PowerPoint Presentation

RSNA Sunday Night

Film Panel 2014

<div class="sg" id="s16" data-sgid="Subtitle 2" style="z-index:2;left:23.24px;top:6.70px;width:696.76px;height:126.85px" data-valign="top"> <div id="s16_t" class="sg" style="z-index:2;left:0.00px;top:-10.41px;width:696.76px;height:159.66px;"><div><p para="{al:2}"><span data-textwidth="264.40" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:267%; left:222.80px;top:20.51px;">2014 RSNA </span></p><p para="{al:2}"><span data-textwidth="614.50" class="sg nowrap f2" style="z-index:3;color:#19B5E9;font-size:267%; left:41.09px;top:78.13px;">Image Interpretation Session</span></p></div></div></div> <div class="sg" id="s18" data-sgid="TextBox 7" style="z-index:4;left:227.68px;top:137.77px;width:444.37px;height:138.70px" data-valign="top"> <div id="s18_t" class="sg" style="z-index:2;left:-14.96px;top:-9.00px;width:474.32px;height:159.66px;"><div><p para="{al:2}"><span data-textwidth="193.23" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:222%; left:140.62px;top:17.26px;">Moderator:</span></p><p para="{al:2}"><span data-textwidth="425.59" class="sg nowrap f2" style="z-index:3;color:#FFFFFF;font-size:222%; left:24.44px;top:65.27px;">Jeffrey C. Weinreb, MD </span></p><p para="{al:2}"><span data-textwidth="358.98" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:156%; left:57.81px;top:112.68px;">FACR, FISMRM, FSCBT/MR</span></p></div></div></div> <div class="sg" id="s15" data-sgid="Picture 8" style="z-index:1;left:57.64px;top:137.77px;width:144.66px;height:194.63px"> <img class="sg" src="17FF2BAA.png" id="s15_i" style="z-index:1;left:0px;top:0px;width:145.02px;height:195.11px" > </div> <div class="sg" id="s17" data-sgid="Rectangle 1" style="z-index:3;left:203.74px;top:304.02px;width:504.27px;height:75.81px" data-valign="top" data-pointer-events="none"> <div id="s17_t" class="sg" style="z-index:2;left:0.00px;top:-4.56px;width:504.27px;height:93.07px;"><div><p para="{al:2}"><span data-textwidth="430.27" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:156%; left:41.10px;top:12.69px;">Professor of Diagnostic Radiology </span><span data-textwidth="298.73" class="sg nowrap f2" style="z-index:3;color:#FFFFFF;font-size:156%; left:102.91px;top:46.30px;">Yale School of Medicine</span></p></div></div></div> <div class="sg" id="s23" data-sgid="Rectangle 1" style="z-index:2;left:221.70px;top:22.52px;width:442.22px;height:226.28px" data-valign="top" data-pointer-events="none"> <div id="s23_t" class="sg" style="z-index:2;left:-11.27px;top:-6.00px;width:453.50px;height:240.54px;"><div><p><span data-textwidth="397.75" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:167%; left:18.81px;top:13.93px;">Yale Department of Radiology</span></p><p><span data-textwidth="274.85" class="sg nowrap f3" style="z-index:3;color:#FFFFFF;font-style:italic; font-size:133%; left:18.81px;top:48.57px;">Director Imaging Services</span></p><p><span data-textwidth="303.05" class="sg nowrap f3" style="z-index:4;color:#FFFFFF;font-style:italic; font-size:133%; left:18.81px;top:77.38px;">Chief Body Imaging Section </span></p><p><span data-textwidth="382.98" class="sg nowrap f3" style="z-index:5;color:#FFFFFF;font-style:italic; font-size:133%; left:18.81px;top:106.19px;">Director of Clinical Quality Initiatives</span></p><p></p><p><span data-textwidth="347.22" class="sg nowrap f2" style="z-index:6;color:#19B5E9;font-size:167%; left:18.81px;top:165.16px;">Yale-New Haven Hospital </span></p><p><span data-textwidth="221.32" class="sg nowrap f3" style="z-index:9;color:#FFFFFF;font-style:italic; font-size:133%; left:18.81px;top:199.81px;">Director MRI Section</span></p></div></div></div> <div class="sg" id="s22" data-sgid="Picture 5" style="z-index:1;left:57.64px;top:137.77px;width:144.66px;height:194.63px"> <img class="sg" src="17FF2BAA.png" id="s22_i" style="z-index:1;left:0px;top:0px;width:145.02px;height:195.11px" > </div> <div class="sg" id="s24" data-sgid="Rectangle 2" style="z-index:3;left:203.74px;top:262.09px;width:492.29px;height:124.44px" data-valign="top" data-pointer-events="none"> <div id="s24_t" class="sg" style="z-index:2;left:0.00px;top:-3.84px;width:494.56px;height:137.28px;"><div><p para="{al:2}"><span data-textwidth="417.67" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:133%; left:40.62px;top:10.65px;">“… a leading authority on MRI contrast </span><span data-textwidth="455.12" class="sg nowrap f2" style="z-index:3;color:#19B5E9;font-size:133%; left:22.02px;top:39.46px;">agents, MRI for the abdomen (focusing on </span><span data-textwidth="459.08" class="sg nowrap f2" style="z-index:4;color:#19B5E9;font-size:133%; left:19.98px;top:68.26px;">the liver), pelvis (focusing on the prostate), </span><span data-textwidth="263.08" class="sg nowrap f2" style="z-index:5;color:#19B5E9;font-size:133%; left:114.67px;top:97.07px;">and abdominal body CT”</span></p></div></div></div> <div class="sg" id="s25" data-sgid="TextBox 1" style="z-index:1;left:34.51px;top:16.52px;width:651.09px;height:56.32px" data-valign="top"> <div id="s25_t" class="sg" style="z-index:2;left:0.00px;top:-8.97px;width:651.09px;height:85.52px;"><div><p para="{al:2}"><span data-textwidth="436.75" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:222%; left:118.40px;top:17.02px;">Jeffrey C. Weinreb, MD  </span></p></div></div></div> <div class="sg" id="s26" data-sgid="TextBox 4" style="z-index:2;left:35.22px;top:88.40px;width:711.02px;height:262.21px" data-valign="top"> <div id="s26_t" class="sg" style="z-index:2;left:-2.97px;top:-3.00px;width:713.99px;height:269.76px;"><div><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="587.62" class="sg nowrap f4" style="z-index:2;color:#19B5E9;font-size:94%; left:10.36px;top:9.10px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1970-1974:<span style="letter-spacing:14.84px"> </span>Phi Beta Kappa; Massachusetts Institute of  Technology (MIT)</span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="396.31" class="sg nowrap f4" style="z-index:7;color:#19B5E9;font-size:94%; left:10.36px;top:35.51px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1974-1978:<span style="letter-spacing:14.84px"> </span>MD, Mount Sinai School of Medicine</span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="609.34" class="sg nowrap f4" style="z-index:12;color:#19B5E9;font-size:94%; left:10.36px;top:61.91px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1978-1979:<span style="letter-spacing:14.72px"> </span>Internship Internal Medicine; Long Island Jewish Medical Center </span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="655.07" class="sg nowrap f4" style="z-index:17;color:#19B5E9;font-size:94%; left:10.36px;top:88.32px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1979-1982:<span style="letter-spacing:14.84px"> </span>Radiology residency/chief resident: Long Island Jewish Medical Center</span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="649.43" class="sg nowrap f4" style="z-index:22;color:#19B5E9;font-size:94%; left:10.36px;top:114.72px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.40px"> </span>1982-1983:<span style="letter-spacing:14.60px"> </span>Fellowship: cross-sectional imaging at the Hospital of the University of</span></span><span data-textwidth="101.30" class="sg nowrap f2" style="z-index:29;color:#FFFFFF;font-size:94%; left:131.82px;top:135.13px;">Pennsylvania</span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="435.91" class="sg nowrap f4" style="z-index:30;color:#19B5E9;font-size:94%; left:10.36px;top:161.53px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1983-1986:<span style="letter-spacing:14.84px"> </span>Faculty, University of Texas Southwestern</span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="545.49" class="sg nowrap f4" style="z-index:36;color:#19B5E9;font-size:94%; left:10.36px;top:187.94px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1986-1988:<span style="letter-spacing:14.84px"> </span>Faculty, Columbia College for Physicians and Surgeons </span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="484.76" class="sg nowrap f4" style="z-index:41;color:#19B5E9;font-size:94%; left:10.36px;top:214.35px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>1988-2002:<span style="letter-spacing:14.84px"> </span>Faculty, New York University School of Medicine</span></span></p><p para="{bl:{ch:167},spaf:6.00}"><span data-textwidth="61.33" class="sg nowrap f4" style="z-index:46;color:#19B5E9;font-size:94%; left:10.36px;top:240.75px;"><span class="f2" style="color:#FFFFFF;"><span style="letter-spacing:7.28px"> </span>2002-</span></span><span data-textwidth="328.61" class="sg nowrap f2" style="z-index:49;color:#FFFFFF;font-size:94%; left:131.94px;top:240.75px;">Faculty, Yale University School of Medicine </span></p></div></div></div> <div class="sg" id="s27" data-sgid="Picture 1" style="z-index:1;left:69.62px;top:11.26px;width:312.44px;height:336.83px"> <img class="sg" src="6BA2B5A1.png" id="s27_i" style="z-index:1;left:0px;top:0px;width:313.21px;height:337.66px" > </div> <div class="sg" id="s28" data-sgid="Picture 2" style="z-index:2;left:409.01px;top:12.70px;width:264.38px;height:336.94px"> <img class="sg" src="994EA07C.png" id="s28_i" style="z-index:1;left:0px;top:0px;width:265.03px;height:337.77px" > </div> <div class="sg" id="s29" data-sgid="TextBox 3" style="z-index:3;left:157.35px;top:351.09px;width:138.76px;height:51.99px" data-valign="top"> <div id="s29_t" class="sg" style="z-index:2;left:0.00px;top:-7.44px;width:138.76px;height:77.40px;"><div><p para="{al:2}"><span data-textwidth="80.17" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:200%; left:28.68px;top:16.27px;">1984</span></p></div></div></div> <div class="sg" id="s30" data-sgid="TextBox 4" style="z-index:4;left:472.65px;top:351.09px;width:138.76px;height:51.99px" data-valign="top"> <div id="s30_t" class="sg" style="z-index:2;left:0.00px;top:-7.44px;width:138.76px;height:77.40px;"><div><p para="{al:2}"><span data-textwidth="80.17" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:200%; left:29.15px;top:16.27px;">2013</span></p></div></div></div> <div class="sg" id="s31" data-sgid="Rectangle 2" style="z-index:1;left:114.56px;top:70.44px;width:492.43px;height:264.47px" data-valign="top" data-pointer-events="none"> <div id="s31_t" class="sg" style="z-index:2;left:0.00px;top:-6.00px;width:494.58px;height:285.46px;"><div><p para="{al:2}"><span data-textwidth="341.70" class="sg nowrap f5" style="z-index:2;color:#19B5E9;font-weight:bold; font-size:189%; left:75.31px;top:13.90px;">Professional welfare:</span></p><p para="{al:2}"></p><p para="{al:2}"><span data-textwidth="417.67" class="sg nowrap f2" style="z-index:3;color:#FFFFFF;font-size:133%; left:40.51px;top:82.03px;">“… a leading authority on MRI contrast </span><span data-textwidth="455.12" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:133%; left:21.90px;top:110.84px;">agents, MRI for the abdomen (focusing on </span><span data-textwidth="459.08" class="sg nowrap f2" style="z-index:5;color:#FFFFFF;font-size:133%; left:19.86px;top:139.65px;">the liver), pelvis (focusing on the prostate), </span><span data-textwidth="280.61" class="sg nowrap f2" style="z-index:6;color:#FFFFFF;font-size:133%; left:105.80px;top:168.45px;">and abdominal body CT...”</span></p><p para="{al:2}"></p><p para="{al:2}"><span data-textwidth="286.97" class="sg nowrap f3" style="z-index:7;color:#19B5E9;font-style:italic; font-size:189%; left:102.68px;top:227.54px;">and patient welfare</span></p></div></div></div> <div class="sg" id="s33" data-sgid="Subtitle 2" style="z-index:2;left:8.98px;top:0.00px;width:702.03px;height:127.58px" data-valign="top"> <div id="s33_t" class="sg" style="z-index:2;left:0.00px;top:-11.26px;width:702.03px;height:159.80px;"><div><p para="{al:2}"><span data-textwidth="264.40" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:267%; left:225.42px;top:21.10px;">2014 RSNA </span></p><p para="{al:2}"><span data-textwidth="614.50" class="sg nowrap f2" style="z-index:3;color:#19B5E9;font-size:267%; left:43.71px;top:78.71px;">Image Interpretation Session</span></p></div></div></div> <div class="sg" id="s32" data-sgid="Picture 1" style="z-index:1;left:107.14px;top:125.77px;width:196.17px;height:259.80px"> <img class="sg" src="8D9B88F7.png" id="s32_i" style="z-index:1;left:0px;top:0px;width:196.65px;height:260.44px" > </div> <div class="sg" id="s34" data-sgid="TextBox 5" style="z-index:3;left:311.59px;top:172.25px;width:389.00px;height:167.95px" data-valign="top"> <div id="s34_t" class="sg" style="z-index:2;left:-0.74px;top:-9.82px;width:401.73px;height:199.43px;"><div><p para="{al:2}"><span data-textwidth="347.70" class="sg nowrap f3" style="z-index:2;color:#FFFFFF;font-style:italic; font-size:244%; left:27.73px;top:19.77px;">Running the race </span><span data-textwidth="85.81" class="sg nowrap f3" style="z-index:3;color:#FFFFFF;font-style:italic; font-size:244%; left:158.79px;top:72.58px;">and </span></p><p para="{al:2}"><span data-textwidth="306.05" class="sg nowrap f3" style="z-index:4;color:#FFFFFF;font-style:italic; font-size:244%; left:42.13px;top:125.39px;">panelist welfare</span></p></div></div></div> <div class="sg" id="s37" data-sgid="Subtitle 2" style="z-index:3;left:8.98px;top:0.00px;width:702.03px;height:127.58px" data-valign="top"> <div id="s37_t" class="sg" style="z-index:2;left:0.00px;top:-11.26px;width:702.03px;height:159.80px;"><div><p para="{al:2}"><span data-textwidth="264.40" class="sg nowrap f2" style="z-index:2;color:#19B5E9;font-size:267%; left:225.42px;top:21.10px;">2014 RSNA </span></p><p para="{al:2}"><span data-textwidth="614.50" class="sg nowrap f2" style="z-index:3;color:#19B5E9;font-size:267%; left:43.71px;top:78.71px;">Image Interpretation Session</span></p></div></div></div> <div class="sg" id="s36" data-sgid="TextBox 3" style="z-index:2;left:310.14px;top:184.22px;width:402.43px;height:95.25px" data-valign="top"> <div id="s36_t" class="sg" style="z-index:2;left:-7.54px;top:-7.53px;width:416.66px;height:120.03px;"><div><p para="{al:2}"><span data-textwidth="174.15" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:200%; left:121.91px;top:15.91px;">Moderator:</span></p><p para="{al:2}"><span data-textwidth="372.78" class="sg nowrap f2" style="z-index:3;color:#FFFFFF;font-size:200%; left:22.53px;top:59.12px;">Jeffrey C. Weinreb, MD</span></p></div></div></div> <div class="sg" id="s35" data-sgid="Picture 2" style="z-index:1;left:103.43px;top:134.03px;width:208.87px;height:225.32px"> <img class="sg" src="27AB32F6.png" id="s35_i" style="z-index:1;left:0px;top:0px;width:209.39px;height:225.88px" > </div> <div class="sg sgTitle" id="s38" data-sgid="Title 3" style="z-index:1;left:35.96px;top:10.55px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s38_t" class="sg" style="z-index:2;left:0.00px;top:-15.10px;width:648.93px;height:114.14px;"><div><p para="{al:2}"><span data-textwidth="204.03" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:221.96px;top:22.31px;">Panelists</span></p></div></div></div> <div class="sg" id="s40" data-sgid="Picture 8" style="z-index:3;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s40_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s39" data-sgid="Picture 7" style="z-index:2;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s39_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s41" data-sgid="Picture 6" style="z-index:4;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s41_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s42" data-sgid="Picture 7 (2)" style="z-index:5;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s42_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s43" data-sgid="Picture 13" style="z-index:6;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s43_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg sgTitle" id="s48" data-sgid="Title 3" style="z-index:1;left:35.96px;top:34.51px;width:642.10px;height:138.70px" data-valign="middle" data-pointer-events="none"> <div id="s48_t" class="sg" style="z-index:2;left:0.00px;top:-32.25px;width:642.92px;height:171.65px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:260.49px;top:13.94px;">Panelists</span><span data-textwidth="254.20" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:193.88px;top:70.64px;">Carol H. Lee, MD</span><span data-textwidth="273.41" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:200%; left:184.28px;top:109.52px;">Breast Radiologist</span></p></div></div></div> <div class="sg" id="s49" data-sgid="Picture 8" style="z-index:2;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s49_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s53" data-sgid="Picture 7 (2)" style="z-index:6;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s53_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s50" data-sgid="Picture 6" style="z-index:3;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s50_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s51" data-sgid="Picture 7" style="z-index:4;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s51_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s52" data-sgid="Picture 16" style="z-index:5;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s52_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg sgTitle" id="s54" data-sgid="Title 3" style="z-index:1;left:35.96px;top:34.51px;width:642.10px;height:138.70px" data-valign="middle" data-pointer-events="none"> <div id="s54_t" class="sg" style="z-index:2;left:0.00px;top:-32.25px;width:642.92px;height:171.65px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:260.49px;top:13.94px;">Panelists</span><span data-textwidth="343.62" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:149.23px;top:70.64px;">Theodore T. Miller, MD</span><span data-textwidth="412.87" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:200%; left:114.55px;top:109.52px;">Musculoskeletal Radiologist</span></p></div></div></div> <div class="sg" id="s59" data-sgid="Picture 8" style="z-index:6;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s59_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s55" data-sgid="Picture 7" style="z-index:2;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s55_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s56" data-sgid="Picture 6" style="z-index:3;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s56_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s57" data-sgid="Picture 7 (2)" style="z-index:4;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s57_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s58" data-sgid="Picture 16" style="z-index:5;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s58_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg" id="s65" data-sgid="Title 3" style="z-index:6;left:35.96px;top:34.51px;width:642.10px;height:138.70px" data-valign="middle"> <div id="s65_t" class="sg" style="z-index:2;left:0.00px;top:-32.25px;width:642.10px;height:171.65px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:260.49px;top:13.94px;">Panelists</span><span data-textwidth="528.21" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:67.02px;top:70.64px;">Reginald Munden, MD, DMD, MBA  </span><span data-textwidth="259.96" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:200%; left:191.00px;top:109.52px;">Chest Radiologist</span></p></div></div></div> <div class="sg" id="s61" data-sgid="Picture 8" style="z-index:2;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s61_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s60" data-sgid="Picture 7" style="z-index:1;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s60_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s64" data-sgid="Picture 6" style="z-index:5;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s64_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s62" data-sgid="Picture 7 (2)" style="z-index:3;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s62_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s63" data-sgid="Picture 12" style="z-index:4;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s63_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg" id="s72" data-sgid="Title 3 (2)" style="z-index:7;left:35.96px;top:34.51px;width:642.10px;height:138.70px" data-valign="middle"> <div id="s72_t" class="sg" style="z-index:2;left:0.00px;top:-32.25px;width:642.10px;height:171.65px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:260.49px;top:13.94px;">Panelists</span><span data-textwidth="395.10" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:123.43px;top:70.64px;">Anwar R. Padhani, MB BS</span><span data-textwidth="402.91" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:200%; left:119.47px;top:109.52px;">Body/Oncology Radiologist</span></p></div></div></div> <div class="sg" id="s68" data-sgid="Picture 8" style="z-index:3;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s68_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s67" data-sgid="Picture 7" style="z-index:2;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s67_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s69" data-sgid="Picture 6" style="z-index:4;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s69_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s71" data-sgid="Picture 7 (2)" style="z-index:6;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s71_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s70" data-sgid="Picture 12" style="z-index:5;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s70_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg sgTitle" id="s66" data-sgid="Title 3" style="z-index:1;left:185.75px;top:244.13px;width:684.04px;height:138.70px" data-valign="middle" data-pointer-events="none"> <div id="s66_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:684.89px;height:152.22px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:281.73px;top:14.37px;">Panelists</span><span data-textwidth="164.55" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:260.00px;top:71.07px;">Radiologist</span></p></div></div></div> <div class="sg sgTitle" id="s73" data-sgid="Title 3" style="z-index:1;left:35.96px;top:34.51px;width:642.10px;height:138.70px" data-valign="middle" data-pointer-events="none"> <div id="s73_t" class="sg" style="z-index:2;left:0.00px;top:-32.25px;width:642.92px;height:171.65px;"><div><p para="{al:2}"><span data-textwidth="120.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:260.49px;top:13.94px;">Panelists</span><span data-textwidth="351.78" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:200%; left:145.15px;top:70.64px;">Howard A. Rowley, MD</span><span data-textwidth="234.28" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:200%; left:203.84px;top:109.52px;">Neuoradiologist</span></p></div></div></div> <div class="sg" id="s75" data-sgid="Picture 8" style="z-index:3;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s75_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s74" data-sgid="Picture 7" style="z-index:2;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s74_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s76" data-sgid="Picture 6" style="z-index:4;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s76_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s77" data-sgid="Picture 7 (2)" style="z-index:5;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s77_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s78" data-sgid="Picture 12" style="z-index:6;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s78_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg sgTitle" id="s79" data-sgid="Title 3" style="z-index:1;left:41.94px;top:64.44px;width:648.11px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s79_t" class="sg" style="z-index:2;left:0.00px;top:-78.70px;width:648.93px;height:225.69px;"><div><p para="{al:2}"><span data-textwidth="166.35" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:240.83px;top:17.90px;">Panelists</span><span data-textwidth="169.47" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:133%; left:239.27px;top:68.83px;">Carol H. Lee, MD</span><span data-textwidth="228.76" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:209.62px;top:97.64px;">Theodore T. Miller, MD</span><span data-textwidth="339.42" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:133%; left:154.29px;top:126.44px;">Reginald Munden, MD, DMD, MBA</span><span data-textwidth="263.92" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:192.10px;top:155.25px;">Anwar R. Padhani, MB BS</span><span data-textwidth="234.16" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:133%; left:206.98px;top:184.06px;">Howard A. Rowley, MD</span></p></div></div></div> <div class="sg" id="s81" data-sgid="Picture 8" style="z-index:3;left:162.00px;top:196.50px;width:131.50px;height:168.00px"> <img class="sg" src="8AFADCE.jpg" id="s81_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:131.43px;height:168.10px" > </div> <div class="sg" id="s80" data-sgid="Picture 7" style="z-index:2;left:29.95px;top:196.21px;width:131.82px;height:168.40px"> <img class="sg" src="76C8A64B.png" id="s80_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:132.15px;height:168.82px" > </div> <div class="sg" id="s82" data-sgid="Picture 6" style="z-index:4;left:294.00px;top:196.50px;width:138.00px;height:170.50px"> <img class="sg" src="4E1D0E3.jpg" id="s82_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:138.17px;height:170.26px" > </div> <div class="sg" id="s84" data-sgid="Picture 7 (2)" style="z-index:6;left:432.00px;top:196.50px;width:126.00px;height:171.13px"> <img class="sg" src="2E4E982B.jpg" id="s84_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:126.15px;height:171.11px" > </div> <div class="sg" id="s83" data-sgid="Picture 10" style="z-index:5;left:557.26px;top:196.21px;width:128.11px;height:172.14px"> <img class="sg" src="1F1886EA.jpg" id="s83_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:128.43px;height:172.57px" > </div> <div class="sg sgTitle" id="s85" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s85_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="297.77" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:175.16px;top:17.71px;">Program Details</span></p></div></div></div> <div class="sg" id="s86" data-sgid="Content Placeholder 2" style="z-index:2;left:65.91px;top:94.40px;width:606.14px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s86_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:621.84px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="581.98" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>Each panelist received 2 cases in July to </span><span data-textwidth="100.22" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:47.00px;top:51.92px;">review </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="359.35" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.99px;top:98.01px;">•<span style="letter-spacing:5.61px"> </span>Very explicit instructions</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="450.20" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:19.99px;top:144.10px;">•<span style="letter-spacing:5.61px"> </span>Required to submit slides with  </span><span data-textwidth="327.77" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:178%; left:47.00px;top:182.51px;">evaluations by October 1</span></p></div></div></div> <div class="sg sgTitle" id="s92" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s92_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="297.77" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:175.16px;top:17.71px;">Program Details</span></p></div></div></div> <div class="sg" id="s93" data-sgid="Content Placeholder 2" style="z-index:2;left:65.91px;top:94.40px;width:618.13px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s93_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:631.68px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="522.33" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>Panelists will be given their cases in </span><span data-textwidth="184.23" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:47.00px;top:51.92px;">random order</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="582.82" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.99px;top:98.01px;">•<span style="letter-spacing:5.61px"> </span>Asked to describe the findings, provide a </span><span data-textwidth="516.81" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:47.00px;top:136.42px;">focused differential diagnosis, provide </span><span data-textwidth="208.71" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:47.00px;top:174.83px;">their top choice</span></p></div></div></div> <div class="sg sgTitle" id="s94" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s94_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="297.77" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:175.16px;top:17.71px;">Program Details</span></p></div></div></div> <div class="sg" id="s95" data-sgid="Content Placeholder 2" style="z-index:2;left:65.91px;top:94.40px;width:618.13px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s95_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:631.68px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="507.09" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>The diagnosis will then be revealed </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="524.25" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:19.99px;top:59.60px;">•<span style="letter-spacing:5.61px"> </span>A brief overview of the entity will be </span><span data-textwidth="116.54" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:47.00px;top:98.01px;">provided</span></p></div></div></div> <div class="sg sgTitle" id="s96" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s96_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="297.77" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:175.16px;top:17.71px;">Program Details</span></p></div></div></div> <div class="sg" id="s97" data-sgid="Content Placeholder 2" style="z-index:2;left:65.91px;top:94.40px;width:618.13px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s97_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:641.37px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="536.61" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>The primary objective is to learn how </span><span data-textwidth="328.01" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:47.00px;top:51.92px;">experts approach a case</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="519.69" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.99px;top:98.01px;">•<span style="letter-spacing:5.61px"> </span>All of the cases are challenging, and </span><span data-textwidth="573.34" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:47.00px;top:136.42px;">“nailing” the