Radiology
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A new method was developed to differentiate the upper lobe from the middle lobe of the right lung with thin-section, high-resolution computed tomography. In the upper lobe, a medial subsegmental bronchus of an anterior segmental bronchus is always located lateral to the corresponding artery. ⋯ In other words, the anatomic relationship between the subsegmental bronchi and the corresponding pulmonary arteries in the upper lobe is opposite to that in the middle lobe. One hundred seventeen cases, including 54 cases of lobar volume loss, were reviewed with this method, and in each case it was possible to differentiate the upper lobe from the middle lobe without the contiguous section analysis.
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Cancer that recurs after surgery and radiation therapy remains a major problem. The claimed effectiveness of thermobrachytherapy in patients with this problem prompted the present study. Forty-six lesions (20 head and neck, 18 pelvic, seven chest wall, and one limb sarcoma) in 38 patients were treated with interstitial hyperthermia that sandwiched the use of Ir-192 with the aim of delivering 2,000-6,000 cGy, depending on prior dose and tissue tolerance. ⋯ No significant relation was found between heating patterns and tumor response. Of all the prognostic factors studied, the radiation dose was the most significant, with a complete response rate being 78% when the total radiation dose exceeded 6,000 cGy, compared with 8% when the dose was lower than 5,000 cGy (P less than .005). The tumor volume also was important, with smaller lesions responding much better than larger ones (P = .1).