Osteopetrosis in the pediatric patient: what the radiologist needs to know.

Osteopetrosis describes several types of rare sclerosing bone dysplasias of varying clinical and radiographic severity. The classic autosomal dominant subtype emerges most often in adolescence but can present from infancy through adulthood. The autosomal recessive osteopetrosis, or "malignant infantile osteopetrosis," presents in infancy with a grimmer prognosis, though the autosomal dominant forms (often mislabeled as "benign") actually can have life-threatening consequences as well.

Contemporary Outcomes of Transduodenal Sphincteroplasty: the Importance of Surgical Quality.

Background: Sphincter of Oddi dysfunction (SOD) is managed primarily by endoscopic sphincterotomy (ES); however, surgical transduodenal sphincteroplasty (TDS) is a treatment option for select patients. In our high-volume pancreatico-biliary practice, we have observed variable outcomes among TDS patients; therefore, we sought to determine preoperative predictors of durable improvement in quality of life.

Methods: SOD patients treated by TDS between January 2006 and December 2015 were studied.

Starting an Emergency Radiology Division: Scheduling and Staffing, Compensation, and Equity and Parity.

Establishing an emergency radiology division in a practice that has long-standing patterns of operational routines comes with both challenges and opportunities. In this article, considerations around scheduling and staffing, compensation, and equity and parity are provided with supporting literature references. Furthermore, a panel of experts having established, grown and managed emergency radiology divisions in North America and Europe share their experiences through a question and answer format.

Imaging of Treated Thyroid and Parathyroid Disease.

The thyroid and parathyroid glands are endocrine structures located in the visceral space of the infrahyoid neck. Imaging plays a critical role in the evaluation of patients with thyroid cancer, both in the pre and posttreatment setting. Disorders of thyroid function, that is, hyperthyroidism and hypothyroidism, are also fairly common, although imaging utilization is less frequent with these conditions.

Short- and Long-Term Outcomes Associated with Large for Gestational Age Birth Weight.

Large for gestational age birth weight is associated with adverse short- and long-term outcomes. Infants born with large for gestational age birth weight are at increased risk for neonatal intensive care unit admission, respiratory distress, neonatal metabolic abnormalities including hypoglycemia, birth trauma, and even stillbirth or neonatal death. The risk for many of these complications increases with higher birth weights.

Chronic Lateral Ankle Instability: Open Surgical Management.

Open surgical reconstruction for chronic lateral ankle instability is a proven and effective means of providing renewed stability. Ankle arthroscopy is recommended before reconstruction to address intra-articular pathology. The open procedure discussed is well researched and proven to restore stability and the ability to return to sport and daily activity.

Cyclic Change of Sphincter of Oddi Motility and Its Relationship with Small Bowel Migrating Motor Complex in Humans.

Background: Several animal and human studies have reported that sphincter of Oddi (SO) motility shows cyclical changes during the fasting state. However, to date, the relationship between the SO motility and the migrating motor complex (MMC) of the small bowel (SB) remains unclear in humans.

Aims: We observed SO motility over a long study period and evaluated its relationship with the MMC of the SB in humans using percutaneous long-term manometry.

Do Surgical Margins Affect Local Recurrence and Survival in Extremity, Nonmetastatic, High-grade Osteosarcoma?

Background: Long-term survival for all patients with osteosarcoma using current aggressive adjuvant chemotherapy and surgical resection is between 60% and 70%. In patients who present with nonmetastatic, high-grade extremity osteosarcoma of bone, limb salvage surgery is favored, when appropriate, over amputation to preserve the limb, because limb salvage may lead to a superior quality of life compared with amputation. However, concern remains that in the attempt to preserve the limb, close or microscopically positive surgical margins may have an adverse effect on event-free survival.

Colonoscopy: the current king of the hill in the USA.

Colonoscopy is the dominant colorectal cancer screening strategy in the USA. There are no randomized controlled trials completed of screening colonoscopy, but multiple lines of evidence establish that colonoscopy reduces colorectal cancer incidence in both the proximal and distal colon. Colonoscopy is highly operator dependent, but systematic efforts to measure and improve quality are impacting performance.

Microsphere localization and dose quantification using positron emission tomography/CT following hepatic intraarterial radioembolization with yttrium-90 in patients with advanced hepatocellular carcinoma.

Purpose: To characterize the distribution of absorbed radiation dose after glass microsphere radioembolization for hepatocellular carcinoma (HCC) using yttrium-90 ((90)Y) positron emission tomography/computed tomography (PET/CT).

Materials And Methods: In this retrospective study, 64 (90)Y PET/CT scans performed after treatment were evaluated following (90)Y glass-bead radioembolization in patients with advanced HCC. The intended dose to the target volume ranged from 83-129 Gy.