diagnosis may not be possible</span></p></div></div></div> <div class="sg" id="s98" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s98_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="229.72" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.16px;top:22.20px;">First Case</span></p></div></div></div> <div class="sg sgTitle" id="s99" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s99_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="381.54" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.27px;top:15.90px;">Theodore T. Miller, MD</span></p></div></div></div> <div class="sg" id="s101" data-sgid="Picture 4" style="z-index:3;left:36.00px;top:112.50px;width:153.13px;height:195.75px"> <img class="sg" src="31153EA1.jpg" id="s101_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:153.17px;height:195.84px" > </div> <div class="sg" id="s100" data-sgid="Content Placeholder 3" style="z-index:2;left:227.68px;top:88.40px;width:510.28px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s100_t" class="sg" style="z-index:2;left:-8.24px;top:-5.26px;width:519.38px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="275.44" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.80px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Attending Radiologist</span></span></p><p para="{spbf:0.20}"><span data-textwidth="331.62" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:87.81px;top:52.25px;">Hospital for Special Surgery</span></p><p para="{bl:{ch:167},spbf:0.20}"></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="294.52" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.80px;top:134.19px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Professor of Radiology</span></span></p><p para="{spbf:0.20}"><span data-textwidth="335.82" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:87.81px;top:173.24px;">Weill Cornell Medical College</span></p></div></div></div> <div class="sg sgTitle" id="s108" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s108_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="381.54" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.27px;top:15.90px;">Theodore T. Miller, MD</span></p></div></div></div> <div class="sg" id="s110" data-sgid="Picture 5" style="z-index:3;left:36.00px;top:112.50px;width:153.13px;height:195.75px"> <img class="sg" src="31153EA1.jpg" id="s110_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:153.17px;height:195.84px" > </div> <div class="sg" id="s109" data-sgid="Content Placeholder 3" style="z-index:2;left:239.67px;top:88.40px;width:456.36px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s109_t" class="sg" style="z-index:2;left:-8.25px;top:-5.26px;width:465.45px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="380.95" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.82px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Univ of Penn: Majored in Latin</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="297.42" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.82px;top:53.53px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Med School: Vanderbilt</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="300.30" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.82px;top:93.86px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Residency: Mount Sinai</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="283.13" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:156%; left:15.82px;top:134.19px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>MSK Fellowship: HSS</span></span></p></div></div></div> <div class="sg sgTitle" id="s111" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s111_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="381.54" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.27px;top:15.90px;">Theodore T. Miller, MD</span></p></div></div></div> <div class="sg" id="s113" data-sgid="Picture 5" style="z-index:3;left:36.00px;top:112.50px;width:153.13px;height:195.75px"> <img class="sg" src="31153EA1.jpg" id="s113_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:153.17px;height:195.84px" > </div> <div class="sg" id="s112" data-sgid="Content Placeholder 3" style="z-index:2;left:239.67px;top:88.40px;width:456.36px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s112_t" class="sg" style="z-index:2;left:-8.25px;top:-5.26px;width:465.45px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="341.58" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.82px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>>80 peer reviewed articles</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="212.08" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.82px;top:53.53px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>17 book chapter</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="331.98" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.82px;top:93.86px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Textbook on MSK imaging</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="287.33" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:156%; left:15.82px;top:134.19px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>RSNA Editorial Fellow</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="375.67" class="sg nowrap f4" style="z-index:10;color:#FFFFFF;font-size:156%; left:15.82px;top:174.52px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>International Skeletal Society </span></span><span data-textwidth="216.04" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:42.83px;top:206.84px;">Presidents’ Medal </span></p></div></div></div> <div class="sg" id="s115" data-sgid="Picture 5" style="z-index:2;left:72.00px;top:88.50px;width:318.00px;height:212.25px"> <img class="sg" src="14EEFD86.jpg" id="s115_i" title="" alt="drummin fool 2.jpg" style="z-index:1;left:0px;top:0px;width:318.35px;height:212.29px" > </div> <div class="sg" id="s114" data-sgid="Picture 4" style="z-index:1;left:414.00px;top:22.50px;width:216.00px;height:352.88px"> <img class="sg" src="CB58C33B.jpg" id="s114_i" title="" alt="Ted Abbey Rd 2.JPG" style="z-index:1;left:0px;top:0px;width:216.23px;height:353.40px" > </div> <div class="sg" id="s116" data-sgid="Picture 1" style="z-index:1;left:78.00px;top:10.50px;width:597.25px;height:336.00px"> <img class="sg" src="5F41E766.jpg" id="s116_i" title="" alt="Mille Family.jpeg" style="z-index:1;left:0px;top:0px;width:597.67px;height:336.22px" > </div> <div class="sg" id="s117" data-sgid="TextBox 1" style="z-index:2;left:103.43px;top:345.94px;width:76.56px;height:32.33px" data-valign="top"> <div id="s117_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:87.84px;height:43.59px;"><div><p><span data-textwidth="60.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.62px;top:9.18px;">Landon</span></p></div></div></div> <div class="sg" id="s118" data-sgid="TextBox 3" style="z-index:3;left:193.31px;top:345.94px;width:48.88px;height:32.33px" data-valign="top"> <div id="s118_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:58.60px;height:43.59px;"><div><p><span data-textwidth="32.89" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.75px;top:9.18px;">Ben</span></p></div></div></div> <div class="sg" id="s119" data-sgid="TextBox 4" style="z-index:4;left:319.12px;top:345.94px;width:55.62px;height:32.33px" data-valign="top"> <div id="s119_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:66.17px;height:43.59px;"><div><p><span data-textwidth="39.85" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.96px;top:9.18px;">Elisa</span></p></div></div></div> <div class="sg" id="s120" data-sgid="TextBox 5" style="z-index:5;left:443.41px;top:345.94px;width:56.45px;height:32.33px" data-valign="top"> <div id="s120_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:66.99px;height:43.59px;"><div><p><span data-textwidth="40.69" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.14px;top:9.18px;">Mom</span></p></div></div></div> <div class="sg" id="s121" data-sgid="TextBox 6" style="z-index:6;left:503.34px;top:345.94px;width:57.15px;height:32.33px" data-valign="top"> <div id="s121_t" class="sg" style="z-index:2;left:-5.30px;top:-3.00px;width:65.46px;height:43.59px;"><div><p><span data-textwidth="39.61" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.25px;top:9.18px;">Jack</span></p></div></div></div> <div class="sg" id="s122" data-sgid="TextBox 7" style="z-index:7;left:551.26px;top:345.94px;width:60.16px;height:32.33px" data-valign="top"> <div id="s122_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:69.14px;height:43.59px;"><div><p><span data-textwidth="44.05" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.30px;top:9.18px;">Terry</span></p></div></div></div> <div class="sg sgTitle" id="s123" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s123_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="248.56" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:199.76px;top:17.71px;">MSK Case #1</span></p></div></div></div> <div class="sg" id="s124" data-sgid="Subtitle 2" style="z-index:2;left:113.86px;top:103.37px;width:504.27px;height:135.73px" data-valign="top"> <div id="s124_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:504.27px;height:146.25px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="278.45" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:117.18px;top:13.51px;">17-year-old girl with </span><span data-textwidth="282.65" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:115.14px;top:51.92px;">left knee pain during </span><span data-textwidth="200.91" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:151.62px;top:90.33px;">athletic activity</span></p></div></div></div> <div class="sg" id="s126" data-sgid="Picture 3" style="z-index:2;left:367.13px;top:58.50px;width:310.88px;height:282.00px"> <img class="sg" src="D7865C38.jpg" id="s126_i" style="z-index:1;left:0px;top:0px;width:310.80px;height:282.20px" > </div> <div class="sg" id="s125" data-sgid="Picture 2" style="z-index:1;left:48.00px;top:58.50px;width:286.75px;height:283.50px"> <img class="sg" src="C6742986.jpg" id="s125_i" style="z-index:1;left:0px;top:0px;width:286.88px;height:283.64px" > </div> <div class="sg" id="s128" data-sgid="Picture 3 (2)" style="z-index:2;left:54.00px;top:52.50px;width:276.00px;height:291.13px"> <img class="sg" src="B097EF23.jpg" id="s128_i" style="z-index:1;left:0px;top:0px;width:276.31px;height:291.19px" > </div> <div class="sg" id="s127" data-sgid="Picture 3" style="z-index:1;left:378.00px;top:53.00px;width:324.00px;height:290.50px"> <img class="sg" src="F9775DC8.jpg" id="s127_i" style="z-index:1;left:0px;top:0px;width:324.37px;height:290.48px" > </div> <div class="sg" id="s129" data-sgid="Picture 2" style="z-index:1;left:258.00px;top:12.00px;width:192.00px;height:379.50px"> <img class="sg" src="6C57A1C4.jpg" id="s129_i" style="z-index:1;left:0px;top:0px;width:192.19px;height:379.84px" > </div> <div class="sg" id="s132" data-sgid="Picture 2" style="z-index:3;left:552.00px;top:70.50px;width:143.38px;height:283.50px"> <img class="sg" src="1AE36106.png" id="s132_i" style="z-index:1;left:0px;top:0px;width:143.45px;height:283.61px" > </div> <div class="sg" id="s131" data-sgid="Picture 3 (2)" style="z-index:2;left:288.00px;top:106.50px;width:237.63px;height:213.00px"> <img class="sg" src="C801D2A8.jpg" id="s131_i" style="z-index:1;left:0px;top:0px;width:237.99px;height:213.15px" > </div> <div class="sg" id="s130" data-sgid="Picture 3" style="z-index:1;left:35.96px;top:106.36px;width:238.22px;height:215.62px"> <img class="sg" src="DFD163C.jpg" id="s130_i" style="z-index:1;left:0px;top:0px;width:238.81px;height:216.15px" > </div> <div class="sg" id="s133" data-sgid="TextBox 1" style="z-index:1;left:173.76px;top:10.55px;width:420.40px;height:61.56px" data-valign="top"> <div id="s133_t" class="sg" style="z-index:2;left:-19.41px;top:-10.55px;width:456.36px;height:93.80px;"><div><p><span data-textwidth="401.59" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.88px;top:17.92px;">Bone-forming Tumors</span></p></div></div></div> <div class="sg" id="s134" data-sgid="TextBox 2" style="z-index:2;left:59.93px;top:76.44px;width:589.71px;height:275.73px" data-valign="top"> <div id="s134_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:602.43px;height:292.28px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="263.69" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:13.47px;">•<span style="letter-spacing:14.61px"> </span>Osteoid Osteoma</span></p><p para="{bl:{ch:8226}}"></p><p para="{bl:{ch:8226}}"><span data-textwidth="226.60" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.00px;top:72.04px;">•<span style="letter-spacing:14.61px"> </span>Osteosarcoma</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="516.20" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:65.25px;top:110.45px;">–<span style="letter-spacing:6.32px"> </span>Osteoblastoma-like OS – can be sclerotic </span><span data-textwidth="379.26" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:92.01px;top:144.06px;">70% older than 25 yrs; femur is </span><span data-textwidth="128.42" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:92.01px;top:177.66px;">uncommon</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="476.72" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:65.25px;top:211.27px;">–<span style="letter-spacing:6.32px"> </span>Low-grade intraosseous OS (aka well-</span><span data-textwidth="214.00" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:156%; left:92.01px;top:244.88px;">differentiated IOS)</span></p></div></div></div> <div class="sg" id="s135" data-sgid="TextBox 1" style="z-index:1;left:173.76px;top:10.55px;width:420.40px;height:61.56px" data-valign="top"> <div id="s135_t" class="sg" style="z-index:2;left:-19.41px;top:-10.55px;width:456.36px;height:93.80px;"><div><p><span data-textwidth="401.59" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.88px;top:17.92px;">Bone-forming Tumors</span></p></div></div></div> <div class="sg" id="s136" data-sgid="TextBox 2" style="z-index:2;left:59.93px;top:76.44px;width:589.71px;height:206.85px" data-valign="top"> <div id="s136_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:602.43px;height:224.13px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="407.47" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:13.47px;">•<span style="letter-spacing:14.61px"> </span>Low-grade intraosseous OS</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="189.75" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:65.25px;top:57.88px;">–<span style="letter-spacing:6.32px"> </span>< 1% of all OS</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="487.52" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:65.25px;top:97.49px;">–<span style="letter-spacing:6.32px"> </span>Majority of patients in 2nd/3rd decades</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="500.48" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:65.25px;top:137.10px;">–<span style="letter-spacing:6.32px"> </span>Distal femoral metaphysis most common</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="280.96" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:65.25px;top:176.70px;">–<span style="letter-spacing:6.32px"> </span>Lytic, mixed, sclerotic</span></p></div></div></div> <div class="sg sgSubtitle" id="s137" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s137_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s138" data-sgid="Subtitle 4" style="z-index:1;left:11.99px;top:124.33px;width:708.01px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s138_t" class="sg" style="z-index:2;left:0.00px;top:-8.97px;width:708.84px;height:120.03px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="576.46" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:71.54px;top:16.71px;">Low Grade Central Osteosarcoma </span><span data-textwidth="626.50" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:40.70px;top:63.72px;">Intraosseous Well-differentiated Osteosarcoma</span></p></div></div></div> <div class="sg" id="s141" data-sgid="Subtitle 4" style="z-index:3;left:65.91px;top:10.55px;width:686.31px;height:72.81px" data-valign="top"> <div id="s141_t" class="sg" style="z-index:2;left:-17.26px;top:-8.99px;width:703.56px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="558.81" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.56px;top:16.48px;"><u>Low Grade Central Osteosarcoma</u></span></p></div></div><img class="sg" src="FFF287D3.png" id="s141_tt" style="left:-17.26px;top:-8.99px;width:703.56px;height:85.52px;z-index:1" > </div> <div class="sg" id="s139" data-sgid="Content Placeholder 2" style="z-index:1;left:47.95px;top:88.40px;width:462.34px;height:256.94px" data-valign="top" data-pointer-events="none"> <div id="s139_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:472.88px;height:263.03px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="322.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.98px;top:11.92px;">•<span style="letter-spacing:8.60px"> </span><1% of all osteosarcomas</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="409.50" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:16.98px;top:52.25px;">•<span style="letter-spacing:8.60px"> </span>Consist of fibroblastic stroma of </span><span data-textwidth="363.54" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:43.98px;top:85.86px;">variable cellularity and osteoid </span><span data-textwidth="309.77" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:43.98px;top:119.46px;">arranged in parallel seams</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="327.89" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:16.98px;top:159.79px;">•<span style="letter-spacing:8.60px"> </span>Most involve long bones -</span><span data-textwidth="370.50" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:156%; left:43.98px;top:193.40px;">especially around the knee joint</span></p></div></div></div> <div class="sg" id="s140" data-sgid="Picture 1" style="z-index:2;left:498.00px;top:100.50px;width:196.38px;height:244.38px"> <img class="sg" src="C75865A8.jpg" id="s140_i" style="z-index:1;left:0px;top:0px;width:196.77px;height:244.62px" > </div> <div class="sg sgTitle" id="s143" data-sgid="Rectangle 2" style="z-index:2;left:23.97px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s143_t" class="sg" style="z-index:2;left:0.00px;top:-5.97px;width:648.93px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="156.75" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:244%; left:245.59px;top:19.34px;">Imaging</span></p></div></div></div> <div class="sg" id="s142" data-sgid="Content Placeholder 2" style="z-index:1;left:47.95px;top:88.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s142_t" class="sg" style="z-index:2;left:-12.73px;top:-6.82px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="459.19" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.48px;">•<span style="letter-spacing:5.60px"> </span>Most common pattern is a large </span><span data-textwidth="542.25" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.99px;top:51.89px;">intracompartmental expansile lytic fibro-</span><span data-textwidth="563.97" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:46.99px;top:90.30px;">osseous lesion with coarsely thick or thin </span><span data-textwidth="302.57" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:46.99px;top:128.71px;">incomplete trabeculae </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="615.34" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:19.99px;top:174.80px;">•<span style="letter-spacing:5.60px"> </span>Less common pattern is a densely sclerotic </span><span data-textwidth="289.37" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:46.99px;top:213.20px;">lesion (<span style="color:#FFFF00;">sclerotic type</span>)</span></p></div></div></div> <div class="sg" id="s145" data-sgid="Subtitle 4" style="z-index:2;left:65.91px;top:10.55px;width:686.31px;height:72.81px" data-valign="top"> <div id="s145_t" class="sg" style="z-index:2;left:-17.26px;top:-8.99px;width:703.56px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="558.81" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.56px;top:16.48px;"><u>Low Grade Central Osteosarcoma</u></span></p></div></div><img class="sg" src="FFF287D3.png" id="s145_tt" style="left:-17.26px;top:-8.99px;width:703.56px;height:85.52px;z-index:1" > </div> <div class="sg" id="s144" data-sgid="Content Placeholder 2" style="z-index:1;left:53.92px;top:34.51px;width:630.12px;height:294.43px" data-valign="top" data-pointer-events="none"> <div id="s144_t" class="sg" style="z-index:2;left:-12.69px;top:0.00px;width:645.82px;height:313.83px;"><div><p para="{spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="575.49" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.98px;top:52.63px;">•<span style="letter-spacing:5.60px"> </span>Indolent course with long history of pain </span><span data-textwidth="176.31" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.98px;top:91.04px;">and swelling </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="606.22" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.98px;top:137.13px;">•<span style="letter-spacing:5.60px"> </span>Metastasis less common than conventional </span><span data-textwidth="202.35" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:46.98px;top:175.54px;">osteosarcomas</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="181.11" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:19.98px;top:221.63px;">•<span style="letter-spacing:5.60px"> </span>Treatment: </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="464.60" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:156%; left:55.99px;top:266.76px;">– Wide local excision +/- chemotherapy</span></p></div></div></div> <div class="sg" id="s146" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s146_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s147" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s147_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="282.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:182.72px;top:15.90px;">Carol H. Lee, MD</span></p></div></div></div> <div class="sg" id="s148" data-sgid="Content Placeholder 3" style="z-index:2;left:227.68px;top:88.40px;width:510.28px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s148_t" class="sg" style="z-index:2;left:-8.24px;top:-5.26px;width:519.38px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="237.04" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.80px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Med School: Yale </span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="212.43" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.80px;top:53.53px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Residency: Yale</span></span></p></div></div></div> <div class="sg" id="s149" data-sgid="Picture 4" style="z-index:3;left:36.00px;top:94.50px;width:171.00px;height:256.50px"> <img class="sg" src="639978F7.jpg" id="s149_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:171.18px;height:256.61px" > </div> <div class="sg sgTitle" id="s150" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s150_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="282.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:182.72px;top:15.90px;">Carol H. Lee, MD</span></p></div></div></div> <div class="sg" id="s151" data-sgid="Content Placeholder 3" style="z-index:2;left:227.68px;top:88.40px;width:510.28px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s151_t" class="sg" style="z-index:2;left:-8.24px;top:-5.26px;width:519.38px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="275.44" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.80px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Attending Radiologist</span></span></p><p para="{spbf:0.20}"><span data-textwidth="298.73" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:55.17px;top:52.25px;">Memorial Sloan-Kettering</span></p><p para="{spbf:0.20}"></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="294.52" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:156%; left:15.80px;top:134.19px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Professor of Radiology</span></span></p><p para="{spbf:0.20}"><span data-textwidth="335.82" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:87.81px;top:173.24px;">Weill Cornell Medical College</span></p></div></div></div> <div class="sg" id="s152" data-sgid="Picture 1" style="z-index:3;left:36.00px;top:94.50px;width:171.00px;height:256.50px"> <img class="sg" src="639978F7.jpg" id="s152_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:171.18px;height:256.61px" > </div> <div class="sg sgTitle" id="s153" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s153_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="282.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:182.72px;top:15.90px;">Carol H. Lee, MD</span></p></div></div></div> <div class="sg" id="s154" data-sgid="Content Placeholder 3" style="z-index:2;left:215.73px;top:88.40px;width:510.25px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s154_t" class="sg" style="z-index:2;left:-6.72px;top:-3.85px;width:517.82px;height:272.05px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="297.29" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.23px;top:10.43px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>>40 peer reviewed articles</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="198.75" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.23px;top:45.00px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>10 book chapters</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="456.79" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.23px;top:79.57px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>Chair: ACR Commission on Breast Imaging</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="233.56" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.23px;top:114.13px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>Vice-President: ACR</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="394.98" class="sg nowrap f4" style="z-index:12;color:#FFFFFF;font-size:133%; left:14.23px;top:148.70px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>President: Society of Breast Imaging</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="435.79" class="sg nowrap f4" style="z-index:14;color:#FFFFFF;font-size:133%; left:14.23px;top:183.27px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>Member of FDA National Mammography </span></span><span data-textwidth="394.27" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:41.23px;top:211.16px;">Quality Assurance Advisory Committee</span></p></div></div></div> <div class="sg" id="s155" data-sgid="Picture 4" style="z-index:3;left:36.00px;top:94.50px;width:171.00px;height:256.50px"> <img class="sg" src="639978F7.jpg" id="s155_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:171.18px;height:256.61px" > </div> <div class="sg" id="s156" data-sgid="Picture 1" style="z-index:1;left:30.00px;top:19.50px;width:404.00px;height:303.00px"> <img class="sg" src="EF253C9A.jpg" id="s156_i" title="" alt="The family Aug 2014.jpg" style="z-index:1;left:0px;top:0px;width:404.74px;height:303.21px" > </div> <div class="sg" id="s157" data-sgid="Picture 3" style="z-index:2;left:462.00px;top:52.50px;width:229.50px;height:306.00px"> <img class="sg" src="F4F9F592.jpg" id="s157_i" title="" alt="2012-10-21 12.56.17.jpg" style="z-index:1;left:0px;top:0px;width:229.84px;height:306.18px" > </div> <div class="sg" id="s158" data-sgid="TextBox 4" style="z-index:3;left:125.84px;top:327.98px;width:57.15px;height:32.33px" data-valign="top"> <div id="s158_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:66.99px;height:43.59px;"><div><p><span data-textwidth="41.29" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.65px;top:9.13px;">Katie</span></p></div></div></div> <div class="sg" id="s159" data-sgid="TextBox 5" style="z-index:4;left:215.73px;top:327.98px;width:49.73px;height:32.33px" data-valign="top"> <div id="s159_t" class="sg" style="z-index:2;left:-5.30px;top:-3.00px;width:60.16px;height:43.59px;"><div><p><span data-textwidth="33.85" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.81px;top:9.13px;">Hod</span></p></div></div></div> <div class="sg" id="s160" data-sgid="TextBox 6" style="z-index:5;left:335.56px;top:327.98px;width:59.42px;height:32.33px" data-valign="top"> <div id="s160_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:67.70px;height:43.59px;"><div><p><span data-textwidth="41.65" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.97px;top:9.13px;">John</span></p></div></div></div> <div class="sg" id="s161" data-sgid="Picture 1" style="z-index:1;left:162.00px;top:28.50px;width:432.00px;height:332.13px"> <img class="sg" src="7F23F06D.jpg" id="s161_i" title="" alt="2012-02-14 21.47.36.jpg" style="z-index:1;left:0px;top:0px;width:432.49px;height:332.39px" > </div> <div class="sg sgTitle" id="s162" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s162_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="283.85" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:182.12px;top:17.71px;">Breast Case #1</span></p></div></div></div> <div class="sg" id="s163" data-sgid="Content Placeholder 1" style="z-index:2;left:74.18px;top:103.37px;width:573.90px;height:165.66px" data-valign="top"> <div id="s163_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:573.90px;height:172.48px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="340.50" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:120.85px;top:13.51px;">44-year-old woman with </span><span data-textwidth="415.03" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:83.65px;top:51.92px;">family history of breast cancer </span><span data-textwidth="459.92" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:56.88px;top:90.33px;">being evaluated for lung transplant</span></p></div></div></div> <div class="sg" id="s164" data-sgid="Picture 4" style="z-index:1;left:54.00px;top:40.50px;width:596.00px;height:333.00px"> <img class="sg" src="F1452344.jpg" id="s164_i" title="" alt="HILBISH_SANDRA_L_CT_2_0028" style="z-index:1;left:0px;top:0px;width:596.96px;height:333.24px" > </div> <div class="sg" id="s165" data-sgid="Picture 4" style="z-index:1;left:46.75px;top:10.50px;width:313.25px;height:360.00px"> <img class="sg" src="63E4137E.jpg" id="s165_i" title="" alt="HILBISH_SANDRA_L_MG_13_0003" style="z-index:1;left:0px;top:0px;width:313.80px;height:360.24px" > </div> <div class="sg" id="s166" data-sgid="Picture 5" style="z-index:2;left:370.38px;top:10.50px;width:329.00px;height:372.00px"> <img class="sg" src="BE60F73.jpg" id="s166_i" title="" alt="HILBISH_SANDRA_L_MG_13_0004" style="z-index:1;left:0px;top:0px;width:329.51px;height:372.24px" > </div> <div