bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of aortoiliac aneurysms with spontaneous large vein fistula
Authors: Duong Cuong , Atkinson Noel 
Published: March 2003

Background: Arteriovenous fistula is a rare complication of aortoiliac aneurysmal disease, accounting for less than 2% of clinical presentations. Methods: In addition to the 191 cases reviewed in the literature, an additional 14 cases seen at Royal Melbourne Hospital over the last 22 years are presented to illustrate the challenges in the diagnosis of this condition. Conclusion: An increase in awareness may lead to better management of these patients.
Intraoperative vascular localization to facilitate endopyelotomy after renal transplantation
Authors: Siddins Mark , Kanchanabat Burapa , Rao M. Mohan 
Published: March 2003

Background: Pelviureteric junction (PUJ) obstruction after renal transplantation is uncommon. Surgical correction can be technically challenging due to dense perinephric adhesions and variable hilar vascular anatomy. Endopyelotomy is well established in the treatment of PUJ obstruction in native kidneys. Methods: The present paper reports the first experience of antegrade visual cold‐knife endopyelotmy performed in a renal allograft. In orientating the incision at the PUJ, preoperative imaging was supplemented by intrarenal Doppler ultrasound, using a probe designed for transoesophageal cardiac monitoring. To the authors’ knowledge this approach has not previously been reported. Results: Renal vascular relationships were readily indentified by identifying arterial and venous waveforms. Conclusions: For this uncommon procedure the use of intrarenal Doppler ultrasound provides greater security in avoiding inadvertent vascular injury.
Treatment of childhood phimosis with a moderately potent topical steroid
Authors: Ng Wai‐Tat , Fan Ning , Wong Chi Keung , Leung Siu Lan , Yuen Kar Shing , Sze Yeung Shing , Cheng Pak Wing 
Published: March 2003

Background: Recently, topical steroid application has been shown by a small number of studies to be an effective alternative to circumcision for the treatment of phimosis. However, only potent or very potent corticosteroids have been more thoroughly studied in this treatment option. A prospective study was conducted to determine whether comparable results could be achieved using a weaker steroid cream. Methods: Boys, 3–13 years of age, with non‐retractable foreskin due to a tight ring at the tip were offered the regimen of twice‐daily preputial retraction and topical application of 0.02% triamcinolone acetonide cream. The degree of preputial retractability was assessed at presentation and at 4 and 6 weeks of treatment. Success was defined as full retraction or free retraction up to agglutination of the foreskin to the glans. Results: Eighty‐three boys completed the treatment. Successful retraction was achieved in 48/83 (58%) patients after 4 weeks and 70/83 (84%) patients after 6 weeks of application. The overall response rate aggregated from six published series using 0.05% betamethasone was 87% at 4 weeks and 90% on completion of treatment. Thus, the results appear inferior when analysed at 4 weeks but compare favourably with those reported for a more potent steroid on completion of the full course of treatment. Conclusions: Even though the triamcinolone cream used in the present study is less potent than the more commonly used 0.05% betamethasone valerate cream, it could effect comparable improvements in foreskin retractability after 6 weeks of treatment.
How are we treating patients with hepatic colorectal metastases in Sydney?
Authors: Moore Katrina H. , Bokey Les , Chapuis Pierre H. , Tait Noel 
Published: March 2003

Introduction:  Colorectal cancer is common. At presentation 25% of patients have established hepatic metastases and overall at least half will develop hepatic metastases. Many different therapeutic options have been proposed. This study evaluates the current resources available and patterns of care for patients with hepatic colorectal metastases in the Sydney metropolitan area.Methods:  Prospective data were collated describing all patients presenting to any one of nine hospitals within the Sydney metropolitan area in a 12‐month period, diagnosed with hepatic metastases. The data included patient demographics and background, treatment of the primary tumour, diagnosis and treatment of the hepatic metastases and histopathology both of the primary and of the hepatic metastases.Results:  There were 194 patients in the study. Most when diagnosed with hepatic colorectal metastases were independent, active, retired and usually had existing social supports. The majority had had their primary colorectal cancer resected and were later treated with systemic chemotherapy.Conclusions:  This study highlights the need for a comprehensive multicentre, prospective data collection of patients with hepatic metastatic disease. This would clarify the effectiveness or otherwise of the health system caring for such patients and provide additional information for the development and implementation of guidelines.
Doppler ultrasound (pre‐ and post‐contrast enhancement) for detection of recurrent stenosis in stented renal arteries: Preliminary results
Authors: House Molly K , Dowling Richard J , King Paula , Bourke Jayne L , Jardine Catherine , Thomson Kenneth R , Gibson Robert N 
Published: March 2003

