritoneal recurrence. The CEA level in the wash fluid was not related to peritoneal recurrence. Peritoneal cytological examination was the most significant predictive factor for peritoneal recurrence with a sensitivity of 46%, specificity of 94% and accuracy of 73%, while the corresponding values of the CEA RT‐PCR assay were 31%, 95%, and 73%. Combining cytological examination with CEA RT‐PCR assay resulted in a sensitivity rate for peritoneal recurrence of 57%, an 11% improvement over that of cytology alone. Conclusion: The data indicate that the use of a combination of CEA RT‐PCR and cytological assay is more likely to identify patients who will develop peritoneal recurrence. This may be useful for the classification of patients for the most suitable therapeutic trials.
Therapeutic embolization for acute haemorrhage in the abdomen and pelvis
Authors: Moore Hm , List A , Holden A , Osborne Tm 
Published: March 2003

SUMMARYTherapeutic embolization for acute haemorrhage is increasingly being utilized. An audit of 34 patients undergoing therapeutic embolization for acute abdominal or pelvic haemorrhage was undertaken, in an attempt to assess the importance of the following variables in determining a successful outcome: coagulation status, transfusion status, time to procedure after onset of circulatory instability, duration of procedure, and the effect of the embolization technique employed. Overall success was 79%, with definitive control of haemorrhage achieved by embolization; 21% required surgical management for rebleeding 4–24 h post embolization. The duration of the procedure and transfusion status of the patient were the most important factors associated with a successful outcome.
The rate of breast‐conserving surgery in early breast cancer: An audit of surgical practice at St Vincent’s campus, NSW in 1990 and 1994
Authors: Back Michael F , Morgan Graeme W 
Published: March 2003

SUMMARYAn audit was undertaken to document the use of breast‐conserving surgery (BCS) in the management of early breast cancer (EBC) at St Vincent’s campus during two time periods, the calendar years 1990 and 1994. The medical records of all women diagnosed with a new primary breast cancer at St Vincent’s Public and Private Hospitals initially treated during 1990 and 1994 were reviewed to document patient, tumour and treatment characteristics. Comparisons were made with data on BCS in EBC from the Australian medical literature. A total of 228 patients was managed with a definitive surgical procedure in the years 1990 and 1994. There were no major differences in the manner of presentation, the tumour subtypes or the treatment techniques between the two years. There was an apparent increase in the number of tumours < 2 cm managed in 1994 but no major difference in the use of BCS. The BCS rates for the two years were 33 and 36%, respectively. There were wide variations in the rate of BCS between surgeons, and for the same surgeon, between the two calendar years. These data from a major teaching hospital serving a largely non‐mammographically screened population would suggest that BCS rates for EBC are lower than expected. The data on BCS rates for EBC in Australia are limited and the optimal rate of BCS in current practice is unknown.
Angiomatosis of the hand demonstrated by contrast‐enhanced magnetic resonance angiogram
Authors: Yung Bck , Loke Tkl , Chan Yl 
Published: March 2003

SUMMARYContrast‐enhanced digital subtraction dynamic MR angiography has been applied to lower limb arteries, with accuracy comparable to that of conventional angiography. Application of this technique to hands has not been reported. A 2‐year‐old girl with a diffuse haemangioma of the right hand elegantly demonstrated by MR angiogram is presented. The feeding vessel and the relationship with surrounding palmar blood vessels were clearly identified. This provided essential preoperative information facilitating surgical resection, yet without the technical difficulties and morbidity associated with conventional angiography.
Florid computed tomographic appearance of acute Campylobacter enterocolitis
Authors: Brown Gregor , Bui Andrew , Vrazas John 
Published: March 2003

SUMMARYA 28‐year‐old male presented with severe abdominal pain and bloody diarrhoea. Computed tomographic scan showed marked swelling of the distal ileum and entire colorectum. The patient recovered and Campylobacter jejuni was subsequently grown from his faeces.
Gastrostomy: An improved technique
Authors: Cameron Dc , Styles Cl 
Published: March 2003