class="sg" id="s167" data-sgid="Picture 4" style="z-index:1;left:40.63px;top:28.50px;width:325.38px;height:333.00px"> <img class="sg" src="5043D29C.jpg" id="s167_i" title="" alt="HILBISH_SANDRA_L_MG_13_0008" style="z-index:1;left:0px;top:0px;width:325.82px;height:333.21px" > </div> <div class="sg" id="s168" data-sgid="Picture 5" style="z-index:2;left:383.63px;top:28.50px;width:330.38px;height:333.00px"> <img class="sg" src="840EEFC4.jpg" id="s168_i" title="" alt="HILBISH_SANDRA_L_MG_13_0012" style="z-index:1;left:0px;top:0px;width:330.39px;height:333.21px" > </div> <div class="sg" id="s169" data-sgid="Picture 6" style="z-index:1;left:180.00px;top:52.50px;width:408.00px;height:287.25px"> <img class="sg" src="7E37F821.jpg" id="s169_i" title="" alt="axial 2" style="z-index:1;left:0px;top:0px;width:408.46px;height:287.36px" > </div> <div class="sg" id="s170" data-sgid="Picture 6" style="z-index:1;left:32.63px;top:94.50px;width:325.38px;height:205.50px"> <img class="sg" src="833AFD5D.jpg" id="s170_i" title="" alt="HILBISH_SANDRA_L_US_1_0011" style="z-index:1;left:0px;top:0px;width:325.08px;height:205.57px" > </div> <div class="sg" id="s171" data-sgid="Picture 7" style="z-index:2;left:371.38px;top:93.50px;width:336.63px;height:221.50px"> <img class="sg" src="928D9F6A.jpg" id="s171_i" title="" alt="HILBISH_SANDRA_L_US_1_0004" style="z-index:1;left:0px;top:0px;width:337.10px;height:221.43px" > </div> <div class="sg" id="s172" data-sgid="Picture 4" style="z-index:1;left:54.00px;top:40.50px;width:596.00px;height:333.00px"> <img class="sg" src="F1452344.jpg" id="s172_i" title="" alt="HILBISH_SANDRA_L_CT_2_0028" style="z-index:1;left:0px;top:0px;width:596.96px;height:333.24px" > </div> <div class="sg" id="s173" data-sgid="Picture 4" style="z-index:1;left:191.75px;top:28.51px;width:188.75px;height:266.51px"> <img class="sg" src="BA4FCC13.jpg" id="s173_i" title="" alt="HILBISH_SANDRA_L_MG_13_0008" style="z-index:1;left:0px;top:0px;width:189.22px;height:267.17px" > </div> <div class="sg" id="s174" data-sgid="Picture 5" style="z-index:2;left:432.00px;top:28.50px;width:229.75px;height:270.00px"> <img class="sg" src="DE56F5D2.jpg" id="s174_i" title="" alt="HILBISH_SANDRA_L_MG_13_0012" style="z-index:1;left:0px;top:0px;width:229.81px;height:270.17px" > </div> <div class="sg" id="s175" data-sgid="Text Box 7" style="z-index:3;left:143.81px;top:315.98px;width:586.73px;height:95.25px" data-valign="top"> <div id="s175_t" class="sg" style="z-index:2;left:-7.43px;top:-3.82px;width:594.16px;height:108.88px;"><div><p><span data-textwidth="535.17" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.85px;top:9.95px;">Oval, partially circumscribed, partially obscured mass</span></p><p><span data-textwidth="164.55" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:133%; left:14.85px;top:38.76px;">No calcifications</span></p><p><span data-textwidth="280.25" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.85px;top:67.56px;">Central retroareolar location</span></p></div></div></div> <div class="sg" id="s177" data-sgid="Text Box 3" style="z-index:2;left:383.48px;top:34.51px;width:336.52px;height:124.44px" data-valign="top"> <div id="s177_t" class="sg" style="z-index:2;left:-12.70px;top:-6.84px;width:349.22px;height:146.25px;"><div><p><span data-textwidth="267.28" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.49px;top:13.38px;">Oval circumscribed </span><span data-textwidth="228.04" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:20.49px;top:51.79px;">heterogeneously </span><span data-textwidth="215.92" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.49px;top:90.20px;">enhancing mass</span></p></div></div></div> <div class="sg" id="s176" data-sgid="Picture 6" style="z-index:1;left:84.00px;top:22.50px;width:280.25px;height:352.50px"> <img class="sg" src="85B0D3CA.jpg" id="s176_i" title="" alt="axial 2" style="z-index:1;left:0px;top:0px;width:280.88px;height:352.67px" > </div> <div class="sg" id="s178" data-sgid="Picture 6" style="z-index:1;left:30.00px;top:22.50px;width:325.38px;height:205.50px"> <img class="sg" src="9C1985E1.jpg" id="s178_i" title="" alt="HILBISH_SANDRA_L_US_1_0011" style="z-index:1;left:0px;top:0px;width:325.93px;height:205.57px" > </div> <div class="sg" id="s179" data-sgid="Picture 7" style="z-index:2;left:360.00px;top:22.50px;width:324.00px;height:213.25px"> <img class="sg" src="72D8E11E.jpg" id="s179_i" title="" alt="HILBISH_SANDRA_L_US_1_0004" style="z-index:1;left:0px;top:0px;width:324.35px;height:213.15px" > </div> <div class="sg" id="s180" data-sgid="Text Box 4" style="z-index:3;left:65.91px;top:250.10px;width:584.47px;height:142.43px" data-valign="top"> <div id="s180_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:594.19px;height:160.40px;"><div><p><span data-textwidth="509.60" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.02px;top:12.26px;">Oval, hypoechoic circumscribed mass with </span><span data-textwidth="492.56" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:156%; left:17.02px;top:45.86px;">parallel orientation, increased vascularity, </span><span data-textwidth="316.61" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:17.02px;top:79.47px;">enhanced posterior echoes</span></p><p><span data-textwidth="427.75" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:17.02px;top:113.08px;">Surrounding lucency, duct extension</span></p></div></div></div> <div class="sg sgTitle" id="s181" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s181_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="278.21" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:184.88px;top:17.71px;">Salient Factors</span></p></div></div></div> <div class="sg" id="s182" data-sgid="Rectangle 3" style="z-index:2;left:59.93px;top:112.36px;width:630.12px;height:255.50px" data-valign="top" data-pointer-events="none"> <div id="s182_t" class="sg" style="z-index:2;left:-12.72px;top:-6.84px;width:643.66px;height:263.06px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="202.96" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:13.55px;">•<span style="letter-spacing:5.61px"> </span>Non-palpable</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="246.53" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:20.00px;top:59.64px;">•<span style="letter-spacing:5.61px"> </span>No calcifications</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="307.74" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:20.00px;top:105.73px;">•<span style="letter-spacing:5.61px"> </span>Retroareolar location</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="576.82" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:20.00px;top:151.82px;">•<span style="letter-spacing:5.61px"> </span>Surrounding lucency, intraductal location</span></p></div></div></div> <div class="sg sgTitle" id="s183" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s183_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="393.55" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:127.27px;top:17.71px;">Differential Diagnosis</span></p></div></div></div> <div class="sg" id="s184" data-sgid="Content Placeholder 2" style="z-index:2;left:149.79px;top:100.37px;width:522.27px;height:48.88px" data-valign="top" data-pointer-events="none"> <div id="s184_t" class="sg" style="z-index:2;left:-12.70px;top:-6.82px;width:535.81px;height:69.96px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="451.39" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.14px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Invasive ductal carcinoma, NOS</span></p></div></div></div> <div class="sg" id="s188" data-sgid="Text Box 9" style="z-index:6;left:155.79px;top:154.29px;width:264.61px;height:46.59px" data-valign="top"> <div id="s188_t" class="sg" style="z-index:2;left:-12.69px;top:-6.82px;width:282.57px;height:69.93px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="240.88" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.13px;top:13.61px;">• Phyllodes tumor</span></p></div></div></div> <div class="sg" id="s185" data-sgid="Text Box 5" style="z-index:3;left:119.83px;top:205.91px;width:498.30px;height:46.59px" data-valign="top"> <div id="s185_t" class="sg" style="z-index:2;left:0.00px;top:-6.70px;width:498.30px;height:69.82px;"><div><p para="{in:2,bl:{ch:8226}}"><span data-textwidth="362.82" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:43.52px;top:13.48px;">• DCIS/papillary carcinoma</span></p></div></div></div> <div class="sg" id="s187" data-sgid="Text Box 7" style="z-index:5;left:155.79px;top:256.10px;width:332.07px;height:46.59px" data-valign="top"> <div id="s187_t" class="sg" style="z-index:2;left:-12.69px;top:-6.82px;width:344.77px;height:69.96px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="301.73" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.13px;top:13.82px;">• Large duct papilloma</span></p></div></div></div> <div class="sg" id="s186" data-sgid="Text Box 6" style="z-index:4;left:155.79px;top:304.02px;width:15.22px;height:46.59px"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg sgTitle" id="s189" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s189_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="393.55" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:127.27px;top:17.71px;">Differential Diagnosis</span></p></div></div></div> <div class="sg" id="s190" data-sgid="Content Placeholder 2" style="z-index:2;left:149.79px;top:100.37px;width:522.27px;height:48.88px" data-valign="top" data-pointer-events="none"> <div id="s190_t" class="sg" style="z-index:2;left:-12.70px;top:-6.82px;width:535.81px;height:69.96px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="451.39" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.14px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Invasive ductal carcinoma, NOS</span></p></div></div></div> <div class="sg" id="s193" data-sgid="Text Box 7" style="z-index:5;left:149.79px;top:148.29px;width:264.61px;height:46.59px" data-valign="top"> <div id="s193_t" class="sg" style="z-index:2;left:-12.70px;top:-6.82px;width:282.60px;height:69.96px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="240.88" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.14px;top:13.60px;">• Phyllodes tumor</span></p></div></div></div> <div class="sg" id="s191" data-sgid="Text Box 4" style="z-index:3;left:112.41px;top:194.65px;width:438.36px;height:46.70px" data-valign="top"> <div id="s191_t" class="sg" style="z-index:2;left:0.00px;top:-6.70px;width:438.36px;height:69.82px;"><div><p para="{in:2,bl:{ch:8226}}"><span data-textwidth="362.82" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:43.14px;top:13.45px;">• DCIS/papillary carcinoma</span></p></div></div></div> <div class="sg" id="s192" data-sgid="Text Box 6" style="z-index:4;left:149.08px;top:240.28px;width:331.25px;height:46.73px" data-valign="top"> <div id="s192_t" class="sg" style="z-index:2;left:-12.70px;top:-5.99px;width:343.95px;height:69.96px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="301.73" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.89px;top:13.20px;">• Large duct papilloma</span></p></div></div></div> <div class="sg sgSubtitle" id="s194" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s194_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s195" data-sgid="Subtitle 4" style="z-index:1;left:11.99px;top:124.33px;width:696.03px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s195_t" class="sg" style="z-index:2;left:0.00px;top:-11.97px;width:696.88px;height:117.03px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="589.06" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:267%; left:53.42px;top:20.59px;">Solitary Intraductal Papilloma</span></p></div></div></div> <div class="sg" id="s198" data-sgid="Subtitle 4" style="z-index:3;left:65.91px;top:10.55px;width:594.16px;height:104.21px" data-valign="top"> <div id="s198_t" class="sg" style="z-index:2;left:-19.41px;top:-10.55px;width:613.57px;height:114.77px;"><div><p para="{spbf:0.20}"><span data-textwidth="537.81" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.71px;top:17.92px;"><u>Solitary Intraductal Papilloma</u></span></p></div></div><img class="sg" src="D7D4F2B2.png" id="s198_tt" style="left:-19.41px;top:-10.55px;width:613.57px;height:114.77px;z-index:1" > </div> <div class="sg" id="s196" data-sgid="Rectangle 3" style="z-index:1;left:47.95px;top:63.59px;width:396.43px;height:262.35px" data-valign="top" data-pointer-events="none"> <div id="s196_t" class="sg" style="z-index:2;left:-12.73px;top:0.00px;width:421.96px;height:263.06px;"><div><p para="{spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="265.96" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:29.43px;">•<span style="letter-spacing:5.60px"> </span>Arise from major </span><span data-textwidth="340.62" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.99px;top:60.16px;">lactiferous ducts, usually </span><span data-textwidth="199.23" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:46.99px;top:90.88px;">near the nipple</span></p><p para="{bl:{ch:8226},spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="379.50" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:19.99px;top:167.70px;">•<span style="letter-spacing:5.60px"> </span>2-3% of female population</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="283.25" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:56.00px;top:206.11px;">–<span style="letter-spacing:10.04px"> </span>average age 48 years</span></p></div></div></div> <div class="sg" id="s197" data-sgid="Content Placeholder 5" style="z-index:2;left:456.00px;top:124.50px;width:239.38px;height:201.25px"> <img class="sg" src="9D3DBD75.jpg" id="s197_i" style="z-index:1;left:0px;top:0px;width:239.55px;height:201.15px" > </div> <div class="sg sgTitle" id="s199" data-sgid="Rectangle 2" style="z-index:1;left:23.97px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s199_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.72px;top:17.95px;">Imaging</span></p></div></div></div> <div class="sg" id="s200" data-sgid="Rectangle 3" style="z-index:2;left:47.95px;top:100.37px;width:654.06px;height:275.76px" data-valign="top" data-pointer-events="none"> <div id="s200_t" class="sg" style="z-index:2;left:-12.73px;top:-6.82px;width:667.63px;height:283.28px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="543.69" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Circumscribed benign-appearing mass</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="213.87" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:56.00px;top:58.64px;">– often subareolar</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="515.84" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:56.00px;top:98.97px;">– Small ones often occult on mammography</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="436.99" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:56.00px;top:139.30px;">– Suspicious cluster of calcifications </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="459.91" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:178%; left:19.99px;top:180.59px;">•<span style="letter-spacing:5.60px"> </span>Solitary or multiple dilated ducts</span></p></div></div></div> <div class="sg" id="s202" data-sgid="Subtitle 4" style="z-index:2;left:65.91px;top:10.55px;width:594.16px;height:104.21px" data-valign="top"> <div id="s202_t" class="sg" style="z-index:2;left:-19.41px;top:-10.55px;width:613.57px;height:114.77px;"><div><p para="{spbf:0.20}"><span data-textwidth="537.81" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.71px;top:17.92px;"><u>Solitary Intraductal Papilloma</u></span></p></div></div><img class="sg" src="D7D4F2B2.png" id="s202_tt" style="left:-19.41px;top:-10.55px;width:613.57px;height:114.77px;z-index:1" > </div> <div class="sg" id="s201" data-sgid="Rectangle 3" style="z-index:1;left:59.93px;top:106.36px;width:624.11px;height:222.57px" data-valign="top" data-pointer-events="none"> <div id="s201_t" class="sg" style="z-index:2;left:-12.72px;top:-6.81px;width:644.40px;height:230.10px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="577.78" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>Benign, but women with this lesion have </span><span data-textwidth="577.17" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:47.01px;top:51.92px;">relative risk 1.5-2x for developing invasive </span><span data-textwidth="333.89" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:47.01px;top:90.33px;">breast ca in their lifetime</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="381.91" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:20.00px;top:136.42px;">•<span style="letter-spacing:5.61px"> </span>Treated with duct excision</span></p></div></div></div> <div class="sg" id="s203" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s203_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s204" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s204_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="380.34" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.87px;top:15.90px;">Howard A Rowley, MD</span></p></div></div></div> <div class="sg" id="s206" data-sgid="Picture 4" style="z-index:3;left:48.00px;top:107.00px;width:150.00px;height:201.63px"> <img class="sg" src="997524A6.jpg" id="s206_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:150.16px;height:201.86px" > </div> <div class="sg" id="s205" data-sgid="Content Placeholder 3" style="z-index:2;left:210.43px;top:88.40px;width:510.40px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s205_t" class="sg" style="z-index:2;left:-8.14px;top:-5.26px;width:519.26px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="399.31" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.79px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Joseph F. Sackett Professor of </span></span><span data-textwidth="121.94" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:42.79px;top:45.53px;">Radiology </span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="334.14" class="sg nowrap f4" style="z-index:7;color:#FFFFFF;font-size:156%; left:15.79px;top:87.14px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Professor of Neurology & </span></span><span data-textwidth="161.79" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:42.79px;top:119.46px;">Neurosurgery</span></p><p para="{spbf:0.20}"><span data-textwidth="402.55" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:156%; left:86.72px;top:159.79px;">University of Wisconsin School of </span><span data-textwidth="316.73" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:87.80px;top:193.40px;">Medicine and Public Health</span></p></div></div></div> <div class="sg sgTitle" id="s207" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s207_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="380.34" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.87px;top:15.90px;">Howard A Rowley, MD</span></p></div></div></div> <div class="sg" id="s209" data-sgid="Picture 4" style="z-index:3;left:48.00px;top:107.00px;width:150.00px;height:201.63px"> <img class="sg" src="997524A6.jpg" id="s209_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:150.16px;height:201.86px" > </div> <div class="sg" id="s208" data-sgid="Content Placeholder 3" style="z-index:2;left:210.43px;top:88.40px;width:510.40px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s208_t" class="sg" style="z-index:2;left:-8.14px;top:-5.26px;width:519.26px;height:281.02px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="268.00" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.79px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Med School: Wash U</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="367.86" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.79px;top:53.53px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Residency/Fellowship: UCSF</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="410.34" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:156%; left:15.79px;top:93.86px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Board certified in Radiology and </span></span><span data-textwidth="119.42" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:42.79px;top:126.19px;">Neurology</span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="375.42" class="sg nowrap f4" style="z-index:11;color:#FFFFFF;font-size:156%; left:15.79px;top:167.80px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Chairman of the Board of the </span></span><span data-textwidth="460.16" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:42.79px;top:200.12px;">Foundation of the American Society of </span><span data-textwidth="178.59" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:42.79px;top:233.73px;">Neuroradiology</span></p></div></div></div> <div class="sg sgTitle" id="s210" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s210_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="380.34" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.87px;top:15.90px;">Howard A Rowley, MD</span></p></div></div></div> <div class="sg" id="s212" data-sgid="Picture 4" style="z-index:3;left:48.00px;top:107.00px;width:150.00px;height:201.63px"> <img class="sg" src="997524A6.jpg" id="s212_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:150.16px;height:201.86px" > </div> <div class="sg" id="s211" data-sgid="Content Placeholder 3" style="z-index:2;left:209.72px;top:130.33px;width:510.28px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s211_t" class="sg" style="z-index:2;left:-8.28px;top:-5.27px;width:519.38px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="346.13" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.80px;top:13.29px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>>130 peer reviewed papers</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="275.92" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.80px;top:53.62px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>>600 invited lectures</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="296.20" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.80px;top:93.95px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Consistent NIH funding</span></span></p></div></div></div> <div class="sg" id="s213" data-sgid="Picture 2" style="z-index:1;left:36.00px;top:16.50px;width:289.25px;height:243.63px"> <img class="sg" src="58FB1AB6.jpg" id="s213_i" title="" alt="Howard tractor.jpg" style="z-index:1;left:0px;top:0px;width:289.88px;height:243.88px" > </div> <div class="sg" id="s214" data-sgid="Picture 3" style="z-index:2;left:338.88px;top:154.50px;width:354.25px;height:233.50px"> <img class="sg" src="DFD0D825.jpg" id="s214_i" title="" alt="Howard_Carol_36 Ford.jpg" style="z-index:1;left:0px;top:0px;width:354.40px;height:233.30px" > </div> <div class="sg" id="s215" data-sgid="Picture 1" style="z-index:1;left:162.00px;top:16.50px;width:450.00px;height:337.50px"> <img class="sg" src="458F41C7.jpg" id="s215_i" title="" alt="Joe Annie Paul.JPG" style="z-index:1;left:0px;top:0px;width:450.53px;height:337.66px" > </div> <div class="sg" id="s216" data-sgid="TextBox 2" style="z-index:2;left:245.68px;top:357.91px;width:48.17px;height:32.36px" data-valign="top"> <div id="s216_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:56.45px;height:43.62px;"><div><p><span data-textwidth="30.61" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.83px;top:9.21px;">Joe</span></p></div></div></div> <div class="sg" id="s217" data-sgid="TextBox 4" style="z-index:3;left:365.51px;top:357.91px;width:63.87px;height:32.36px" data-valign="top"> <div id="s217_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:74.41px;height:43.62px;"><div><p><span data-textwidth="48.25" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.02px;top:9.21px;">Annie</span></p></div></div></div> <div class="sg" id="s218" data-sgid="TextBox 5" style="z-index:4;left:509.32px;top:357.91px;width:52.73px;height:32.36px" data-valign="top"> <div id="s218_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:62.43px;height:43.62px;"><div><p><span data-textwidth="36.61" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.24px;top:9.21px;">Paul</span></p></div></div></div> <div class="sg sgTitle" id="s219" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s219_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="275.09" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:186.44px;top:17.71px;">Neuro Case #1</span></p></div></div></div> <div class="sg" id="s220" data-sgid="Content Placeholder 1" style="z-index:2;left:74.18px;top:103.37px;width:573.90px;height:176.10px" data-valign="top" data-pointer-events="none"> <div id="s220_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:574.75px;height:183.73px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="341.46" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:120.37px;top:13.51px;">33-year-old woman with </span><span data-textwidth="288.29" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:147.02px;top:51.92px;">altered mental status </span><span data-textwidth="357.42" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:108.13px;top:90.33px;">and facial/arm dyskinesias</span></p></div></div></div> <div class="sg" id="s221" data-sgid="Picture 7" style="z-index:1;left:54.00px;top:34.50px;width:307.38px;height:316.75px"> <img class="sg" src="BA952F4D.jpg" id="s221_i" style="z-index:1;left:0px;top:0px;width:307.90px;height:316.65px" > </div> <div class="sg" id="s222" data-sgid="Picture 8" style="z-index:2;left:384.00px;top:34.50px;width:306.13px;height:317.88px"> <img class="sg" src="1DC9B103.jpg" id="s222_i" style="z-index:1;left:0px;top:0px;width:306.36px;height:318.21px" > </div> <div class="sg" id="s223" data-sgid="Picture 11" style="z-index:1;left:162.00px;top:46.50px;width:420.00px;height:292.00px"> <img class="sg" src="A2502352.jpg" id="s223_i" style="z-index:1;left:0px;top:0px;width:420.48px;height:291.92px" > </div> <div class="sg" id="s224" data-sgid="Picture 6" style="z-index:1;left:181.88px;top:32.75px;width:387.75px;height:337.25px" data-rotation = "10"> <img class="sg" src="55375ECE.jpg" id="s224_i" style="z-index:1;left:0px;top:0px;width:388.18px;height:336.95px" > </div> <div class="sg sgTitle" id="s225" data-sgid="Rectangle 2" style="z-index:1;left:0.00px;top:4.55px;width:720.00px;height:45.88px" data-valign="middle" data-pointer-events="none"> <div id="s225_t" class="sg" style="z-index:2;left:0.00px;top:-9.81px;width:720.82px;height:77.37px;"><div><p para="{al:2}"><span data-textwidth="591.94" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-weight:bold; font-size:200%; left:63.97px;top:14.54px;">Differential Diagnosis, Fast and Slow</span></p></div></div></div> <div class="sg" id="s226" data-sgid="Rectangle 3" style="z-index:2;left:437.40px;top:54.63px;width:266.16px;height:305.69px" data-valign="top"> <img class="sg" src="7AD3470D.png" id="s226_i" style="z-index:1;left:0px;top:0px;width:266.82px;height:306.44px" > <div id="s226_t" class="sg" style="z-index:2;left:-9.69px;top:-9.71px;width:275.85px;height:315.39px;"><div><p para="{bl:{ch:8226},spbf:0.30}"><span data-textwidth="162.87" class="sg nowrap f2" style="z-index:2;color:#FB0209;font-size:178%; left:19.00px;top:15.05px;">•<span class="f5" style="font-weight:bold; color:#FFFFFF;"><span style="letter-spacing:4.41px"> </span>System 2</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="133.94" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:133%; left:55.01px;top:58.10px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Deliberate</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="143.30" class="sg nowrap f2" style="z-index:6;color:#FFFFFF;font-size:133%; left:55.01px;top:92.67px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Methodical</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="132.38" class="sg nowrap f2" style="z-index:8;color:#FFFFFF;font-size:133%; left:55.01px;top:127.24px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Reasoned</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="103.09" class="sg nowrap f2" style="z-index:10;color:#FFFFFF;font-size:133%; left:55.01px;top:161.81px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Orderly</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="146.06" class="sg nowrap f2" style="z-index:12;color:#FFFFFF;font-size:133%; left:55.01px;top:196.37px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Self critical</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="177.99" class="sg nowrap f2" style="z-index:14;color:#FFFFFF;font-size:133%; left:55.01px;top:230.94px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Imposes logic</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="74.17" class="sg nowrap f2" style="z-index:16;color:#FFFFFF;font-size:133%; left:55.01px;top:265.51px;">–<span class="f5" style="font-weight:bold; "><span style="letter-spacing:-0.04px"> </span>Slow</span></span></p></div></div></div> <div class="sg" id="s227" data-sgid="Rectangle 3 (2)" style="z-index:3;left:40.49px;top:55.47px;width:291.58px;height:304.84px" data-valign="top"> <img class="sg" src="9528FB7C.png" id="s227_i" style="z-index:1;left:0px;top:0px;width:292.30px;height:305.59px" > <div id="s227_t" class="sg" style="z-index:2;left:-11.25px;top:-5.29px;width:302.83px;height:311.68px;"><div><p para="{bl:{ch:8226},spbf:3.00}"><span data-textwidth="155.66" class="sg nowrap f1" style="z-index:2;color:#FF0000;font-size:178%; left:19.97px;top:13.31px;">•<span class="f1" style="font-weight:bold; color:#FFFFFF;"><span style="letter-spacing:5.60px"> </span>System 1</span></span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="64.82" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:55.97px;top:53.72px;">–<span style="letter-spacing:5.25px"> </span>Fast</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="101.30" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:55.97px;top:85.53px;">–<span style="letter-spacing:5.25px"> </span>Intuitive</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="123.99" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:55.97px;top:117.34px;">–<span style="letter-spacing:5.25px"> </span>Automatic</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="186.04" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:55.97px;top:149.14px;">–<span style="letter-spacing:5.25px"> </span>Mental ‘shotgun’</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="163.83" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:55.97px;top:180.95px;">–<span style="letter-spacing:5.25px"> </span>‘Off the shelf’ </span><span data-textwidth="84.97" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:78.54px;top:209.76px;">answers</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="206.07" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:133%; left:55.97px;top:241.56px;">–<span