Design specifications for a treatment stand used for total body photon irradiation with patients in a standing position.

One total body photon irradiation technique used to treat patients employs a standing treatment position and a horizontally directed high-energy photon field. This standing technique presents special problems, including keeping the patient immobile during treatment and offering protection from injury if the patient develops weakness or loss of consciousness due to either medication (anxiolytics, narcotics, or antiemetics) or other causes. In this article we describe a treatment stand designed to manage these problems and use effectively total body photon irradiation.

Managed care: imaging issues and impact.

The advent of managed care and capitation is dramatically changing our imaging management focus away from centralized inpatient services toward a decentralized ambulatory environment. In many ways, managed care is a response to an industry unwilling to meet the essential needs of its customers. Success in the new climate will depend on our ability to accept the reality of our future, strategically position our services and take absolute control of our costs.

Determination of a T/G polymorphism at nucleotide 3206 of the apolipoprotein C III gene by amplification refractory mutation system.

We used the amplification refractory mutation system (ARMS)--a polymerase-chain-reaction-based method--to determine the 3206 T-to-G polymorphism on exon 4 of the apolipoprotein (apo) C III gene. Apo C III is an inhibitor of the enzyme lipoprotein lipase (EC 3.1.

Chemoprophylaxis with oral ciprofloxacin in ovarian cancer patients receiving taxol.

The purpose of this study was to review the clinical outcomes and cost of administration of a prophylactic antibiotic compared to G-CSF for the prevention of neutropenic morbidity associated with taxol. The study group was composed of 62 patients with ovarian cancer who received a 24-h infusion of a taxol-based regimen at doses less than or equal to 175 mg/m2 between June 1992 and April 1994. The records were retrospectively reviewed and the patients were grouped and analyzed according to the management of their myelosuppression.

Chronic iliac artery occlusions: primary recanalization with endovascular stents.

Purpose: The authors describe treatment of chronic iliac artery occlusions with primary stent placement without prior thrombolysis or angioplasty.

Patients And Methods: Eight patients with chronic iliac artery occlusions (six men and two women) underwent primary stent placement without prior use of thrombolytic agents or angioplasty. Palmaz stents were placed in seven patients and a Wallstent device was placed in one.

Serial MR after bone marrow transplantation in two patients with metachromatic leukodystrophy.

Two children with metachromatic leukodystrophy underwent bone marrow transplantation. In both patients MR subsequently showed, first, white matter changes, then later, lack of change as the patients stabilized clinically.

Trauma to the cerebrovascular system.

Trauma to the cerebrovascular system can result in vascular injuries, such as dissection, pseudoaneurysm, thrombosis, rupture, and arteriovenous fistula. Although the diagnosis of vascular injury is usually considered in all cases of penetrating trauma, it may be overlooked in patients with nonpenetrating trauma. The possibility of vascular injury should be considered in all patients with head and neck trauma, especially those patients with acute or delayed neurologic dysfunction.

Embryology of the cerebral vasculature.

Although much remains to be learned about the embryology of the intracranial vasculature, much of the developmental pathways of the intracranial vascular system are now apparent. Understanding these pathways offers the potential to appreciate the nature of such arterial anomalies as the azygos anterior cerebral artery and the trigeminal artery and such venous anomalies as the vein of Galen malformation and the venous angioma.

Resting Tl-201 scintigraphy in the evaluation of coronary artery disease in children with Hurler syndrome.

Severe coronary artery disease may occur early in the course of mucopolysaccharidosis. The authors present radiologic, scintigraphic, and pathologic findings in five patients with Hurler syndrome. Thallium-201 myocardial scintigraphy and selective coronary angiography obtained within 2 days to 6 months were correlated in five patients.

Direct detection of the Philadelphia chromosome in CD20-positive lymphocytes in chronic myeloid leukemia by tri-color immunophenotyping/FISH.

Six patients with previously diagnosed chronic myelogenous leukemia (CML) were studied by a tri-color immunophenotyping/FISH method for direct determination of the Philadelphia (Ph) chromosome in B and T lymphocytes. Two patients had involvement of CD20-positive lymphocytes. CD3-positive lymphocytes in all patients were negative for the Ph chromosome.

Association of immunohistochemical staining for p53 with metastatic progression and poor survival in patients with renal cell carcinoma.

Background: Mutations of the p53 gene have been found in many types of human tumors. In some tumors, p53 gene mutations are associated with advanced disease and poor prognosis. There is wide variation in the reported incidence of p53 mutation in renal cell carcinoma, and its prognostic significance for this tumor is unknown.

Fluorescence in situ hybridization (FISH) detection of trisomy 8 in myeloid cells in chronic myeloid leukemia (CML): a study of archival blood and bone marrow smears.

