Extended field-of-view two-dimensional ultrasonography of the breast: improvement in lesion documentation.

The purpose of this study was to evaluate the use of extended field-of-view two-dimensional ultrasonographic imaging for improvement in overall breast lesion documentation. Sonographic images of 59 patients with breast lesions or silicone implants were evaluated by three radiologists retrospectively to compare traditional static linear array images alone with images obtained with the addition of an extended field of view to determine if documentation of lesions was improved. The addition of extended field-of-view imaging improved lesion conspicuity by 21% over traditional images. It provided overall improvement in lesion documentation by including a reference point (nipple) or by more completely imaging large masses in 79% and implants in 69%. The larger field of view of this technique is promising as an adjunct to traditional sonography for breast lesion documentation.

Patient compliance in mobile screening mammography.

RATIONALE AND OBJECTIVES: We assessed the follow-up behavior of women who had abnormal results of screening mammograms taken on a mobile van. METHODS: A retrospective cohort study was conducted between 1988 and 1991 of all women served by a mobile mammography van in rural North Carolina. Compliance with radiologist recommendations for follow-up was assessed through review of patient records and mail surveys of patients with incomplete records. RESULTS: Compliance was 44% for negative or benign mammograms, 57% for indeterminate mammograms, and 62% for probably malignant or malignant mammograms. Women who had a previous mammogram or had a malignant finding were more likely to comply with follow-up recommendations (p < .0001) than women with normal or benign results and no history of mammography. Compliers and noncompliers did not differ with respect to family history of breast cancer or personal history of breast discomfort. CONCLUSION: Compliance with recommendations in this setting was lower than expected. This may be because rural women using mobile van mammography have limited access to the resources needed for appropriate follow-up. Further research is needed to examine explanations for poor compliance in this setting.

Diagnostic and prognostic value of bromide partition test in tuberculous meningitis.

Bromide partition ratio was determined in 32 cases of tuberculous meningitis, 6 pyogenic meningitis, 8 viral meningitis and 9 cases of febrile convulsions. Bromide partition ratio below the critical value of 1.6 was present in 30 out of 32 tuberculous meningitis patients (93.74%) whereas all the control children had a ratio above 1.6. Two children who were on regular chemotherapy showed progressively rising ratio. It is concluded that in doubtful cases with inconclusive CSF picture, a low bromide partition ratio is a strong reason for starting antituberculous treatment without any delay. A very low ratio also suggests poor prognosis.

Hemiplegia and retrobulbar neuritis after subarachnoid block.

A 25 year old man was given a subarachnoid anaesthetic for repair of hydrocele. He developed left-sided hemiplegia and retrobulbar neuritis three hours after the procedure. He recovered 45 days later after steroid therapy. There was some residual neurological deficit. The differential diagnosis is discussed.