Search PubMed⌕ Search

Biomedical subjects

A C Winfield

Publications and source records attributed to A C Winfield.

52 records · Page 3Linked to original sources
PubMed1983

Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress.

The purpose of this study was to evaluate the diagnostic virtues and limitations of the combined use of high frequency, real-time ultrasound scanning (US) using hand-held transducers and xeromammography (XM) in the evaluation of palpable breast masses. Seventy-one patients, who ranged in age from 14 to 88 years and who had histologically proved masses, were examined by both imaging modalities. US demonstrated the highest degree of accuracy in establishing the presence of cysts (96%) and fibroadenomas (89%). XM afforded better overall depiction of the breast and correctly identified seven carcinomas, five of which were prospectively diagnosed by sonography. When all types of breast masses were considered, the combined use of XM and US was more accurate (89%) than when either XM (70%) or US (85%) was used alone. For this reason, a combined approach using both modalities in the examination of most patients with palpable breast masses is advocated. The advantages and limitations of both XM and US in the evaluation of palpable masses are discussed and illustrated.

Adenofibroma↗
PubMed1983

Certificate-of-need in an antitrust context.

Recent cases such as National Gerimedical Hospital and Gerontology Center v. Blue Cross of Kansas City have found that certificate-of-need (CON) legislation did not intend to remove antitrust considerations. This note discusses the exemptions from antitrust provided by the state action doctrine of Parker v. Brown as well as the Noerr-Pennington doctrine, both of which appear to protect provider input into the CON process. Providing information that assists decision-making must be carefully distinguished from providing data that serve the interests of physicians and hospitals.

Certificate of Need↗
PubMed1983

Iohexol for excretory urography: a comparative study.

A new iodinated nonionic contrast agent (Iohexol) was compared to an ionic contrast agent (renografin 60) in a double-blind study. Fifty-five patients with normal renal function were studied for incidence of undesirable side-effects and quality of the resultant excretory urogram. No major adverse reactions occurred. Minor side-effects due to the contrast occurred more than two times as often with Renografin than when Iohexol was used. The quality of visualization of the collecting system on urography was considered excellent in 44% of the patients receiving Iohexol as compared to a 17% frequency when Renografin was used.

Adolescent↗
PubMed1982

Pneumoperitoneum secondary to pneumocolon examination.

A patient had pneumoperitoneum after an air contrast barium examination. We therefore reviewed perforations secondary to barium enema examinations and concluded that conservative management of this most unusual complication may be considered if there is no evidence of barium extravasation and if the clinical course is benign.

Air↗
PubMed1982

Evaluation of digital venous angiography for the diagnosis of renovascular hypertension.

Thirty-two patients being evaluated for hypertension by angiography were also studied by digital video subtraction angiography (DVSA). Twenty-three of the 76 renal arteries were found by conventional angiography to have significant lesions. Two experienced angiographers evaluated the DVSA studies without knowledge of the angiographic results. The accuracy of DVSA for evaluation of renal arteries was 87% for Observer I and 80% for Observer II. Sensitivities were 87% and 83% and specificities 87% and 79% for the two observers. Of the 13 patients with significant lesions, Observer I identified at lest one lesion in all 13 while Observer II identified a lesion in 12 of the 13. The high false-positive rate (26% for Observer I and 37% for Observer II) was thought to be caused by subtraction artifacts, quantum noise, relatively low spatial resolution, and the Mach effect.

Angiography↗
PubMed1982

Hysterosalpingography: comparison of Conray 60 and Sinografin.

Conray 60 and Sinografin were compared as contrast agents for hysterosalpingography in 40 consecutive patients in a double-blind protocol. Emphasis was centered on the incidence and severity of symptoms during and after the procedure. Of patients receiving Conray, 36% suffered moderate or severe discomfort compared with 78% of the patients receiving Sinografin, and 13% of patients receiving Conray complained of moderate delayed discomfort compared with 28% of those receiving Sinografin. Both agents produced excellent diagnostic studies. Conray was clearly superior to Sinografin in terms of patient comfort.

Diatrizoate↗
PubMedDate not supplied

Diagnostic imaging of fertility disorders.

It is estimated that as many as 15% of married couples are affected by fertility disorders. The number of such couples seeking medical help has increased dramatically in the past 10 years due to both relative and absolute factors. The increase in population, the rising rate of sexually transmitted diseases, and the reduced availability of adoptable infants all contribute to the magnitude of this problem. The role of diagnostic imaging in the effective and compassionate care of couples desiring offspring is the subject of this review. Infertility is a disorder of a couple, not of two individuals. The diagnostic evaluation, therefore, must include both partners. Hysterosalpingography and ultrasound constitute the mainstay of the evaluation of the female member. The various techniques and complications of hysterosalpingography are reviewed. The normal appearance of the uterine cavity together with a review of the numerous anomalies and variations that might be encountered are presented. Along similar lines, the possible filling defects, synechiae, postoperative changes, and other alterations that may be encountered in imaging the uterine cavity are described. Evaluation of the fallopian tubes is of paramount importance, primarily to assess patency but also to assess the possibility of patent but diseased salpinges or disease of the surrounding peritubal tissue. Recently, interventional techniques using radiographic and sonographic control have been developed and are beginning to demonstrate promising results in the management of fallopian tube obstruction. These procedures, adapted from previously established radiographic interventive techniques, are discussed. The role of diagnostic imaging of the male partner is of lesser magnitude. Clinical assessment and semen evaluation generally permit adequate assessment of the male factor. Occasionally, however, vasography and seminal vesiculography are called into play. More frequently, sonographic evaluation to establish the presence of varicoceles is necessary. Such techniques are reviewed, as well as the interventional approaches for ablating varicoceles. The application of conventional and transvaginal sonography in the management of gynecologic fertility disorders is reviewed. Follicular monitoring, guided follicle aspiration, assessment of the status of the endometrium, guided embryo transfer and tubal cannulation, and evaluation of other pelvic disorders are significant factors in the appropriate management of the infertile couple.(ABSTRACT TRUNCATED AT 400 WORDS)

Diagnostic Imaging↗