SUMMARYThe purpose of the present paper was to assess whether conventional renal Doppler ultrasound and the commonly used parameters of peak systolic velocity and renal aortic ratio may be an appropriate modality for the follow‐up of renal artery stents. A total of 19 arteries in 15 patients was examined with both renal Doppler ultrasound and angiography for the presence or absence of recurrent renal artery stenosis. Disease was considered present on angiography if the arterial diameter was more than 60% stenotic. Doppler criteria for stenosis were either a peak systolic velocity of > 180 cm/s or a renal aortic ratio of > 3.0. Echo enhancement with Levovist (Schering, Berlin, Germany) was used if studies were technically unsuccessful or to improve diagnostic confidence. Renal Doppler ultrasound detected 100% of renal artery stenoses. The specificity was 75%, the positive predictive value was 67% and the negative predictive value was 100%. Echo enhancement improved the technical success rate from 89 to 95% and also increased diagnostic confidence in six examinations. The present limited study suggests that similar renal Doppler parameters as used for the study of unstented renal arteries may be applied to the examination of renal arteries with renal stents in situ. It therefore suggests that Doppler ultrasound may provide an adequate non‐invasive means of renal artery stent follow‐up, particularly when combined with echo‐enhancing agents. Further study is warranted to confirm these initial conclusions.
Armrest versus vacuum bag immobilization in the treatment of breast cancer by radiation therapy: A randomized comparison
Authors: Graham P , Elomari F , Browne L 
Published: March 2003

SUMMARYThirty patients in randomized sequence were simulated in both an armrest and a vacuum bag immobilization device and also randomized to treatment in one of the two devices. Overall patient comfort significantly favoured the use of the armrest, although both were acceptable. Lung exposed in the tangential beams was less in the vacuum bag device. Supraclavicular skin folding was greater in the vacuum bag, but this is probably related to the angle of arm abduction. Treatment times and stability of the setups were not significantly different. This is a small study piloting a technical comparison and the findings require confirmation in a larger sample.
Giant cell tumour of the tendon sheath of the hand: A pictorial essay
Authors: Peh Wilfred CG , Wong Yik , Shek Tony WH , Ip Wing‐Yuk 
Published: March 2003

SUMMARYGiant cell tumour of the tendon sheath is a soft tissue mass found occasionally in the hand. Its diagnosis can be readily made preoperatively if the characteristic MRI features are appreciated. This pictorial essay demonstrates and describes the imaging findings correlated with histopathological findings in a group of patients with proven giant cell tumour of the tendon sheath.
Lace‐like enhancement pattern of osteosarcoma of rib and liver metastasis in CT scans
Authors: Chan Helen HL , Chan John KF , Ng Wai‐Man , Shek Tony WH , Chan Fu‐Luk 
Published: March 2003

SUMMARYThe rib is an uncommon site of osteosarcoma. With the use of adjuvant chemotherapy and aggressive surgical resection of the metastatic pulmonary lesions, extrapulmonary metastases are becoming more clinically evident. Primary rib osteosarcoma with extrapulmonary metastasis is exceedingly rare. A case is reported, showing that the pattern of metastasis of rib osteosarcoma is similar to that of primary bone osteosarcoma. The liver metastasis occurred after resection of the metastatic pulmonary lesions. A CT scan of the primary rib lesion and liver metastasis both showed a lace‐like enhancement pattern, its histological appearance corresponding with neoplastic osteoid. With the increasing use of CT abdomen for localization of extrapulmonary metastases, lace‐like enhancement may be seen more readily in the future.
Tandem lesions of the carotid circulation: Combined extracranial endarterectomy and intracranial transluminal angioplasty
Authors: Gock Stephen L , Mitchell Peter J , Field Peter L , Atkinson Noel , Thomson Kenneth R 
Published: March 2003