style="letter-spacing:5.25px"> </span>Priming effects <span class="f4" ></span></span><span data-textwidth="120.74" class="sg nowrap f1" style="z-index:18;color:#FFFFFF;font-size:133%; left:78.54px;top:270.37px;">creates bias</span></p></div></div></div> <div class="sg" id="s228" data-sgid="Straight Arrow Connector 4" style="z-index:4;left:295.15px;top:166.99px;width:177.73px;height:81.81px" data-pointer-events="none"> <img class="sg" src="E8624CF4.png" id="s228_i" style="z-index:1;left:0px;top:0px;width:178.17px;height:82.01px" > </div> <div class="sg" id="s230" data-sgid="Picture 4" style="z-index:6;left:435.50px;top:50.00px;width:268.75px;height:319.00px"> <img class="sg" src="6FF36DC7.jpg" id="s230_i" style="z-index:1;left:0px;top:0px;width:268.86px;height:318.95px" > </div> <div class="sg" id="s229" data-sgid="Rectangle 8" style="z-index:5;left:95.86px;top:368.35px;width:588.18px;height:32.45px" data-valign="top" data-pointer-events="none"> <div id="s229_t" class="sg" style="z-index:2;left:0.00px;top:-3.00px;width:588.18px;height:43.71px;"><div><p para="{al:2}"><span data-textwidth="434.95" class="sg nowrap f1" style="z-index:2;color:#A3C2E0;font-style:italic; font-size:111%; left:79.49px;top:9.21px;">After Kahneman, D. “Thinking, Fast and Slow” 2011 </span></p></div></div></div> <div class="sg sgTitle" id="s231" data-sgid="Rectangle 2" style="z-index:1;left:0.00px;top:4.55px;width:720.00px;height:45.88px" data-valign="middle" data-pointer-events="none"> <div id="s231_t" class="sg" style="z-index:2;left:0.00px;top:-9.81px;width:720.82px;height:77.37px;"><div><p para="{al:2}"><span data-textwidth="591.94" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-weight:bold; font-size:200%; left:63.97px;top:14.54px;">Differential Diagnosis, Fast and Slow</span></p></div></div></div> <div class="sg" id="s232" data-sgid="Rectangle 3" style="z-index:2;left:437.40px;top:54.63px;width:266.16px;height:305.69px" data-valign="top"> <img class="sg" src="7AD3470D.png" id="s232_i" style="z-index:1;left:0px;top:0px;width:266.82px;height:306.44px" > <div id="s232_t" class="sg" style="z-index:2;left:-11.25px;top:-9.71px;width:277.41px;height:315.39px;"><div><p para="{bl:{ch:8226},spbf:0.30}"><span data-textwidth="156.51" class="sg nowrap f1" style="z-index:2;color:#FB0209;font-size:178%; left:20.56px;top:13.89px;">•<span class="f1" style="font-weight:bold; color:#FFFFFF;"> System 2</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="118.70" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:56.57px;top:57.06px;">– Deliberate</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="125.66" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:56.57px;top:91.63px;">– Methodical</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="115.46" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:56.57px;top:126.20px;">– Reasoned</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="92.65" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:56.57px;top:160.77px;">– Orderly</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="131.78" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:56.57px;top:195.33px;">– Self critical</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="154.70" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:56.57px;top:229.90px;">– Imposes logic</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="68.17" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:56.57px;top:264.47px;">– Slow</span></p></div></div></div> <div class="sg" id="s233" data-sgid="Rectangle 3 (2)" style="z-index:3;left:40.49px;top:55.47px;width:291.58px;height:304.84px" data-valign="top"> <img class="sg" src="9528FB7C.png" id="s233_i" style="z-index:1;left:0px;top:0px;width:292.30px;height:305.59px" > <div id="s233_t" class="sg" style="z-index:2;left:-11.25px;top:-5.29px;width:302.83px;height:311.68px;"><div><p para="{bl:{ch:8226},spbf:3.00}"><span data-textwidth="155.66" class="sg nowrap f1" style="z-index:2;color:#FF0000;font-size:178%; left:19.97px;top:13.31px;">•<span class="f1" style="font-weight:bold; color:#FFFFFF;"><span style="letter-spacing:5.60px"> </span>System 1</span></span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="64.82" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:55.97px;top:53.72px;">–<span style="letter-spacing:5.25px"> </span>Fast</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="101.30" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:55.97px;top:85.53px;">–<span style="letter-spacing:5.25px"> </span>Intuitive</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="123.99" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:55.97px;top:117.34px;">–<span style="letter-spacing:5.25px"> </span>Automatic</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="186.04" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:55.97px;top:149.14px;">–<span style="letter-spacing:5.25px"> </span>Mental ‘shotgun’</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="163.83" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:55.97px;top:180.95px;">–<span style="letter-spacing:5.25px"> </span>‘Off the shelf’ </span><span data-textwidth="84.97" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:78.54px;top:209.76px;">answers</span></p><p para="{in:2,bl:{ch:8211},spbf:3.00}"><span data-textwidth="206.07" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:133%; left:55.97px;top:241.56px;">–<span style="letter-spacing:5.25px"> </span>Priming effects <span class="f4" ></span></span><span data-textwidth="120.74" class="sg nowrap f1" style="z-index:18;color:#FFFFFF;font-size:133%; left:78.54px;top:270.37px;">creates bias</span></p></div></div></div> <div class="sg" id="s234" data-sgid="Straight Arrow Connector 4" style="z-index:4;left:295.15px;top:166.99px;width:177.73px;height:81.81px" data-pointer-events="none"> <img class="sg" src="E8624CF4.png" id="s234_i" style="z-index:1;left:0px;top:0px;width:178.17px;height:82.01px" > </div> <div class="sg" id="s235" data-sgid="Rectangle 8" style="z-index:5;left:95.86px;top:368.35px;width:588.18px;height:32.45px" data-valign="top" data-pointer-events="none"> <div id="s235_t" class="sg" style="z-index:2;left:0.00px;top:-3.00px;width:588.18px;height:43.71px;"><div><p para="{al:2}"><span data-textwidth="434.95" class="sg nowrap f1" style="z-index:2;color:#A3C2E0;font-style:italic; font-size:111%; left:79.49px;top:9.21px;">After Kahneman, D. “Thinking, Fast and Slow” 2011 </span></p></div></div></div> <div class="sg sgTitle" id="s236" data-sgid="Rectangle 2" style="z-index:1;left:0.00px;top:4.55px;width:720.00px;height:45.88px" data-valign="middle" data-pointer-events="none"> <div id="s236_t" class="sg" style="z-index:2;left:0.00px;top:-9.81px;width:720.82px;height:77.37px;"><div><p para="{al:2}"><span data-textwidth="591.94" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-weight:bold; font-size:200%; left:63.97px;top:14.54px;">Differential Diagnosis, Fast and Slow</span></p></div></div></div> <div class="sg" id="s239" data-sgid="Straight Connector 2" style="z-index:4;left:47.21px;top:56.89px;width:403.99px;height:5.52px" data-pointer-events="none"> <img class="sg" src="BE850811.png" id="s239_i" style="z-index:1;left:0px;top:0px;width:403.99px;height:4.52px" > </div> <div class="sg" id="s237" data-sgid="Rectangle 3" style="z-index:2;left:441.96px;top:56.89px;width:266.05px;height:305.69px" data-valign="top"> <img class="sg" src="9C910B5B.png" id="s237_i" style="z-index:1;left:0px;top:0px;width:266.71px;height:306.44px" > <div id="s237_t" class="sg" style="z-index:2;left:-11.25px;top:-9.70px;width:277.30px;height:315.39px;"><div><p para="{bl:{ch:8226},spbf:0.30}"><span data-textwidth="156.50" class="sg nowrap f1" style="z-index:2;color:#FB0209;font-size:178%; left:20.45px;top:13.90px;">•<span class="f1" style="font-weight:bold; color:#FFFFFF;"> System 2</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="118.70" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:56.45px;top:57.07px;">– Deliberate</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="125.66" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:56.45px;top:91.64px;">– Methodical</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="115.46" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:56.45px;top:126.21px;">– Reasoned</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="92.65" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:56.45px;top:160.78px;">– Orderly</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="131.78" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:56.45px;top:195.34px;">– Self critical</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="154.70" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:56.45px;top:229.91px;">– Imposes logic</span></p><p para="{in:2,bl:{ch:8211},spbf:0.30}"><span data-textwidth="68.17" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:56.45px;top:264.48px;">– Slow</span></p></div></div></div> <div class="sg" id="s238" data-sgid="Rectangle 3 (2)" style="z-index:3;left:47.95px;top:58.44px;width:402.41px;height:333.38px" data-valign="top"> <div id="s238_t" class="sg" style="z-index:2;left:-4.45px;top:-11.25px;width:406.85px;height:344.64px;"><div><p para="{spbf:6.00}"><span data-textwidth="187.83" class="sg nowrap f1" style="z-index:2;color:#FFFF00;font-style:italic; font-weight:bold; font-size:178%; left:72.80px;top:13.90px;">“VINDICATE”</span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="94.45" class="sg nowrap f4" style="z-index:5;color:#FFFFFF;font-size:111%; left:11.59px;top:55.59px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> V</span><span class="f1" > ascular</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="324.05" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:111%; left:11.59px;top:83.20px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> I</span><span class="f1" ><span style="letter-spacing:8.72px"> </span>nfectious / inflammatory / immune</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="298.85" class="sg nowrap f4" style="z-index:12;color:#FFFFFF;font-size:111%; left:11.59px;top:110.80px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> N</span><span class="f1" > eoplastic (primary, mets, para-)</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="72.25" class="sg nowrap f4" style="z-index:20;color:#FFFFFF;font-size:111%; left:11.59px;top:138.41px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> D</span><span class="f1" > rugs</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="110.41" class="sg nowrap f4" style="z-index:23;color:#FFFFFF;font-size:111%; left:11.59px;top:166.02px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> I</span><span class="f1" ><span style="letter-spacing:8.72px"> </span>atrogenic</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="109.69" class="sg nowrap f4" style="z-index:26;color:#FFFFFF;font-size:111%; left:11.59px;top:193.62px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> C</span><span class="f1" > ongenital</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="182.91" class="sg nowrap f4" style="z-index:29;color:#FFFFFF;font-size:111%; left:11.59px;top:221.23px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> A</span><span class="f1" > natomic / Artifact</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="84.97" class="sg nowrap f4" style="z-index:33;color:#FFFFFF;font-size:111%; left:11.59px;top:248.84px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> T</span><span class="f1" > rauma</span></span></p><p para="{bl:{ch:167},spbf:6.00}"><span data-textwidth="359.82" class="sg nowrap f4" style="z-index:36;color:#FFFFFF;font-size:111%; left:11.59px;top:276.44px;"><span class="f1" style="font-weight:bold; color:#FFFF00;"> E </span><span class="f1" >nvironmental exposure / endocrine      </span></span><span data-textwidth="139.94" class="sg nowrap f1" style="z-index:40;color:#FFFFFF;font-size:111%; left:83.60px;top:297.37px;">toxic / metabolic</span></p></div></div></div> <div class="sg sgTitle" id="s240" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:0.00px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s240_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="560.73" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:178%; left:43.61px;top:17.40px;">Differential Diagnosis: Limbic Encephalitis</span></p></div></div></div> <div class="sg" id="s242" data-sgid="Picture 3" style="z-index:3;left:601.38px;top:69.50px;width:111.25px;height:127.00px"> <img class="sg" src="2565AB2F.png" id="s242_i" title="" alt="im003" style="z-index:1;left:0px;top:0px;width:111.25px;height:127.00px" > </div> <div class="sg" id="s243" data-sgid="Picture 4" style="z-index:4;left:480.00px;top:69.50px;width:124.63px;height:127.00px"> <img class="sg" src="F9AE3CC7.png" id="s243_i" title="" alt="im006" style="z-index:1;left:0px;top:0px;width:124.71px;height:126.93px" > </div> <div class="sg" id="s247" data-sgid="TextBox 8" style="z-index:8;left:565.51px;top:166.99px;width:85.58px;height:37.60px" data-valign="top"> <img class="sg" src="5F1B22AE.png" id="s247_i" style="z-index:1;left:0px;top:0px;width:85.79px;height:37.69px" > <div id="s247_t" class="sg" style="z-index:2;left:-7.54px;top:-3.74px;width:98.38px;height:51.17px;"><div><p><span data-textwidth="69.12" class="sg nowrap f5" style="z-index:2;color:#FFFFFF;font-weight:bold; font-size:133%; left:15.85px;top:9.99px;">HSV-1</span></p></div></div></div> <div class="sg" id="s241" data-sgid="Rectangle 3" style="z-index:2;left:71.92px;top:82.40px;width:402.41px;height:258.50px" data-valign="top" data-pointer-events="none"> <div id="s241_t" class="sg" style="z-index:2;left:-9.72px;top:-11.96px;width:412.97px;height:271.17px;"><div><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="140.67" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.01px;top:11.90px;">•<span style="letter-spacing:8.61px"> </span>Infectious</span></p><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="147.99" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:17.01px;top:44.78px;">•<span style="letter-spacing:8.61px"> </span>Neoplastic</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="213.88" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:17.01px;top:78.39px;">•<span style="letter-spacing:8.61px"> </span>Toxic-metabolic</span></p><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="207.04" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:17.01px;top:111.28px;">•<span style="letter-spacing:8.61px"> </span>Paraneoplastic </span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="311.33" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:53.02px;top:144.53px;">–<span class="f6" > “</span>Onconeural<span class="f6" >”</span> antibodies</span></p><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="175.11" class="sg nowrap f1" style="z-index:17;color:#FFFFFF;font-size:156%; left:17.01px;top:177.05px;">•<span style="letter-spacing:8.61px"> </span>Autoimmune</span></p></div></div></div> <div class="sg" id="s244" data-sgid="Picture 1" style="z-index:5;left:480.00px;top:223.25px;width:117.13px;height:144.00px"> <img class="sg" src="B720544D.png" id="s244_i" style="z-index:1;left:0px;top:0px;width:117.12px;height:144.08px" > </div> <div class="sg" id="s245" data-sgid="Picture 2" style="z-index:6;left:591.78px;top:223.17px;width:118.28px;height:144.44px"> <img class="sg" src="C69BC4C8.png" id="s245_i" style="z-index:1;left:0px;top:0px;width:118.57px;height:144.80px" > </div> <div class="sg" id="s246" data-sgid="TextBox 5" style="z-index:7;left:554.26px;top:338.39px;width:97.68px;height:36.89px" data-valign="top"> <img class="sg" src="CC919FF5.png" id="s246_i" style="z-index:1;left:0px;top:0px;width:97.92px;height:36.98px" > <div id="s246_t" class="sg" style="z-index:2;left:-7.42px;top:-3.71px;width:112.52px;height:51.15px;"><div><p><span data-textwidth="81.49" class="sg nowrap f5" style="z-index:2;color:#FFFFFF;font-weight:bold; font-size:133%; left:15.21px;top:9.96px;">Glioma</span></p></div></div></div> <div class="sg" id="s248" data-sgid="Picture 4 (2)" style="z-index:9;left:0.00px;top:366.90px;width:95.86px;height:32.93px"> <img class="sg" src="1AE8D483.png" id="s248_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg sgTitle" id="s249" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:-1.56px;width:648.08px;height:69.22px" data-valign="middle" data-pointer-events="none"> <div id="s249_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:73.66px;"><div><p para="{al:2}"><span data-textwidth="462.08" class="sg nowrap f2" style="z-index:2;color:#FFCC4F;font-size:178%; left:92.94px;top:19.04px;">Autoimmune Limbic Encephalitis</span></p></div></div></div> <div class="sg" id="s252" data-sgid="Picture 4" style="z-index:4;left:450.00px;top:72.63px;width:258.00px;height:123.88px"> <img class="sg" src="584049D7.jpg" id="s252_i" style="z-index:1;left:0px;top:0px;width:258.30px;height:123.93px" > </div> <div class="sg" id="s250" data-sgid="Rectangle 3" style="z-index:2;left:29.95px;top:52.48px;width:420.40px;height:323.65px" data-valign="top" data-pointer-events="none"> <div id="s250_t" class="sg" style="z-index:2;left:-7.42px;top:-3.85px;width:428.67px;height:340.20px;"><div><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="342.77" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:133%; left:14.68px;top:9.42px;">•<span style="letter-spacing:4.64px"> </span>Faciobrachial Dystonic Seizures</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="342.89" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;left:46.84px;top:44.23px;">–<span style="letter-spacing:3.68px"> </span>Frequent, brief, unilateral dystonic seizures</span></p><p para="{in:3,bl:{ch:167}}"><span data-textwidth="315.05" class="sg nowrap f4" style="z-index:7;color:#FFFFFF;left:79.01px;top:66.40px;"><span class="f1" ><span style="letter-spacing:4.76px"> </span>Arm (100%) > Face (76%) > Leg (34%) </span></span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="366.79" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;left:46.84px;top:93.44px;">–<span style="letter-spacing:3.68px"> </span>Precedes limbic encephalitis (median 36 days)</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="335.69" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;left:46.84px;top:121.05px;">–<span style="letter-spacing:3.68px"> </span>Adult onset, mean age 64 years, 19:10 M:F</span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="171.87" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;left:46.84px;top:148.65px;">–<span style="letter-spacing:3.68px"> </span>Hyponatremia (88%)</span></p><p para="{bl:{ch:8226},spbf:6.00}"><span data-textwidth="376.98" class="sg nowrap f1" style="z-index:17;color:#FFCC4F;font-size:133%; left:14.68px;top:176.26px;">•<span style="letter-spacing:4.64px"> </span>Voltage-gated potassium channels  </span></p><p para="{in:2,bl:{ch:8211},spbf:6.00}"><span data-textwidth="232.96" class="sg nowrap f1" style="z-index:21;color:#FFFFFF;font-size:111%; left:46.84px;top:211.07px;">– VGKC-complex antibodies</span></p><p para="{in:3,bl:{ch:167},spbf:6.00}"><span data-textwidth="62.05" class="sg nowrap f4" style="z-index:25;color:#FFFFFF;font-size:133%; left:79.01px;top:241.99px;"><span class="f1" ><span style="letter-spacing:0.32px"> </span>Lgi 1</span></span></p><p para="{in:3,bl:{ch:167},spbf:6.00}"><span data-textwidth="81.49" class="sg nowrap f4" style="z-index:28;color:#FFFFFF;font-size:111%; left:79.01px;top:276.56px;"><span class="f1" ><span style="letter-spacing:3.32px"> </span>Caspr 2</span></span></p><p para="{in:3,bl:{ch:167},spbf:6.00}"><span data-textwidth="111.25" class="sg nowrap f4" style="z-index:31;color:#FFFFFF;font-size:111%; left:79.01px;top:306.57px;"><span class="f1" ><span style="letter-spacing:3.32px"> </span>Contactin 2</span></span></p></div></div></div> <div class="sg" id="s251" data-sgid="TextBox 3" style="z-index:3;left:476.36px;top:207.36px;width:194.25px;height:43.71px" data-valign="top"> <img class="sg" src="F1161AF6.png" id="s251_i" style="z-index:1;left:0px;top:0px;width:194.73px;height:43.82px" > <div id="s251_t" class="sg" style="z-index:2;left:0.00px;top:-0.74px;width:194.25px;height:48.18px;"><div><p para="{al:2}"><span data-textwidth="145.82" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-style:italic; font-size:78%; left:24.60px;top:6.47px;">Modified from Irani et al, </span></p><p para="{al:2}"><span data-textwidth="176.43" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-style:italic; font-size:78%; left:9.36px;top:23.27px;">Ann Neurol 2011; 69: 892-900</span></p></div></div></div> <div class="sg" id="s253" data-sgid="Group 22" style="z-index:5;left:348.63px;top:257.38px;width:364.75px;height:145.63px" data-shape="group"> <div class="sg" id="s255" data-sgid="Straight Arrow Connector 16" style="z-index:7;left:74.52px;top:63.04px;width:58.00px;height:43.73px" data-pointer-events="none"> <img class="sg" src="E3527302.png" id="s255_i" style="z-index:1;left:0px;top:0px;width:58.14px;height:43.84px" > </div> <div class="sg" id="s256" data-sgid="Straight Arrow Connector 5" style="z-index:6;left:-1.82px;top:60.78px;width:58.60px;height:41.44px" data-pointer-events="none"> <img class="sg" src="420A6364.png" id="s256_i" style="z-index:1;left:0px;top:0px;width:58.74px;height:41.54px" > </div> <div class="sg" id="s257" data-sgid="TextBox 12" style="z-index:5;left:22.86px;top:112.53px;width:95.41px;height:30.18px" data-valign="top"> <img class="sg" src="27179570.png" id="s257_i" style="z-index:1;left:0px;top:0px;width:95.65px;height:30.25px" > <div id="s257_t" class="sg" style="z-index:2;left:-3.71px;top:-3.00px;width:102.83px;height:39.18px;"><div><p><span data-textwidth="78.61" class="sg nowrap f5" style="z-index:2;color:#2970FF;font-weight:bold; left:11.48px;top:9.18px;">T2 FLAIR</span></p></div></div></div> <div class="sg" id="s258" data-sgid="TextBox 11" style="z-index:4;left:199.63px;top:116.24px;width:95.41px;height:29.48px" data-valign="top"> <div id="s258_t" class="sg" style="z-index:2;left:-3.71px;top:-3.00px;width:102.83px;height:39.18px;"><div><p><span data-textwidth="78.98" class="sg nowrap f5" style="z-index:2;color:#2970FF;font-weight:bold; left:11.99px;top:8.95px;">FDG-PET</span></p></div></div></div> <div class="sg" id="s259" data-sgid="Picture 9" style="z-index:3;left:247.83px;top:0.26px;width:116.92px;height:130.86px"> <img class="sg" src="2F370FA1.jpg" id="s259_i" style="z-index:1;left:0px;top:0px;width:117.12px;height:130.65px" > </div> <div class="sg" id="s260" data-sgid="Picture 2" style="z-index:2;left:130.90px;top:0.26px;width:116.92px;height:130.86px"> <img class="sg" src="C9BC93A2.jpg" id="s260_i" style="z-index:1;left:0px;top:0px;width:117.15px;height:130.65px" > </div> <div class="sg" id="s261" data-sgid="Picture 1" style="z-index:1;left:9.46px;top:-0.55px;width:122.84px;height:116.78px"> <img class="sg" src="D0E2FFA3.png" id="s261_i" style="z-index:1;left:0px;top:0px;width:123.14px;height:117.07px" > </div> </div> <div class="sg" id="s254" data-sgid="Picture 4 (2)" style="z-index:13;left:0.00px;top:366.90px;width:95.86px;height:32.93px"> <img class="sg" src="1AE8D483.png" id="s254_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg" id="s263" data-sgid="Title 1" style="z-index:2;left:53.92px;top:64.44px;width:624.14px;height:68.29px" data-valign="top"> <div id="s263_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:624.14px;height:93.80px;"><div><p para="{al:2}"><span data-textwidth="329.09" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:244%; left:147.47px;top:18.05px;">Additional History</span></p></div></div></div> <div class="sg" id="s262" data-sgid="Content Placeholder 1" style="z-index:1;left:155.79px;top:148.29px;width:408.41px;height:78.81px" data-valign="top" data-pointer-events="none"> <div id="s262_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:409.26px;height:86.36px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="351.90" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:28.20px;top:13.60px;">CT scan of pelvis obtained</span></p></div></div></div> <div class="sg" id="s266" data-sgid="TextBox 2" style="z-index:3;left:215.73px;top:22.52px;width:108.81px;height:46.59px" data-valign="top"> <div id="s266_t" class="sg" style="z-index:2;left:-12.73px;top:-6.82px;width:133.52px;height:69.96px;"><div><p><span data-textwidth="92.65" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.24px;top:13.35px;">-14 HU</span></p></div></div></div> <div class="sg" id="s264" data-sgid="Picture 4" style="z-index:1;left:366.00px;top:58.50px;width:329.38px;height:292.75px"> <img class="sg" src="9CA11C39.jpg" id="s264_i" style="z-index:1;left:0px;top:0px;width:329.65px;height:292.66px" > </div> <div class="sg" id="s267" data-sgid="Picture 7" style="z-index:4;left:48.00px;top:100.50px;width:310.75px;height:216.13px"> <img class="sg" src="ADBD16C.jpg" id="s267_i" style="z-index:1;left:0px;top:0px;width:310.91px;height:216.15px" > </div> <div class="sg" id="s265" data-sgid="Oval 1" style="z-index:2;left:477.92px;top:224.58px;width:21.93px;height:21.92px" data-pointer-events="none"> <img class="sg" src="6BF35CB2.png" id="s265_i" style="z-index:1;left:0px;top:0px;width:21.98px;height:21.97px" > </div> <div class="sg sgSubtitle" id="s268" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s268_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s269" data-sgid="Subtitle 4" style="z-index:1;left:65.91px;top:106.36px;width:654.09px;height:222.57px" data-valign="top" data-pointer-events="none"> <div id="s269_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:654.91px;height:243.65px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="290.81" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:181.57px;top:22.51px;">Anti-NMDAR</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="219.52" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:200%; left:222.38px;top:93.97px;">(autoimmune) </span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="287.09" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:300%; left:191.17px;top:152.14px;">Encephalitis </span></p></div></div></div> <div class="sg" id="s271" data-sgid="Subtitle 4" style="z-index:2;left:125.84px;top:10.55px;width:516.26px;height:72.81px" data-valign="top"> <div id="s271_t" class="sg" style="z-index:2;left:-17.25px;top:-8.99px;width:533.52px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="438.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.63px;top:16.48px;"><u>Anti-NMDAR Encephalitis</u> </span></p></div></div><img class="sg" src="CFCFDC1D.png" id="s271_tt" style="left:-17.25px;top:-8.99px;width:533.52px;height:85.52px;z-index:1" > </div> <div class="sg" id="s270" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:82.40px;width:660.07px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s270_t" class="sg" style="z-index:2;left:-12.72px;top:-7.55px;width:683.33px;height:275.76px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="643.18" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:15.37px;">•<span style="letter-spacing:8.84px"> </span>Severe form of encephalitis with antibodies </span><span data-textwidth="557.74" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.97px;top:53.78px;">against N-methyl D-aspartate receptors</span></p><p para="{spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="508.04" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:178%; left:19.97px;top:144.80px;">•<span style="letter-spacing:5.60px"> </span>Present with psychiatric symptoms </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="535.66" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:55.97px;top:189.93px;">– Progress to memory disturbance, seizures, </span><span data-textwidth="292.01" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:78.54px;top:223.54px;">dyskinesia, and catatonia</span></p></div></div></div> <div class="sg" id="s273" data-sgid="Subtitle 4" style="z-index:2;left:125.84px;top:10.55px;width:516.26px;height:72.81px" data-valign="top"> <div id="s273_t" class="sg" style="z-index:2;left:-17.25px;top:-8.99px;width:533.52px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="438.