Postresection CA19-9 and margin status as predictors of recurrence after adjuvant treatment for pancreatic carcinoma: Analysis of NRG oncology RTOG trial 9704.

Purpose: NRG Oncology RTOG 9704 was the first adjuvant trial to validate the prognostic value of postresection CA19-9 levels for survival in patients with pancreatic carcinoma. The data resulting from this study also provide information about predictors of recurrence that may be used to tailor individualized management in this disease setting. This secondary analysis assessed the prognostic value of postresection CA19-9 and surgical margin status (SMS) in predicting patterns of disease recurrence.

The use of routine non density calibrated clinical computed tomography data as a potentially useful screening tool for identifying patients with osteoporosis.

Objectives: To evaluate whether lumbar vertebral body density CT attenuation values measured in Hounsfield Units (HUs) on routine Computed Tomography (CT) examinations can be reliably measured with limited variability, and to evaluate for a correlation between HUs and bone mineral density as measured by dual energy X-ray absorptiometry (DXA) scan.

Methods: Retrospective review of a total of 249 routine MDCT examinations, performed to measure HUs at the first non-rib bearing lumbar vertebral body on axial images, cross-referenced to the lateral scout image.

Results: The overall ICC and RC for intra-reader variability on CT HU were 0.

Wartime toxin exposure: recognising the silent killer.

Wartime toxin exposures have been implicated in the genesis of malignancy in war veterans. Agent Orange, one toxin among many, has been linked to malignancy and the subcomponent phenoxyacetic acid has been associated with soft tissue sarcomas (STSs). This case demonstrates the association between a wartime toxin exposure (Agent Orange) and subsequent cancer development.

Radiographic scoring system to evaluate union of distal radius fractures.

Purpose: To evaluate the intra- and interobserver reliability of a scoring system for distal radius fracture union based on specific radiographic parameters obtainable from x-rays.

Methods: Two sets of 35 anteroposterior and lateral x-rays were obtained by retrospective review of consecutive patients with distal radius fractures (AO types A and C) treated by a single surgeon in 2009. One set was assembled for those patients treated nonsurgically and 1 set for those treated with open reduction and internal fixation (ORIF) with volar plating.

Image guided core needle biopsy of musculoskeletal lesions: are nondiagnostic results clinically useful?

Background: The clinical utility of nondiagnostic core needle biopsies is not fully understood. Understanding the clinical and radiologic factors associated with nondiagnostic core needle biopsies may help determine the utility of these nondiagnostic biopsies and guide clinical decision making.

Questions/purposes: We asked (1) whether benign or malignant bone and soft tissue lesions have a higher rate of nondiagnostic core needle biopsy results, and which diagnoses have the lowest diagnostic yield; (2) how often nondiagnostic results affected clinical decision-making; and (3) what clinical factors are associated with nondiagnostic but useful core needle biopsies.

Angiosarcoma of the thyroid: a case report with review of the literature.

Angiosarcoma is a rare and aggressive tumor of the thyroid gland, mainly seen in the Alpine regions. We present such a case with literature review. We present the case of a 60-year-old man with cough, dyspnea, and hemoptysis along with slow increase in the size of his long-standing goiter.

On-call musculoskeletal radiographs: discrepancy rates between radiology residents and musculoskeletal radiologists.

Objective: The purpose of this study was to determine the rate of discrepancy between radiology residents and attending musculoskeletal radiologists in interpretation of on-call musculoskeletal radiographs.

Materials And Methods: We performed a retrospective review of 2219 consecutive musculoskeletal radiology reports on patients who visited the emergency department between January 2009 and December 2010. The images were initially interpreted overnight by on-call residents (postgraduate years 3-5), and a final interpretation was rendered the next morning by a musculoskeletal radiologist.

Pseudotear of the peroneus longus tendon on MRI, secondary to a fibrocartilaginous node.

Objective: The purpose of this study was to identify the presence of a fibrocartilaginous node within the distal peroneus longus tendon (PLT) just proximal to the cubital tunnel and correlate this with MRI signal characteristics of the distal PLT, which could result in a pseudotear appearance on MRI. We correlated imaging characteristics with pathologic specimens.

Materials And Methods: Institutional review board approval was obtained.

Image-guided stereotactic radiosurgery for locally advanced pancreatic adenocarcinoma results of first 85 patients.

Background: Locally advanced unresectable pancreatic adenocarcinoma is characterized by poor survival despite chemotherapy and conventional radiation therapy (RT). Recent advances in real-time image-guided stereotactic radiosurgery (SRS) have made it possible to treat these cancers in two to four fractions followed by systemic chemotherapy.

Aims: The aims of this study includes the following: (1) obtain local control of the disease; (2) improve the survival of these unresectable patients; (3) evaluate the toxicity of SRS; and (4) report results of the largest series from a single center.

A young patient with polyarthralgia and hearing loss: a case report of Muenke syndrome.