Patients in accelerated phase or blast crisis of chronic myeloid leukemia (CML) frequently develop clonal cytogenetic abnormalities in addition to the Philadelphia chromosome. Using a DNA probe directed to the centromere of chromosome 8, we performed fluorescence in situ hybridization (FISH) on archival Wright-stained blood and bone marrow smears of seven patients with CML and with a known +8 clone by metaphase cytogenetics to determine the distribution of +8 in interphase cells. All slides had been stored at ambient temperature for 12-26 months.

Clonal determination by the fragile X (FMR1) and phosphoglycerate kinase (PGK) genes in hematological malignancies.

The polymerase chain reaction (PCR) clonality assay based on the principle of random X chromosome methylation in females provides a potentially important tool in both cancer research and diagnostics. This assay, however, has not been compared to the standard Southern blot assay and is limited by the rate of heterozygosity of the X-linked phosphoglycerate kinase (PGK) and androgen receptor genes, the only two genes yet described with which this technique may be used. Using 46 marrow and blood specimens from females with and without hematological malignancies, the PCR and Southern blot methods of clonality were compared.

Childhood cerebral form of adrenoleukodystrophy: short-term effect of bone marrow transplantation on brain MR observations.

Purpose: To report the serial brain MR observations in patients with childhood-onset cerebral adrenoleukodystrophy 1 to 2 years after bone marrow transplantation.

Methods: Eight boys with childhood-onset cerebral adrenoleukodystrophy have undergone successful transplantation at our institution. Seven patients (mean age, 8 years 10 months; range, 5 years 3 months to 11 years 9 months) had serial MR studies before and after transplantation.

Adrenoleukodystrophy: a scoring method for brain MR observations.

Purpose: To develop a scoring method for brain observations in patients with X-linked adrenoleukodystrophy.

Methods: One hundred seventy-five brain MR scans in 83 male subjects less than 20 years of age with proved biochemical defects were reviewed. A severity score (0 to 34), based on a point system derived from location and extent of disease and the presence of focal and/or global atrophy, was calculated for each exam.

The role of radiation therapy in the treatment of colorectal cancer. Implications for the older patient.

Radiation therapy plays an important role in the treatment of patients with colorectal cancer. Randomized trials show that patients with rectal cancer have an 8% improved local control rate with postoperative radiation and an 11-13% improved local control rate with combined postoperative radiation and chemotherapy. Survival is also improved for these patients.

Role of radiology in medical education: perspective of nonradiologists.

Rationale And Objectives: We asked our nonradiologist colleagues to evaluate and comment on the most desirable format for radiology education.

Methods: Questionnaires were distributed to 631 nonradiologist physicians affiliated with the University of Minnesota and representing all medical specialties and academic ranks. Three hundred twenty-seven surveys were returned after one mailing.

Value of routine pressure monitoring system changes after 72 hours of continuous use.

Objective: To assess the infection potential of not routinely changing invasive monitoring kits and associated plasticware.

Design: A prospective, observational study of microbiological contamination of a cohort of pressure monitoring infusion systems.

Setting: Adult intensive care units in a university tertiary care center.

Effects of long-term drugs on alfentanil clearance in patients undergoing renal transplantation.

Although patients in renal failure frequently take several drugs on a long-term basis, drug-induced alterations in alfentanil metabolism have not been examined as a possible source of variability in alfentanil clearance in this population. We compared the pharmacokinetics of alfentanil during renal transplantation in seven patients receiving and six not receiving long-term drug therapy. After the rapid intravenous injection of alfentanil 100 micrograms/kg during isoflurane anesthesia, plasma concentrations were measured at intervals up to 6 hours by radioimmunoassay.

In vitro metal fatigue testing of inferior vena cava filters.

Rationale And Objectives: Inferior vena cava filter fractures have been described in vivo on several occasions. No studies have compared the fatigue life of the different filter types. Four different, frequently used filters (Vena-Tech filters [VTF], stainless-steel Greenfield filters [SSGF], Simon nitinol filters [SNF], and titanium Greenfield filters [TGF]) were, therefore, tested with regard to fatigue life.

Effect of glycemic control on early diabetic renal lesions. A 5-year randomized controlled clinical trial of insulin-dependent diabetic kidney transplant recipients.

Objective: To determine whether optimized glycemic control in type I diabetic recipients of renal allografts will prevent or delay diabetic renal lesions in the allograft.

Design: Prospective, controlled, and randomized trial of glycemic control in an inception cohort of type I diabetic renal allograft recipients. The experimental group underwent maximized glycemic control, and the standard group was treated in the same way as other patients in the transplant clinic.