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.63px;top:16.48px;"><u>Anti-NMDAR Encephalitis</u> </span></p></div></div><img class="sg" src="CFCFDC1D.png" id="s273_tt" style="left:-17.25px;top:-8.99px;width:533.52px;height:85.52px;z-index:1" > </div> <div class="sg" id="s272" data-sgid="Content Placeholder 2" style="z-index:1;left:59.93px;top:82.40px;width:648.08px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s272_t" class="sg" style="z-index:2;left:-12.72px;top:-6.81px;width:675.06px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="393.31" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:13.47px;">•<span style="letter-spacing:5.61px"> </span>80% females, often young  </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="602.50" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:56.01px;top:58.60px;">– approximately half associated with an underlying </span><span data-textwidth="197.92" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:78.57px;top:92.21px;">ovarian teratoma</span></p><p para="{in:2,spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="632.39" class="sg nowrap f2" style="z-index:8;color:#FFFFFF;font-size:178%; left:20.00px;top:174.99px;">•<span style="letter-spacing:8.85px"> </span>Tumor removal, immunotherapy, intensive </span><span data-textwidth="310.97" class="sg nowrap f2" style="z-index:10;color:#FFFFFF;font-size:178%; left:47.01px;top:213.39px;">care, physical therapy</span></p></div></div></div> <div class="sg" id="s274" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s274_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s275" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s275_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="439.63" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:104.22px;top:15.90px;">Anwar R. Padhani, MB BS</span></p></div></div></div> <div class="sg" id="s277" data-sgid="Picture 5" style="z-index:3;left:48.00px;top:112.00px;width:144.00px;height:195.63px"> <img class="sg" src="ABE5F903.jpg" id="s277_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:144.17px;height:195.98px" > </div> <div class="sg" id="s276" data-sgid="Content Placeholder 3" style="z-index:2;left:197.73px;top:82.40px;width:510.28px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s276_t" class="sg" style="z-index:2;left:-6.71px;top:-3.81px;width:517.85px;height:275.73px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="164.55" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.21px;top:10.39px;"><span class="f1" ><span style="letter-spacing:11.25px"> </span>Born: Uganda</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="445.76" class="sg nowrap f4" style="z-index:5;color:#FFFFFF;font-size:133%; left:14.21px;top:44.96px;"><span class="f1" ><span style="letter-spacing:11.25px"> </span>Med School: Kasturba Med College (India)</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="439.87" class="sg nowrap f4" style="z-index:10;color:#FFFFFF;font-size:133%; left:14.21px;top:79.52px;"><span class="f1" ><span style="letter-spacing:11.25px"> </span>Radiology: Cambridge and Guys Hospital </span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="446.48" class="sg nowrap f4" style="z-index:14;color:#FFFFFF;font-size:133%; left:14.21px;top:114.09px;"><span class="f1" ><span style="letter-spacing:11.25px"> </span>Chest/Cross Sectional Fellowship: Johns </span></span><span data-textwidth="87.61" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:41.22px;top:141.98px;">Hopkins </span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="449.00" class="sg nowrap f4" style="z-index:17;color:#FFFFFF;font-size:133%; left:14.21px;top:177.47px;"><span class="f1" ><span style="letter-spacing:11.25px"> </span>Senior Lecturer and Honorary Consultant </span></span><span data-textwidth="458.36" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:133%; left:41.22px;top:205.35px;">Radiologist: Institute of Cancer Research and </span><span data-textwidth="273.89" class="sg nowrap f1" style="z-index:20;color:#FFFFFF;font-size:133%; left:41.22px;top:234.16px;">the Royal Marsden Hospital</span></p></div></div></div> <div class="sg sgTitle" id="s278" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s278_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="439.63" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:104.22px;top:15.90px;">Anwar R. Padhani, MB BS</span></p></div></div></div> <div class="sg" id="s280" data-sgid="Picture 5" style="z-index:3;left:48.00px;top:112.00px;width:144.00px;height:195.63px"> <img class="sg" src="ABE5F903.jpg" id="s280_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:144.17px;height:195.98px" > </div> <div class="sg" id="s279" data-sgid="Content Placeholder 3" style="z-index:2;left:209.72px;top:76.44px;width:510.28px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s279_t" class="sg" style="z-index:2;left:-8.28px;top:-5.29px;width:519.38px;height:310.98px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="286.60" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.80px;top:13.19px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Consultant Radiologist</span></span></p><p para="{spbf:0.20}"><span data-textwidth="308.57" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:39.44px;top:52.24px;">Head of Imaging Research</span></p><p para="{in:2,spbf:0.20}"><span data-textwidth="292.49" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:87.81px;top:90.61px;">Mount Vernon Cancer Centre</span></p><p para="{spbf:0.20}"><span data-textwidth="148.58" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:87.81px;top:125.17px;">Middlesex, UK </span></p><p para="{bl:{ch:167},spbf:0.20}"></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="363.66" class="sg nowrap f4" style="z-index:12;color:#FFFFFF;font-size:156%; left:15.80px;top:197.55px;"><span class="f1" ><span style="letter-spacing:8.48px"> </span>Professor of Cancer Imaging</span></span></p><p para="{spbf:0.20}"><span data-textwidth="286.12" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:87.81px;top:234.64px;">Institute of Cancer Research</span></p><p para="{spbf:0.20}"><span data-textwidth="73.69" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:87.81px;top:269.21px;">London</span></p></div></div></div> <div class="sg sgTitle" id="s281" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s281_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="439.63" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:104.22px;top:15.90px;">Anwar R. Padhani, MB BS</span></p></div></div></div> <div class="sg" id="s283" data-sgid="Picture 5" style="z-index:3;left:48.00px;top:112.00px;width:144.00px;height:195.63px"> <img class="sg" src="ABE5F903.jpg" id="s283_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:144.17px;height:195.98px" > </div> <div class="sg" id="s282" data-sgid="Content Placeholder 3" style="z-index:2;left:203.74px;top:100.37px;width:510.25px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s282_t" class="sg" style="z-index:2;left:-6.72px;top:-3.82px;width:517.82px;height:272.02px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="300.89" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.22px;top:10.43px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>>180 peer reviewed papers</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="239.92" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.22px;top:45.00px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>>300 invited lectures</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="245.56" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.22px;top:79.57px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>> 20 research grants </span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="431.95" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.22px;top:114.14px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>Advisor to NCI and Cancer Research UK</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="416.70" class="sg nowrap f4" style="z-index:10;color:#FFFFFF;font-size:133%; left:14.22px;top:148.70px;"><span class="f1" ><span style="letter-spacing:11.24px"> </span>Numerous outstanding teacher awards</span></span></p></div></div></div> <div class="sg" id="s284" data-sgid="Picture 1" style="z-index:1;left:132.00px;top:34.50px;width:474.00px;height:317.25px"> <img class="sg" src="595D4F6D.jpg" id="s284_i" title="" alt="DSC_0482.JPG" style="z-index:1;left:0px;top:0px;width:474.53px;height:317.36px" > </div> <div class="sg" id="s285" data-sgid="Picture 1" style="z-index:1;left:138.00px;top:16.50px;width:444.00px;height:338.50px"> <img class="sg" src="74DF93AF.jpg" id="s285_i" title="" alt="Sept 03 (10).JPG" style="z-index:1;left:0px;top:0px;width:444.47px;height:338.40px" > </div> <div class="sg" id="s286" data-sgid="TextBox 1" style="z-index:2;left:304.87px;top:351.94px;width:91.55px;height:32.33px" data-valign="top"> <div id="s286_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:101.39px;height:43.59px;"><div><p><span data-textwidth="75.73" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.81px;top:9.18px;">Femeeda</span></p></div></div></div> <div class="sg sgTitle" id="s287" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s287_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="447.07" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:100.50px;top:17.71px;">Body/Oncology Case #1</span></p></div></div></div> <div class="sg" id="s288" data-sgid="Content Placeholder 1" style="z-index:2;left:74.18px;top:103.37px;width:573.90px;height:200.06px" data-valign="top" data-pointer-events="none"> <div id="s288_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:574.75px;height:207.69px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="341.70" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:120.25px;top:13.51px;">35-year-old woman with </span><span data-textwidth="235.72" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:173.42px;top:51.92px;">menorrhagia and </span><span data-textwidth="304.85" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:138.74px;top:90.33px;">two years intermittent </span><span data-textwidth="274.73" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:178%; left:149.42px;top:128.74px;">nausea and vomiting</span></p></div></div></div> <div class="sg" id="s289" data-sgid="Picture 4" style="z-index:1;left:144.00px;top:70.50px;width:432.00px;height:245.38px"> <img class="sg" src="B321A06D.jpg" id="s289_i" style="z-index:1;left:0px;top:0px;width:432.49px;height:245.32px" > </div> <div class="sg" id="s290" data-sgid="Picture 3" style="z-index:1;left:372.00px;top:82.50px;width:333.38px;height:234.00px"> <img class="sg" src="D125B115.jpg" id="s290_i" style="z-index:1;left:0px;top:0px;width:334.11px;height:234.16px" > </div> <div class="sg" id="s291" data-sgid="Picture 4" style="z-index:2;left:30.00px;top:82.50px;width:328.75px;height:234.00px"> <img class="sg" src="81760993.jpg" id="s291_i" style="z-index:1;left:0px;top:0px;width:328.95px;height:234.16px" > </div> <div class="sg" id="s292" data-sgid="Picture 2" style="z-index:1;left:378.00px;top:19.13px;width:279.13px;height:167.00px"> <img class="sg" src="9B97AAB5.jpg" id="s292_i" style="z-index:1;left:0px;top:0px;width:279.32px;height:166.55px" > </div> <div class="sg" id="s293" data-sgid="Picture 3" style="z-index:2;left:101.63px;top:19.13px;width:264.38px;height:167.00px"> <img class="sg" src="29E3922.jpg" id="s293_i" style="z-index:1;left:0px;top:0px;width:264.38px;height:167.00px" > </div> <div class="sg" id="s294" data-sgid="Picture 5" style="z-index:3;left:245.63px;top:196.50px;width:244.00px;height:180.00px"> <img class="sg" src="207A42DA.jpg" id="s294_i" style="z-index:1;left:0px;top:0px;width:243.98px;height:180.10px" > </div> <div class="sg" id="s295" data-sgid="Picture 4" style="z-index:1;left:30.00px;top:34.50px;width:240.00px;height:150.00px"> <img class="sg" src="BB2E922C.jpg" id="s295_i" style="z-index:1;left:0px;top:0px;width:240.29px;height:150.07px" > </div> <div class="sg" id="s296" data-sgid="Picture 3" style="z-index:2;left:270.88px;top:130.50px;width:230.88px;height:162.00px"> <img class="sg" src="79158223.jpg" id="s296_i" style="z-index:1;left:0px;top:0px;width:231.26px;height:162.10px" > </div> <div class="sg" id="s297" data-sgid="Picture 5" style="z-index:3;left:510.00px;top:238.50px;width:203.38px;height:150.00px"> <img class="sg" src="80D1A75C.jpg" id="s297_i" style="z-index:1;left:0px;top:0px;width:203.50px;height:150.10px" > </div> <div class="sg sgTitle" id="s298" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s298_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="226.24" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:210.92px;top:17.71px;">Key findings</span></p></div></div></div> <div class="sg" id="s299" data-sgid="Rectangle 3" style="z-index:2;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s299_t" class="sg" style="z-index:2;left:-9.72px;top:-5.29px;width:672.79px;height:273.47px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="592.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.97px;top:11.95px;">•<span style="letter-spacing:8.60px"> </span>Collection containing dependent faceted stones, </span><span data-textwidth="612.22" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:43.97px;top:45.56px;">inflammatory reaction, no internal enhancement, no </span><span data-textwidth="276.41" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:43.97px;top:79.17px;">intravoxel fat on IP/OP </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="564.09" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:16.97px;top:119.50px;">•<span style="letter-spacing:8.60px"> </span>Small amount of free fluid; left ovary not seen</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="505.28" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:16.97px;top:159.82px;">•<span style="letter-spacing:8.60px"> </span>Normal uterus, right ovary, bowel, nodes</span></p></div></div></div> <div class="sg sgTitle" id="s300" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s300_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="387.90" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:130.03px;top:17.71px;">Differential diagnosis</span></p></div></div></div> <div class="sg" id="s301" data-sgid="Rectangle 3" style="z-index:2;left:71.92px;top:58.44px;width:648.08px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s301_t" class="sg" style="z-index:2;left:-12.73px;top:0.00px;width:661.63px;height:280.91px;"><div><p para="{bl:{ch:8226},spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="282.41" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.02px;top:52.70px;">•<span style="letter-spacing:5.61px"> </span>Torsion of dermoid</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="142.10" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:56.03px;top:97.83px;">– Doesn’t fit</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="409.27" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:20.02px;top:139.12px;">•<span style="letter-spacing:5.61px"> </span>Dropped gall stones abscess</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="317.57" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:56.03px;top:184.25px;">– Clinical h/o laparoscopy?</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="307.26" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:20.02px;top:225.54px;">•<span style="letter-spacing:5.61px"> </span>Would like to see: CT</span></p></div></div></div> <div class="sg" id="s305" data-sgid="Title 1" style="z-index:4;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="top"> <div id="s305_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:648.08px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="329.09" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:159.43px;top:17.56px;">Additional History</span></p></div></div></div> <div class="sg" id="s302" data-sgid="Picture 2" style="z-index:1;left:26.13px;top:81.00px;width:345.88px;height:217.50px"> <img class="sg" src="3518F62.jpg" id="s302_i" style="z-index:1;left:0px;top:0px;width:346.10px;height:217.71px" > </div> <div class="sg" id="s303" data-sgid="Picture 4" style="z-index:2;left:384.00px;top:76.50px;width:315.50px;height:305.38px"> <img class="sg" src="2BDD99FB.jpg" id="s303_i" style="z-index:1;left:0px;top:0px;width:316.08px;height:305.36px" > </div> <div class="sg" id="s304" data-sgid="TextBox 1" style="z-index:3;left:98.16px;top:292.02px;width:220.37px;height:66.14px" data-valign="top"> <div id="s304_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:236.92px;height:71.40px;"><div><p><span data-textwidth="203.67" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.82px;top:12.35px;">Two years earlier</span></p></div></div></div> <div class="sg" id="s307" data-sgid="Title 1" style="z-index:2;left:53.92px;top:64.44px;width:624.14px;height:68.29px" data-valign="top"> <div id="s307_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:624.14px;height:93.80px;"><div><p para="{al:2}"><span data-textwidth="329.09" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:244%; left:147.47px;top:18.05px;">Additional History</span></p></div></div></div> <div class="sg" id="s306" data-sgid="Content Placeholder 2" style="z-index:1;left:95.86px;top:172.25px;width:588.18px;height:102.77px" data-valign="top" data-pointer-events="none"> <div id="s306_t" class="sg" style="z-index:2;left:-12.69px;top:-6.82px;width:601.72px;height:110.33px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="542.37" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.05px;top:13.65px;">•<span style="letter-spacing:5.60px"> </span>Subsequent transvaginal laparoscopic </span><span data-textwidth="224.68" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:47.05px;top:52.06px;">cholecystectomy</span></p></div></div></div> <div class="sg sgSubtitle" id="s308" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s308_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s309" data-sgid="Subtitle 4" style="z-index:1;left:41.94px;top:82.40px;width:654.09px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s309_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:654.94px;height:117.88px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="581.38" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:36.31px;top:22.47px;">Spilled Gallstone Abscess</span></p></div></div></div> <div class="sg" id="s311" data-sgid="Subtitle 4" style="z-index:2;left:89.88px;top:16.52px;width:540.23px;height:66.85px" data-valign="top"> <div id="s311_t" class="sg" style="z-index:2;left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;"><div><p para="{spbf:0.20}"><span data-textwidth="474.44" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.75px;top:17.92px;"><u>Spilled Gallstone Abscess</u></span></p></div></div><img class="sg" src="E855D05A.png" id="s311_tt" style="left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;z-index:1" > </div> <div class="sg" id="s310" data-sgid="Content Placeholder 2" style="z-index:1;left:65.91px;top:94.40px;width:642.10px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s310_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:655.65px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="589.66" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>5-19% of laparoscopic cholecystectomies </span><span data-textwidth="555.21" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:47.00px;top:51.92px;">have stones spilled with variable rates of </span><span data-textwidth="111.26" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:47.00px;top:90.33px;">retrieval</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="442.63" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:56.00px;top:133.50px;">–<span style="letter-spacing:5.24px"> </span>Rarely occurs with open cholecystectomy</span></p></div></div></div> <div class="sg" id="s312" data-sgid="Content Placeholder 2" style="z-index:1;left:53.92px;top:16.52px;width:648.08px;height:267.50px" data-valign="top"> <div id="s312_t" class="sg" style="z-index:2;left:0.00px;top:-7.52px;width:648.08px;height:275.02px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="434.35" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:178%; left:106.91px;top:15.20px;">Transvaginal Cholecystectomy</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="569.37" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:156%; left:39.34px;top:59.17px;">(natural orifice transluminal endoscopic surgery)</span></p></div></div></div> <div class="sg" id="s314" data-sgid="Picture 3" style="z-index:3;left:390.00px;top:106.50px;width:192.00px;height:270.25px"> <img class="sg" src="F6BCDB15.jpg" id="s314_i" title="" alt="transvaginalgallbladderremaovalnotes.JPG" style="z-index:1;left:0px;top:0px;width:192.19px;height:270.17px" > </div> <div class="sg" id="s313" data-sgid="Picture 2" style="z-index:2;left:156.00px;top:107.88px;width:162.00px;height:269.75px"> <img class="sg" src="7DAC88B4.jpg" id="s313_i" title="" alt="icimages-3.jpeg" style="z-index:1;left:0px;top:0px;width:162.17px;height:270.17px" > </div> <div class="sg" id="s316" data-sgid="Subtitle 4" style="z-index:2;left:89.88px;top:16.52px;width:540.23px;height:66.85px" data-valign="top"> <div id="s316_t" class="sg" style="z-index:2;left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;"><div><p para="{spbf:0.20}"><span data-textwidth="474.44" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.75px;top:17.92px;"><u>Spilled Gallstone Abscess</u></span></p></div></div><img class="sg" src="E855D05A.png" id="s316_tt" style="left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;z-index:1" > </div> <div class="sg" id="s315" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:88.40px;width:648.08px;height:258.50px" data-valign="top" data-pointer-events="none"> <div id="s315_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:658.65px;height:264.47px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="540.09" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.97px;top:11.92px;">•<span style="letter-spacing:8.60px"> </span>Occurs up to seven years following surgery</span></p><p para="{spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="311.69" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:16.97px;top:92.58px;">•<span style="letter-spacing:8.60px"> </span>Most common locations </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="182.68" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:52.97px;top:130.95px;">–<span style="letter-spacing:5.25px"> </span>Abdominal wall </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="578.02" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:133%; left:52.97px;top:165.51px;">–<span style="letter-spacing:5.25px"> </span>Intra-abdominal cavity, usually in the subhepatic space </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="190.72" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:133%; left:52.97px;top:200.08px;">–<span style="letter-spacing:5.25px"> </span>Retroperitoneum</span></p></div></div></div> <div class="sg" id="s318" data-sgid="Subtitle 4" style="z-index:2;left:89.88px;top:16.52px;width:540.23px;height:66.85px" data-valign="top"> <div id="s318_t" class="sg" style="z-index:2;left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;"><div><p para="{spbf:0.20}"><span data-textwidth="474.44" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:26.75px;top:17.92px;"><u>Spilled Gallstone Abscess</u></span></p></div></div><img class="sg" src="E855D05A.png" id="s318_tt" style="left:-19.41px;top:-10.52px;width:559.64px;height:93.78px;z-index:1" > </div> <div class="sg" id="s317" data-sgid="Content Placeholder 2" style="z-index:1;left:47.95px;top:88.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s317_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:673.61px;height:274.17px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="618.10" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.98px;top:11.92px;">•<span style="letter-spacing:8.60px"> </span>Consider dropped gallstones as a potential source </span><span data-textwidth="547.77" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:43.98px;top:45.53px;">of recurrent abscess in any patient presenting </span><span data-textwidth="415.15" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:43.98px;top:79.14px;">months to years after laparoscopic </span><span data-textwidth="204.63" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:43.98px;top:112.74px;">cholecystectomy </span></p><p para="{bl:{ch:8226},spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="639.82" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:16.98px;top:193.40px;">•<span style="letter-spacing:8.60px"> </span>Calculi identified using US, CT, or MRI within a fluid </span><span data-textwidth="332.82" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:43.98px;top:227.01px;">collection is often diagnostic</span></p></div></div></div> <div class="sg" id="s319" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s319_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s320" data-sgid="Title 1" style="z-index:1;left:47.95px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s320_t" class="sg" style="z-index:2;left:0.00px;top:-2.26px;width:648.93px;height:84.81px;"><div><p para="{al:2}"><span data-textwidth="576.22" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:41.58px;top:15.91px;">Reginald Munden, MD, DMD, MBA </span></p></div></div></div> <div class="sg" id="s322" data-sgid="Picture 6" style="z-index:3;left:54.00px;top:106.50px;width:180.00px;height:222.38px"> <img class="sg" src="4601BD30.jpg" id="s322_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:180.21px;height:222.87px" > </div> <div class="sg" id="s321" data-sgid="Content Placeholder 3" style="z-index:2;left:251.66px;top:106.36px;width:456.36px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s321_t" class="sg" style="z-index:2;left:-8.28px;top:-5.26px;width:465.48px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="262.25" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.86px;top:13.24px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Professor and Chair</span></span></p><p></p><p><span data-textwidth="280.85" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:87.88px;top:79.18px;">Deparment of Radiology</span></p><p></p><p><span data-textwidth="328.85" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:87.88px;top:146.39px;">Houston Methodist Hospital </span><span data-textwidth="261.88" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:87.88px;top:180.00px;">and Research Institute</span></p></div></div></div> <div class="sg sgTitle" id="s323" data-sgid="Title 1" style="z-index:1;left:47.95px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s323_t" class="sg" style="z-index:2;left:0.00px;top:-2.26px;width:648.93px;height:84.81px;"><div><p para="{al:2}"><span data-textwidth="576.22" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:41.58px;top:15.91px;">Reginald Munden, MD, DMD, MBA </span></p></div></div></div> <div class="sg" id="s325" data-sgid="Picture 6" style="z-index:3;left:54.00px;top:106.50px;width:180.00px;height:222.38px"> <img class="sg" src="4601BD30.jpg" id="s325_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:180.21px;height:222.87px" > </div> <div class="sg" id="s324" data-sgid="Content Placeholder 3" style="z-index:2;left:251.66px;top:88.40px;width:414.42px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s324_t" class="sg" style="z-index:2;left:-8.28px;top:-5.26px;width:423.52px;height:273.47px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="277.25" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.86px;top:13.20px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Dental School: MUSC</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="251.93" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.86px;top:53.53px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Med School: MUSC</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="235.12" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.86px;top:93.86px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Residency: MUSC</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="375.07" class="sg nowrap f4" style="z-index:8;color:#FFFFFF;font-size:156%; left:15.86px;top:134.19px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>Chest Fellowship: Brigham & </span></span><span data-textwidth="114.50" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:42.87px;top:166.51px;">Women’s </span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="377.83" class="sg nowrap f4" style="z-index:11;color:#FFFFFF;font-size:156%; left:15.86px;top:208.12px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>M.D. Anderson Cancer Center</span></span></p></div></div></div> <div class="sg sgTitle" id="s326" data-sgid="Title 1" style="z-index:1;left:47.95px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s326_t" class="sg" style="z-index:2;left:0.00px;top:-2.26px;width:648.93px;height:84.81px;"><div><p para="{al:2}"><span data-textwidth="576.22" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:41.58px;top:15.91px;">Reginald Munden, MD, DMD, MBA </span></p></div></div></div> <div class="sg" id="s327" data-sgid="Content Placeholder 3" style="z-index:2;left:251.66px;top:100.37px;width:390.45px;height:174.65px" data-valign="top" data-pointer-events="none"> <div id="s327_t" class="sg" style="z-index:2;left:-8.28px;top:-5.26px;width:399.54px;height:180.65px;"><div><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="353.10" class="sg nowrap f4" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.86px;top:13.23px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>>120 peer reviewed articles</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="227.56" class="sg nowrap f4" style="z-index:4;color:#FFFFFF;font-size:156%; left:15.86px;top:53.56px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>10 book chapters</span></span></p><p para="{bl:{ch:167},spbf:0.20}"><span data-textwidth="270.53" class="sg nowrap f4" style="z-index:6;color:#FFFFFF;font-size:156%; left:15.86px;top:93.89px;"><span class="f1" ><span style="letter-spacing:8.49px"> </span>>140 invited lectures</span></span></p></div></div></div> <div class="sg" id="s328" data-sgid="Picture 6" style="z-index:3;left:54.00px;top:106.50px;width:180.00px;height:222.38px"> <img class="sg" src="4601BD30.jpg" id="s328_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:180.21px;height:222.87px" > </div> <div class="sg" id="s329" data-sgid="Picture 1" style="z-index:1;left:30.00px;top:17.38px;width:331.75px;height:263.13px"> <img class="sg" src="3CC64A82.jpg" id="s329_i" title="" alt="M and R Dental School02.jpg" style="z-index:1;left:0px;top:0px;width:331.93px;height:263.45px" > </div> <div class="sg" id="s330" data-sgid="Picture 4" style="z-index:2;left:372.00px;top:94.50px;width:332.00px;height:249.00px"> <img class="sg" src="AC2083D7.jpg" id="s330_i" title="" alt="Bham.Snowfall.MartheandReggie.2009.41.JPG" style="z-index:1;left:0px;top:0px;width:332.67px;height:249.15px" > </div> <div class="sg" id="s331" data-sgid="TextBox 1" style="z-index:3;left:119.83px;top:280.06px;width:74.41px;height:32.33px" data-valign="top"> <div id="s331_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:84.13px;height:43.59px;"><div><p><span data-textwidth="58.21" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.66px;top:9.04px;">Marthe</span></p></div></div></div> <div class="sg" id="s332" data-sgid="TextBox 4" style="z-index:4;left:509.32px;top:345.94px;width:74.41px;height:32.33px" data-valign="top"> <div id="s332_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:84.13px;height:43.59px;"><div><p><span data-textwidth="58.21" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:13.24px;top:9.18px;">Marthe</span></p></div></div></div> <div class="sg sgTitle" id="s333" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s333_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="267.