SUMMARYA case series is presented demonstrating a unique approach to the treatment of tandem atherosclerotic lesions of the internal carotid artery. Between 1994 and 1999 eight patients with tandem lesions of the internal carotid artery were treated by combined carotid endarterectomy for the proximal lesion and intraoperative angioplasty of the distal intracranial lesion via the carotid arteriotomy. The success and complication rates were evaluated. A 100% technical success rate was achieved with one post procedural complication by ipsilateral stroke within 24 h. The advantages of this technique include the treatment of tandem lesions by the one procedure, improved transluminal access to the intracranial lesion and the ability to reduce the risk of embolism by flow control during balloon inflation.
Focal myositis
Authors: Galloway Howard R , Dahlstrom Jane E , Bennett Genevieve M 
Published: March 2003

SUMMARYFocal myositis is a rare, benign focal inflammation of muscle. The lesion often presents as a mass that may be mistaken for a soft tissue sarcoma. This report describes the MRI and histopathological features of a case and illustrates how the diagnosis may be suspected on the basis of the MR findings.
Fetus in fetu. Rare cause of a lump in an adult’s abdomen
Authors: Awasthi M , Narlawar R , Hira P , Shah P 
Published: March 2003

SUMMARYFetus in fetu is a rare entity. The patient usually presents in childhood. A case in which the patient presented in adulthood, with a lump in the abdomen, is reported. Computed tomography findings were diagnostic of this condition and a prospective diagnosis could be made. Computed tomography also helped to differentiate it from mature teratoma.
Comparison of lung scintigraphy and CT angiography in the diagnosis of pulmonary embolism
Authors: Chen Suet‐Wan , Mouratidis Bill 
Published: March 2003

SUMMARYIn our institution, as in others, pulmonary angiography is not used in the diagnosis of pulmonary embolism because of its perceived risks. We compared the results on lung scintigraphy and computed tomography angiography (CTA) in 116 consecutive patients with suspected pulmonary embolism. In 14 patients with normal lung scans 13 (93%) were also normal with CTA. In the 73 patients with low probability lung scans only five (7%) demonstrated pulmonary embolism with CTA. In 12 patients with high probability lung scans 11 (92%) demonstrated pulmonary embolism on CTA. However, in the 17 patients with intermediate probability lung scans, 10 (58.8%) showed embolism with CTA. We conclude that wherever practicable lung scans should be performed in all patients due to its relatively low radiation burden and that CTA be performed in patients with intermediate probability scans due to the high incidence of pulmonary embolism. Patients with either a normal scan or high probability scan should be treated appropriately. In patients with low probability scans CTA should be performed in those with a high clinical suspicion of thromboembolism.
Renal involvement in multifocal osteosarcoma
Authors: Karabulut Nevzat , Ariyürek O Macit , Gülsün Meltem , Akyüz Canan 
Published: March 2003

SUMMARYA rare case of multifocal osteosarcoma metastatic to kidney, lung and lymph nodes is presented. Radiological findings included multiple foci of sclerotic lesions involving the axial and peripheral skeleton, a heterogeneous renal mass with areas of calcification, multiple pulmonary metastases with pneumothorax, and partially calcified enlarged mediastinal and abdominal lymph nodes.
Mycosis fungoides involving the oral cavity
Authors: Chua Margaret S‐T , Veness Michael J 
Published: March 2003

SUMMARYMycosis fungoides is a malignant T‐cell lymphoproliferative disease with a predilection for cutaneous involvement. Extracutaneous disease is uncommon and oral mucosal involvement is rare. We describe a case of mycosis fungoides involving the hard palate treated with radiotherapy. The relevant literature on this topic is reviewed.
Management preferences following radical inguinal orchidectomy for Stage I testicular seminoma in Australasia
Authors: Hruby G , Choo R , Jackson M , Warde P , Sandler H 
Published: March 2003

