Biomedical subjects
Publications and source records attributed to D J Soffa.
A case of melorheostosis with overlying linear skin changes is reported. The radiographic appearance is that of a linear hyperostosis which appears to flow along the cortex of the bone. This is believed to be the twelfth such case in the literature.
A case of acquired double pylorus, incident to peptic ulcer disease, is described. Fiberoptic gastroscopy confirmed a scarred antrum, a shallow prepyloric ulcer and a pylorus consisting of two large openings divided by a septum. The duodenum was visualized through each channel. This appearance probably represents a pyloroduodenal fistula caused by penetration of a prepyloric ulcer into the duodenum.
A patient was successfully treated with hyperbaric oxygen for chronic osteomyelitis of the mandible associated with osteopetrosis. This mode of therapy appears to have a definite place in the management of such patients. There was no clinical, radiographic, or laboratory evidence that the osteopetrosis was made worse by the hyperbaric oxygen.
Recently, managed care has received a great deal of criticism from the public and press, some of it richly deserved. One of the areas of greatest concern is pre-certification requirements and possible denial of services. Experience with programs of this sort in diagnostic imaging suggests that, implemented correctly, the consultative interface created by a pre-certification program can be of tremendous value in physician education. Appropriate behavior modification programs need to be crafted with an educational rather than economic bias and the methodology not be totally abandoned simply because it has been misused by some. The pre-certification process can be used as a vehicle to disseminate information about rapidly emerging new therapies and technologies.