ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00384.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The period 1895 to 1897 was a vintage time for physical science, perhaps its greatest vintage ever, and one of the chief vineyards proved to be the Cavendish Laboratory for Experimental Physics down Free School Lane in the ancient English university town of Cambridge. At Cambridge, some 5 months before Röntgen's discovery of X‐rays on 8 November 1895, the academic politicians, after agonizing long over the matter, decided to admit graduates of other universities to the University as research students, without requiring them to first under‐take a preliminary 3 year Cambridge Bachelor of Arts degree. Some 5 weeks before Röntgen's discovery, within 24 h of each other, the first two students to avail themselves of this new possibility appeared in Cambridge. Both made their way to the Cavendish Laboratory for Experimental Physics.1One, an Irishman, John Townsend, went on to become Waynflete Professor of Physics in the University of Oxford. The other was a youth from the far antipodes; a young man with a somewhat bucolic manner and a booming voice. The Director of the Cavendish Laboratory, JJ Thomson,2and his wife seemed to take an immediate liking to the New Zealand flax farmer's son and went out of their way to introduce him to the Cambridge society of the time, which is so evocatively described in Gwen Raverat's little bookPeriod Piece,3just recently rei

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00385.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SUMMARYFifteen patients with carcinoma of the gastro‐oesophageal junction were pre‐operatively staged with endoscopic ultrasound (EUS) and computed tomography (CT). The accuracy of tumour and nodal staging using both modalities was compared to the final histological staging of the resected specimens. In staging depth of tumour growth, EUS was significantly more accurate (87% of lesions correctly staged) than CT (40% correctly staged). In staging nodal involvement, EUS was again significantly more accurate (73% correctly staged) than CT (33%). Two‐thirds of the lesions were traversable with the endoscopic probe, but most of the nontraversed lesions were correctly staged on EUS. In this study, CT has performed poorly as a staging modality for carcinoma at the gastro‐oesophageal junction. Other studies have shown CT to be less accurate at this location than at other oesophageal sites. The orientation of the gastro‐oesophageal junction, lack of surrounding fat planes, proximity of adjacent organs and patient motion contribute to the poor staging performance of CT at this location. In contrast, EUS has been an accurate staging modality at the gastro‐oesophageal junction in this study and compares well with other studies evaluating EUS in the more proximal oesophagus. Endoscopic ultrasound is therefore a necessary modality if accurate pre‐operative staging of gastro‐oesophageal junction carcinoma is

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00386.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

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 angi

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00387.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

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.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00388.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

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 ‘n

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00389.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SUMMARYThe value of mammography and ultrasound in evaluating abscesses in the non‐lactating breast was assessed in 20 patients. Inflammatory breast masses in the non‐lactating period are uncommon and the clinical diagnosis can be very difficult when signs of inflammation are absent. There were 20 patients ranging in age from 25 to 60 years in the present study; the mean age was 39.35 years. Patients presented with a lump and/or pain without other clinical signs of inflammation. Mammography was performed to exclude malignancy. Mammograms showed an ill‐defined mass in 11 patients and an area of focal increased density in seven patients. Ultrasonograms showed echoic masses with central echopenia in 17 cases and central septation in three cases. Half the lesions were subareolar and half were peripheral. Two of 20 patients were treated by excision, three by incision and drainage, eight by aspiration and seven by antibiotics. The combination of mammographic and sonographic features may enable the radiologist to recognize this entity, thus preventing unnecessary su

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00390.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

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 manag

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00391.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

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 perf

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00392.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SUMMARYA prospective, randomized three‐arm trial is presented of 150 consecutive patients attending for double‐contrast barium enema (BE). This compares ‘Picolax’(a combined stimulant and osmotic agent),‘Picolaxfollowing ‘ a 3 day low‐residue diet and ‘Kleen‐Prep’(a polyethylene‐glycol osmotic agent). Faecal clearance, mucosal coating and colon fluid were scored in four colonic segments by two radiologists working independently and blinded to the preparation used. Analyses of an elderly subgroup and of side effects was performed. Low‐residue diet conferred no benefit to Picolax preparation, which was satisfactory (ability to exclude 5 mm polyps) in 80% of patients. Kleen‐Prep failed to achieve adequate preparation in 46%, due to excess fluid and poor mucosal coating. Kleen‐Prep caused more patient nausea, abdominal bloating and pain than Picolax. Patients 70 years and older had similar results. Low‐residue diet need not be used in addition to Picolax. Kleen‐Prep as a single agent is not

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1996.tb00393.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY