Acute cholecystitis: MR findings and differentiation from chronic cholecystitis.

Purpose: To retrospectively determine the sensitivity and specificity of magnetic resonance (MR) imaging for differentiation between acute and chronic cholecystitis, with histopathologic analysis as the reference standard.

Materials And Methods: Institutional review board approval with waived informed consent was obtained for this HIPAA-compliant study. Four reviewers blinded to the cholecystitis type but aware that cholecystitis was present retrospectively evaluated MR images for predetermined findings in 32 patients (15 male, 17 female; mean age +/- standard deviation, 55 years +/- 20) with histopathologically proved acute or chronic cholecystitis.

Splenic sarcoidosis.

Sarcoidosis is a multisystem granulomatous disease of unknown cause that can produce either homogeneous splenomegaly or multiple splenic nodules. Systemic symptoms can accompany splenic involvement. Although the chest radiograph may be suggestive of sarcoidosis, a normal chest radiograph is seen in one quarter to one third of patients with splenic sarcoidosis.

Randomized controlled trial of reduced-dose bolus fluorouracil plus leucovorin and irinotecan or infused fluorouracil plus leucovorin and oxaliplatin in patients with previously untreated metastatic colorectal cancer: a North American Intergroup Trial.

Purpose: Previously, we reported results of Intergroup N9741, which compared standard bolus fluorouracil (FU), leucovorin, plus irinotecan (IFL) with infused FU, leucovorin, plus oxaliplatin (FOLFOX4) and irinotecan plus oxaliplatin in patients with untreated metastatic colorectal cancer. High rates of grade > or = 3 toxicity on IFL (resulting in some deaths) led us to reduce the starting doses of both irinotecan and FU by 20% (rIFL). This article compares rIFL with FOLFOX4.

Fetal abdomino-perineal lymphangioma: differential diagnosis and management.

Fetal lymphangiomas are rare congenital anomalies of the lymphatic system most commonly presenting in the head and neck. Cystic abdominal lymphangiomas are more rare with only a few cases reported prenatally. We report a case of a prenatally detected abdomino-perineal lymphangioma that mimicked the more fatal prenatally detected sacrococcygeal teratoma (SCT), which resulted in one caregiver suggesting termination of the pregnancy.

Staged sentinel lymph node biopsy before mastectomy facilitates surgical planning for breast cancer patients.

Background: In patients with breast cancer who choose mastectomy with immediate reconstruction, the sentinel lymph node (SLN) status on permanent histology may complicate treatment if a metastasis is found. The purpose of this study was to determine how performing an SLN biopsy (SLNB) before the definitive operation would influence subsequent surgical procedures.

Methods: Our SLN database was searched for patients who underwent staged SLNB with subsequent mastectomy between 2001 and 2004.

MRI of acute abdominal and pelvic pain in pregnant patients.

Objective: The purpose of this study was to show the usefulness of MRI in the evaluation of pregnant women with acute abdominal or pelvic pain.

Subjects And Methods: All MRI studies of pregnant patients who were referred for examination because of acute abdominal or pelvic pain between June 2002 and May 2004 were included in this study (n=29). The use of MRI was at the discretion of the clinician.

High-resolution axillary ultrasound is a poor prognostic test for determining pathologic lymph node status in patients undergoing neoadjuvant chemotherapy for locally advanced breast cancer.

Background: The purpose of this study was to evaluate the efficacy of high-resolution axillary ultrasound in detecting axillary lymph node metastases after neoadjuvant chemotherapy in patients with locally advanced breast cancer.

Methods: Fifty-three patients with stage II or III breast cancer undergoing neoadjuvant chemotherapy who had a physical examination, high-resolution axillary ultrasound, and axillary lymph node dissection from January 1999 to September 2003 were included in this study.

Results: The positive predictive value of the postchemotherapy ultrasound for predicting pathologic nodal involvement was 83%, but the negative predictive value was only 52%.

Inflammatory myofibroblastic tumor of the hepatobiliary system: report of MR imaging appearance in four patients.

The purpose of this report is to describe the magnetic resonance (MR) imaging features of hepatic inflammatory myofibroblastic tumor (IMT). Two observers retrospectively analyzed images from six MR imaging examinations in four consecutive patients. Tumor location, size, extent, morphology, and number; signal intensity on nonenhanced images; enhancement pattern on serial gadolinium-enhanced images; duct wall thickness; and presence of biliary dilatation, vascular invasion, and lymphadenopathy were assessed.

Chemoradiation for locally advanced squamous cell carcinoma of the head and neck for organ preservation and palliation.

Objectives: To measure the efficacy and toxic effects of our chemoradiotherapy regimen by means of response and survival in patients with advanced squamous cell carcinoma of the head and neck (HNSCC) for organ preservation in resectable disease or palliation in unresectable disease.

Design: All patients underwent evaluation by the multidisciplinary head and neck cancer team, with pathological diagnosis and staging. All patients underwent assessment for response to therapy using results of physical examination and radiologic imaging.

Superior mesenteric vein thrombosis with radiologically occult cause: a retrospective study of 43 cases.

Objective: Our purpose was to examine the clinical presentation, imaging appearance, etiology, and clinical outcome in patients who had acute thrombosis of the superior mesenteric vein with radiologically occult cause.

Conclusion: The most common predisposing factors in superior mesenteric vein thrombosis with radiologically occult cause are recent abdominal surgery, infection, and hypercoagulable states. Although no correlation was noted between risk factor and outcome, the presence of bowel wall thickening and mesenteric congestion on CT or MR imaging was associated with the development of bowel ischemia.

Access to palliative care and hospice in nursing homes.

Nursing homes are the site of death for many elderly patients with incurable chronic illness, yet dying nursing home residents have limited access to palliative care and hospice. The probability that a nursing home will be the site of death increased from 18.7% in 1986 to 20.