SUMMARYGastrostomy is a commonly performed procedure. The forceps described in this article help make this procedure easier and safer to carry out, reducing the need for complex and costly equipment. The forceps used have been adapted from standard surgical steel instruments by soldering a guidance device to one jaw. This device enables guided placement of a needle alongside the forceps tip. Any hospital technical service department could adapt standard forceps for this procedure.
Giant spinal arachnoid cysts: Computed tomography, magnetic resonance imaging and magnetic resonance myelography correlation
Authors: Buxi Tbs , Sud S , Vohra R , Kakkar A , Byotra Sp 
Published: March 2003

SUMMARYTwo cases of giant spinal arachnoid cysts, one of them being symptomatic, are discussed, along with their CT, MRI and MR myelography findings.
Pericardial lipoma: Ultrasound, computed tomography and magnetic resonance imaging findings
Authors: Puvaneswary Murugasu , Edwards James Rm , Bastian Bruce C , Khatri Shailesh K 
Published: March 2003

SUMMARYPrimary tumours of the heart and pericardium are extremely rare. Cardiac lipomas account for only 10% of all primary cardiac tumours. A case of surgically proven pericardial lipoma demonstrated by ultrasound, CT and MRI is presented here.
Treatment of choroidal melanoma by stereotactic radiosurgery
Authors: Sia Serena , Harper Chris , McAllister Ian , Perry Adrian 
Published: March 2003

SUMMARYThe case of a 49‐year‐old woman with an intermediate‐sized choroidal melanoma who was treated with stereotactic radiosurgery with good tumour resolution is presented. Sight and globe preservation were achieved. The treatment technique is discussed.
Introduction and implementation of the basic treatment equivalent in a Varian‐based department
Authors: Herbert Clare E , Joseph David J , Whittall David S , Wilkinson Stephen 
Published: March 2003

SUMMARYThe increasing popularity of 3‐D planning leads to procedural alterations as both workload and resource utilization increase. Although the complexity of the techniques has increased (as well as the set‐up and treatment times), the workload statistics must still include the number of fields treated. It is commonly known that machine statistics of fields treated per day do not accurately represent workload because there are major differences between techniques. A mantle treatment technique and an opposed spine technique both have (statistically) two fields, although the set‐up requirements and treatment times are very different. A basic treatment equivalent (BTE) formula was reported in early 1999 by Delaney et al. and incorporates a large number of variables inherent in patient treatment. The formula considers different factors that affect overall treatment time, and aims to represent a more accurate treatment time indicator. The aim of introducing the BTE into the Department of Radiation Oncology at Sir Charles Gairdner Hospital was to create a more accurate scheduling system and even out workloads on all treatment units. Therefore the BTE formula was used to assess accuracy of treatment times in order to determine if the values could be relied upon as accurate time indicators. Patients undergoing a variety of treatment techniques were timed for the duration of their treatment procedure, and their treatment times compared to the time estimated using the BTE formula. A few minor alterations were made to the equation for treatment units with multi‐leaf collimation (MLC). A trial conducted at Sir Charles Gairdner Hospital found that, using the BTE formula (with a few modifications required for the MLC treatment units), of 60 patients timed for the duration of their set‐up and treatment, 85% of values were in the range of ± 3 min, and 95% were in the range of ± 5 min of the estimated times. Through the routine use of the BTE equation a more sensitive indication of treatment machine workload can be found. Advantages such as: (i) a more accurate measure of treatment workload (for comparison with other departments) and (ii) increased scheduling accuracy will succeed over the currently accepted system of fields per hour.
Phase III, randomized, double‐blind, cross‐over comparison of gadoteridol and gadopentetate dimeglumine in magnetic resonance imaging of patients with intracranial lesions
Authors: Greco Alina , Parker John R , Ratcliffe C George , Kirchin Miles A , McNamara Michael T 
Published: March 2003

