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Biomedical subjects

Douglas P Beall

Publications and source records attributed to Douglas P Beall.

10 recordsLinked to original sources

Primary periosteal lymphoma: an unusual presentation of non-Hodgkin's lymphoma with radiographic, MR imaging, and pathologic correlation.

This report describes a primary periosteal location of non-Hodgkin's lymphoma, without nodal disease, and without adjacent intramedullary disease at presentation. The clinical and imaging appearance of periosteal lymphoma simulates other neoplastic osseous surface tumors more than that of lymphoma in other locations. Consideration of this rare presentation of non-Hodgkin's lymphoma in the differential diagnosis of periosteal bone lesions can be helpful to ensure proper diagnosis and treatment.

Adult↗

Association of biceps tendon tears with rotator cuff abnormalities: degree of correlation with tears of the anterior and superior portions of the rotator cuff.

OBJECTIVE: This study was performed to examine the relationship and association of abnormalities seen in the long head of the biceps brachii tendon to abnormal findings in the rotator cuff. MATERIALS AND METHODS: One hundred eleven patients underwent MR imaging for shoulder pain followed by arthroscopic or open shoulder surgery from January 1997 to December 2000. Patients were identified by a retrospective search, and all consecutive patients having undergone both MR imaging and surgery were included in the patient cohort. Official MR imaging interpretations were compared with operative reports, and all findings were recorded. RESULTS: Twenty-three patients were identified with partial- or full-thickness tears of the long head of the biceps tendon. The sensitivity, specificity, and accuracy of unenhanced MR imaging of the shoulder for detecting these bicipital tears were 52%, 86%, and 79%, respectively. When a tear was present in the biceps tendon, the prevalence of supraspinatous, infraspinatus, and subscapularis tendon tears was 96.2%, 34.6%, and 47.1%, respectively. Patients with biceps tendon tears were significantly more likely to also have subscapularis tendon tears (p < 0.0001) and supraspinatous tendon tears (p < 0.008) than those patients who did not have biceps tendon tears. No significant relationship was found between the presence or absence of a biceps tendon tear and the presence or absence of a infraspinatus or teres minor tendon tear (p = 0.17). CONCLUSION: Tears of the long head of the biceps tendon have a statistically significant association with tears of the anterior and superior rotator cuff and are highly correlated with tears of the supraspinatous and subscapularis tendons. When tears of these tendons are detected, specific attention directed toward the long biceps tendon is warranted to characterize the status of this structure that provides additional stability to the shoulder joint.

Adolescent↗

Osseous change adjacent to soft-tissue hemangiomas of the extremities: correlation with lesion size and proximity to bone.

OBJECTIVE: The purpose of this study was to describe the findings of MR imaging and radiographic changes that occur in osseous structures adjacent to soft-tissue hemangiomas of the extremities and to correlate them with patient symptomatology, the size of the hemangiomas, and their proximity to adjacent bone. MATERIALS AND METHODS: We retrospectively reviewed the radiographs and MR images of 35 patients with soft-tissue hemangiomas of the extremities. The pattern and extent of the osseous change were categorized as periosteal, cortical, or medullary. Symptomatology, size, and proximity of the hemangioma to the adjacent bone were compared with the presence or absence of osseous change. Statistical analysis was performed using the Student's t test. RESULTS: Osseous change was noted on radiographs in 13 (37%) of 35 patients and on MR images in 11 (31%) of 35 patients with a total of 14 patients (40%) showing osseous change on at least one study. Periosteal change was present in eight (23%) of 35 patients; cortical change, in 11 (31%) of 35 patients; and medullary change, in 10 (29%) of 35 patients. Direct contact between the soft-tissue hemangioma and the adjacent bone was seen in 13 of 14 patients with osseous change. In those patients without osseous change, the average distance between the soft-tissue hemangioma and bone was 1.06 cm (range, 0-4 cm). No correlation was found between symptoms and the presence of osseous change. CONCLUSION: Soft-tissue hemangiomas of the extremities frequently result in adjacent osseous change that can be categorized as either periosteal, cortical, or medullary. Only medullary changes correspond with hemangioma size, whereas all three categories of change correlate with the proximity of the hemangioma to the adjacent bone. The presence of osseous change does not correlate with patient symptomatology.

Adolescent↗

Speech recognition interface to a hospital information system using a self-designed visual basic program: initial experience.

Speech recognition (SR) in the radiology department setting is viewed as a method of decreasing overhead expenses by reducing or eliminating transcription services and improving care by reducing report turnaround times incurred by transcription backlogs. The purpose of this study was to show the ability to integrate off-the-shelf speech recognition software into a Hospital Information System in 3 types of military medical facilities using the Windows programming language Visual Basic 6.0 (Microsoft, Redmond, WA). Report turnaround times and costs were calculated for a medium-sized medical teaching facility, a medium-sized nonteaching facility, and a medical clinic. Results of speech recognition versus contract transcription services were assessed between July and December, 2000. In the teaching facility, 2042 reports were dictated on 2 computers equipped with the speech recognition program, saving a total of US dollars 3319 in transcription costs. Turnaround times were calculated for 4 first-year radiology residents in 4 imaging categories. Despite requiring 2 separate electronic signatures, we achieved an average reduction in turnaround time from 15.7 hours to 4.7 hours. In the nonteaching facility, 26600 reports were dictated with average turnaround time improving from 89 hours for transcription to 19 hours for speech recognition saving US dollars 45500 over the same 6 months. The medical clinic generated 5109 reports for a cost savings of US dollars 10650. Total cost to implement this speech recognition was approximately US dollars 3000 per workstation, mostly for hardware. It is possible to design and implement an affordable speech recognition system without a large-scale expensive commercial solution.

Cost-Benefit Analysis↗

Extraskeletal mesenchymal chondrosarcoma: case report.

This is a case report of an extraskeletal mesenchymal chondrosarcoma (ESMC) that originally occurred in the retroperitoneum of a 24-year-old female and later metastasized to the left proximal humerus. Mesenchymal chondrosarcomas are very rare in comparison to conventional chondrosarcomas and even more so when arising from an extraskeletal location. In this report, we discuss the major characteristics of ESMC and offer a review of the current knowledge regarding this rare disease entity.

Adult↗