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Biomedical subjects

R M Slone

Publications and source records attributed to R M Slone.

At least 37 records · Page 2Linked to original sources
PubMed1996

Coauthors' contributions to major papers published in the AJR: frequency of undeserved coauthorship.

OBJECTIVE: Over half of the major papers published in the American Journal of Roentgenology (AJR) have five or more coauthors. This project was designed to evaluate the specific contributions of coauthors and the prevalence of undeserved authorship in major papers from institutions in the United States. MATERIALS AND METHODS: Questionnaires were mailed to the first author of 275 major papers from institutions in the United States that were published in the AJR in 1992 and 1993. Questions focused on coauthors' contributions to research design, data collection, data analysis, and manuscript preparation, and on undeserving authorship. RESULTS: One hundred ninety-six (72%) of the surveys were returned. Ninety-nine percent of first authors, 75% of second authors, fewer than half of third authors, and one third of fourth authors and beyond were said to have contributed to at least three of the following: research design, data collection, data analysis, and manuscript preparation (p < .02). A strong correlation was indicated between authorship position and contribution (r = -.69, p < .001), with a mean overall contribution of 63 +/- 17% (mean +/- SD) for the first author, 20 +/- 12% for the second author, 10 +/- 7% for the third author, 7 +/- 6% for the fourth author, and 5 +/- 5% for all other authors. Coauthors were listed in decreasing order of contribution in 70% of articles. However, the last author was the second major contributor in 10% of articles with three or more authors. The incidence of "undeserved" coauthors increased from 9% on papers with three authors to 30% on papers with more than six authors (mean, 17%; r = .97; p < .001). Undeserved authorship was attributed largely to individuals who contributed only cases (29%) or who created a sense of obligation or fear in the first author (40%). Manuscripts were more likely to include an undeserved coauthor when the first author was a nontenured staff member (45%) than when he or she was tenured faculty (28%) (p < .02). When decision about authorship were made at project conception, there were fewer coauthors (3.9 versus 5.4, p < .02) and a lower incidence of manuscripts with undeserving coauthors (23% versus 47%, p < .01). The final manuscript was read by all coauthors in 80% of manuscripts, and all coauthors were thought to understand the manuscript to the extent they could publicly defend it in 78% of manuscripts. The most commonly cited reason that otherwise honest individuals accept undeserved authorship was academic promotion. CONCLUSION: Undeserved authorship is a common and serious problem that is motivated primarily by academic promotion policies. The first two authors are said to account for the preponderance of work in almost all major papers.

Authorship↗
PubMed1996

Radiology of pulmonary emphysema and lung volume reduction surgery.

Lung volume reduction surgery (LVRS), which involves the bilateral wedge resection of 20% to 30% of the most diseased lung through a median sternotomy, is emerging as a promising treatment option for select patients with severe, debilitating emphysema. This article details our observations and preliminary investigations related to the imaging evaluation of patients including selection criteria, postoperative findings, and structural changes in the thorax after surgery. Routine preoperative evaluation includes inspiratory and expiratory chest radiographs, computed tomography (CT) examination, and nuclear medicine lung scan. Investigational studies include quantitative CT to assess disease severity and dynamic magnetic resonance imaging to study respiratory movements. Postoperative improvement in FEV1, oxygenation, and exercise tolerance correlate with the degree of heterogeneity, hyperinflation, lung compression, upper lobe severity, and percentage of retained mildly diseased lung shown on preoperative imaging studies. Postoperative radiographic monitoring is important for detection of complications. Postoperative follow-up examinations show reduced thoracic distention, improved coordination of respiratory movement, and increased diaphragm curvature and excursion, supporting the hypothesis of improved respiratory mechanics as a major contributing factor to the success of LVRS.

Follow-Up Studies↗
PubMed1995

Principles and imaging of spinal instrumentation.

This articles focuses on the principles of spinal surgery, the basic types of spinal instrumentation, and imaging of the postoperative spine. It is the first of three articles in this issue that discuss the spine. Complications are discussed and illustrated throughout. This article should assist radiologists in the review of spinal, chest, and abdominal films of spinal surgery patients.

Equipment Failure↗
PubMed1995

Fixation techniques and instrumentation used in the cervical spine.

This article emphasizes the techniques and instrumentation used in the cervical spine to provide insight into the identification and function of the fixation, grafting, and wiring techniques used for stabilization and fusion. Fracture reduction and stabilization in degenerative disease, the most common reasons for spinal fixation in the cervical spine, are discussed, as are infections, spinal stenosis, and tumors.

Cervical Vertebrae↗
PubMed1995

Fixation techniques and instrumentation used in the thoracic, lumbar, and lumbosacral spine.

The radiologist is faced with continual changes in both surgical techniques and instrumentation for the spine. To properly evaluate radiographic and special imaging studies, it is necessary to have a working knowledge of the devices used and the principles that direct their use. This article discusses the identification and function of the most common instrumentation in the thoracic, lumbar, and lumbosacral spine.