SUMMARYThis study compares the efficacy and safety of gadoteridol with that of gadopentetate dimeglumine for enhanced MRI in subjects with intracranial lesions. A total of 92 subjects at three European centres underwent one MRI study enhanced with 0.1 mmol/kg gadoteridol and another with 0.1 mmol/kg gadopentetate dimeglumine. Contrast agents were assigned in random order, separated by 3–7 days. Eighty subjects were evaluated for efficacy. The presence of pathology, degree of enhancement, location and number of lesions, as well as additional information gained, were compared for each subject’s unenhanced and enhanced scans for both the gadoteridol and gadopentetate dimeglumine examination. Safety was evaluated in all treated subjects by means of pre‐ and post‐dose vital signs, laboratory tests and by monitoring for adverse events. There was no significant difference in the number of lesions visualized pre‐ and post‐contrast for the two contrast agents. A high degree of correlation was noted between the two blinded readers. When post‐contrast image sets were compared between contrast agents, there was no significant difference in superiority of one agent over the other for any of the evaluators (P > 0.05). No significant differences for any safety parameter were noted between the two agents. Gadoteridol and gadopentetate dimeglumine are effective and well tolerated for use in contrast‐enhanced MRI of the CNS at a dose of 0.1 mmol/kg.
HASTE MRCP and MRI findings in alveolar echinococcosis of the liver
Authors: Tarhan Nefise C , Agildere Ahmet M , Gur Gurden , Boyacio˘glu Sedat 
Published: March 2003

SUMMARYAlveolar echinococcosis is a rare mass‐producing inflammatory process of the liver. Experience with MRI, and particularly magnetic resonance cholangiopancreatography (MRCP), demonstrates that features of this disease are limited. The HASTE (half‐Fourier acquisition single‐shot turbo spin echo) MRCP and MRI findings of alveolar echinococcosis of the liver are presented in this report. HASTE MRCP was used to define the biliary system and the biliary system–mass relationship. It was found that results were comparable with those of invasive techniques such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography.
Pancreatic islet cell tumours presenting as recurrent acute pancreatitis: Imaging features in three cases
Authors: Ramsay Duncan , Gibson Paul , Edmunds Simon , Mendelson Richard 
Published: March 2003

SUMMARYWe present three cases of recurrent pancreatitis that occurred in patients with small islet cell tumours of the pancreas which were obstructing the main pancreatic duct. This is a very uncommon presentation of pancreatic islet cell tumours. The radiological findings in these cases are shown and the implications for imaging of ‘idiopathic’ relapsing pancreatitis are discussed.
A case of primary cerebral neuroblastoma in adolescence
Authors: White Benjamin D , Pozza Christopher H , Davies Roger , Hanieh Ahmad 
Published: March 2003

SUMMARYPrimary cerebral neuroblastoma is one of a group of highly malignant undifferentiated primitive neuroectodermal tumours arising from germinal matrix cells of the embryonic neural tube. They occur primarily in young children and are extremely rare in adults. They may be multicentric and have often spread throughout the central nervous system at the time of diagnosis. A case of a 16‐year‐old man is described, and the recent literature is reviewed.
Radiographic imaging procedures in the diagnosis of the major central neuropathological consequences of alcohol abuse
Authors: Scroop Rebecca , Sage Michael R , Voyvodic Frank , Kat Evelyn 
Published: March 2003

SummaryExcessive consumption of alcohol is well recognized to have specific neurologic sequelae. The MRI and CT findings in these syndromes is presented and correlated with pathological findings and suspected pathogenesis. The role of imaging in both the diagnosis and monitoring of patients is discussed.
Computed tomography perfusion imaging in acute stroke
Authors: Keith CJ , Griffiths M , Petersen B , Anderson RJ , Miles KA 
Published: March 2003