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:190.16px;top:17.71px;">Chest Case #1</span></p></div></div></div> <div class="sg" id="s334" data-sgid="Rectangle 3" style="z-index:2;left:35.96px;top:103.37px;width:648.08px;height:150.69px" data-valign="top"> <div id="s334_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.08px;height:157.51px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="318.89" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:168.91px;top:13.51px;">71 year old female with </span><span data-textwidth="248.56" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:204.08px;top:51.92px;">splenomegaly and </span><span data-textwidth="261.40" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:193.28px;top:90.33px;">shortness of breath</span></p></div></div></div> <div class="sg" id="s335" data-sgid="Picture 4" style="z-index:1;left:120.00px;top:31.50px;width:504.00px;height:334.38px"> <img class="sg" src="369FDC85.jpg" id="s335_i" style="z-index:1;left:0px;top:0px;width:504.58px;height:334.65px" > </div> <div class="sg" id="s336" data-sgid="Picture 6" style="z-index:1;left:18.00px;top:117.00px;width:350.63px;height:180.00px"> <img class="sg" src="BA61D3CE.jpg" id="s336_i" style="z-index:1;left:0px;top:0px;width:351.42px;height:180.10px" > </div> <div class="sg" id="s337" data-sgid="Picture 8" style="z-index:2;left:378.00px;top:117.00px;width:334.88px;height:180.63px"> <img class="sg" src="93D1A345.jpg" id="s337_i" style="z-index:1;left:0px;top:0px;width:335.65px;height:180.82px" > </div> <div class="sg" id="s339" data-sgid="Picture 4" style="z-index:2;left:27.00px;top:100.38px;width:363.00px;height:186.00px"> <img class="sg" src="B740B43A.jpg" id="s339_i" style="z-index:1;left:0px;top:0px;width:363.41px;height:186.15px" > </div> <div class="sg" id="s338" data-sgid="Picture 2" style="z-index:1;left:400.13px;top:99.88px;width:307.88px;height:188.13px"> <img class="sg" src="9B0E4319.jpg" id="s338_i" style="z-index:1;left:0px;top:0px;width:307.79px;height:188.41px" > </div> <div class="sg" id="s342" data-sgid="Picture 2 (2)" style="z-index:3;left:66.00px;top:18.00px;width:635.00px;height:167.25px"> <img class="sg" src="646A5DAF.jpg" id="s342_i" style="z-index:1;left:0px;top:0px;width:635.99px;height:167.40px" > </div> <div class="sg" id="s341" data-sgid="TextBox 5" style="z-index:2;left:185.75px;top:190.21px;width:353.04px;height:32.33px" data-valign="top"> <div id="s341_t" class="sg" style="z-index:2;left:-5.28px;top:-3.00px;width:358.31px;height:43.62px;"><div><p><span data-textwidth="318.42" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.76px;top:8.87px;">Technetium-99m labeled sulfur colloid</span></p></div></div></div> <div class="sg" id="s340" data-sgid="Picture 2" style="z-index:1;left:72.00px;top:220.50px;width:604.63px;height:144.75px"> <img class="sg" src="3F070505.jpg" id="s340_i" style="z-index:1;left:0px;top:0px;width:605.23px;height:144.80px" > </div> <div class="sg" id="s343" data-sgid="Picture 4" style="z-index:1;left:42.00px;top:46.50px;width:327.63px;height:217.38px"> <img class="sg" src="469F0652.jpg" id="s343_i" style="z-index:1;left:0px;top:0px;width:328.10px;height:217.60px" > </div> <div class="sg" id="s344" data-sgid="Picture 8" style="z-index:2;left:378.00px;top:154.50px;width:334.88px;height:203.13px"> <img class="sg" src="4E70FF92.jpg" id="s344_i" style="z-index:1;left:0px;top:0px;width:335.65px;height:203.30px" > </div> <div class="sg" id="s345" data-sgid="Group 1" style="z-index:1;left:26.98px;top:82.40px;width:681.04px;height:216.58px"> <img class="sg" src="4A5AB83C.png" id="s345_i" style="z-index:1;left:0px;top:0px;width:682.72px;height:217.11px" > </div> <div class="sg sgSubtitle" id="s346" data-sgid="Subtitle 4" style="z-index:1;left:53.92px;top:58.44px;width:654.09px;height:292.87px" data-valign="top" data-pointer-events="none"> <div id="s346_t" class="sg" style="z-index:2;left:-9.69px;top:-5.26px;width:664.63px;height:301.13px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="587.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.98px;top:11.87px;">•<span style="letter-spacing:26.61px"> </span>Cardiomegaly, enlarged vessels, ground glass </span><span data-textwidth="103.34" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:61.99px;top:45.48px;">opacities</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="237.64" class="sg nowrap f2" style="z-index:5;color:#FFFFFF;font-size:156%; left:62.23px;top:80.37px;">–<span class="f1" ><span style="letter-spacing:5.36px"> </span>Pulmonary edema</span></span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="503.48" class="sg nowrap f2" style="z-index:7;color:#FFFFFF;font-size:156%; left:62.23px;top:113.98px;">–<span class="f1" ><span style="letter-spacing:5.36px"> </span>Infection, inflammatory (hypersensitivity </span></span><span data-textwidth="151.35" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:88.99px;top:146.30px;">pneumonitis)</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="569.26" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:16.98px;top:186.63px;">•<span style="letter-spacing:26.61px"> </span>Sclerotic, mottled bones – myeloproliferative</span><span data-textwidth="583.42" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:61.99px;top:220.24px;">disorder, malignancy, marrow stimulating therapy</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="175.10" class="sg nowrap f2" style="z-index:15;color:#FFFFFF;font-size:156%; left:62.23px;top:255.13px;">–<span class="f1" ><span style="letter-spacing:5.36px"> </span>Drug toxicity</span></span></p></div></div></div> <div class="sg" id="s349" data-sgid="Picture 2 (2)" style="z-index:3;left:66.00px;top:18.00px;width:635.00px;height:167.25px"> <img class="sg" src="646A5DAF.jpg" id="s349_i" style="z-index:1;left:0px;top:0px;width:635.99px;height:167.40px" > </div> <div class="sg" id="s348" data-sgid="TextBox 5" style="z-index:2;left:185.75px;top:190.21px;width:353.04px;height:32.33px" data-valign="top"> <div id="s348_t" class="sg" style="z-index:2;left:-5.28px;top:-3.00px;width:358.31px;height:43.62px;"><div><p><span data-textwidth="318.42" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:111%; left:12.76px;top:8.87px;">Technetium-99m labeled sulfur colloid</span></p></div></div></div> <div class="sg" id="s347" data-sgid="Picture 2" style="z-index:1;left:72.00px;top:220.50px;width:604.63px;height:144.75px"> <img class="sg" src="3F070505.jpg" id="s347_i" style="z-index:1;left:0px;top:0px;width:605.23px;height:144.80px" > </div> <div class="sg sgSubtitle" id="s350" data-sgid="Subtitle 4" style="z-index:1;left:71.92px;top:52.48px;width:624.11px;height:294.43px" data-valign="top" data-pointer-events="none"> <div id="s350_t" class="sg" style="z-index:2;left:-12.73px;top:-6.85px;width:637.68px;height:301.98px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="485.24" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.02px;top:13.42px;">•<span style="letter-spacing:23.61px"> </span>Colloid shift, severe liver disease</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="538.89" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:156%; left:65.27px;top:53.11px;">–<span class="f1" ><span style="letter-spacing:5.37px"> </span>Pulmonary uptake: Veno-occlusive disease, </span></span><span data-textwidth="152.55" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:92.04px;top:85.44px;">drug toxicity </span></p><p para="{in:2,spbf:0.20}"></p><p para="{spbf:0.20}"><span data-textwidth="389.47" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:20.02px;top:144.01px;">= Myeloproliferative Disorder</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="525.81" class="sg nowrap f2" style="z-index:13;color:#FFFFFF;font-size:156%; left:65.27px;top:183.70px;">–<span class="f1" ><span style="letter-spacing:5.37px"> </span>RSNA film panel – thoracic case, not MSK!</span></span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="546.70" class="sg nowrap f2" style="z-index:17;color:#FFFFFF;font-size:156%; left:65.27px;top:217.31px;">–<span class="f1" ><span style="letter-spacing:5.37px"> </span>So the diffuse pulmonary uptake if not likely </span></span><span data-textwidth="227.08" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:156%; left:92.04px;top:249.63px;">from hepatic failure</span></p></div></div></div> <div class="sg sgTitle" id="s351" data-sgid="Title 1" style="z-index:1;left:53.92px;top:26.96px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s351_t" class="sg" style="z-index:2;left:0.00px;top:-6.71px;width:648.93px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="178.35" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:234.85px;top:17.84px;">Diagnosis</span></p></div></div></div> <div class="sg" id="s352" data-sgid="Rectangle 3" style="z-index:2;left:35.96px;top:88.40px;width:672.05px;height:240.54px" data-valign="top"> <div id="s352_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:672.05px;height:240.54px;"><div><p para="{al:2,spbf:0.20}"></p><p para="{al:2,spbf:0.20}"><span data-textwidth="210.76" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:236.73px;top:70.91px;">Pulmonary </span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="560.72" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:244%; left:55.62px;top:134.29px;">Extramedullary Hematopoiesis</span></p></div></div></div> <div class="sg sgSubtitle" id="s353" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s353_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s354" data-sgid="Subtitle 4" style="z-index:1;left:23.97px;top:76.44px;width:696.03px;height:104.19px" data-valign="top" data-pointer-events="none"> <div id="s354_t" class="sg" style="z-index:2;left:0.00px;top:-9.00px;width:696.85px;height:223.28px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="191.55" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:257.96px;top:16.62px;">Pulmonary </span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="508.88" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:222%; left:93.53px;top:74.23px;">Extramedullary Hematopoeisis</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="368.70" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:168.06px;top:128.92px;">Myeloproliferative disorder </span><span data-textwidth="290.09" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:211.87px;top:167.33px;">(Polycythemia Vera)  </span></p></div></div></div> <div class="sg" id="s356" data-sgid="Rectangle 3" style="z-index:2;left:29.95px;top:16.52px;width:702.03px;height:60.85px" data-valign="top"> <div id="s356_t" class="sg" style="z-index:2;left:-14.96px;top:-7.52px;width:717.00px;height:77.37px;"><div><p para="{spbf:0.20}"><span data-textwidth="670.31" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.22px;top:15.57px;"><u>Pulmonary Extramedullary Hematopoiesis</u></span></p></div></div><img class="sg" src="9F069C97.png" id="s356_tt" style="left:-14.96px;top:-7.52px;width:717.00px;height:77.37px;z-index:1" > </div> <div class="sg" id="s355" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:88.40px;width:660.07px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s355_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:682.62px;height:273.47px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="599.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.97px;top:11.92px;">•<span style="letter-spacing:8.60px"> </span>Development of blood cells outside bone marrow</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="615.11" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:52.97px;top:50.29px;">–<span style="letter-spacing:5.25px"> </span>Usually secondary process resulting from chronic primary </span><span data-textwidth="564.21" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:75.54px;top:79.10px;">process such as myeloproliferative disorders (including </span><span data-textwidth="191.19" class="sg nowrap f1" style="z-index:7;color:#FFFF00;font-size:133%; left:75.54px;top:107.90px;">polycythemia vera<span style="color:#FFFFFF;">)</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="478.05" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:133%; left:52.97px;top:142.47px;">–<span style="letter-spacing:5.25px"> </span>Most common in liver, spleen, & lymph nodes</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="578.26" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:133%; left:52.97px;top:177.04px;">–<span style="letter-spacing:5.25px"> </span>Less common in GI, breast, skin, kidneys, pleura & <span style="color:#FFFF00;">lung</span></span></p></div></div></div> <div class="sg sgTitle" id="s357" data-sgid="Title 1" style="z-index:1;left:35.96px;top:10.55px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s357_t" class="sg" style="z-index:2;left:0.00px;top:-6.84px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.93px;">Imaging</span></p></div></div></div> <div class="sg" id="s358" data-sgid="Content Placeholder 2" style="z-index:2;left:35.96px;top:76.44px;width:666.05px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s358_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:679.62px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="63.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.47px;">•<span style="letter-spacing:5.60px"> </span>CT</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="214.12" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:55.97px;top:58.60px;">– Paraspinal mass</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="527.25" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:55.97px;top:98.93px;">– Non-specific ground-glass opacities, septal</span><span data-textwidth="225.28" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:78.54px;top:132.53px;">thickening, nodules</span></p><p para="{in:2,bl:{ch:8226},spbf:0.20}"><span data-textwidth="590.62" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:178%; left:19.97px;top:173.82px;">•<span style="letter-spacing:5.60px"> </span>Technetium-99m-colloid shows uptake in </span><span data-textwidth="433.87" class="sg nowrap f1" style="z-index:23;color:#FFFFFF;font-size:156%; left:46.97px;top:212.23px;">macrophages in erythropoietic tissue</span></p></div></div></div> <div class="sg" id="s360" data-sgid="Rectangle 3" style="z-index:2;left:29.95px;top:16.52px;width:702.03px;height:60.85px" data-valign="top"> <div id="s360_t" class="sg" style="z-index:2;left:-14.96px;top:-7.52px;width:717.00px;height:77.37px;"><div><p para="{spbf:0.20}"><span data-textwidth="670.31" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.22px;top:15.57px;"><u>Pulmonary Extramedullary Hematopoiesis</u></span></p></div></div><img class="sg" src="9F069C97.png" id="s360_tt" style="left:-14.96px;top:-7.52px;width:717.00px;height:77.37px;z-index:1" > </div> <div class="sg" id="s359" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:88.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s359_t" class="sg" style="z-index:2;left:-12.72px;top:-6.82px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="542.73" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.48px;">•<span style="letter-spacing:5.60px"> </span>Usually no serious clinical implications</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="578.97" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.97px;top:59.57px;">•<span style="letter-spacing:5.60px"> </span>Definitive diagnosis often made with fine </span><span data-textwidth="322.73" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:46.97px;top:97.98px;">needle aspiration biopsy</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="461.83" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:178%; left:19.97px;top:144.07px;">•<span style="letter-spacing:5.60px"> </span>Treatment of underlying etiology</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="341.58" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:55.97px;top:189.20px;">– Low dose radiation therapy</span></p></div></div></div> <div class="sg" id="s361" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s361_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s362" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s362_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="381.54" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.27px;top:15.90px;">Theodore T. Miller, MD</span></p></div></div></div> <div class="sg" id="s363" data-sgid="Picture 4" style="z-index:2;left:264.00px;top:76.50px;width:210.00px;height:268.50px"> <img class="sg" src="CC78E301.jpg" id="s363_i" title="" alt="Miller_3624_P.jpeg" style="z-index:1;left:0px;top:0px;width:210.24px;height:268.61px" > </div> <div class="sg sgTitle" id="s364" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s364_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="255.76" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:196.16px;top:17.71px;">MSK Case #2</span></p></div></div></div> <div class="sg" id="s365" data-sgid="Content Placeholder 1" style="z-index:2;left:53.92px;top:103.37px;width:616.69px;height:159.69px" data-valign="top" data-pointer-events="none"> <div id="s365_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:617.42px;height:167.21px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="220.72" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:202.32px;top:13.51px;">16-year-old boy </span><span data-textwidth="247.48" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:184.44px;top:51.92px;">with shoulder pain</span></p></div></div></div> <div class="sg" id="s366" data-sgid="Picture 2" style="z-index:1;left:66.00px;top:34.50px;width:624.00px;height:321.25px"> <img class="sg" src="59B67A6D.jpg" id="s366_i" style="z-index:1;left:0px;top:0px;width:624.71px;height:321.19px" > </div> <div class="sg" id="s367" data-sgid="Picture 2" style="z-index:1;left:30.00px;top:106.50px;width:319.75px;height:193.50px"> <img class="sg" src="2FB4FF7.jpg" id="s367_i" style="z-index:1;left:0px;top:0px;width:319.94px;height:193.58px" > </div> <div class="sg" id="s368" data-sgid="Picture 3" style="z-index:2;left:366.13px;top:112.50px;width:353.88px;height:184.50px"> <img class="sg" src="EA81AEF8.png" id="s368_i" style="z-index:1;left:0px;top:0px;width:354.40px;height:184.55px" > </div> <div class="sg" id="s369" data-sgid="Picture 2" style="z-index:1;left:66.00px;top:34.50px;width:624.00px;height:321.25px"> <img class="sg" src="59B67A6D.jpg" id="s369_i" style="z-index:1;left:0px;top:0px;width:624.71px;height:321.19px" > </div> <div class="sg" id="s370" data-sgid="Picture 2" style="z-index:1;left:30.00px;top:106.50px;width:319.75px;height:193.50px"> <img class="sg" src="2FB4FF7.jpg" id="s370_i" style="z-index:1;left:0px;top:0px;width:319.94px;height:193.58px" > </div> <div class="sg" id="s371" data-sgid="Picture 3" style="z-index:2;left:366.13px;top:112.50px;width:353.88px;height:184.50px"> <img class="sg" src="EA81AEF8.png" id="s371_i" style="z-index:1;left:0px;top:0px;width:354.40px;height:184.55px" > </div> <div class="sg sgTitle" id="s372" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s372_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:78.10px;"><div><p para="{al:2}"><span data-textwidth="478.16" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:84.90px;top:15.81px;">Permeative Destructive Lesions</span></p></div></div></div> <div class="sg" id="s373" data-sgid="Rectangle 5" style="z-index:2;left:101.87px;top:76.44px;width:498.30px;height:295.84px" data-valign="top" data-pointer-events="none"> <div id="s373_t" class="sg" style="z-index:2;left:-12.70px;top:-6.85px;width:510.99px;height:305.69px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="137.78" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.05px;top:13.47px;">•<span style="letter-spacing:14.60px"> </span>Benign </span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="179.08" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:56.05px;top:51.88px;">–<span style="letter-spacing:6.33px"> </span>osteomyelitis</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="294.89" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:56.05px;top:85.48px;">–<span style="letter-spacing:6.33px"> </span>eosinophilic granuloma</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="172.58" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:20.05px;top:119.09px;">•<span style="letter-spacing:14.60px"> </span>Malignant </span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="288.41" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:56.05px;top:157.50px;">–<span style="letter-spacing:6.33px"> </span>Ewing’s sarcoma        </span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="188.92" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:156%; left:56.05px;top:191.11px;">–<span style="letter-spacing:6.33px"> </span>osteosarcoma</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="153.75" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:56.05px;top:224.71px;">–<span style="letter-spacing:6.33px"> </span>Lymphoma</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="263.21" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:156%; left:56.05px;top:258.32px;">–<span style="letter-spacing:6.33px"> </span>neuroblastoma mets</span></p></div></div></div> <div class="sg" id="s375" data-sgid="Rectangle 5" style="z-index:2;left:71.92px;top:15.70px;width:624.11px;height:51.97px" data-valign="top" data-pointer-events="none"> <div id="s375_t" class="sg" style="z-index:2;left:-14.99px;top:-7.44px;width:639.10px;height:77.40px;"><div><p><span data-textwidth="565.18" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.28px;top:14.82px;">Permeative/Lytic Destructive Lesions</span></p></div></div></div> <div class="sg" id="s374" data-sgid="Rectangle 3" style="z-index:1;left:53.92px;top:82.40px;width:636.12px;height:252.50px" data-valign="top" data-pointer-events="none"> <div id="s374_t" class="sg" style="z-index:2;left:-12.69px;top:-6.81px;width:648.82px;height:300.54px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="508.17" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.98px;top:13.47px;">•<span style="letter-spacing:14.61px"> </span>Angiomatous/Lymphatic Processes</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="554.85" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:144%; left:55.99px;top:51.88px;">–<span style="letter-spacing:7.76px"> </span>Gorham’s Disease-progressive osteolysis due to </span><span data-textwidth="142.34" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:144%; left:82.75px;top:83.08px;">angiomatosis</span></p><p para="{in:2,bl:{ch:8226}}"><span data-textwidth="250.96" class="sg nowrap f2" style="z-index:9;color:#FFFFFF;font-size:144%; left:55.99px;top:115.33px;">•<span class="f1" ><span style="letter-spacing:12.32px"> </span>“massive osteolysis”</span></span></p><p para="{in:2,bl:{ch:8226}}"><span data-textwidth="300.04" class="sg nowrap f2" style="z-index:12;color:#FFFFFF;font-size:144%; left:55.99px;top:146.54px;">•<span class="f1" ><span style="letter-spacing:12.32px"> </span>“vanishing bone disease”</span></span></p><p para="{bl:{ch:8226}}"></p><p para="{bl:{ch:8226}}"><span data-textwidth="401.23" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:19.98px;top:193.51px;">•<span class="f1" style="font-size:108%; "><span style="letter-spacing:26.61px"> </span>Generalized Lymphatic Anomaly-</span></span><span data-textwidth="229.47" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:144%; left:55.99px;top:224.72px;">“lymphangiomatosis”</span></p><p para="{in:2,bl:{ch:8211}}"><span data-textwidth="533.84" class="sg nowrap f1" style="z-index:22;color:#FFFFFF;font-size:144%; left:55.99px;top:255.92px;">–<span style="letter-spacing:7.76px"> </span>systemic disease with cystic bony involvement</span></p></div></div></div> <div class="sg" id="s376" data-sgid="TextBox 3" style="z-index:1;left:89.88px;top:16.52px;width:538.79px;height:42.18px" data-valign="top"> <div id="s376_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:551.51px;height:59.41px;"><div><p><span data-textwidth="518.49" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.06px;top:11.78px;">Gorham’s Disease – prevalence in flat bones</span></p></div></div></div> <div class="sg" id="s377" data-sgid="Group 5" style="z-index:2;left:197.73px;top:64.44px;width:332.07px;height:259.21px"> <img class="sg" src="3D895E86.png" id="s377_i" style="z-index:1;left:0px;top:0px;width:332.89px;height:259.85px" > </div> <div class="sg" id="s378" data-sgid="Rectangle 7" style="z-index:5;left:119.83px;top:323.42px;width:540.23px;height:72.81px" data-valign="top" data-pointer-events="none"> <div id="s378_t" class="sg" style="z-index:2;left:-3.71px;top:-3.00px;width:543.95px;height:82.66px;"><div><p><span data-textwidth="466.88" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;left:11.10px;top:8.77px;">Lala S et al. Gorham-Stout disease and generalized lymphatic </span><span data-textwidth="506.72" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;left:11.10px;top:30.38px;">anomaly—clinical, radiologic, and histologic differentiation. Skeletal </span><span data-textwidth="199.47" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;left:11.10px;top:51.98px;">Radiol. 2013 Jul;42:917-24</span></p></div></div></div> <div class="sg" id="s379" data-sgid="Title 1" style="z-index:1;left:53.92px;top:148.29px;width:624.14px;height:68.29px" data-valign="top"> <div id="s379_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:624.14px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="329.09" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:244%; left:147.47px;top:18.18px;">Additional History</span></p></div></div></div> <div class="sg" id="s382" data-sgid="Title 1" style="z-index:3;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="top"> <div id="s382_t" class="sg" style="z-index:2;left:0.00px;top:-8.97px;width:648.08px;height:85.52px;"><div><p para="{al:2}"><span data-textwidth="258.16" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:222%; left:194.96px;top:16.13px;">Two years later</span></p></div></div></div> <div class="sg" id="s380" data-sgid="Picture 2" style="z-index:1;left:30.00px;top:75.88px;width:330.00px;height:271.38px"> <img class="sg" src="B37C115F.jpg" id="s380_i" style="z-index:1;left:0px;top:0px;width:330.39px;height:271.73px" > </div> <div class="sg" id="s381" data-sgid="Picture 3" style="z-index:2;left:372.00px;top:76.50px;width:324.00px;height:270.50px"> <img class="sg" src="9FC416E.jpg" id="s381_i" style="z-index:1;left:0px;top:0px;width:324.37px;height:270.88px" > </div> <div class="sg sgSubtitle" id="s383" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s383_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s384" data-sgid="Subtitle 4" style="z-index:1;left:41.94px;top:76.44px;width:660.07px;height:258.47px" data-valign="top" data-pointer-events="none"> <div id="s384_t" class="sg" style="z-index:2;left:0.00px;top:-12.85px;width:660.92px;height:286.31px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="409.27" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:125.37px;top:22.47px;">Gorham’s Disease</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="436.39" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:111.81px;top:91.96px;">Gorham Vanishing Bone Disease</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="310.01" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:175.06px;top:138.05px;">Phantom Bone Disease</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="253.48" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:203.26px;top:184.14px;">Massive Osteolysis</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="462.55" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:112.17px;top:230.23px;">(“Boneless Arm” reported in 1819)</span></p></div></div></div> <div class="sg" id="s386" data-sgid="Subtitle 4" style="z-index:2;left:83.88px;top:10.55px;width:564.21px;height:90.78px" data-valign="top"> <div id="s386_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:564.21px;height:101.33px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="331.38" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:116.43px;top:17.92px;"><u>Gorham’s Disease</u></span></p></div></div><img class="sg" src="56DBAF8E.png" id="s386_tt" style="left:0.00px;top:-10.55px;width:564.21px;height:101.33px;z-index:1" > </div> <div class="sg" id="s385" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:82.40px;width:666.05px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s385_t" class="sg" style="z-index:2;left:-14.99px;top:-7.55px;width:681.89px;height:275.76px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="316.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.24px;top:15.21px;">• Rare bone disorder</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="605.39" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:58.24px;top:64.14px;">– proliferation of distended, thin walled vascular or </span><span data-textwidth="362.46" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:80.81px;top:97.75px;">lymphatic channels in the bone</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="513.33" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:58.24px;top:138.08px;">– Resorption and replacement of bone with </span><span data-textwidth="292.97" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:80.81px;top:171.68px;">angiomas and/or fibrosis</span></p></div></div></div> <div class="sg" id="s388" data-sgid="Subtitle 4" style="z-index:2;left:83.88px;top:10.55px;width:564.21px;height:90.78px" data-valign="top"> <div id="s388_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:564.21px;height:101.33px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="331.38" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:116.43px;top:17.92px;"><u>Gorham’s Disease</u></span></p></div></div><img class="sg" src="56DBAF8E.png" id="s388_tt" style="left:0.00px;top:-10.55px;width:564.21px;height:101.33px;z-index:1" > </div> <div class="sg" id="s387" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:70.44px;width:666.05px;height:294.43px" data-valign="top" data-pointer-events="none"> <div id="s387_t" class="sg" style="z-index:2;left:-9.72px;top:0.00px;width:690.05px;height:295.13px;"><div><p para="{bl:{ch:8226},spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="630.70" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.97px;top:25.82px;">•<span style="letter-spacing:8.60px"> </span>Cause unknown, but 57% of patients report history </span><span data-textwidth="112.70" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:43.97px;top:52.71px;">of trauma</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="525.93" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:52.97px;top:86.31px;">– Most common in children and young adults</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="656.62" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:16.97px;top:131.92px;">•<span style="letter-spacing:8.60px"> </span>May occur in single bone or spread to soft tissue and </span><span data-textwidth="176.07" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:43.97px;top:165.53px;">adjacent bones</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="600.71" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:156%; left:52.97px;top:199.14px;">– Most common in shoulder, pelvic girdle, and skull</span></p></div></div></div> <div class="sg sgTitle" id="s389" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s389_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.71px;">Imaging</span></p></div></div></div> <div class="sg" id="s390" data-sgid="Content Placeholder 2" style="z-index:2;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s390_t" class="sg" style="z-index:2;left:-12.72px;top:-11.26px;width:675.80px;height:295.13px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="399.66" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:14.08px;">•<span style="letter-spacing:5.60px"> </span>Non-specific in early stages</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="198.39" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:19.97px;top:56.33px;">•<span style="letter-spacing:5.60px"> </span>Progression </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="525.45" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:144%; left:55.97px;top:97.86px;">–<span style="letter-spacing:3.57px"> </span>foci of intramedullary and subcortical lucency </span><span data-textwidth="134.78" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:144%; left:78.54px;top:125.95px;">(osteopenia)</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="603.83" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:144%; left:55.97px;top:160.27px;">–<span style="letter-spacing:3.57px"> </span>dissolution, fragmentation and fractures of bone may </span><span data-textwidth="491.60" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:144%; left:78.54px;top:188.36px;">result in long bone tapering (“sucked candy” </span><span data-textwidth="141.50" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:144%; left:78.54px;top:216.45px;">appearance) </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="247.49" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:144%; left:55.97px;top:250.77px;">–<span style="letter-spacing:10.77px"> </span>complete resorption</span></p></div></div></div> <div class="sg" id="s392" data-sgid="Subtitle 4" style="z-index:2;left:83.88px;top:10.55px;width:564.21px;height:90.78px" data-valign="top"> <div id="s392_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:564.21px;height:101.33px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="331.38" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:116.43px;top:17.92px;"><u>Gorham’s Disease</u></span></p></div></div><img class="sg" src="56DBAF8E.png" id="s392_tt" style="left:0.00px;top:-10.55px;width:564.21px;height:101.33px;z-index:1" > </div> <div class="sg" id="s391" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s391_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="542.01" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Because of rarity, no standard therapy</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="573.22" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:55.97px;top:58.64px;">– surgical resection, interferon, biphosphonates, </span><span data-textwidth="521.01" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:78.54px;top:92.25px;">radiation, sclerotherapy, bone cement, bone </span><span data-textwidth="89.53" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:78.54px;top:125.86px;">graft…..