Deborah A. Hall

Accuracy and reproducibility of clinical measures of testicular volume

3. Perrine SP, Greene MF, Failer DV. Delay in the fetal globin switch in infants of diabetic mothers. N Engl J Med 1985;312:334-8. 4. Bard H, Prosmanne J. Relative rates of fetal hemoglobin and adult hemoglobin synthesis in cord blood of infants of insulin-dependent mothers. Pediatrics 1985;75:1143-7. 5. Bard H, Prosmanne J. Postnatal fetal and adult hemoglobin synthesis in preterm infants whose birth weight was less than 1,000 grams. J Clin Invest 1982;70:50-2. 6. Ali SA. Milder variant of sickle~cell disease in Arabs in Kuwait associated with unusually high level of foetal haemoglobin. Br J Haematol 1970;19:613-9. 7. Abraham EC, Huff TA, Cope ND, Wilson JB, Bransome ED, Haisman THJ. Determination of the glycosylated hemoglobins (HbA1) with a new mierocolumn procedure. Diabetes 1978;27:931-7. 8. Abraham EC, Perry RE, Stallings M. Application of affinity chromatography for separation and quantitation of glycosylated hemoglobins. J Lab Clin Med 1983;102:187-97. 9. Rosenbaum DL. Hemoglobin electrophoresis on cellulose acetate. Am J Med Sci 1966;252:726-31. 10. Singer K, Chernoff AL, Singer L. Studies on abnormal hemoglobins. I. Their demonstration in sickle cell anemia and other hematologic disorders by means of alkali denaturation. Blood 1951;6:413-20. 11. Huisman TJH, Schroeder WA, Brodie AN, Mayson SM, Jakway J. Microchromatography of hemoglobins. III. A simplified procedure for the determination of hemoglobin Az. J Lab Clin Med 1975;86:700-2. 12. Kleihauer E, Braun H, Betke K. Demonstration yon fetalem Hamoglobin in den Erythrocyten eines Blutausstrichs. Klin Wochenschr 1957;35:637-8. 13. Dover G J, Humphries RK, Young N, et al. Pharmacologic manipulation of fetal hemoglobin synthesis. In: Experimental approaches for the study of hemoglobin switching. New York: Alan R. Liss, 1985:447-54.

Breast cancer survival among women under age 50: is mammography detrimental?

Great uncertainty exists about the benefit of detecting breast cancer by mammography in women under 50 years of age. We have reviewed the survival of patients aged 49 years or less whose cancers were detected by mammography alone. 117 women under the age of 50 years were diagnosed with breast cancer between 1978 and 1991 based only on an abnormal mammogram. Ductal carcinoma in-situ (DCIS) was found in 47 (40%) of these women, whilst 70 (60%) had infiltrating ductal or infiltrating lobular carcinomas. During the same interval, 928 women in this age group presented with palpable breast cancer. DCIS was diagnosed in 82 (9%) of these women, whilst 846 (91%) had infiltrating carcinoma. Among the infiltrating cancers detected by mammography alone, 50% were stage I, whilst only 30% of the women with palpable cancers were stage I. Five-year survival for all mammographically detected cancer patients was 95%, whereas for women with palpable cancers the survival was 74% (p < 0.00005). If DCIS is not included, the corresponding survivals are 91% for mammographically detected infiltrating cancers and 72% for palpable infiltrating cancers. Only 1 woman who died among those with palpable cancer had had a mammogram before diagnosis. Our data contradict the suggestion that women under 50 are put at a survival disadvantage by undergoing mammography. We believe that investigators who have reported negative results in this age group must examine other causes for their results.

Computed tomography-guided needle localization of nonpalpable breast lesions: review of 24 cases.

RATIONALE AND OBJECTIVESnWe examined the role of computed tomography (CT) in breast imaging, especially in guiding needle localization procedures.nnnMETHODSnWe reviewed our institutions breast imaging database, from 1978 to 1994, for procedures in which CT scanning was used. Twenty-four CT-guided needle localizations were identified. Medical records, mammograms, CT scans, and pathology reports were reviewed for all patients.nnnRESULTSnTwenty-four needle localizations were performed on 22 female patients. The average size of the lesions localized was 12 mm. The most common reason for CT scanning was the inability to image a suspicious density by conventional mammography on two orthogonal views. Nine malignant and 15 benign lesions were localized under CT guidance. One patient developed a postoperative hematoma. No other complications occurred.nnnCONCLUSIONnCT-guided breast localization is a reliable technique that may be used to define selected breast lesions that are difficult to triangulate or localize by conventional two-view mammography.

Telepaque — The ubiquitous contrast

An unusual case of cholecystographic contrast material outlining a fistulous tract from the duodenum to an aortic graft is presented.