Breast neoplasms: duplex sonographic imaging as an adjunct in diagnosis

Sonographic breast imaging has been useful in the differentiation of cystic from solid masses. It has also been helpful in the characterization of palpable breast masses in the absence of corresponding abnormalities. The authors undertook a prospective study that incorporated pulsed Doppler analysis into sonographic real-time imaging of solid breast masses. Thirty-eight patients were examined. In 12 of the patients there were positive Doppler signals, while in 26 patients there were no Doppler signals. The 12 patients showing positive Doppler signals proved to have infiltrating ductal carcinoma, while the 26 patients with negative Doppler signals proved to have benign breast disorders. Pulsed Doppler analysis as a supplement to sonographic real-time imaging shows promise for the identification of breast carcinoma.     

Carcinoma of the breast: detection with MR imaging versus xeromammography

Detectability of breast cancer with magnetic resonance (MR) imaging versus xeromammography was quantitatively compared. MR images were obtained of breasts of 120 women who underwent xeromammography. T1 values were determined for masses larger than 2 cm. Cancer was histologically confirmed in 39 breasts and was considered excluded from 81 due to results of biopsy, cyst aspiration, or sonography or absence of change in xeromammographic findings over time. Images were blindly interpreted by three observers, and results were expressed as receiver operating characteristic curves. Detectability of breast cancer was substantially better with xeromammography than with MR imaging for all observers (P less than .03, 10(-6), and .001). On MR images, spiculation of a mass, distorted architecture, skin thickening, and nipple or skin retraction were specific but relatively insensitive indicators of cancer. Masses with smooth, distinct margins and signal intensity greater than that of fat on T2-weighted images were always benign. Other findings and T1 values were not diagnostically useful. The authors conclude that xeromammography is superior to MR imaging in detection of breast cancer.     

AIDS awareness in the conduct of radiologic procedures: guidelines to safe practice

The epidemic of the acquired immunodeficiency syndrome (AIDS) has affected all geographic regions of the United States. Indeed, it is likely that a majority of U.S. hospitals have cared for patients who are infected with the human immunodeficiency virus (HIV), the virus that causes AIDS. More than 46,000 individuals with HIV infection have fulfilled the strict diagnostic criteria for AIDS (1). All of these patients with AIDS have been seriously ill and have been hospitalized, often multiple times and for prolonged periods. Another, larger group patients with HIV infection has had another form of the disease, the so-called AIDS-related complex. Many of these patients have also spent time in hospitals. An even larger group of individuals has been infected with HIV but has remained asymptomatic to date. Some of these persons have been admitted to hospitals or have received outpatient diagnostic procedures for intercurrent medical or dental complaints that were unrelated to their asymptomatic HIV infection. At the time of their medical evaluation, some of these asymptomatic individuals were known to have a positive HIV antibody test. It is likely, however, that the serologic status of the majority of asymptomatically infected patients was unknown. Thus, by now a very large number of health-care personnel in the United States, including diagnostic radiology staff, have assisted in the care of HIV-infected patients.     

The effects of fasting on body composition, glucose turnover, enzymes and metabolites in the chicken

Chickens (1,200 g) were fasted 1, 4, or 8 days. Significant decreases occurred in total body protein and fat with fasting, with the greatest energy loss from fat. Glucose production determined with either [2-3H] or [6-3H] glucose injected simultaneously with [U-14C] glucose remained constant with fasting at 10 to 13 mg/minute/kg body weight which is much higher than reported for mammals. Blood lactate and glycerol were unchanged with fasting, while pyruvate increased and plateaued. Plasma alanine, serine and glycine levels were extremely high compared to values in fasted mammals. Blood beta-hydroxybutyrate increased dramatically with fasting (350 to 3,500 nm/ml), while acetoacetate remained constant. The hepatic lactate: pyruvate ratio was unchanged with fasting, while the beta-hydroxybutyrate:acetoacetate ratio increased. These ratios have been reported to influence phosphoenolpyruvate (PEP) and glucose production in mammals. Hepatic and renal phospyoenolpyruvate carboxykinase (PEPCK) levels remained constant, while hepatic lactate dehydrogenase increased with fasting. Beta-Hydroxybutyrate dehydrogenase levels were very low at all times. The results indicate little glucose sparing adaptation per kg in the fasting chicken.