The authors conducted a complete audit of results of 38,633 mammographic examinations performed by 12 general radiologists during a 2-year period with a computerized reporting system. During this period, 11 group members attended 17 dedicated mammography courses. Audit results were analyzed for each radiologist and the entire group. In the 2nd year, the number of breast cancers diagnosed increased 50% (from 121 to 181), with a 6.5% increase in patient volume. Sensitivity increased from 80% to 87%, and there was no change in the positive predictive value of 32%. Median tumor size and node positivity decreased. Most major variables of population and technical factors were unchanged. Diagnostic approach was altered during the 2nd year, as shown by a 50% increase in the use of spot compression, magnification views, and sonography. Analysis of each radiologist's performance before and after attending mammography courses showed similar changes. These data suggest that dedicated mammography courses can help improve radiologists' performance and alter their interpretive approach.
Pre-nephrectomy therapeutic renal infarction by injecting gelfoam into the renal artery was done in 10 patients with hypernephroma. This technique facilitates nephrectomy and decreases blood loss. A post-infarction syndrome characterized by flank pain, fever and nausea occurred in most patients. In addition, a dialysis patient underwent bilateral renal infarction with improvement of blood pressure control. Distal embolization of gelfoam occurred in this patient, resulting in significant gangrene of 1 foot.
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