The purpose of this study was to investigate whether the four-fold magnification mammography (direct magnification, DIMA) technique would perform better than conventional 1.5-fold magnification mammography in the differentiation of breast microcalcifications into benign and malignant. Fifty patients with non-palpable microcalcifications detected by mammography were examined immediately prior to surgical biopsy using both a conventional (1.5-fold) and the DIMA (fourfold) magnification mammography techniques. The microcalcifications were classified by five experienced radiologists using morphological criteria. A receiver operating characteristics curve (ROC) analysis of the sensitivity and specificity of both techniques in assessing malignancy was then carried out. The DIMA mammography technique was slightly but non-significantly superior to the conventional method in detecting malignancy (p > 0.05). Coarse granular and pleomorphic calcifications were detected more frequently with the DIMA technique. Coarse calcifications were significantly more frequently associated with histologically benign findings, whereas fine granular calcifications were significantly more likely to be malignant lesions. Assessment of malignancy associated with microcalcifications using morphological criteria is not significantly improved by mammography techniques with higher magnification.
A United States Marine with an open abdominal injury from a single gunshot wound to the chest and abdomen was placed in the prone position after suffering from acute respiratory distress syndrome (ARDS). Prone ventilation in traumatic injuries involving an open abdomen has been rarely reported or attempted because of the potentially fatal complication of bowel dehiscence. Improvement of gas exchange in patients with ARDS has been shown to occur with prone ventilation when conventional modes of ventilation have failed. The patient benefited from a sustained improvement in oxygenation hours after return to the supine position allowing for his rapid transport to a higher echelon of care and definitive management.
Die Erfahrungen mit der Hormonbehandlung des metastasierenden Mammakarzinoms haben gezeigt, daß es mit den bisher üblichen Maßnahmen in ungefähr 30-40% der behandelten Fälle möglich ist, eine objektiv erfaßbare Rückbildung des Primärtumors oder seiner Metastasen zu erzielen.
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