ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00221.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYAnterior spread of nasopharyngeal carcinoma (NPC) may infiltrate the maxillary sinus. In a prospective study of 114 patients comparing magnetic resonance imaging (MRI) and computed tomography (CT) in the staging of NPC, 10 (9%) patients were noted to have tumour infiltration of the maxillary sinuses. All of the patients except one had associated infiltration of the sphenoidal sinuses indicating advanced local spread. Computed tomography was excellent in outlining the extent of bony erosion and associated soft tissue mass within the antra. T1‐weighted images could not demonstrate bony erosions directly although soft tissue extension into the sinuses could be clearly visualized. Both CT and MRI showed good demarcation between tumour and mucosal thickening within the maxillary sinus. Although MRI demonstrated soft tissue involvement more elegantly than CT, it did not appear to offer significantly more information that may affect clinical managemen

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00222.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYSix widely used X‐ray contrast media (XRC) were tested against nine commonly isolated organisms to determine the practicality of using XRC to outline body spaces prior to obtaining specimens for culture and to assess the feasibility of using XRC in divided doses to reduce cost. Preparations ofEscherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, Streptococcus pyogenesandStreptococcus milleriin two approximate concentrations of 104and 108colony forming units/mL (cfu/mL) were inoculated into the following XRC: Conray 280, Hexabrix 320, lopamiro 370, Omnipaque 350, Ultravist 300 and Optiray 320 each in two concentrations. Sampling was performed in triplicate at 0, 2, 4 and 20 h with the 20 h counts made after exposure at both 22°C and 4°C. There were 16 significant interactions, predominantly with the Gram‐negative organisms. Conray 280 produced the greatest number of effects. Most effects were bacteriostatic. Organisms were most susceptible at low concentration and after prolonged contact with XRC. No effect was seen with dilute XRC. All weekly sterility checks were negative. Non‐ionic XRC have no significant effect on the growth of Gram‐positive organisms and little effect on Gram‐negative organisms if processing is performed promptly. Using standard aseptic technique, no contamination of XRC occurred, suggesting multi‐dosing may be a safe and cost‐effective method of

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00223.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYPrevious reports on computed tomography findings in pulmonary embolism have concentrated on describing large peripheral wedged‐shaped opacities thought to represent infarcts, and filling defects in the central vessels presumed to represent emboli. Two cases are presented of mosaic oligaemia with areas of apparent increase in density initially thought to represent infiltrate

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00224.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYThe aim of this study is to demonstrate the spectrum of mammographic appearances of mammary duct ectasia that mimic carcinoma in a breast cancer screening programme. Between February 1989 and March 1993, 40 003 women underwent screening mammography as part of the Western Australia Women's Cancer Prevention Unit screening programme. Fine needle aspiration or excisional biopsy was performed on 1437 women, and 12 cases of cytologically or histologically confirmed mammary duct ectasia were detected. A total of 14 mammographic abnormalities from 12 asymptomatic female patients were biopsied, and confirmed to represent mammary duct ectasia. The mammographic spectrum included eight areas of microcalcification (two of which were extensive), three spiculated masses and three lobulated, partially smooth masses. Five of these women showed no other mammographic stigmata of mammary duct ectasia in either breast. Additional features of mammary duct ectasia, including nipple retraction, retro‐areolar duct dilatation or macrocalcification were identified in seven women. Mammographic features of mammary duct ectasia are frequently detected in asymptomatic women undergoing screening mammography and cause no diagnostic dilemma. Occasionally mammary duct ectasia will have a mammographic appearance that is indistinguishable from carcinoma, necessitating breast biospy. In this study 40% of those women with mammary duct ectasia that were submitted for biopsy had no other feature of mammary duct ectasia that could have suggested the pre‐operative diagno

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00225.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYTechnetium‐99m mercaptoacetyltriglycine(MAG3) is the most recently introduced renal radiopharmaceutical in Australia and is established as the agent of choice for use in diuresis renography, particularly in neonates and infants. It provides superior anatomical information compared to previously used agents. Three cases are reported in which MAG3 diuresis renography was performed in neonates, who were found to have hydronephrosis detected antenatally. In two neonates, a previously unrecognized horseshoe kidney was demonstrated and in case 3 there were scan features characteristic of a ureterocele. It is highly unlikely that these abnormalities would have been delineated with99mTc dimethyltriamine penta‐acetic acid (DTPA) study, as confirmed in case 1, because of the relatively poor uptake of DTPA when compared to M