</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="542.85" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:19.97px;top:167.15px;">•<span style="letter-spacing:5.60px"> </span>In some cases, spontaneous remission</span></p></div></div></div> <div class="sg" id="s393" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s393_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s394" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s394_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="282.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:182.72px;top:15.90px;">Carol H. Lee, MD</span></p></div></div></div> <div class="sg" id="s395" data-sgid="Picture 1" style="z-index:2;left:264.00px;top:82.50px;width:180.00px;height:270.00px"> <img class="sg" src="4F6A313F.jpg" id="s395_i" title="" alt="Carol Lee_2604R.jpg" style="z-index:1;left:0px;top:0px;width:180.21px;height:270.20px" > </div> <div class="sg sgTitle" id="s396" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s396_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="291.05" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:178.52px;top:17.71px;">Breast Case #2</span></p></div></div></div> <div class="sg" id="s397" data-sgid="Rectangle 3" style="z-index:2;left:125.84px;top:107.81px;width:534.23px;height:176.21px" data-valign="top"> <div id="s397_t" class="sg" style="z-index:2;left:-12.72px;top:-6.71px;width:546.95px;height:196.32px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="427.40" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:178%; left:20.10px;top:13.40px;">•<span style="letter-spacing:5.61px"> </span>51-year-old woman with new </span><span data-textwidth="402.79" class="sg nowrap f1" style="z-index:8;color:#E3EBF1;font-size:178%; left:47.11px;top:51.81px;">palpable mass left breast 9:00</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="478.89" class="sg nowrap f1" style="z-index:9;color:#E3EBF1;font-size:178%; left:20.10px;top:102.22px;">•<span style="letter-spacing:5.61px"> </span>Excisional biopsy UOQ left breast </span><span data-textwidth="349.74" class="sg nowrap f1" style="z-index:11;color:#E3EBF1;font-size:178%; left:47.11px;top:140.63px;">two years ago was benign</span></p></div></div></div> <div class="sg" id="s400" data-sgid="Group 3" style="z-index:5;left:374.49px;top:46.48px;width:339.50px;height:289.87px"> <img class="sg" src="F9E57C56.png" id="s400_i" style="z-index:1;left:0px;top:0px;width:340.34px;height:290.59px" > </div> <div class="sg" id="s399" data-sgid="Group 2" style="z-index:2;left:26.98px;top:40.48px;width:339.50px;height:304.87px"> <img class="sg" src="B0D64BE7.png" id="s399_i" style="z-index:1;left:0px;top:0px;width:340.34px;height:305.62px" > </div> <div class="sg" id="s398" data-sgid="Text Box 3" style="z-index:1;left:485.35px;top:310.01px;width:210.68px;height:30.18px"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg" id="s401" data-sgid="Picture 3" style="z-index:1;left:204.00px;top:34.50px;width:347.25px;height:329.00px"> <img class="sg" src="66B60E96.jpg" id="s401_i" title="" alt="LORENZO_ESTHER_L_US_5_0000" style="z-index:1;left:0px;top:0px;width:347.67px;height:329.35px" > </div> <div class="sg" id="s403" data-sgid="Picture 3" style="z-index:2;left:399.25px;top:40.50px;width:308.75px;height:288.00px"> <img class="sg" src="31D4E858.jpg" id="s403_i" title="" alt="LORENZO_ESTHER_L_MR_save" style="z-index:1;left:0px;top:0px;width:309.34px;height:288.21px" > </div> <div class="sg" id="s402" data-sgid="Picture 2" style="z-index:1;left:32.00px;top:45.00px;width:358.00px;height:283.50px"> <img class="sg" src="5F615263.jpg" id="s402_i" title="" alt="LORENZO_ESTHER_L_MR_103_0056" style="z-index:1;left:0px;top:0px;width:358.12px;height:283.76px" > </div> <div class="sg" id="s404" data-sgid="Picture 2" style="z-index:1;left:41.13px;top:106.50px;width:312.88px;height:179.75px"> <img class="sg" src="91EECDD3.jpg" id="s404_i" title="" alt="LORENZO_ESTHER_L_CT_3_0017" style="z-index:1;left:0px;top:0px;width:313.07px;height:180.13px" > </div> <div class="sg" id="s405" data-sgid="Picture 3" style="z-index:2;left:365.75px;top:106.50px;width:345.25px;height:206.50px"> <img class="sg" src="A7CEAF09.jpg" id="s405_i" title="" alt="LORENZO_ESTHER_L_PT_103_0003" style="z-index:1;left:0px;top:0px;width:345.39px;height:206.31px" > </div> <div class="sg" id="s406" data-sgid="TextBox 1" style="z-index:3;left:455.39px;top:318.98px;width:183.70px;height:46.59px"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg" id="s408" data-sgid="Picture 2" style="z-index:2;left:66.00px;top:10.50px;width:138.00px;height:296.75px"> <img class="sg" src="623BEC91.jpg" id="s408_i" title="" alt="LORENZO_ESTHER_L_MG_2_0000" style="z-index:1;left:0px;top:0px;width:138.17px;height:297.19px" > </div> <div class="sg" id="s409" data-sgid="Picture 4" style="z-index:3;left:234.00px;top:12.38px;width:156.00px;height:301.75px"> <img class="sg" src="8F9AC13A.jpg" id="s409_i" title="" alt="LORENZO_ESTHER_L_MG_2_0001" style="z-index:1;left:0px;top:0px;width:156.17px;height:301.76px" > </div> <div class="sg" id="s410" data-sgid="TextBox 1" style="z-index:4;left:431.42px;top:64.44px;width:258.63px;height:240.54px" data-valign="top"> <div id="s410_t" class="sg" style="z-index:2;left:-12.69px;top:-6.82px;width:271.32px;height:261.61px;"><div><p><span data-textwidth="230.44" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.54px;top:13.44px;">Large mass with </span><span data-textwidth="196.59" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:20.54px;top:51.84px;">predominately </span><span data-textwidth="206.79" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.54px;top:90.25px;">circumscribed, </span><span data-textwidth="216.28" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:20.54px;top:128.66px;">partly obscured </span><span data-textwidth="170.91" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:20.54px;top:167.07px;">margins. No </span><span data-textwidth="173.91" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:20.54px;top:205.48px;">calcifications</span></p></div></div></div> <div class="sg" id="s407" data-sgid="Text Box 3" style="z-index:1;left:485.35px;top:310.01px;width:210.68px;height:30.18px"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg" id="s413" data-sgid="Straight Arrow Connector 5" style="z-index:3;left:171.49px;top:113.07px;width:46.02px;height:12.22px" data-pointer-events="none"> <img class="sg" src="8F66CB1C.png" id="s413_i" style="z-index:1;left:0px;top:0px;width:46.13px;height:12.25px" > </div> <div class="sg" id="s411" data-sgid="Picture 3" style="z-index:1;left:65.91px;top:22.52px;width:221.70px;height:209.62px"> <img class="sg" src="5490DA5A.jpg" id="s411_i" title="" alt="LORENZO_ESTHER_L_US_5_0000" style="z-index:1;left:0px;top:0px;width:222.25px;height:210.14px" > </div> <div class="sg" id="s412" data-sgid="TextBox 1" style="z-index:2;left:305.58px;top:36.66px;width:396.43px;height:240.65px" data-valign="top"> <div id="s412_t" class="sg" style="z-index:2;left:-12.69px;top:-6.70px;width:409.12px;height:261.47px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="249.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.36px;top:13.25px;">•<span style="letter-spacing:14.61px"> </span>Oval mass with </span><span data-textwidth="307.61" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:56.37px;top:51.66px;">circumscribed margins</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="286.49" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:20.36px;top:90.07px;">•<span style="letter-spacing:14.61px"> </span>Parallel orientation</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="360.90" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:20.36px;top:128.47px;">•<span style="letter-spacing:14.61px"> </span>Internal anechoic space </span></p><p para="{bl:{ch:8226}}"><span data-textwidth="336.90" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:178%; left:20.36px;top:166.88px;">•<span style="letter-spacing:14.61px"> </span>No effect on posterior </span><span data-textwidth="95.18" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:178%; left:56.37px;top:205.29px;">echoes</span></p></div></div></div> <div class="sg" id="s414" data-sgid="Picture 2" style="z-index:1;left:48.00px;top:16.50px;width:252.00px;height:199.50px"> <img class="sg" src="53742D5B.jpg" id="s414_i" title="" alt="LORENZO_ESTHER_L_MR_103_0056" style="z-index:1;left:0px;top:0px;width:252.28px;height:199.58px" > </div> <div class="sg" id="s415" data-sgid="Picture 3" style="z-index:2;left:306.00px;top:16.50px;width:213.88px;height:199.50px"> <img class="sg" src="ECFED8DD.jpg" id="s415_i" title="" alt="LORENZO_ESTHER_L_MR_save" style="z-index:1;left:0px;top:0px;width:213.99px;height:199.58px" > </div> <div class="sg" id="s416" data-sgid="TextBox 1" style="z-index:3;left:53.92px;top:254.54px;width:654.09px;height:124.58px" data-valign="top"> <div id="s416_t" class="sg" style="z-index:2;left:-12.69px;top:-6.70px;width:666.78px;height:146.25px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="594.70" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.98px;top:13.82px;">•<span style="letter-spacing:14.61px"> </span>Oval enhancing mass with circumscribed </span><span data-textwidth="108.26" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:55.99px;top:52.23px;">margins</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="402.67" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:19.98px;top:90.63px;">•<span style="letter-spacing:14.61px"> </span>Internal irregular low signal</span></p></div></div></div> <div class="sg" id="s417" data-sgid="Picture 2" style="z-index:1;left:43.63px;top:16.63px;width:312.88px;height:179.75px"> <img class="sg" src="9BDD356E.jpg" id="s417_i" title="" alt="LORENZO_ESTHER_L_CT_3_0017" style="z-index:1;left:0px;top:0px;width:313.07px;height:180.13px" > </div> <div class="sg" id="s418" data-sgid="Picture 3" style="z-index:2;left:365.75px;top:3.75px;width:345.25px;height:206.50px"> <img class="sg" src="C5C8EF6C.jpg" id="s418_i" title="" alt="LORENZO_ESTHER_L_PT_103_0003" style="z-index:1;left:0px;top:0px;width:345.39px;height:206.42px" > </div> <div class="sg" id="s420" data-sgid="TextBox 1 (2)" style="z-index:4;left:215.73px;top:238.13px;width:354.46px;height:124.44px" data-valign="top"> <div id="s420_t" class="sg" style="z-index:2;left:-12.73px;top:-6.81px;width:367.18px;height:146.25px;"><div><p><span data-textwidth="324.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.24px;top:13.77px;">Hypermetabolic on PET </span><span data-textwidth="290.81" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:20.24px;top:52.18px;">with central low FDG </span><span data-textwidth="87.01" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.24px;top:90.59px;">avidity</span></p></div></div></div> <div class="sg" id="s419" data-sgid="TextBox 1" style="z-index:3;left:455.39px;top:318.98px;width:183.70px;height:46.59px"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg sgTitle" id="s421" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s421_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="278.21" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:184.88px;top:17.71px;">Salient Factors</span></p></div></div></div> <div class="sg" id="s422" data-sgid="Content Placeholder 2" style="z-index:2;left:185.75px;top:118.36px;width:372.45px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s422_t" class="sg" style="z-index:2;left:-12.70px;top:-6.85px;width:386.00px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="288.05" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.18px;top:13.56px;">•<span style="letter-spacing:5.61px"> </span>Prior benign biopsy</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="182.08" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.18px;top:59.65px;">•<span style="letter-spacing:5.61px"> </span>Large mass</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="317.46" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:20.18px;top:105.74px;">•<span style="letter-spacing:5.61px"> </span>Irregular cystic space</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="183.40" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:20.18px;top:151.83px;">•<span style="letter-spacing:5.61px"> </span>FDG uptake</span></p></div></div></div> <div class="sg sgTitle" id="s423" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s423_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="202.71" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:222.68px;top:17.71px;">Differential</span></p></div></div></div> <div class="sg" id="s427" data-sgid="TextBox 6" style="z-index:5;left:263.64px;top:76.44px;width:390.45px;height:163.37px" data-valign="top"> <div id="s427_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:403.14px;height:184.47px;"><div><p><span data-textwidth="256.12" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.47px;">Invasive carcinoma</span></p><p><span data-textwidth="150.15" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:92.31px;top:51.88px;">Metaplastic</span></p><p><span data-textwidth="130.46" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:92.31px;top:90.28px;">Medullary</span></p><p><span data-textwidth="285.65" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:92.31px;top:128.69px;">Triple negative ductal</span></p></div></div></div> <div class="sg" id="s424" data-sgid="Content Placeholder 2" style="z-index:2;left:263.64px;top:238.13px;width:216.69px;height:54.85px" data-valign="top" data-pointer-events="none"> <div id="s424_t" class="sg" style="z-index:2;left:-12.69px;top:-6.81px;width:230.21px;height:69.93px;"><div><p para="{spbf:0.20}"><span data-textwidth="165.39" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.77px;">Fat necrosis</span></p></div></div></div> <div class="sg" id="s425" data-sgid="TextBox 4" style="z-index:3;left:263.64px;top:282.21px;width:330.52px;height:46.73px" data-valign="top"> <div id="s425_t" class="sg" style="z-index:2;left:-12.69px;top:-6.71px;width:343.21px;height:69.84px;"><div><p><span data-textwidth="296.33" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.52px;">Fibromatosis/desmoid</span></p></div></div></div> <div class="sg" id="s426" data-sgid="TextBox 5" style="z-index:4;left:259.93px;top:327.98px;width:246.64px;height:47.30px" data-valign="top"> <div id="s426_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:259.33px;height:69.96px;"><div><p><span data-textwidth="217.60" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.28px;top:13.98px;">Phyllodes tumor</span></p></div></div></div> <div class="sg sgTitle" id="s428" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s428_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="311.33" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:168.31px;top:17.71px;">Phyllodes Tumor</span></p></div></div></div> <div class="sg" id="s429" data-sgid="Content Placeholder 2" style="z-index:2;left:245.68px;top:94.40px;width:288.58px;height:261.47px" data-valign="top" data-pointer-events="none"> <div id="s429_t" class="sg" style="z-index:2;left:-12.70px;top:-6.85px;width:302.09px;height:269.05px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="120.03" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.26px;top:13.51px;">•<span style="letter-spacing:5.61px"> </span>Benign</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="167.43" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:20.26px;top:59.60px;">•<span style="letter-spacing:5.61px"> </span>Borderline</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="154.95" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:20.26px;top:105.69px;">•<span style="letter-spacing:5.61px"> </span>Malignant</span></p></div></div></div> <div class="sg sgTitle" id="s430" data-sgid="Title 3" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-pointer-events="none"> <div style='width:100%;height:100%;background:rgba(0,0,0,0)'></div></div> <div class="sg" id="s431" data-sgid="Picture 4" style="z-index:2;left:42.00px;top:46.50px;width:339.38px;height:197.25px"> <img class="sg" src="469D8242.jpg" id="s431_i" style="z-index:1;left:0px;top:0px;width:340.11px;height:197.29px" > </div> <div class="sg" id="s432" data-sgid="Picture 5" style="z-index:3;left:391.63px;top:183.13px;width:308.75px;height:186.00px"> <img class="sg" src="977EEC7F.jpg" id="s432_i" style="z-index:1;left:0px;top:0px;width:309.34px;height:186.15px" > </div> <div class="sg sgTitle" id="s433" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s433_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="202.71" class="sg nowrap f1" style="z-index:2;color:#19B5E9;font-size:244%; left:222.68px;top:17.71px;">Differential</span></p></div></div></div> <div class="sg" id="s437" data-sgid="TextBox 6" style="z-index:5;left:263.64px;top:76.44px;width:390.45px;height:163.37px" data-valign="top"> <div id="s437_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:403.14px;height:184.47px;"><div><p><span data-textwidth="256.12" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.47px;">Invasive carcinoma</span></p><p><span data-textwidth="150.15" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:178%; left:92.31px;top:51.88px;">Metaplastic</span></p><p><span data-textwidth="130.46" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:92.31px;top:90.28px;">Medullary</span></p><p><span data-textwidth="285.65" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:92.31px;top:128.69px;">Triple negative ductal</span></p></div></div></div> <div class="sg" id="s434" data-sgid="Content Placeholder 2" style="z-index:2;left:263.64px;top:238.13px;width:216.69px;height:54.85px" data-valign="top" data-pointer-events="none"> <div id="s434_t" class="sg" style="z-index:2;left:-12.69px;top:-6.81px;width:230.21px;height:69.93px;"><div><p para="{spbf:0.20}"><span data-textwidth="165.39" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.77px;">Fat necrosis</span></p></div></div></div> <div class="sg" id="s435" data-sgid="TextBox 4" style="z-index:3;left:263.64px;top:282.21px;width:330.52px;height:46.73px" data-valign="top"> <div id="s435_t" class="sg" style="z-index:2;left:-12.69px;top:-6.71px;width:343.21px;height:69.84px;"><div><p><span data-textwidth="296.33" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.30px;top:13.52px;">Fibromatosis/desmoid</span></p></div></div></div> <div class="sg" id="s436" data-sgid="TextBox 5" style="z-index:4;left:259.93px;top:327.98px;width:246.64px;height:47.30px" data-valign="top"> <div id="s436_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:259.33px;height:69.96px;"><div><p><span data-textwidth="217.60" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.28px;top:13.98px;">Phyllodes tumor</span></p></div></div></div> <div class="sg sgSubtitle" id="s438" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s438_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s439" data-sgid="Subtitle 4" style="z-index:1;left:29.95px;top:106.36px;width:684.04px;height:180.65px" data-valign="top" data-pointer-events="none"> <div id="s439_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:684.89px;height:194.17px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="612.70" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:35.70px;top:22.51px;">Malignant Phyllodes Tumor</span></p></div></div></div> <div class="sg" id="s442" data-sgid="Subtitle 4" style="z-index:3;left:53.92px;top:16.52px;width:642.10px;height:78.84px" data-valign="top"> <div id="s442_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:642.10px;height:93.78px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="307.37" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:167.40px;top:17.92px;"><u>Phyllodes Tumor</u></span></p></div></div><img class="sg" src="2F9A0ECC.png" id="s442_tt" style="left:0.00px;top:-10.52px;width:642.10px;height:93.78px;z-index:1" > </div> <div class="sg" id="s441" data-sgid="Picture 6" style="z-index:2;left:30.00px;top:112.50px;width:192.00px;height:173.38px"> <img class="sg" src="62CBC9D9.jpg" id="s441_i" title="" alt="mal phllodes 6" style="z-index:1;left:0px;top:0px;width:192.22px;height:173.27px" > </div> <div class="sg" id="s440" data-sgid="Rectangle 3" style="z-index:1;left:221.70px;top:82.40px;width:468.34px;height:310.13px" data-valign="top"> <div id="s440_t" class="sg" style="z-index:2;left:-8.27px;top:-4.55px;width:487.87px;height:314.68px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="437.23" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:156%; left:15.81px;top:12.49px;">•<span style="letter-spacing:11.48px"> </span>Composed of an epithelial and a </span><span data-textwidth="343.14" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:156%; left:42.81px;top:46.10px;">cellular stromal component </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="301.85" class="sg nowrap f2" style="z-index:5;color:#FFFFFF;font-size:156%; left:15.81px;top:86.43px;">•<span style="letter-spacing:11.48px"> </span>< 1% of breast tumors</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="443.35" class="sg nowrap f2" style="z-index:7;color:#FFFFFF;font-size:156%; left:15.81px;top:126.76px;">•<span style="letter-spacing:11.48px"> </span>Most are benign, but 10-15% are </span><span data-textwidth="129.50" class="sg nowrap f2" style="z-index:11;color:#FFFFFF;font-size:156%; left:42.81px;top:160.36px;">malignant </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="421.64" class="sg nowrap f2" style="z-index:12;color:#FFFFFF;font-size:133%; left:51.81px;top:198.49px;">–<span style="letter-spacing:4.53px"> </span>Core biopsy has moderate sensitivity </span><span data-textwidth="286.73" class="sg nowrap f2" style="z-index:14;color:#FFFFFF;font-size:133%; left:74.38px;top:227.30px;">due to tumor heterogeneity</span></p></div></div></div> <div class="sg" id="s444" data-sgid="Subtitle 4" style="z-index:2;left:53.92px;top:16.52px;width:642.10px;height:78.84px" data-valign="top"> <div id="s444_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:642.10px;height:93.78px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="307.37" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:167.40px;top:17.92px;"><u>Phyllodes Tumor</u></span></p></div></div><img class="sg" src="2F9A0ECC.png" id="s444_tt" style="left:0.00px;top:-10.52px;width:642.10px;height:93.78px;z-index:1" > </div> <div class="sg" id="s443" data-sgid="Rectangle 3" style="z-index:1;left:83.88px;top:112.36px;width:624.14px;height:315.39px" data-valign="top"> <div id="s443_t" class="sg" style="z-index:2;left:-11.25px;top:-7.55px;width:635.39px;height:322.94px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="543.81" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:178%; left:18.59px;top:15.42px;">•<span style="letter-spacing:8.84px"> </span>Typically middle age or older woman</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="554.61" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:178%; left:18.59px;top:61.51px;">•<span style="letter-spacing:8.84px"> </span>Painless rapidly growing breast mass</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="398.34" class="sg nowrap f2" style="z-index:6;color:#FFFFFF;font-size:156%; left:54.59px;top:106.76px;">– Benign ones may grow rapidly</span></p></div></div></div> <div class="sg sgTitle" id="s446" data-sgid="Title 1" style="z-index:2;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s446_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.71px;">Imaging</span></p></div></div></div> <div class="sg" id="s445" data-sgid="Rectangle 3" style="z-index:1;left:53.92px;top:76.44px;width:624.14px;height:302.69px" data-valign="top" data-pointer-events="none"> <div id="s445_t" class="sg" style="z-index:2;left:-11.25px;top:-7.56px;width:636.21px;height:310.95px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="249.04" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:178%; left:18.54px;top:15.34px;">•<span style="letter-spacing:8.84px"> </span>Mammography:</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="544.89" class="sg nowrap f2" style="z-index:4;color:#FFFFFF;font-size:156%; left:54.55px;top:60.59px;">– Large, circumscribed, round or oval mass </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="178.11" class="sg nowrap f2" style="z-index:6;color:#FFFFFF;font-size:178%; left:18.54px;top:101.76px;">•<span style="letter-spacing:8.84px"> </span>US & MRI:</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="379.62" class="sg nowrap f2" style="z-index:8;color:#FFFFFF;font-size:156%; left:54.55px;top:147.01px;">– Inhomogeneous, solid mass </span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="524.60" class="sg nowrap f2" style="z-index:10;color:#FFFFFF;font-size:156%; left:54.55px;top:187.34px;">– Similar to fibroadenoma except margins </span><span data-textwidth="517.65" class="sg nowrap f2" style="z-index:12;color:#FFFFFF;font-size:156%; left:77.11px;top:220.94px;">may be ill defined and may contain cystic </span><span data-textwidth="88.93" class="sg nowrap f2" style="z-index:13;color:#FFFFFF;font-size:156%; left:77.11px;top:254.55px;">spaces</span></p></div></div></div> <div class="sg" id="s448" data-sgid="Subtitle 4" style="z-index:2;left:53.92px;top:16.52px;width:642.10px;height:78.84px" data-valign="top"> <div id="s448_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:642.10px;height:93.78px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="495.56" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:73.30px;top:17.92px;"><u>Malignant Phyllodes Tumor</u></span></p></div></div><img class="sg" src="2F9A0ECC.png" id="s448_tt" style="left:0.00px;top:-10.52px;width:642.10px;height:93.78px;z-index:1" > </div> <div class="sg" id="s447" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:100.37px;width:648.08px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s447_t" class="sg" style="z-index:2;left:-12.72px;top:-6.82px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="593.