SUMMARYThe development of thrombolytic and neuroprotective agents for the treatment of acute stroke has created an imperative for improved imaging techniques in the assessment of acute stroke. Five cases are presented to illustrate the value of perfusion CT in the evaluation of suspected acute stroke. To obtain the perfusion data, a rapid series of images was acquired without table movement following a bolus of contrast medium. Cerebral blood flow, cerebral blood volume and mean transit time were determined by mathematically modelling the temporal changes in contrast enhancement in the brain and vascular system. Pixel‐by‐pixel analysis allowed generation of perfusion maps. In two cases, CT‐perfusion imaging usefully excluded acute stroke, including one patient in whom a low‐density area on conventional CT was subsequently proven to be tumour. Cerebral ischaemia was confirmed in three cases, one with an old and a new infarction, one with a large conventional CT abnormality but only a small perfusion defect, and one demonstrating infarct and penumbra. Perfusion CT offers the ability to positively identify patients with non‐haemorrhagic stroke in the presence of a normal conventional CT, to select those cases where thrombolysis is appropriate, and to provide an indication for prognosis.
Concomitant diminishing magnetization‐transfer effect and increasing choline level in radiation‐induced temporal‐lobe changes
Authors: Rumpel Helmut , Ho Gaik L , Chan Ling L , Lim Winston EH , Chong Vincent FH 
Published: March 2003

SUMMARYThis article reports on the use of both magnetization–transfer (MT) imaging and 1H‐MR spectroscopy in two cases of bilateral temporal‐lobe changes after radiation therapy for nasopharyngeal carcinoma. In the first case, the following patterns were noted: (i) although the temporal lobes appeared relatively normal on T2‐weighted MR imaging, corresponding MT imaging clearly showed signal abnormalities (decreased MT effect) consistent with alterations in macromolecular structure; and (ii) concomitant strongly elevated choline on 1H‐MR spectroscopy was observed, and this is associated with metabolic changes in cell membranes. The second case presented similar characteristics. In addition, there was an increased lactate signal and T2 signal changes in keeping with established oedema. Both MT and proton‐spectroscopic findings were consistent with postulated pathophysiological features of radiation injury, but their specificity for this condition remains unclear. Magnetization‐transfer imaging, and possibly 1H‐MR spectroscopy, might be sensitive techniques for the early detection of late radiation injury.
Geographic delivery models for radiotherapy services
Authors: Roberts Gisele H , Dunscombe Peter B , Samant Rajiv S 
Published: March 2003

SUMMARYThe study described here was undertaken to quantify the societal cost of radiotherapy in idealized urban and rural populations and, hence, to generate a measure of impediment to access. The costs of centralized, distributed comprehensive and satellite radiotherapy delivery formats were examined by decomposing them into institutional, productivity and geographical components. Our results indicate that centralized radiotherapy imposes the greatest financial burden on the patient population in both urban and rural scenarios. The financial burden faced by patients who must travel for radiotherapy can be interpreted as one component of the overall impediment to access. With advances in remote‐monitoring systems, it is possible to maintain technical quality while enhancing patient access. However, the maintenance of professional competence will remain a challenge with a distributed service‐delivery format.
ATM induction insufficiency in a radiosensitive breast‐cancer patient
Authors: Clarke RA , Fang ZH , Marr PJ , Lee CS , Kearsley JH , Papadatos G 
Published: March 2003

SUMMARYThe ataxia telangiectasia (A–T) gene (ATM) is a dominant breast cancer gene with tumour suppressor activity. ATM also regulates cellular sensitivity to ionising radiation (IR) presumably through its role as a facilitator of DNA repair. In normal cells and tissues the ATM protein is rapidly induced by IR to threshold/maximum levels. The kinase function of the ATM protein is also rapidly activated in response to IR. The fact that women carriers of ATM mutations can have an increased risk of developing breast cancer and that many sporadic breast tumours have reduced levels of the ATM protein broadens the scope of ATM's tumour suppressor within the breast. This report describes the downregulation of ATM protein levels in a radiosensitive breast cancer patient. Postinduction ATM levels were up to tenfold lower in the patient's fresh tissues compared to normal controls. These results might indicate a much broader role for ATM anomalies in breast cancer aetiology.