Humans↗
PubMed1993

Spinal fixation. Part 1. Principles, basic hardware, and fixation techniques for the cervical spine.

Spinal fixation devices provide stability and restore anatomic alignment in the treatment of fractures, degenerative disease, infection, and tumors and correct congenital deformities such as those seen in scoliosis. The devices provide immediate stability but are not strong enough to withstand prolonged stress and eventually fail, in most cases, if bone fusion does not occur. Bone graft material is often used to promote fusion and to replace bone after resection. Internal fixation is used to maintain position and alignment and to prevent motion as the spine fuses. Plates and rods are attached to the vertebral body or posterior elements with wire, screws, and hooks. Screws and wire can also be used alone as a means of fixation. Surgical techniques and instrumentation have advanced in recent years, and radiologists are exposed to a myriad of devices. They need to be able to identify the various plates, screws, wiring techniques, and grafts used most commonly and to understand their function in the cervical spine for fusions and treatment of fractures and degenerative disease.

Cervical Vertebrae↗
PubMed1993

Spinal fixation. Part 2. Fixation techniques and hardware for the thoracic and lumbosacral spine.

Spinal fixation devices are used in the thoracic and lumbosacral spine to stabilize the spine, reduce deformities and fractures, and replace abnormal vertebrae. A bone fusion is usually attempted along with placement of the instrumentation because in most cases the hardware would eventually fail if it were used alone. The thoracolumbar spine is inherently unstable, and early operative intervention improves mobilization and rehabilitation. In some cases of lumbar spinal pain, surgical intervention is necessary for the treatment of conditions such as herniated disks, spondylolysis with spondylolisthesis, and degenerative disease with scoliosis. Surgical procedures consist of posterior (posterior elements) and anterior (vertebral body) fixation. Radiologists face continual changes in both surgical technique and instrumentation and should be knowledgeable about the devices available and the biomechanical principles that direct their use. They need to work with their surgical colleagues to become familiar with the techniques used at their institutions.

Humans↗
PubMed1993

Spinal fixation. Part 3. Complications of spinal instrumentation.

Spinal fixation devices can be used to form a rigid construct with the spine to replace bone, restore alignment, maintain position, and prevent motion in the treatment of fractures, degenerative disease, neoplasm, and congenital deformities. Because most spinal constructs will eventually fail if bone fusion does not occur, bone graft material is often used along with the implant to promote fusion. Conventional radiographs, obtained in two projections, remain the mainstay of implant evaluation, demonstrating the position of the spinal elements, hardware, graft material, and evidence of complication. Possible complications connected with use of fixation devices include intraoperative soft-tissue injuries, postoperative hematomas, and infection. The components (through incorrect use, malpositioning at surgery, and later dislodgment or fracture) may also contribute to complications such as instability; failure of fusion; or pain, with possible resultant neurologic damage. Bone graft material can migrate or hypertrophy, resulting in impingement on the spinal canal or neural foramen. Radiologists should be familiar with the various spinal fixation devices and techniques to better identify evolving complications.

Adult↗
PubMed1991

Orthopedic fixation devices.

Orthopedic fixation devices are used in the treatment of fractures, soft-tissue injuries, and reconstructive surgery. After fracture reduction, internal, external, or intramedullary fixation devices may be used to provide stability and maintain the alignment of bone fragments during the healing process. They must be strong and secure enough to allow early mobilization of the injured part, as well as the entire patient. Compression is used whenever possible to increase the contact area and the stability between fragments and to decrease the stress on the implant. Screws are used primarily to provide interfragmental compression or to attach plates, which can then provide compression, prevent displacement, and support the fragments during healing. Pins and wires can be used for fixation of small fragments or fractures in small bones and for attachment of external fixation devices and traction. A basic understanding of the devices and principles of use is needed to interpret radiographs obtained after the treatment of musculoskeletal injuries.

Fracture Fixation↗
PubMed1991

Perivalvular pseudoaneurysm complicating bacterial endocarditis: MR detection in five cases.

Bacterial endocarditis usually affects the valve leaflets, but erosion into the valve anulus and adjacent myocardium may form a myocardial abscess. Perivalvular abscesses can drain into the ventricles or aorta, forming a life-threatening pseudoaneurysm. We reviewed our experience with cardiac MR imaging of this disorder. Fourteen patients with complicated bacterial endocarditis underwent ECG-gated spin-echo cardiac MR imaging in addition to conventional duplex two-dimensional echocardiography (2-D echo). Angiography was performed in seven patients, six of whom underwent surgery for valve replacement. MR imaging detected the pseudoaneurysms in all five of the surgically proved cases, while 2-D echo detected only three. Clinical follow-up suggested there were no false-negative examinations, but no autopsy data were available for confirmation. Postoperative MR imaging studies were conducted in three patients, revealing two recurrent pseudoaneurysms and one thrombosed aneurysm. Cardiac MR imaging provides useful pre- and postoperative information in patients with perivalvular pseudoaneurysms due to endocarditis.

Aneurysm, Infected↗