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00226.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYPaget's disease of the nipple is characterized by the presence of Paget's cells in the epidermis of the nipple or areola. Two case reports of Paget's disease are described and used to highlight unusual features of the disease. The literature on the radiographic and pathologic findings of this disease is reviewed.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00227.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYThe patterns of fractionation used to treat bone metastases in a single centre in two time periods were determined. Clinical audit was carried out, for two periods of 6 months each, in 1988 and 1993. Data recorded included patient, tumour and treatment variables. Palliation of bone metastases represented 40% and 44% of palliative treatment courses, and 20% and 21% of total treatment courses, respectively, in both time periods. Shorter treatment schedules were used in 1993 compared to 1988, with mean fraction numbers of 6.4 versus 8.5, respectively (P<0.001). This reduction in fraction numbers occurred for the common primary tumour sites. In 1993, the mean numbers of fractions used were related to the primary tumour site (7.8 fractions for breast, 5.0 for lung, 6.7 for melanoma, 6.4 for other primary sites,P= 0.05), the treatment site (7.3 fractions for weight‐bearing bones, 4.0 for non‐weight‐bearing bones,P<0.001) and patient address (6.0 fractions for city postcodevs7.8 for country postcode,P= 0.02). Treating radiation oncologist (5.7‐7.8 mean fractions,P= 0.06) and patient age (P= 0.56) were not significant factors for the number of fractions used. It is likely that there were multiple causes for a reduction in the number of fractions used to treat bone metastases, including the results of clinical trials and increasing pressure to optimize the use of scarce resources. However, patients who may have a better prognosis (breast primary) and those with metastases in weight‐bearing bones continued to receive longer treatment

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00228.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYThe records of four patients presenting with a histological diagnosis of haemangiopericytoma of the central nervous system, in Auckland, New Zealand, between 1970 and 1990 were reviewed retrospectively, with the aim of determining the natural history of the disease and response to various treatment modalities. Three out of the four patients reviewed presented with primary cerebral disease and the fourth with a primary spinal cord tumour. All three cerebral primary patients were initially treated with local surgical excision. All three patients received radical radiotherapy following local recurrence. The first two patients remained disease‐free locally although one patient developed a solitary liver metastasis 5 years after radiotherapy. The third patient was referred with multiple cerebral metastases and failed to respond to radiotherapy. The patient with the primary lesion in the spinal cord was treated with local excision followed by postoperative radiotherapy and remains disease‐free 17 years after treatment. One patient failed to respond to chemotherapy, prescribed to treat a local recurrence adjacent to the previous radiotherapy field. This was successfully excised subsequently. The patient presenting with multiple cerebral metastases was the only patient to die of this disease. Results suggest that local recurrence is avoidable with adequate wide excision of the primary tumour followed by local radical radiotherapy. The role of chemotherapy remains controversial and no conclusion could be drawn regarding the role of palliative radiotherapy from this study. Active treatment and long‐term follow‐up are necessary because of the relative aggressiveness of this disease and the propensity for late r

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00229.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

SUMMARYThree recent publications have reported the development of erythema multiforme and Stevens‐Johnson syndrome in patients receiving cranial irradiation and sodium phenytoin. Some authors have recommended that patients receiving whole brain radiation therapy and who have had seizures should not be prescribed phenytoin but an alternative anticonvulsant. This article reviews the current literature pertaining to the development of this potentially lethal complication in patients receiving whole brain radiation and phenytoin, with reference to the single recorded case of Stevens‐Johnson syndrome in a patient receiving cranial irradiation and phenytoin in Auckland, New Zealand. While the clinical picture in the 16 patients reported in the literature and the current case report differed from the classical form of erythema multiforme, a similar pattern of presentation and outcome appeared in all patients reviewed, suggesting that the combination of phenytoin, cranial irradiation and the gradual reduction of concomitant steroids seem to lead to the development of erythema multiforme and/or Stevens‐Johnson syndrome. The data presented, although sparse, suggest that phenytoin should not be prescribed in patients receiving cranial irradi

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1995.tb00230.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY