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Biomedical subjects

L Cox

Publications and source records attributed to L Cox.

53 records · Page 3Linked to original sources

Intraabdominal testis with yolk sac tumor in a 2-year-old child.

A case of a large yolk sac tumor in an undescended testicle in a 2-year-old child is presented. No such similar finding has been reported in a young child. Despite the large size of the primary tumor, the high level of serum alpha-fetoprotein and the relatively late clinical presentation, this was a stage I lesion, and the child responded to surgical resection of the tumor and chemotherapy.

Child, Preschool↗

Limited resection for breast cancer: a study of inked specimen margins before radiotherapy.

This is an analysis of tumor margins of 108 patients who underwent a limited resection for infiltrating breast cancer, prior to starting radiation therapy. This represented the initial resection (IR) in 75 patients, and a re-excision (RE) after biopsy elsewhere in 33 patients. All specimens were processed by the India ink method prior to frozen and paraffin section analysis. Overall, the incidence of involved margins was 28% for the IR group, and 15% for the RE group. No correlation was found with the axillary node status, or with the type of prior surgery in the RE group. The data suggest a correlation between increasing tumor size and margin involvement. Further surgery in the IR group with involved margins yielded negative margins in all cases; the finding of residual carcinoma was correlated with the type of secondary surgery, that is, further re-excision or mastectomy.

Biopsy↗

EKG-gated digital subtraction angiography in the detection of pulmonary emboli.

Detection of pulmonary emboli was investigated using electrocardiographically gated (EKG-gated) intravenous digital subtraction angiography (DSA) in 6 anesthetized and paralyzed dogs. Six autologous blood clots were introduced into the internal jugular vein of each dog and both conventional pulmonary angiography and EKG-gated DSA performed in frontal and oblique projections. When two observers scored any definite or equivocal embolus as positive, sensitivity was 82.1% for one and 92.9% for the other; the respective positive predictive values (PPV) were 88.5% and 65%. When only definite emboli were considered positive, sensitivity was 75% for one observer and 71.4% for the other; PPV was 100% for both. The authors conclude that DSA can demonstrate individual emboli with good sensitivity and excellent precision. If several emboli are present, EKG-gated DSA should prove highly accurate; however, care must be taken because overinterpretation is more likely with DSA than with conventional pulmonary angiography.

Angiography↗

ECG-synchronized DSA exposure control: improved cervicothoracic image quality.

An electrocardiogram (ECG)-synchronized x-ray exposure sequence was used to acquire digital subtraction angiographic (DSA) images during 13 arterial injection studies of the aortic arch or carotid bifurcations. These "gated" images were compared with matched "ungated" DSA images acquired using the same technical factors, contrast material volume, and patient positioning. Subjective assessments by five experienced observers of edge definition, vessel conspicuousness, and overall diagnostic quality showed overall preference for one of the two acquisition methods in 69% of cases studied. Of these, the ECG-synchronized exposure series were rated superior in 76%. Linear intensity gradients across vessel margins generally showed improved or unchanged edge definition in the gated subtraction images as compared with their ungated pairs. These results, as well as the relatively simple and inexpensive modifications required, suggest that routine use of ECG exposure control can facilitate improved arterial DSA evaluations of suspected cervicothoracic vascular disease.

Adult↗

Dynamic computed tomography of the brain: techniques, data analysis, and applications.

Rapid sequence computed tomography (CT) scanning has many potential applications in studying intracranial physiologic events. However, visual inspection of these rapid sequence scans fails to extract the large amount of information inherent in the digital data. The concept of corrected mean transit time applied to rapid sequence scans after intravenous bolus injection of contrast material provides quantitative data on relative hemispheric flow. Use of histogram-based areas of interest permits accurate and reproducible identification of anatomic structures including arteries and gray and white matter. Gamma variate curve fit techniques reduce statistical noise. The concept of transit time can be expanded to the creation of functional CT images.

Blood Flow Velocity↗

Identification of an unusual gamma counter fault using Trigg's technique for trend detection.

A simultaneous deterioration in performance of several radioimmunoassays suggested that equipment was malfunctioning. Replicate counts from an automated gamma counter showed unacceptable variation during a 24-hour period; this variation was detected using Trigg's technique, a sensitive method for trend analysis, and was not identified by the usual laboratory testing procedures. A defective capacitor was found in the voltage stabilisation unit in the gamma counter, which probably made it responsive to small variations in the power supply to the laboratory. It is suggested that the analysis of replicate counts using Trigg's technique is a valuable test of gamma counter function which should become routine.

Analysis of Variance↗