James D. Collins

Minimal detectable pleural effusions. A roentgen pathology model.

Abstract To determine the minimal amount of fluid required for routine radiographic recognition of pleural effusions, a model was devised using artificial pleural effusions produced in cadavers. As little as 25 ml was shown to cause elevation of the apparent level of the diaphragm on both postero-anterior and lateral upright chest films.

Percutaneous Biopsy Following Positive Bone Scans

When a bone scan reveals an abnormal radionuclide accumulation and the cause is uncertain, bone biopsy is sometimes necessary. One hundred thirty biopsies have been performed in our institution with a percutaneous needle guided by fluoroscopy. This procedure is safe and effective.

MR imaging of the thorax: a comparison of axial, coronal, and sagittal imaging planes

We performed direct multisection coronal and sagittal magnetic resonance (MR) images in addition to axial images to determine the value and limitations of coronal and sagittal planes compared with axial planes. Ninety-four MR examinations of the thorax were performed with a 0.3 T permanent magnet system (Fonar) by spin echo technique. The MR axial images were found superior to coronal in demonstrating prevascular adenopathy (one case), pretracheal nodes (nine cases), left paraaortic nodes (three cases), subcarinal nodes (three cases), and small pleural effusions (three cases). The coronal or sagittal planes were better to determine relationship of a mass at the lung apex (five cases) or an abnormality at the lung base (five cases). The anteroposterior displacement or compromise of great vessels and bronchi was best displayed on the axial plane whereas craniocaudal displacement of above structures was best seen on the coronal plane. The axial images were found most informative and we suggest that they be performed routinely. Coronal or sagittal planes may be added in selected cases.

Ewing's sarcoma metastatic to placenta

Summary In a case report of Ewings sarcoma with multiple metastases, histological findings of the placental involvement were demonstrated.

Successful radiation protection of the normal intestinal tract in the dog.

Successful experimental radiation protection of the small bowel and the proximal colon has been achieved in controlled animal studies, utilizing a selective superior mesenteric artery infusion of vasopressin during abdominal irradiation. The success of this technique contrasts with the nonreliability of a combination of propranolol and epinephrine infused by the same route. The differences in efficacy of these two categories of vasoconstrictors may be related to differences in the locus of activity of vasopressin and propranolol-epinephrine in the mesenteric arterial tree.

Radiographic assessment of inverted papilloma.

Conclusion. Both CT and MRI defined the extent of histologically proven recurrent disease, although it was impossible to radiographically distinguish recurrent disease from postoperative scar tissue or mucoperiosteal thickening. Objective. A retrospective analysis of radiographic findings of patients with known inverted papilloma (IP) was performed to identify those characteristics that should prompt preoperative biopsy in patients with polypoid nasal masses. Materials and methods. The radiologic studies from a group of 77 patients with biopsy-proven IP of the nasal cavity or paranasal sinuses were reviewed. Fifty-three computed tomography (CT) scans, 17 cases of plain sinus radiography and 7 cases of magnetic resonance imaging (MRI) were analyzed. Results. Although no preoperative MRI examinations were available for comparison, CT was the most helpful study for evaluation of primary, nonrecurrent inverted papilloma. CT demonstrated disease-related abnormalities in 90% of studies. The finding of frequent unilateral bony remodeling was demonstrated in 43% of scans. Plain sinus X-rays were abnormal in 70% of cases of primary tumor, with all positive studies showing nonspecific unilateral opacification of the maxillary antrum.

Extrathoracic musculature mimicking pleural lesions.

The thoracic cage musculature can project over the lung fields in such a way as to mimic pleural-based densities on the posteroanterior chest radiograph. The characteristics of these muscular shadows and their differentiation from actual pleural lesions are described. This differentiation is of utmost importance in patients with suspected primary or metastatic malignancy.

Radiation protection of the normal kidney by selective arterial infusions

Successful unilateral renal radioprotection has been attained in 10 of 18 experimental animals receiving protracted and fractionated radiation to large abdominal fields and unilateral renal artery epinephrine infusions, including 6 of the last 7 animals so treated. In a pilot series of patients with Stage III ovarian malignancies who were treated in a similar manner with unilateral renal artery epinephrine infusions, successful unilateral renal radioprotection has also been achieved in 3 out of 5 evaluable patients (the other 2 patients received potentially nephritic radiation doses to both kidneys, but have not in fact developed radiation nephritis on either side). In a series of 10 experimental animals, production of temporary unilateral renal hypoxia during abdominal irradiation by the use of a balloon occlusion catheter has not proved reliable in effecting unilateral renal radioprotection. However, in a subgroup of 5 animals, the data suggest that simultaneous infusion of a vasoconstrictor combination into the superior mesenteric artery during irradiation may prevent morbidity and mortality from acute radiation enteritis, under the experimental conditions employed.

Thymoma Metastatic to Bone Report of a Case Diagnosed by Percutaneous Biopsy

Abstract A case of metastatic thymoma which presented as foci in the lung and in the right femur seven years after resection of a primary mediastinal thymoma is reported. The histological diagnosis was obtained through fluoroscopic biopsy.

A Woman Post Scalenectomy and First-Rib Resection With Dilated Vertebral Venous Plexus and a Facial Rash

Background Sickle cell disease (SCD) is found in many ethnic groups, with the highest prevalence of heterozygote carriers (sickle cell trait [SCT]) in African Americans. SCT is associated with an increased risk of fatal exertional heat illness, renal papillary necrosis, and splenic infarction. Since 2006, all infants born in the United States are required to be screened for hemoglobinopathies as part of newborn screening (NBS). In 2010, as part of a legal settlement, the National Collegiate Athletic Association (NCAA) implemented SCT screening in division I athletes.