SUMMARYA survey to evaluate the preferred patterns of management of Stage I seminoma was conducted during March 2001. The questionnaire was distributed by the Royal Australian and New Zealand College of Radiologists to all qualified radiation oncologists, 74 out of 170 responded. All performed a staging CT scan of the abdomen and pelvis. Thoracic imaging consisted of either chest X‐ray (29%) or chest CT (38%) while 33% performed both. Fifty‐four percent of radiation oncologists discussed surveillance with their patients but estimated that 5% or less would choose this option. The most commonly prescribed dose was 25 Gy in 15 or 20 fractions (79%). Sixty‐five percent of respondents treated the para‐aortic (PA) nodes alone. Forty‐two of 48 clinicians treating the PA field reported a change in practice after publication of the Medical Research Council study in 1999. Of these, 40 and 23% perform CT scans of the pelvis annually and every 6 months. Thirty‐one percent did no follow‐up CT scan. Compared to a similar survey from North America, we are more likely to use PA fields and less likely to discuss surveillance. As in the USA, and in contrast to Canada, few patients choose surveillance. There is no consensus regarding the frequency of follow‐up scans in either North America or Australasia.
Magnetic resonance imaging findings in an unusual case of atlanto axial dislocation and vertebral artery–vein fistulas in a patient of neurofibromatosis‐1
Authors: Maheshwari Sharad , Kale Hrishikesh A , Desai Shrinivas B , Kohli Anirudh 
Published: March 2003

SUMMARYVertebral arteriovenous fistulas are uncommon in neurofibromatosis. We describe MRI findings of a patient with an unusual association of bilateral vertebral arteriovenous fistulas with an atlantoaxial dislocation in the setting of neurofibromatosis.
Tuberous sclerosis: A presentation of less‐commonly encountered stigmata
Authors: Morris BS , Garg A , Jadhav PJ 
Published: March 2003

SummaryThe protean manifestations of the tuberous sclerosis complex have lent this condition to extensive review in textbooks and in the medical literature. This condition generally presents by virtue of its neurological manifestations. Osseous stigmata, when encountered, are generally asymptomatic and do not require specific treatment owing to their benignity. We present the case of a young man with a slowly enlarging facial swelling for whom cosmetic surgery was considered. The swelling, present since childhood, had in time assumed disfiguring proportions. In what was hitherto considered an isolated facial deformity, a skull radiograph followed by CT revealed neurological stigmata of tuberous sclerosis. A large cerebellar hamartoma, proliferative soft tissue in the scalp adjacent to focal hyperostosis of the calvarium and the accompanying hemifacial changes seen in this patient constitute less commonly described features of tuberous sclerosis.
Abnormal uptake of Technetium‐99 m hydroxymethylene diphosphonate in the liver
Authors: Roman Marcin R , Larcos George , Angelides Socrates , Devadas Michael 
Published: March 2003

SummaryDiffuse liver uptake on bone scintigraphy is a rare occurrence with only a few reports in the literature. A case of diffusely increased uptake in a patient with acute hepatitis is presented.
MRI in kernicterus
Authors: Shah Zarine , Chawla Ashish , Patkar Deepak , Pungaonkar Sona 
Published: March 2003

SUMMARYKernicterus (bilirubin encephalopathy) is a disease entity with a very high rate of mortality in neonates. The children who survive are left with neurological deficits such as choreoathetosis, sensorineural deafness and mental retardation. Magnetic resonance imaging of the brain in this condition has specfic findings which aid in the accurate diagnosis of the condition, along with clinical and biochemical criteria. Reports have shown involvement of the globus pallidus, putamen, and less commonly the thalamus. More specific involvement may be isolated lesions of the globus pallidus. Magnetic resonance imaging has shown a good sensitivity in this condition.
Coexistent gallbladder carcinoma in Mirizzi syndrome
Authors: Chiam Quee Li , Lau Kenneth 
Published: March 2003