ERCP via gastrostomy vs. double balloon enteroscopy in patients with prior bariatric Roux-en-Y gastric bypass surgery.

Background: Roux-en-Y gastric bypass (RYGB) is the most common bariatric surgery. The performance of ERCP in bariatric RYGB is challenging due to the long Roux limb. We herein compared the indications and technical outcomes of ERCP via percutaneous gastrostomy (GERCP) and double balloon enteroscopy (DBERCP) for patients with prior bariatric RYGB anatomy.

A 75-year-old female with hemoptysis and recurrent respiratory infections.

This paper describes the case of a 75-year-old female who presented with significant hemoptysis over a 7-10 day period. She had a history of a left lower lobectomy 10 years prior for a "lung abscess." She subsequently had multiple episodes of cough, fevers, and possible pneumonia treated with multiple courses of Amoxicillin and Amoxicillin/Clavulanate.

Hyperglycemia-induced oxidative stress is independent of excess abdominal adiposity in normal-weight women with polycystic ovary syndrome.

Study Question: What is the effect of glucose ingestion on leukocytic reactive oxygen species (ROS) generation in normal-weight women with polycystic ovary syndrome (PCOS) with and without excess abdominal adiposity (AA)?

Summary Answer: Normal-weight women with PCOS exhibit an increase in leukocytic ROS generation in response to glucose ingestion, and this increase is independent of excess AA.

What Is Known Already: Excess adipose tissue is a source of oxidative stress. Normal-weight women with PCOS exhibit oxidative stress and can have excess AA.

Hyperandrogenism exerts an anti-inflammatory effect in obese women with polycystic ovary syndrome.

We determined the effect of chronic androgen suppression on inflammation in women with polycystic ovary syndrome (PCOS) compared to weight-matched controls. We performed a pilot project using samples from previous prospective, controlled studies. Nine women with PCOS (5 obese, 4 lean) and 9 ovulatory controls (5 obese, 4 lean) participated in the study.

Deep sedation in natural orifice transluminal endoscopic surgery (NOTES): a comparative study with dogs.

Background: Natural orifice transluminal endoscopic surgery (NOTES) has been mostly performed with the animal under general and inhalational anesthesia (IA-NOTES). To date, NOTES using propofol sedation (PS-NOTES) has not been investigated. This study aimed to assess the feasibility and safety of PS-NOTES for transgastric oophorectomy with carbon dioxide insufflation and to compare its success rates with those of conventional IA-NOTES.

Improving protection against proximal colon cancer by colonoscopy.

Colonoscopy protection against proximal cancer can be achieved, but the level of protection has thus far been less than left colon protection. Improved proximal protection begins with effective right colon bowel preparation, best achieved by split dosing the preparation regimen. Cecal intubation in screening examinations should exceed 95%, and must be documented by photography.

Early steroid withdrawal in repeat kidney transplantation.

Background And Objectives: Kidney re-transplantation (KRT) candidates are considered at high risk for graft failure. Most of these patients are kept on a chronic steroid maintenance (CSM) regimen. The safety of early steroid withdrawal (ESW) remains unanswered in KRT.

Initial development of the Temporary Utilities Index: a multiattribute system for classifying the functional health impact of diagnostic testing.

Purpose: The effects of testing and screening on quality of life may influence the future behavior of society, but have not been quantified. We derived a health classification and survey items for the morbidities of testing and screening, to be the foundation of a multiattribute utility instrument, the Temporary Utilities Index.

Methods: Seventy-six women ranked the importance of attributes of the testing process after breast biopsy.

Predictors of depth of maximal insertion at double-balloon enteroscopy.

The aim of this study was to determine the factors predictive of the depth of maximal insertion (DMI) at double-balloon enteroscopy (DBE). Eligible patients from the DBE database at our institution were stratified based on their anterograde or retrograde approach. The factors predictive of the DMI were calculated using ANOVA, Spearman, univariate, and multivariate regression analysis.

Choledocholithiasis, ascending cholangitis, and gallstone pancreatitis.

Gallstone disease is encountered commonly in clinical practice. The diagnosis of biliary stones has become less problematic with current, less-invasive imaging methods. The relatively invasive endoscopic techniques should be reserved for therapy and not used for diagnosis.

An overview of endoscopic ultrasound equipment.

Endoscopic ultrasound imaging technology has significantly improved over the last decade. Innovative design of equipment and devices has broadened the utility of EUS as diagnostic and therapeutic tools. Lesions as small as 3 mm can be imaged and targeted for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA).

Colonoscopy-induced splenic injury: report of 3 cases and literature review.

Background: Since its first report in 1974, 66 cases of splenic injury after colonoscopy have been reported in the world literature. Splenic injury is among the rarest complications of colonoscopy. However, it can be associated with severe morbidity and has rarely been fatal.