Biomedical subjects
Publications and source records attributed to R H Gold.
For 3,058 consecutive women who underwent film-screen mammography, oblique, mediolateral, and cephalocaudal images were obtained. Eighty neoplasms were identified. The oblique view disclosed all but one of the cancers; for six patients, it was the only projection that depicted a lesion in the upper-outer quadrant of the breast. Therefore, a two-view mammographic examination should consist of an oblique and cephalocaudal projection.
Explore the source record for details and available documents.
Experience with high-resolution, real-time sonography of four infants with differing extrathoracic left-to-right shunts is presented. Intracranial and parahepatic arteriovenous malformations gave rise to congestive heart failure as their primary or sole manifestation. Partial anomalous pulmonary venous return to the inferior vena cava in one patient and to the portal vein in another was associated with other congenital cardiac anomalies. Once an arteriovenous malformation was suspected, sonography was useful as the initial imaging procedure to localize it and to direct attention to the most useful and least hazardous studies for detailed evaluation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In contrast to most other neoplastic processes of bone, in our study osseous metastases from soft-tissue sarcomas (STS) were more reliably detected by radiography than by scintigraphy. The radiographic manifestations of 65 skeletal metastases in 23 patients with STS were reviewed. Although most metastases (88%) were osteolytic, eight (12%) lesions were osteoblastic. The destructive patterns were geographic in 29%, moth-eaten in 55%, and permeative in 12% of the lesions. The axial skeleton was most commonly involved. In the long bones the diaphyses were the predominant sites of involvement. The bony cortex was frequently breached, with resultant soft-tissue swelling and pathologic fractures. Noteworthy features included subarticular location, involvement of the sacroiliac joint, and an expansile appearance.
Metastatic foci to the breast from a wide variety of primary malignancies appear on mammograms as circumscribed spheroid shadows with only slightly irregular margins, and without evidence of microcalcifications, spiculations, or other signs of desmoplastic response that characterize many primary scirrhous carcinomas. In the cases studied, there was close correlation between the size of the metastatic lesion at palpation and mammography, a feature also characteristic of the well-circumscribed carcinomas. This is not the case with most scirrhous breast carcinomas, whose associated desmoplastic reaction results in an apparent larger size by palpation than observed on mammography.
Explore the source record for details and available documents.
Calcified lipid-filled cysts were observed in mammograms of three patients after limited surgery and primary therapeutic radiation for mammary carcinoma. One patient underwent biopsy which revealed fat necrosis. The mammographic images in the other cases are also consistent with previous descriptions of posttraumatic fat necrosis which had been seen after direct trauma and surgery. This mammographic finding does not represent carcinoma and is not an indication for biopsy.
The radiographs, arthrograms, and bone scans in 23 patients with surgically confirmed failed total-surface hip replacement were reviewed. Guidelines for evaluation of the acetabular component are identical to those for conventional total arthroplasty. The femoral component of a surface-replacement total hip arthroplasty consists of a metallic cup affixed to a resurfaced femoral head with interposed methyl methacrylate. Because of bone-acrylic interface is obscured by the metallic cup, the radiographic features of loosening are limited to an abnormal alignment of the metallic cup in relation to the femoral neck or a change in the position of the cup in serial radiographs. These signs may be subtle. While the metallic cup may often prevent visualization of underlying isotope activity at the bone-acrylic interface, increased activity at the base of the cup when identified suggests loosening or infection.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Liquid-crystal thermography (LCT) was assessed as a means of detecting proliferative disorders of the breast independently of other clinical or radiological data. There was no statistically significant difference between positive diagnosis rates for LCT of the breast in biopsy-proved proliferative disorders and in clinically and radiologically normal volunteers. While this experiment was not designed to evaluate LCT for detection or diagnosis of advanced, clinically occult, or minimal breast cancer, the data suggest that this technique can identify some large, bulky tumors, and that the smaller the lesion, the less likely that it would be detected by LCT.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Radiographs were reviewed of the chest, hands, and feet of 55 patients with progressive systemic sclerosis. These patients had been selected so as to exclude overlap syndromes, particularly mixed connective tissue disease. Soft tissue changes included flexion deformities, generalized or localized atrophy, and dystrophic calcifications. While resorption of distal phalanges was the most common bony change, osteolysis in other sites (feet, ribs, and mandibles) was also frequent. Twelve of 55 patients showed radiographic evidence of inflammatory arthritis, ranging from isolated to generalized joint destruction, that could not be attributed to overlap with rheumatoid arthritis or mixed connective tissue disease.
The radiographic manifestations of 127 skeletal metastases in 50 patients with melanoma were reviewed and correlated with the scintigraphic findings. Although the features of most of the metastases were nonspecific and appeared similar to those of other osteolytic metastases, several of them had unusual features, including expansion, subarticular location, osteosclerosis, and a thin, sclerotic rim. These features could result in some of the metastases being mistaken for other lesions. The radionuclide bone scans were more sensitive in that they detected the lesions earlier and in greater numbers than the radiographs. Prognosis was poor once skeletal metastasis was diagnosed, the mean survival time being 4.7 months.
Explore the source record for details and available documents.