SummaryA 52‐year‐old woman presented with right upper quadrant pain and obstructive jaundice. Computed tomographic scan showed Mirizzi syndrome type 1 and a thickened and calcified gallbladder wall, raising the possibility of coexistent gallbladder carcinoma that was later confirmed on histology post‐cholecystectomy.
Why a breast boost should remain a controversial aspect of routine breast conservation management in Australia and New Zealand in 2002
Authors: Graham P , Capp A , Fox C , Nasser E , Delaney G , Ahern V , Wratten C 
Published: March 2003

SummaryTwo randomized trials have recently shown a statistically significant improvement in local control when a boost is employed in the conservative treatment of early breast cancer. However, unresolved issues of cost effectiveness, potentially increased toxicity and the inability to automatically generalize these results to Australian and New Zealand practice remain. In view of these unresolved controversies, the St George and Wollongong hospitals breast boost trial (SGW trial) will continue to recruit.
Renal colic: A prospective evaluation of non‐enhanced spiral CT versus intravenous pyelography
Authors: Mendelson Richard M , Arnold‐Reed Diane E , Kuan Melvyn , Wedderburn Andrew W , Anderson James E , Sweetman Gregory , Bulsara Max K , Mander Julian 
Published: March 2003

AbstractThe aim of this study was to compare non‐enhanced spiral CT (NECT) and intravenous pyelography (IVP) in patients with suspected acute renal colic. Two‐hundred patients presenting to the Emergency Department with suspected acute renal colic were randomized into groups undergoing NECT or IVP. The main outcome measures were diagnostic utility, incidence of alternative diagnoses, requirement for further imaging, length of hospital stay, urological intervention rates, radiation dosage and costs. Non‐enhanced spiral CT was better than IVP in making a definitive diagnosis of ureteric calculus or of recent calculus passage (65/102 or 66% vs 42/98 or 41%; P = 0.003). Calculi were missed in two patients in the IVP group. Two patients in each group had alternative diagnoses by initial imaging. There was no difference in the length of hospital stay or intervention rate. More plain X‐rays during admission and more IVPs during follow up were performed in the NECT group. Effective radiation dosages were 2.97 mSv (IVP) and up to 5 mSv (NECT). Non‐enhanced spiral CT provided greater diagnostic utility in this randomized comparison but no difference in measured outcomes. The incidence of alternative diagnoses was low, probably due to patient selection. Financial costs for each modality are comparable in a public tertiary hospital. Radiation dosages are higher for NECT and, for this reason, it might be appropriate to consider limiting NECT use to patients who have do not have classical symptoms of renal colic, to older patients and those with a contraindication to the administration of intravenous contrast media.
GENDER DIFFERENCES AND ENDOTHELIUM‐ AND PLATELET‐DERIVED FACTORS IN THE CORONARY CIRCULATION
Authors: Miller Virginia M , Lewis Debra A , Barber Dustan A 
Published: March 2003

1. Experiments were designed to determine whether or not interactions of platelets with coronary arteries are affected by gender or oestrogen‐status.2. Platelets and right coronary arteries were isolated from sexually mature male, female and ovariectomized pigs. Arteries were suspended in organ chambers for the measurement of isometric force. Responses of rings, with and without endothelium, were evaluated to aggregating platelets and the platelet products 5‐hydroxytryptamine (5‐HT) and adenosine diphosphate (ADP).3. Release of 5‐HT, thromboxane A2 (TXA2) and prostacyclin were measured from platelets.4. Platelets caused relaxations of rings with endothelium from all pigs. However, in rings without endothelium, consistent contractions were observed only in rings from male pigs.5. The release of 5‐HT and prostacyclin was greatest from platelets of ovariectomized pigs compared with male and female pigs. Release of TXA2 was greatest from platelets of male pigs.6. Endothelium‐dependent relaxations to ADP and contractions to 5‐HT were similar among the three groups.7. These results suggest that there may be gender‐specific differences in vasomotor responses to autogenous platelets but not to the platelet‐derived products 5‐HT and ADP. Furthermore, there are gender differences in platelets in the release of cyclo‐oxygenase metabolites of arachidonic acid and 5‐HT. These products could contribute to gender differences in response to injury in the coronary circulation.