Distinguishing mucinous from nonmucinous cystic lesions of the pancreas often constitutes a diagnostic dilemma. The clinical management differs between such lesions; therefore it is important to make an accurate preoperative diagnosis. Various centers have reported conflicting results regarding their ability to detect mucin-producing neoplastic cells and appropriately reach a diagnosis based on endoscopic ultrasound (EUS) guided FNA. The aim of this study is to assess the ability of EUS-FNA cytology to diagnose and differentiate mucinous from nonmucinous pancreatic cystic lesions. We reviewed records of patients who underwent EUS of pancreatic cystic lesions. If FNA was performed and mucinous neoplasm was suspected, aspirate was evaluated for cytomorphology and presence of mucin. FNA results were compared to final histologic diagnosis if surgery was performed. Cytologic diagnosis was provided for 28/30 (93%). By comparing EUS-FNA diagnoses with final surgical pathology, FNA accurately diagnosed in 10/11 cases with sensitivity and specificity for detection of malignancy of 100 and 89, respectively, while the accuracy for identification of mucinous cystic neoplasms was 100%. Our results indicate that in the appropriate clinical and imaging setting, EUS-FNA cytology with analysis for mucin production by tumor cells is an important test in distinguishing pancreatic cystic lesions and guiding further management.

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To better understand colorectal cancer (CRC) screening practices in primary care, medical students directly observed physician-patient encounters in 38 physician offices. CRC was discussed with 14% of patients 50 years of age; 87% of discussions were initiated by the physician. The rate of discussions varied among the practices from 0% to 41% of office visits. Discussions were more common for new patient visits, with younger patients, and in the 24% of offices that utilized flow sheets. The frequency of CRC discussions in physician offices varies widely. More widespread implementation of simple office systems, such as flow sheets, is needed to improve CRC screening rates.

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ABSTRACT. A modern coherent Antarctic radar depth so under for probing the ice sheets of Antarctica and Greenland has been designed and developed by the University of Kansas. It was successfully tested during the austral summers of 1987 and 1988 at Downstream Band Upstream B, Antarctica. Ground-based measurements were made with the radar in a mobile hut hauled by a Sno-cat in 1987 and in a Spryte vehicle in 1988.The coherent Antarctic radar depth sounder (CARDS) is an unfocussed synthetic-aperture chirp radar where the along-track resolution is improved by extensive coherent integration. Surface acoustic wave (SAW) devices are used to implement pulse expansion and compression. A common stable oscillator for the transmitter and the receiver establishes coherency. The system signal-to-noise ratio is enhanced by pulse compression and coherent integration . Antennas for the ground-based' measurements are configured with an array of eight dipole elements, four active and four passive, th e latter acting as reflectors. The aircraft antennas also co nsist of four active elements hung underneath the two wings. The wings serve as reflectors. A PC facilitates sys tem control and data recording on a high -density recorder. A-scope plots of selected records allow frequent field checks on system performance. More desc riptive display facilities have been incorporated in the latest version of the syste m .The radar transmits 60 ns , 20 W peak power at 150 MHz. The number of coherent integra tions is selectable up to 64 k. The system is capable of 5 m range resol ution and 5 km range in ice. A programmable sensitivity tim e control (STC) increases the receiver dynamic range . System parameters such as pulse-repetition fr eq uency, number of integrations, and display modes can be chosen during field operations by user-friendly software.This paper describes the design and field operations of the system. Some results of the 1987 operations at Downstream B are presented.