Double Application of TA-90 B Four-Row AutoSuture(c) Stapling Instrument: A Safe, Effective Method of Staple-line Production Indicated by Follow-up GI Series.

BACKGROUND: Controversy continues, concerning the best method of isolating upper and lower gastric pouches in Roux-Y gastric bypass. This paper reports a technique used from August 1991 through May 1996, in which there was a double application of the TA-90 B Four-Row AutoSuture Stapling Instrument to form the proximal gastric pouch. Because of a significant staple-line failure rate historically, many are separating the pouches.

Bone and liver images in medullary carcinoma of the thyroid gland: concise communication.

Thirty-four patients with surgically documented medullary carcinoma of the thyroid (MCT) and elevated serum calcitonin levels had Tc-99m phosphate bone and/or Tc-99m sulfur colloid liver images for suspected metastases. Liver images demonstrated metastatic lesions in nine of 32 patients (28%). Bone images were positive for metastases in eight of 30 patients (27%).

Review: Medullary carcinoma of the thyroid: radiographic features of a unique tumor.

Medullary carcinoma of the thyroid is a unique neoplasm characterized by consistent production of a hormonal marker, calcitonin, calcification of both primary and metastatic foci, and association with other endocrine neoplasms. It accounts for 3.5%--10% of all thyroid malignancies.

Roentgenographic abnormalities in Rocky Mountain Spotted Fever.

Rock Mountain spotted fever (RMSF) is a tick-borne rickettsial disease which produces a widespread vasculitis. A mortality of 7% to 13% has been reported in the United States which is due at least in part to delay in diagnosis and appropriate treatment. The classic features of this disease include a history of tick bite with the clinical presentation of skin rash and fever in association with thrombocytopenia.

Abdominal radiography in the emergency department: a prospective analysis.

We present a prospective analysis of 100 consecutive abdominal radiographs of 96 emergency patients who were referred to radiology with a variety of abdominal complaints. In patients with diffuse, nonspecific abdominal pain, nausea, vomiting, or gastrointestinal bleeding, 98% of the radiographs were negative or had positive findings which were unrelated to the current clinical problem. Ninety-three percent of the positive radiographs that were related to the acute problem occurred in patients with renal colic; hematuria; ingestion of foreign bodies; previously known surgical conditions, such as incarcerated hernias; intra-abdominal metastatic carcinoma; fecal impaction; or true acute abdominal syndromes.

Pulmonary alveolar proteinosis in children.

Three cases of childhood pulmonary alveolar proteinosis (PAP) are presented with emphasis on the radiographic findings on plain chest films and computed tomography. Three different radiographic patterns may be seen on chest radiography: (1) reticulonodular, (2) small acinar nodular mimicking miliary disease, and (3) coalescense of various-sized acinar nodules leading to focal consolidation. Absence of cardiomegaly, pleural effusions, or adenopathy are important differential points.

The value of serial plasma levels of carcinoembryonic antigen and gross cyst disease fluid protein in patients with breast carcinoma and osseous metastases.

Serial plasma levels of the glucoprotein tumor markers carcinoembryonic antigen (CEA) and gross cyst disease fluid protein (GCDFP) were evaluated in 83 patients undergoing treatment for predominant osseous metastases from breast carcinoma. Abnormal plasma levels of CEA (greater than 10 ng/ml) and/or GCDFP (greater than 150 ng/ml) were observed in 53 (63.8%) subjects.

The value of radionuclide bone imaging in selected patients with osteogenic sarcoma metastatic to lung.

Bone scintigraphic findings are presented in three pediatric patients with osteogenic sarcoma metastatic to lung. The bone imaging radionuclide was concentrated to a variable degree within the pulmonary metastases. Radionuclide bone imaging was valuable in confirming the presence of metastatic disease to lung in two patients and diagnosing previously unsuspected pulmonary metastatic disease in one patient.

Retropharyngeal masses in infants and young children.

Six patients are described who illustrate different causes of retropharyngeal mass lesions in infants and young children. Differential diagnosis, clinical history, physical examination, and adequate roentgenographic evaluation of the neck are important.

Streptococcal skeletal infections: observations in four infants.

The radiographic findings and clinical presentations of four patients with group B beta hemolytic streptococcal osteomyelitis and pyoarthritis are described. Radiographic features, though not specific, are similar in these patients and others reported in the literature. The combination of radiographic patterns and clinical presentations in children of this age group should alert clinicians and radiologists to the possibility of infection with this organism.