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Biomedical subjects

M Rebner

Publications and source records attributed to M Rebner.

23 records · Page 2Linked to original sources

CT evaluation of enhancing mediastinal masses.

The CT scans of 132 patients with mediastinal masses and CT scans from our teaching file were retrospectively reviewed to evaluate the role of contrast enhancement in limiting the differential diagnosis of a mediastinal mass. Ten patients with an enhancing mediastinal mass were found. Coupled with mass enhancement, location and hypertension were helpful in limiting the differential diagnosis. Four masses were of thyroid origin, and all were contiguous with neck thyroid. All patients with functioning paragangliomas were hypertensive and all intrapericardial enhancing masses were functioning paragangliomas. A normotensive patient had a nonfunctioning aortic body paraganglioma superiolateral to the aortic arch. An enhancing mass in a similar location in a hypertensive patient was a functioning paraganglioma. Castleman disease occurred posterior to the heart.

Castleman Disease↗

CT appearance of right gonadal vein.

The CT appearance of the right gonadal vein was studied. It is usually first seen 1 cm below the bifurcation of the inferior vena cava (IVC) and empties into the IVC laterally or anterolaterally 4 cm below the union of the right renal vein and IVC. Occasionally, it empties into an accessory right renal vein rather than the IVC. The right gonadal vein was visualized partially or completely in 80% of patients, and generally measured less than or equal to 4 mm in maximum diameter. It was enlarged in a patient with portal hypertension and in a post-partum woman. Knowledge of its typical CT appearance should prevent confusion with abdominopelvic lymph nodes.

Female↗

Fine needle aspiration biopsy of the breast. Influence of the number of passes and the sample size on the diagnostic yield.

The sensitivity of fine needle aspiration (FNA) biopsy of the breast as a function of the number of aspirations performed on any given lesion was investigated. Four separate aspirations each were performed on over 400 lesions of the breast, 93 of which yielded a cytologic diagnosis. The incremental diagnostic yields of each subsequent aspiration were tabulated. The first aspirate of the sequence gave the greatest yield, with smaller incremental yields on the second through the fourth aspirates. Benign and malignant lesions gave similar results, as did palpable and nonpalpable lesions (the latter being usually smaller in size). A mathematical extrapolation of the data indicates that three or four aspirations of any given lesion provide the optimal yield within the limits of practicality. This performance of multiple FNA biopsies is particularly important when the pathologist does not perform the biopsy, or is unable to assist in the immediate interpretation of the specimen to assess its adequacy.

Biopsy, Needle↗

Inadequate follow-up of abnormal mammograms.

Routine mammographic screening increases detection of nonpalpable breast cancer. Timely follow-up of abnormalities is essential because delays may lead to postponement of treatment and decreased survival for women who have cancer. The purpose of this study was to determine the percentage of women with an abnormal mammogram who do not have adequate follow-up and to determine factors associated with inadequate follow-up. The study was conducted in a metropolitan health system that includes a large urban teaching hospital in Detroit and 26 ambulatory care centers. From the radiology database, all women with an abnormal screening mammogram performed between January 1, 1992, and July 31, 1992 were identified. We defined adequate follow-up as follow-up within three months of due date. Follow-up status was determined using medical records and telephone interviews. The percentage of women with inadequate follow-up was calculated. Relative risks compared percentages of women with inadequate follow-up according to demographic and screening-related variables. We calculated adjusted relative risks using multivariate binomial regression. We identified 1,249 women with abnormal screening mammograms. Inadequate follow-up occurred for 226 (18.1%) of the women. Among women with follow-up recommended in 4-6 months, 36.8% had inadequate follow-up. Among women with immediate follow-up recommended (obtain additional views or outside films for comparison, ultrasound, biopsy, or surgical referral), 7.2% had inadequate follow-up. Inadequate follow-up was associated with lower estimated household income and no history of previous mammogram. Among women with inadequate follow-up who were interviewed, 87% reported that they had been notified of their results. We found that the percentage of women with inadequate follow-up of abnormal mammograms is high, especially among women who require six-month follow-up. Women with low income and no history of a previous mammogram were at greatest risk for inadequate follow-up. These results document a previously unrecognized problem with mammography screening and suggest that the implementation of tracking systems to ensure timely follow-up of abnormal screening mammograms is essential. Medical Subject Headings (MeSH): mammography, follow-up, screening.

Adult↗