The authors reviewed mammograms and/or ultrasound (US) scans of 76 lesions (67 patients) suspected of being recurrent breast cancer. All patients had previously undergone mastectomy. Sixty-one cases were malignant disease and 15 were benign. Mammography and US were complementary to clinical examination in evaluating palpable lesions at the mastectomy site. Both imaging methods revealed nonpalpable recurrences. The sensitivity of US was 91%, whereas the sensitivities of clinical examination and mammography were 79% and 45%, respectively. US was the best imaging method for evaluating tumors in the chest wall far from the scar and in the axilla, as these could not be visualized on mammograms. Most recurrent cancers were seen as circumscribed masses at mammography and as hypoechoic lesions at US. Hyperechoic recurrences could not be differentiated from benign lesions. The value of early detection of recurrences with imaging methods remains to be seen.
The majority of the adolescent and young adult patients (59.4%) with a previous paediatric lateral humeral condylar fracture had recovered well and showed good or excellent overall outcomes according to Flynn's criteria for elbow assessment after a mean of 12.4 years post-injury. Long-term sequelae was unchanged regardless of treatment.
We evaluated the performance of low-field MRI in breast disorders by comparing it with high-field MRI and biopsy results. Twenty-eight consecutive patients who were able to undergo two magnetic resonance examinations on following days were examined by high-field and low-field MRI. After T1-weighted sagittal images had been obtained a dynamic 3D axial study was performed followed by the acquisition of contrast-enhanced T1-weighted sagittal images. The images were analyzed separately by two radiologists paying attention to lesion morphology and enhancement kinetics. Six patients had problems in both breasts (34 breasts studied). The results were compared with biopsy results of 27 breasts. There were 16 malignant lesions, two fibroadenomas and nine other benign lesions. The inter-magnetic-resonance-scanner kappa value was 0.77 (substantial agreement), while the interobserver kappa value was 0.86 and 0.81 at low and high field, respectively (excellent agreement). The sensitivity was 100 and 100%, the specificity was 82 and 73% and the accuracy was 93 and 89% at low and high field, respectively. The mean lesion size was 2 cm and the smallest malignant lesion was 8 mm in diameter. Low-field MRI is a promising tool for breast imaging. Larger materials and smaller lesions are needed to evaluate its true sensitivity and specificity.
We report a defined pattern of long-term ulnar nerve morbidity after pediatric supracondylar humeral fracture. The prevalence of neuropathy is alarming in the young population (<25 years of age).
Twenty-nine consecutive patients with stress urinary incontinence were investigated by bead chain urethrocystography (UCG) and single cough urethrocystometry before operation and 8-12 months after a Burch colposuspension producing clinical improvement. The operation significantly elevated the bladder neck and reduced its mobility during acute stress. The urethral inclination angle and the posterior urethrovesical angle also became smaller at rest and on straining. A significant negative correlation was found between the postoperative mobility of the bladder neck and the post-operative pressure transmission ratio (PTR), indicating that correction of the urethrovesical anatomical disorder eliminates the functional disorder in this disease and restores continence.
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