There are few reports of the typical radiographic findings in the hands and feet of patients with Muenke syndrome. We present a case report of a young girl with Muenke syndrome, whose diagnosis was made following the observation of coalitions and coned epiphyses on hand radiographs.

Phase II trial of CI-980 in patients with disseminated malignant melanoma and no prior chemotherapy. A Southwest Oncology Group study.

Malignant melanoma is increasing in frequency at a rapid rate in the United States. Metastatic disease is chemoresistant with DTIC considered the most active single agent. CI-980 is a synthetic mitotic inhibitor that blocks the assembly of tubulin and microtubules.

Diagnostic accuracy of simpson atherectomy catheter biopsy in detecting pancreaticobiliary malignancy.

Objective: Impressive advances have been made in imaging the biliary tree by various modalities in the last few decades. However, the histological diagnosis of stenosing lesions in the biliary ductal system has remained difficult and unreliable. Application of Simpson atherectomy catheter biopsy in obtaining accurate histological diagnosis of bile duct lesions appears promising.

Hepatic resection using intermittent vascular inflow occlusion and low central venous pressure anesthesia improves morbidity and mortality.

Hepatic resection results in significant morbidity and mortality primarily related to intraoperative blood loss. Intermittent vascular inflow occlusion (VO) and low central venous pressure (CVP) during hepatectomy have been used to reduce blood loss. To determine the benefit of VO and low CVP, we reviewed the outcomes of 168 consecutive patients who underwent liver resection.

Pharmacokinetics of dacarbazine in the regional perfusion of extremities with melanoma.

Background: The pharmacokinetics of dacarbazine (DTIC), which has been shown to be an effective therapeutic agent against metastatic melanoma, has not been extensively studied. However, to improve the clinical use of the drug, more information on the kinetics is required.

Methods: A pharmacokinetic study was undertaken in six patients with melanoma of an extremity who were undergoing hyperthermic isolation perfusion with DTIC in order to understand better its clinical pharmacokinetics.

Immediate mandibular stabilization following resection of advanced oral cavity carcinoma using the Joe Hall Morris external fixation device.

Internal mandibular fixation after resection of advanced oral cavity carcinoma with mandibulectomy has a significant complication rate. We placed the Joe Hall Morris (JHM) external mandibular appliance in 29 patients undergoing mandibulectomy for advanced oral cavity carcinoma. Fourteen patients received postoperative radiation therapy (RT).

Use of an instrument-holding clip for deeply recessed anastomoses of the rectum and esophagus.

Posterior layer closure of deeply located anastomoses including those performed in the course of low anterior rectal resection, total gastrectomy, and esophagogastrectomy, are often difficult. Usually five to six seromuscular or through-and-through posterior wall sutures are inserted sequentially and the loop or cut end of bowel is advanced over these parallel sutures. The sutures are then tied down.

Long-term results of a combined modality approach in treating inflammatory carcinoma of the breast.

Twenty-eight patients with inflammatory carcinoma of the breast were managed initially by induction chemotherapy consisting of 3 courses of a combination of cyclophosphamide, doxorubicin hydrochloride, and 5-fluorouracil. Twenty-two showed a partial response, and 21 underwent mastectomies. Histopathologic examination of the surgical specimens revealed no residual tumor in 2 breasts, but all 21 patients had residual metastases in their axillary lymph nodes.

A protocol for the safe administration of debrisoquine in biochemical epidemiologic research protocols for hospitalized patients.

The genetically determined ability to metabolize the antihypertensive drug debrisoquine has been proposed as a genetic risk factor for primary carcinomas of the lung. To test this hypothesis, the metabolism of the drug was evaluated in a case control study. The subjects were characterized by their ability to metabolize debrisoquine after receiving a test dose of the drug followed by the collection of an 8-hour urine sample.

Squamous cell carcinoma of the umbilicus associated with acquired immune deficiency syndrome.

A variety of malignancies, including hematologic malignancies, Kaposi's sarcoma, as well as adenocarcinomas and squamous cell carcinoma have been reported in association with acquired immune deficiency syndrome. Tumors of the umbilical area are unusual and can represent lesions of urachal origin. These may require extensive resection and are associated with a poor prognosis.

Prognostic factors in squamous cell carcinoma of the larynx.

One hundred fifty-two patients with squamous cell carcinoma of the larynx were studied. The disease-free survival and overall survival rates were correlated to 12 variables. Seven of them seemed to affect survival.

Flow cytometric DNA analysis of primary and concurrent metastatic squamous cell carcinoma of the head and neck.

Adequate flow cytometric DNA analysis comparing primary and concurrent metastatic squamous cell carcinoma of the head and neck has not been done in the past. The purpose of this study was to define any differences between the primary and concurrent metastasis of each patient with respect to flow cytometric parameters and histologic grade. Paraffin-embedded archival specimens from 28 patients with primary and metastatic tumors were prepared into nuclei and analyzed by flow cytometry using human lymphocyte standards.