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Biomedical subjects

C D'Orsi

Publications and source records attributed to C D'Orsi.

15 recordsLinked to original sources
PubMed1995

A proposal for a national mammography database: content, purpose, and value.

A national mammography database is a centralized, computerized method of data collection consisting of two possible parts: a national mammography audit and a system for monitoring and tracking patients. A national mammography audit refers to collecting and analyzing medical audit data of individual mammography practices at a national level and is a critical step in improving the interpretive component of mammography. The monitoring and tracking component refers to a centralized system that provides women and physicians with a recruitment and follow-up mechanism to optimize participation in mammography services. Both parts of a national mammography database represent important components in the improvement of mammography quality. However, unique scientific, legal, and fiscal concerns are important to consider before establishing a national mammography database.

Female↗
PubMed1994

Improved mammographic imaging using tissue expanders for breast augmentation.

Several studies indicate that mammographic evaluation of the breast is inhibited by both submammary and submuscular implants, regardless of implant composition. Two hundred radiographs were evaluated following subpectoral placement of 25 combination gel/saline and 25 saline-filled tissue expanders. Within 3 months after augmentation, mammograms were performed using the standard and displacement techniques; patients with inflated implants were followed by a repeat displacement study (with the expander deflated). After completion of the mammogram, expanders were reinflated. Our experience demonstrates that better visualization of breast tissue may be accomplished by implant-deflated views in patients with small amounts of breast tissue, tight skin envelopes, or capsular contraction. In each of these circumstances, the displaced view failed to adequately demonstrate glandular tissue. The presence of the inflated implant impairs mammographic visualization in a number of ways, including implant opacity, impaired automatic exposure control, interference with breast compressibility, and implant displacement. These effects are consistently present in small breasts (< an estimated 300 g), in breasts with grade III or IV capsular contracture, and in breasts with minimal skin laxity (i.e., nonptotic breasts). Breast compression was compromised to a greater degree in the presence of grade III and IV capsular contracture; however, deflation of an adjustable implant optimized radiographic interpretation to a high degree. The deflatable saline implant yields a less obscured evaluation of the augmented breast. We suggest that an extended-use deflatable device (i.e., tissue expander) be considered as an option in our search for a safe and reliable implant for augmentation mammoplasty, particularly in patients with small breasts, tight skin envelopes, or a propensity for capsular contracture.

Breast Implants↗
PubMed1983

Upper rib fractures and mediastinal widening: indications for aortography.

Survival of patients with posttraumatic thoracic aortic rupture depends on early diagnosis. It is frequently stated that fracture of the first or second ribs and mediastinal widening are findings suggestive of thoracic aortic rupture. We found that the probability of sustaining thoracic aortic rupture is the same for patients with upper rib fractures as for those with other rib fractures (1/64 versus 5/149; p = 0.85). Also, our data fail to show a statistical difference in the incidence of thoracic aortic rupture associated with upper (first and second) rib fractures compared with no rib fracture at all (1/64 versus 9/304; p = 0.85). Thus, patients with thoracic aortic rupture are not more likely to have rib fractures (7/21 versus 14/21; p = 0.15), and if a rib fracture is present, the probability of it being at the upper level is the same as that for a fracture at any other level (1/7 versus 6/7; p = 0.06). Ratios of mediastinal width to chest width were used as a measure of mediastinal widening, and were found to be an accurate predictor of thoracic aortic rupture. Ratios greater than 0.28 at the aortic knob were 100% specific and 85% sensitive for this condition.

Aorta, Thoracic↗
PubMed1982

Dynamic cholecystosonography of the contracted gallbladder: the double-arc-shadow sign.

In 41 of 55 patients in whom the gallbladder lumen was not identified by static sonography, a specific image was observed with dynamic scanning. This consisted of two parallel arcuate echogenic lines separated by a thin anechoic space with distal acoustic shadowing: the "double-arc-shadow" sign. The proximal arc represents the near wall of the gallbladder, the anechoic space is bile in the gallbladder lumen, and the distal arc represents the gallstone(s) responsible for the acoustic shadowing. Of the two additional sonographic patterns observed, the "'echo-shadow" pattern, which was seen with static scanning in 44 and with dynamic scanning in eight patients was an accurate, indirect indicator for cholelithiasis. On the other hand, "nonvisualization" was an unreliable sign. Of 11 such patients scanned with static and six with dynamic scanning, four proved to have a normal gallbladder. Comparing static with dynamic cholecystosonography in patients with nonphysiologically contracted gallbladders, the accuracy rate for cholelithiasis increased from 86.3% (44 of 51 patients) to 96% (49 of 51). In 41 of these patients (80%) the double-arc-shadow pattern positively identified the gallbladder lumen, increasing the confidence of the examiner. Furthermore, these images can be produced in a fraction of the time required for complete evaluation with static scanning.

Cholelithiasis↗
PubMed1981

Tumor growth and regression rates relative to tumor size: a clinical study of metastatic pulmonary nodules.

Patients with multiple discrete metastatic pulmonary nodules were serially monitored and tumor growth and regression rates were determined for selected measurable lesions. Tumor volume doubling time (TDT) in growing tumors or tumor volume halving time (THT) in regressing tumors was measured for multiple lesions. The objective of the study was to correlate tumor growth and/or regression rates with initial tumor size. A total of eight patients with 29 nodules of varying sizes was studied over observation periods the nodules regressed in response to specific chemotherapy. This study suggests that metastatic pulmonary nodules grow or regress at a relatively constant rate that is independent of pretreatment size. Growth and regression rates do not generally fluctuate, although tumor nodules may remain stationary or arrested for variable time periods. The study of tumor kinetics by clinical techniques is relevant to understanding tumor biology and to developing approaches to therapy.

Antineoplastic Agents↗
PubMed1981

Traumatic aortic rupture: plain radiographic findings.

The plain radiographic findings on 20 patients with traumatic aortic rupture were analyzed. A mediastinal-width to chest-width (M/C) ratio was calculated at three thoracic levels and compared to two matched groups of patients without aortic tears. Defining an M/C ratio of 0.25 or larger at the level of the aortic arch as abnormal would identify 95% of cases with ruptured aortas, and result in 25% false-positive studies in traumatized patients. A ratio greater than 0.28 retains 85% sensitivity for aortic rupture while increasing specificity to 100%. An analysis of the prevalence and location of rib fractures showed that there was little relation between the presence of fracture and existence of an aortic tear. Therefore, an acutely injured patient with an M/C ratio of greater than 0.25 should be considered highly likely to have an aortic rupture.

Adolescent↗