Search PubMed⌕ Search

Biomedical subjects

S M Polansky

Publications and source records attributed to S M Polansky.

8 recordsLinked to original sources
PubMed1980

Pulmonary changes after primary irradiationfor early breast carcinoma.

The clinical records and radiographs of 37 patients with carcinoma of the breast (stages I and II) treated with primary radiation therapy without mastectomy were reviewed. In 10 patients, there was a radiographic pattern of increased radiopacity in the lung underlying the treated breast. The margins of the lesion corresponded to those of the tangential radiation ports with a well defined posterior border noted on the lateral chest radiograph. Apical fibrosis (secondary to supraclavicular irradiation) was demonstrated in six other patients. No patient had symptoms referable to the radiation injury. With the increasing use of radiation therapy as initial treatment for early stage carcinoma of the breast, it is important to recognize these radiation changes in the lungs and distinguish them from infection or recurrent tumor.

Breast Neoplasms↗
PubMed1979

Post-menopausal oestrogens protect against fractures of hip and distal radius. A case-control study.

To assess the efficacy of oestrogens in preventing the common major limb fractures of postmenopausal women, retrospective case-control research was used for a new purpose--to explore beneficial rather than adverse effect of treatment. Postmenopausal women admitted with fractures of the hip or distal radius and matched women admitted to the orthopaedic service for other reasons were surveyed. The "risk" of the non-oestrogen users, was estimated by inverting the customary odds ratio to calculate protection in terms of numbers of (exposed controls x non-exposed cases) divided by (exposed cases x non-exposed controls). Medical-record data for oestrogen usage in 157 matched case-control pairs gave an odds ratio for "protection" of 1.5 (10 x 150 divided by 7 x 147). If "exposure" was defined as starting oestrogens within 5 years of the menopause, this ratio rose to 2.6 (10x153 divided by 4x147). With oestrogen usage ascertained from standardised interviews of 80 case-control pairs, the ratio was 3.0 (20x72 divided by 8x60) (p=0.01), and rose to 3.8 (16x75 divided by 5x64) (p=0.01) for oestrogen "exposure" that began within five years of menopause. When lateral chest X-rays were blindly reviewed, the prevalence of oesteoporosis was 32% in the fracture cases and 15% in controls (p less than 0.01). The results add epidemiological evidence for the belief that exogenous oestrogens protect against postmenopausal osteoporosis.

Aged↗
PubMed1979

Primary mediastinal seminoma.

Four new cases of primary mediastinal seminoma are presented, and the 103 previously reported cases reviewed. All of the tumors occurred in the anterior mediastinum, and generally appeared as lobulated noncalcified masses on chest radiography. Most patients were in the third and fourth decades, and about 30% were asymptomatic at the time of initial diagnosis. Although mediastinal seminoma is not commonly considered a cause of superior vena caval obstruction, about 10% of patients experience it. The tumors are radiosensitive and potentially radiocurable. A striking reduction in size of the tumor may be noted after radiation therapy. Prognosis is generally good, with a 5-year survival rate of 75%. The controversy surrounding histogenesis of this tumor is reviewed, and the pathologic criteria for making the diagnosis presented.

Adult↗
PubMedDate not supplied

Accuracy of the chest radiograph in diagnosis of pulmonary embolism.

In an effort to determine the sensitivity and specificity of the chest roentgenogram for the diagnosis of pulmonary embolism, roentgenograms of 152 patients who were all suspected of having pulmonary embolism were randomized and presented to nine interpreters. One hundred eight patients in the series were proven to have pulmonary embolism on the basis of a positive pulmonary angiogram. Forty-four patients were assumed not to have embolism on the basis of either a normal perfusion isotope scan or a pulmonary angiogram which did not show embolism. The interpreters were requested to indicate whether pulmonary embolism was present or absent, or whether they could not tell from the roentgenogram. Readers had no prior knowledge of the actual disease state. The average true-positive ratio (sensitivity) was 0.33, with a range of 0.52 to 0.88. The average true-negative ratio (specificity) was 0.59, with a range of 0.31 to 0.80. The false-positive and false-negative ratios were respectively, 0.21 (range 0.05 to 0.39) and 0.41 (range 0.15 to 0.70). A predictive index, reflecting the overall accuracy of diagnosis, was calculated for the entire group and was 0.40, with a range of 0.17 to 0.57. There appeared to be no correlation between training or experience and accuracy of performance in this study.

False Negative Reactions↗