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Complete surgical excision by either wide </span><span data-textwidth="389.11" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.97px;top:51.92px;">local excision or mastectomy</span></p><p para="{spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="596.97" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:19.97px;top:144.10px;">•<span style="letter-spacing:5.60px"> </span>20% of both benign and malignant tumors </span><span data-textwidth="165.99" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:46.97px;top:182.51px;">recur locally</span></p></div></div></div> <div class="sg" id="s449" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s449_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s450" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s450_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="380.34" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:133.87px;top:15.90px;">Howard A Rowley, MD</span></p></div></div></div> <div class="sg" id="s451" data-sgid="Picture 3" style="z-index:2;left:270.00px;top:86.38px;width:174.00px;height:234.00px"> <img class="sg" src="B39681D1.jpg" id="s451_i" title="" alt="Rowley_July 2013.jpg" style="z-index:1;left:0px;top:0px;width:174.19px;height:234.16px" > </div> <div class="sg sgTitle" id="s452" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s452_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="282.29" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:182.84px;top:17.71px;">Neuro Case #2</span></p></div></div></div> <div class="sg" id="s453" data-sgid="Content Placeholder 1" style="z-index:2;left:76.45px;top:104.81px;width:573.93px;height:188.18px" data-valign="top" data-pointer-events="none"> <div id="s453_t" class="sg" style="z-index:2;left:0.00px;top:-6.71px;width:574.63px;height:195.62px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="294.05" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:144.15px;top:13.40px;">17-year-old man new </span><span data-textwidth="444.07" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:69.13px;top:51.81px;">onset lower extremity weakness </span><span data-textwidth="384.42" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:98.90px;top:90.22px;">followed by upper extremity </span><span data-textwidth="332.22" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:178%; left:120.74px;top:128.63px;">weakness two days later</span></p></div></div></div> <div class="sg" id="s454" data-sgid="Picture 4" style="z-index:1;left:113.86px;top:24.67px;width:182.74px;height:344.38px"> <img class="sg" src="A6C69816.jpg" id="s454_i" style="z-index:1;left:0px;top:0px;width:183.19px;height:345.23px" > </div> <div class="sg" id="s455" data-sgid="Picture 7" style="z-index:2;left:324.00px;top:82.50px;width:354.00px;height:256.13px"> <img class="sg" src="5F81B227.jpg" id="s455_i" style="z-index:1;left:0px;top:0px;width:354.40px;height:256.61px" > </div> <div class="sg sgTitle" id="s456" data-sgid="Title 1" style="z-index:1;left:29.95px;top:0.00px;width:680.33px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s456_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:681.07px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="158.07" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:261.10px;top:17.40px;">2 days later</span></p></div></div></div> <div class="sg" id="s458" data-sgid="Picture 6" style="z-index:3;left:360.00px;top:89.25px;width:270.00px;height:249.75px"> <img class="sg" src="96086C13.jpg" id="s458_i" style="z-index:1;left:0px;top:0px;width:270.29px;height:249.90px" > </div> <div class="sg" id="s457" data-sgid="Picture 4" style="z-index:2;left:156.00px;top:52.50px;width:180.00px;height:335.13px"> <img class="sg" src="2A5E4B30.jpg" id="s457_i" style="z-index:1;left:0px;top:0px;width:180.21px;height:335.37px" > </div> <div class="sg sgTitle" id="s459" data-sgid="Title 1" style="z-index:1;left:377.50px;top:0.00px;width:258.60px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s459_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:259.45px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="158.07" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:50.49px;top:17.40px;">2 days later</span></p></div></div></div> <div class="sg" id="s461" data-sgid="Picture 4 (2)" style="z-index:3;left:173.76px;top:58.44px;width:164.78px;height:310.61px"> <img class="sg" src="8D9ACA96.jpg" id="s461_i" style="z-index:1;left:0px;top:0px;width:165.19px;height:311.38px" > </div> <div class="sg" id="s460" data-sgid="Picture 4" style="z-index:2;left:420.00px;top:58.50px;width:176.38px;height:318.88px"> <img class="sg" src="9EE2BC5B.jpg" id="s460_i" style="z-index:1;left:0px;top:0px;width:176.48px;height:318.95px" > </div> <div class="sg sgTitle" id="s463" data-sgid="Rectangle 2" style="z-index:2;left:35.96px;top:0.00px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s463_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="581.98" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:156%; left:32.93px;top:17.16px;">Differential Dx: <span class="f1" style="font-size:114%; ">Acute Transverse Myelopathy</span></span></p></div></div></div> <div class="sg" id="s469" data-sgid="Straight Arrow Connector 9" style="z-index:8;left:628.45px;top:98.10px;width:56.45px;height:41.44px" data-pointer-events="none"> <img class="sg" src="EAF9BD8D.png" id="s469_i" style="z-index:1;left:0px;top:0px;width:56.59px;height:41.54px" > </div> <div class="sg" id="s465" data-sgid="Picture 2" style="z-index:4;left:472.65px;top:64.44px;width:118.28px;height:139.18px"> <img class="sg" src="DA024C2A.png" id="s465_i" style="z-index:1;left:0px;top:0px;width:118.57px;height:139.52px" > </div> <div class="sg" id="s468" data-sgid="Straight Arrow Connector 7" style="z-index:7;left:473.36px;top:122.07px;width:56.45px;height:41.44px" data-pointer-events="none"> <img class="sg" src="3AF79545.png" id="s468_i" style="z-index:1;left:0px;top:0px;width:56.59px;height:41.54px" > </div> <div class="sg" id="s466" data-sgid="Picture 3" style="z-index:5;left:594.00px;top:64.50px;width:120.00px;height:254.38px"> <img class="sg" src="DCB5CCFD.jpg" id="s466_i" style="z-index:1;left:0px;top:0px;width:120.16px;height:254.35px" > </div> <div class="sg" id="s464" data-sgid="Rectangle 3" style="z-index:3;left:47.95px;top:76.44px;width:420.40px;height:294.43px" data-valign="top" data-pointer-events="none"> <div id="s464_t" class="sg" style="z-index:2;left:-7.46px;top:-9.00px;width:428.67px;height:304.13px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="393.42" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.72px;top:8.86px;">•<span style="letter-spacing:11.48px"> </span>Infectious / parainfectious / immune</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="168.62" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.72px;top:43.90px;">•<span style="letter-spacing:11.48px"> </span>Demyelinating</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="113.89" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.72px;top:78.95px;">•<span style="letter-spacing:11.48px"> </span>Vascular</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="187.23" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.72px;top:114.00px;">•<span style="letter-spacing:11.48px"> </span>Toxic-metabolic</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="103.69" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:14.72px;top:149.05px;">•<span style="letter-spacing:11.48px"> </span>Trauma</span></p><p para="{in:2,bl:{ch:8211},spbf:12.00}"><span data-textwidth="101.89" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:50.73px;top:184.10px;">–<span style="letter-spacing:5.24px"> </span>(SPAM)</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="306.41" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:14.72px;top:219.14px;">•<span style="letter-spacing:11.48px"> </span>Neoplastic / paraneoplastic </span></p></div></div></div> <div class="sg" id="s467" data-sgid="TextBox 6" style="z-index:6;left:461.37px;top:203.62px;width:132.78px;height:95.36px" data-valign="top"> <img class="sg" src="378E1D96.png" id="s467_i" style="z-index:1;left:0px;top:0px;width:133.11px;height:95.60px" > <div id="s467_t" class="sg" style="z-index:2;left:-2.97px;top:-3.70px;width:138.06px;height:108.77px;"><div><p para="{al:2}"><span data-textwidth="89.53" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:133%; left:24.80px;top:9.73px;">Guillian-</span></p><p para="{al:2}"><span data-textwidth="59.17" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:133%; left:40.04px;top:38.53px;">Barré</span><span data-textwidth="107.90" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:133%; left:15.68px;top:67.34px;">Syndrome</span></p></div></div></div> <div class="sg" id="s462" data-sgid="Picture 4" style="z-index:1;left:0.00px;top:369.90px;width:95.86px;height:32.93px"> <img class="sg" src="A38ADD2C.png" id="s462_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg sgTitle" id="s477" data-sgid="Rectangle 2" style="z-index:8;left:35.96px;top:0.00px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s477_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="581.98" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:156%; left:32.93px;top:17.16px;">Differential Dx: <span class="f1" style="font-size:114%; ">Acute Transverse Myelopathy</span></span></p></div></div></div> <div class="sg" id="s474" data-sgid="Picture 5" style="z-index:5;left:469.13px;top:64.50px;width:130.88px;height:126.00px"> <img class="sg" src="8A22CC76.png" id="s474_i" style="z-index:1;left:0px;top:0px;width:130.58px;height:126.08px" > </div> <div class="sg" id="s476" data-sgid="Straight Arrow Connector 13" style="z-index:7;left:489.91px;top:116.07px;width:50.33px;height:41.44px" data-pointer-events="none"> <img class="sg" src="C8FC847E.png" id="s476_i" style="z-index:1;left:0px;top:0px;width:50.45px;height:41.54px" > </div> <div class="sg" id="s473" data-sgid="Straight Arrow Connector 7" style="z-index:4;left:605.18px;top:184.95px;width:56.45px;height:41.44px" data-pointer-events="none"> <img class="sg" src="E272E45D.png" id="s473_i" style="z-index:1;left:0px;top:0px;width:56.59px;height:41.54px" > </div> <div class="sg" id="s471" data-sgid="TextBox 6" style="z-index:2;left:492.91px;top:190.95px;width:75.12px;height:42.15px" data-valign="top"> <img class="sg" src="8648812F.png" id="s471_i" style="z-index:1;left:0px;top:0px;width:75.31px;height:42.25px" > <div id="s471_t" class="sg" style="z-index:2;left:-9.01px;top:-5.29px;width:93.11px;height:59.43px;"><div><p para="{al:2}"><span data-textwidth="59.05" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:156%; left:16.94px;top:12.14px;">NMO</span></p></div></div></div> <div class="sg" id="s472" data-sgid="Picture 4 (2)" style="z-index:3;left:606.00px;top:66.25px;width:110.50px;height:308.25px"> <img class="sg" src="764A4D44.png" id="s472_i" style="z-index:1;left:0px;top:0px;width:110.41px;height:308.48px" > </div> <div class="sg" id="s478" data-sgid="Rectangle 3" style="z-index:9;left:47.95px;top:76.44px;width:420.40px;height:294.43px" data-valign="top"> <div id="s478_t" class="sg" style="z-index:2;left:-7.46px;top:-9.00px;width:427.85px;height:303.42px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="393.43" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.72px;top:8.86px;">•<span style="letter-spacing:11.48px"> </span>Infectious / parainfectious / immune</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="168.62" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.72px;top:43.90px;">•<span style="letter-spacing:11.48px"> </span>Demyelinating</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="113.89" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.72px;top:78.95px;">•<span style="letter-spacing:11.48px"> </span>Vascular</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="187.23" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:14.72px;top:114.00px;">•<span style="letter-spacing:11.48px"> </span>Toxic-metabolic</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="103.69" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:14.72px;top:149.05px;">•<span style="letter-spacing:11.48px"> </span>Trauma</span></p><p para="{in:2,bl:{ch:8211},spbf:12.00}"><span data-textwidth="101.89" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:50.73px;top:184.10px;">–<span style="letter-spacing:5.24px"> </span>(SPAM)</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="299.56" class="sg nowrap f1" style="z-index:18;color:#FFFFFF;font-size:133%; left:14.72px;top:219.14px;">•<span style="letter-spacing:11.48px"> </span>Neoplastic / paraneoplastic</span></p></div></div></div> <div class="sg" id="s475" data-sgid="Straight Arrow Connector 12" style="z-index:6;left:621.73px;top:247.84px;width:56.33px;height:41.44px" data-pointer-events="none"> <img class="sg" src="E1287F6.png" id="s475_i" style="z-index:1;left:0px;top:0px;width:56.47px;height:41.54px" > </div> <div class="sg" id="s470" data-sgid="Picture 4" style="z-index:1;left:0.00px;top:369.90px;width:95.86px;height:32.93px"> <img class="sg" src="A38ADD2C.png" id="s470_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg sgTitle" id="s488" data-sgid="Rectangle 2" style="z-index:10;left:35.96px;top:0.00px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s488_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="581.98" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:156%; left:32.93px;top:17.16px;">Differential Dx: <span class="f1" style="font-size:114%; ">Acute Transverse Myelopathy</span></span></p></div></div></div> <div class="sg" id="s483" data-sgid="Straight Arrow Connector 7" style="z-index:5;left:495.07px;top:74.14px;width:47.44px;height:47.44px" data-pointer-events="none"> <img class="sg" src="933D8921.png" id="s483_i" style="z-index:1;left:0px;top:0px;width:47.56px;height:47.56px" > </div> <div class="sg" id="s481" data-sgid="Picture 5" style="z-index:3;left:484.64px;top:63.59px;width:102.58px;height:119.07px"> <img class="sg" src="366B2E35.png" id="s481_i" style="z-index:1;left:0px;top:0px;width:102.83px;height:119.36px" > </div> <div class="sg" id="s484" data-sgid="Straight Arrow Connector 9" style="z-index:6;left:633.72px;top:115.36px;width:56.33px;height:41.33px" data-pointer-events="none"> <img class="sg" src="90B2D280.png" id="s484_i" style="z-index:1;left:0px;top:0px;width:56.47px;height:41.43px" > </div> <div class="sg" id="s487" data-sgid="TextBox 13" style="z-index:9;left:513.88px;top:151.29px;width:50.33px;height:30.18px" data-valign="top"> <img class="sg" src="C03AFD9B.png" id="s487_i" style="z-index:1;left:0px;top:0px;width:50.45px;height:30.25px" > <div id="s487_t" class="sg" style="z-index:2;left:-3.85px;top:-3.00px;width:58.74px;height:39.18px;"><div><p><span data-textwidth="35.05" class="sg nowrap f5" style="z-index:2;color:#FFCC4F;font-weight:bold; left:11.34px;top:8.86px;">DWI</span></p></div></div></div> <div class="sg" id="s485" data-sgid="Straight Arrow Connector 11" style="z-index:7;left:640.43px;top:181.95px;width:56.45px;height:41.44px" data-pointer-events="none"> <img class="sg" src="26C211E0.png" id="s485_i" style="z-index:1;left:0px;top:0px;width:56.59px;height:41.54px" > </div> <div class="sg" id="s480" data-sgid="Picture 4 (2)" style="z-index:2;left:592.49px;top:63.59px;width:117.57px;height:295.76px"> <img class="sg" src="41F2CFE1.jpg" id="s480_i" style="z-index:1;left:0px;top:0px;width:117.86px;height:296.49px" > </div> <div class="sg" id="s489" data-sgid="Rectangle 3" style="z-index:11;left:47.95px;top:76.44px;width:420.40px;height:294.43px" data-valign="top"> <div id="s489_t" class="sg" style="z-index:2;left:-7.46px;top:-9.00px;width:427.85px;height:303.42px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="393.42" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.72px;top:8.86px;">•<span style="letter-spacing:11.48px"> </span>Infectious / parainfectious / immune</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="168.62" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.72px;top:43.90px;">•<span style="letter-spacing:11.48px"> </span>Demyelinating</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="113.89" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.72px;top:78.95px;">•<span style="letter-spacing:11.48px"> </span>Vascular</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="187.23" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.72px;top:114.00px;">•<span style="letter-spacing:11.48px"> </span>Toxic-metabolic</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="103.69" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:14.72px;top:149.05px;">•<span style="letter-spacing:11.48px"> </span>Trauma</span></p><p para="{in:2,bl:{ch:8211},spbf:12.00}"><span data-textwidth="101.89" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:50.73px;top:184.10px;">–<span style="letter-spacing:5.24px"> </span>(SPAM)</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="306.41" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:14.72px;top:219.14px;">•<span style="letter-spacing:11.48px"> </span>Neoplastic / paraneoplastic </span></p></div></div></div> <div class="sg" id="s482" data-sgid="TextBox 6" style="z-index:4;left:464.38px;top:185.66px;width:132.08px;height:110.33px" data-valign="top"> <img class="sg" src="42D4A9DF.png" id="s482_i" style="z-index:1;left:0px;top:0px;width:132.41px;height:110.60px" > <div id="s482_t" class="sg" style="z-index:2;left:-5.27px;top:-3.00px;width:141.06px;height:119.32px;"><div><p para="{al:2}"><span data-textwidth="55.93" class="sg nowrap f7" style="z-index:2;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:133%; left:43.41px;top:9.42px;">Cord</span></p><p para="{al:2}"><span data-textwidth="109.46" class="sg nowrap f7" style="z-index:3;color:#FFFFFF;font-style:italic; font-weight:bold; font-size:133%; left:16.65px;top:38.23px;">infarction</span></p><p para="{al:2}"><span data-textwidth="82.21" class="sg nowrap f7" style="z-index:4;color:#FFFFFF;font-style:italic; font-weight:bold; left:30.21px;top:66.68px;">after AAA</span></p><p para="{al:2}"><span data-textwidth="49.93" class="sg nowrap f7" style="z-index:5;color:#FFFFFF;font-style:italic; font-weight:bold; left:46.41px;top:88.28px;">repair</span></p></div></div></div> <div class="sg" id="s486" data-sgid="Straight Arrow Connector 12" style="z-index:8;left:628.45px;top:271.80px;width:56.45px;height:41.44px" data-pointer-events="none"> <img class="sg" src="C702F2F.png" id="s486_i" style="z-index:1;left:0px;top:0px;width:56.59px;height:41.54px" > </div> <div class="sg" id="s479" data-sgid="Picture 4" style="z-index:1;left:0.00px;top:369.90px;width:95.86px;height:32.93px"> <img class="sg" src="A38ADD2C.png" id="s479_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg sgTitle" id="s494" data-sgid="Rectangle 2" style="z-index:5;left:35.96px;top:0.00px;width:648.08px;height:68.40px" data-valign="middle" data-pointer-events="none"> <div id="s494_t" class="sg" style="z-index:2;left:0.00px;top:0.00px;width:648.93px;height:74.40px;"><div><p para="{al:2}"><span data-textwidth="581.98" class="sg nowrap f1" style="z-index:2;color:#FFCC4F;font-size:156%; left:32.93px;top:17.16px;">Differential Dx: <span class="f1" style="font-size:114%; ">Acute Transverse Myelopathy</span></span></p></div></div></div> <div class="sg" id="s493" data-sgid="TextBox 12" style="z-index:4;left:502.60px;top:101.10px;width:49.62px;height:42.15px" data-valign="top"> <div id="s493_t" class="sg" style="z-index:2;left:-9.69px;top:-4.55px;width:69.14px;height:59.41px;"><div><p><span data-textwidth="34.09" class="sg nowrap f5" style="z-index:2;color:#FFFFFF;font-weight:bold; font-size:156%; left:17.30px;top:11.67px;">??</span></p></div></div></div> <div class="sg" id="s492" data-sgid="Straight Arrow Connector 11" style="z-index:3;left:549.81px;top:122.07px;width:58.60px;height:41.44px" data-pointer-events="none"> <img class="sg" src="FA7791BA.png" id="s492_i" style="z-index:1;left:0px;top:0px;width:58.74px;height:41.54px" > </div> <div class="sg" id="s495" data-sgid="Rectangle 3" style="z-index:6;left:47.95px;top:76.44px;width:420.40px;height:294.43px" data-valign="top"> <div id="s495_t" class="sg" style="z-index:2;left:-7.46px;top:-9.00px;width:427.85px;height:303.42px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="393.43" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.72px;top:8.86px;">•<span style="letter-spacing:11.48px"> </span>Infectious / parainfectious / immune</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="168.62" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.72px;top:43.90px;">•<span style="letter-spacing:11.48px"> </span>Demyelinating</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="113.89" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.72px;top:78.95px;">•<span style="letter-spacing:11.48px"> </span>Vascular</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="187.23" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:14.72px;top:114.00px;">•<span style="letter-spacing:11.48px"> </span>Toxic-metabolic</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="103.69" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:14.72px;top:149.05px;">•<span style="letter-spacing:11.48px"> </span>Trauma</span></p><p para="{in:2,bl:{ch:8211},spbf:12.00}"><span data-textwidth="101.89" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:50.73px;top:184.10px;">–<span style="letter-spacing:5.24px"> </span>(SPAM)</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="299.56" class="sg nowrap f1" style="z-index:18;color:#FFFFFF;font-size:133%; left:14.72px;top:219.14px;">•<span style="letter-spacing:11.48px"> </span>Neoplastic / paraneoplastic</span></p></div></div></div> <div class="sg" id="s491" data-sgid="Picture 4 (2)" style="z-index:2;left:569.25px;top:59.18px;width:130.38px;height:344.38px"> <img class="sg" src="338710E8.jpg" id="s491_i" style="z-index:1;left:0px;top:0px;width:130.70px;height:345.23px" > </div> <div class="sg" id="s490" data-sgid="Picture 4" style="z-index:1;left:0.00px;top:369.90px;width:95.86px;height:32.93px"> <img class="sg" src="A38ADD2C.png" id="s490_i" style="z-index:1;left:0px;top:0px;width:96.10px;height:33.01px" > </div> <div class="sg" id="s496" data-sgid="Title 1" style="z-index:1;left:53.92px;top:148.29px;width:648.08px;height:68.29px" data-valign="top"> <div id="s496_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:648.08px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="329.09" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:244%; left:159.48px;top:18.18px;">Additional History</span></p></div></div></div> <div class="sg" id="s497" data-sgid="Title 1" style="z-index:1;left:53.92px;top:148.29px;width:648.08px;height:68.29px" data-valign="top"> <div id="s497_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:648.08px;height:93.78px;"><div><p para="{al:2}"><span data-textwidth="369.30" class="sg nowrap f1" style="z-index:2;color:#E3EBF1;font-size:244%; left:139.43px;top:18.18px;">MVA one month ago</span></p></div></div></div> <div class="sg sgSubtitle" id="s498" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s498_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s499" data-sgid="Subtitle 4" style="z-index:1;left:41.94px;top:82.40px;width:660.07px;height:180.65px" data-valign="top" data-pointer-events="none"> <div id="s499_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:660.92px;height:228.68px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="512.97" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:81.08px;top:22.47px;">Subacute Progressive </span><span data-textwidth="508.16" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:300%; left:75.92px;top:87.28px;">Ascending Myelopathy</span></p><p para="{al:2,spbf:0.20}"><span data-textwidth="104.54" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:222%; left:277.79px;top:159.70px;">SPAM</span></p></div></div></div> <div class="sg" id="s501" data-sgid="Subtitle 4" style="z-index:2;left:305.58px;top:10.55px;width:186.71px;height:66.82px" data-valign="top"> <div id="s501_t" class="sg" style="z-index:2;left:-17.26px;top:-8.99px;width:203.97px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="100.94" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.93px;top:16.48px;"><u>SPAM</u></span></p></div></div><img class="sg" src="8DEFDD78.png" id="s501_tt" style="left:-17.26px;top:-8.99px;width:203.97px;height:85.52px;z-index:1" > </div> <div class="sg" id="s500" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:64.44px;width:654.09px;height:288.43px" data-valign="top" data-pointer-events="none"> <div id="s500_t" class="sg" style="z-index:2;left:-12.72px;top:-6.82px;width:667.63px;height:305.69px;"><div><p para="{in:2,bl:{ch:8226},spbf:0.20}"><span data-textwidth="578.25" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.32px;">•<span style="letter-spacing:5.60px"> </span>Rare <span class="f2" >neurological deterioration several </span></span><span data-textwidth="598.66" class="sg nowrap f2" style="z-index:5;color:#FFFFFF;font-size:178%; left:46.97px;top:53.00px;">segments cranial to initial neurologic level </span><span data-textwidth="111.98" class="sg nowrap f2" style="z-index:6;color:#FFFFFF;font-size:178%; left:46.97px;top:91.41px;">of injury</span></p><p para="{in:2,bl:{ch:8226},spbf:0.20}"><span data-textwidth="577.65" class="sg nowrap f2" style="z-index:7;color:#FFFFFF;font-size:178%; left:19.97px;top:137.50px;">•<span style="letter-spacing:8.84px"> </span>Usually occurs within 3 weeks (up to 2 </span><span data-textwidth="502.64" class="sg nowrap f2" style="z-index:9;color:#FFFFFF;font-size:178%; left:46.97px;top:175.91px;">months) of injury to any part of cord</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="212.19" class="sg nowrap f2" style="z-index:10;color:#FFFFFF;font-size:178%; left:19.97px;top:222.00px;">•<span style="letter-spacing:8.84px"> </span>Most recover</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="436.52" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:55.97px;top:264.01px;">–<span style="letter-spacing:5.25px"> </span>Up to 10% mortality if brainstem involved</span></p></div></div></div> <div class="sg sgTitle" id="s502" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s502_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.71px;">Imaging</span></p></div></div></div> <div class="sg" id="s503" data-sgid="Content Placeholder 2" style="z-index:2;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s503_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="589.89" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Non-specific increased intramedullary T2 </span><span data-textwidth="77.89" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:178%; left:46.97px;top:51.92px;">signal</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="554.14" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:55.97px;top:97.05px;">– at least four segments above initial injury site</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="387.79" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:55.97px;top:137.38px;">– rim of peripheral cored sparing</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="201.16" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:156%; left:55.97px;top:177.71px;">– cord expansion</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="131.31" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:55.97px;top:218.04px;">– no syrinx</span></p></div></div></div> <div class="sg" id="s505" data-sgid="Subtitle 4" style="z-index:2;left:305.58px;top:10.55px;width:186.71px;height:66.82px" data-valign="top"> <div id="s505_t" class="sg" style="z-index:2;left:-17.26px;top:-8.99px;width:203.97px;height:85.52px;"><div><p para="{spbf:0.20}"><span data-textwidth="100.94" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.93px;top:16.48px;"><u>SPAM</u></span></p></div></div><img class="sg" src="8DEFDD78.png" id="s505_tt" style="left:-17.26px;top:-8.99px;width:203.97px;height:85.52px;z-index:1" > </div> <div class="sg" id="s504" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s504_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="372.90" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Wide range of treatments;</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="197.92" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:55.97px;top:58.64px;">– anticoagulation</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="200.56" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:55.97px;top:98.97px;">– decompression</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="273.89" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:55.97px;top:139.30px;">– steroids and mannitol</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="160.83" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:55.97px;top:179.63px;">– cordectomy</span></p></div></div></div> <div class="sg" id="s506" data-sgid="Picture 1" style="z-index:1;left:126.00px;top:10.50px;width:510.00px;height:382.50px"> <img class="sg" src="75CA4778.jpg" id="s506_i" title="" alt="thumbs00.jpg" style="z-index:1;left:0px;top:0px;width:510.58px;height:382.69px" > </div> <div class="sg" id="s507" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s507_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s508" data-sgid="Title 1" style="z-index:1;left:35.96px;top:34.51px;width:648.08px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s508_t" class="sg" style="z-index:2;left:0.00px;top:-26.25px;width:648.93px;height:95.36px;"><div><p para="{al:2}"><span data-textwidth="439.63" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:104.22px;top:15.90px;">Anwar R. Padhani, MB BS</span></p></div></div></div> <div class="sg" id="s509" data-sgid="Picture 5" style="z-index:2;left:264.00px;top:70.50px;width:216.00px;height:293.50px"> <img class="sg" src="7E28D45C.jpg" id="s509_i" title="" alt="Pic A _Prof A Padhani_highRes.jpg" style="z-index:1;left:0px;top:0px;width:216.26px;height:293.34px" > </div> <div class="sg sgTitle" id="s510" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s510_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="454.28" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:96.90px;top:17.71px;">Body/Oncology Case #2</span></p></div></div></div> <div class="sg" id="s511" data-sgid="Content Placeholder 1" style="z-index:2;left:74.18px;top:104.81px;width:573.90px;height:164.22px" data-valign="top"> <div id="s511_t" class="sg" style="z-index:2;left:0.00px;top:-6.71px;width:573.90px;height:170.92px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="273.29" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:154.46px;top:13.40px;">43-year-old woman </span><span data-textwidth="404.23" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:84.73px;top:51.81px;">with right upper quadrant pain</span></p></div></div></div> <div class="sg" id="s512" data-sgid="Picture 3" style="z-index:1;left:33.00px;top:85.50px;width:342.00px;height:237.25px"> <img class="sg" src="4F494E4C.jpg" id="s512_i" style="z-index:1;left:0px;top:0px;width:342.38px;height:237.16px" > </div> <div class="sg" id="s513" data-sgid="Picture 4" style="z-index:2;left:386.88px;top:85.50px;width:321.13px;height:238.50px"> <img class="sg" src="38AC7992.jpg" id="s513_i" style="z-index:1;left:0px;top:0px;width:321.36px;height:238.61px" > </div> <div class="sg" id="s514" data-sgid="Picture 5" style="z-index:1;left:150.00px;top:22.50px;width:434.88px;height:318.00px"> <img class="sg" src="96EC1E13.jpg" id="s514_i" style="z-index:1;left:0px;top:0px;width:435.50px;height:318.21px" > </div> <div class="sg" id="s515" data-sgid="Picture 2" style="z-index:1;left:40.88px;top:77.25px;width:326.13px;height:179.25px"> <img class="sg" src="BDFCA007.jpg" id="s515_i" style="z-index:1;left:0px;top:0px;width:325.79px;height:179.39px" > </div> <div class="sg" id="s516" data-sgid="Picture 4" style="z-index:2;left:379.50px;top:77.25px;width:316.50px;height:180.00px"> <img class="sg" src="8093C0AD.jpg" id="s516_i" style="z-index:1;left:0px;top:0px;width:316.79px;height:180.13px" > </div> <div class="sg" id="s517" data-sgid="Picture 3" style="z-index:1;left:120.00px;top:74.00px;width:478.88px;height:254.00px"> <img class="sg" src="E09921DA.jpg" id="s517_i" style="z-index:1;left:0px;top:0px;width:479.81px;height:253.60px" > </div> <div class="sg" id="s518" data-sgid="Rectangle 1" style="z-index:1;left:47.95px;top:22.52px;width:588.15px;height:165.66px" data-valign="top" data-pointer-events="none"> <div id="s518_t" class="sg" style="z-index:2;left:-7.46px;top:-6.82px;width:601.61px;height:180.74px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="507.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.72px;top:9.47px;">•<span style="letter-spacing:11.48px"> </span>Multifocal, confluent masses, irregular margins, </span><span data-textwidth="507.80" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:41.72px;top:35.39px;">follows blood vessels with mass effect on vessels, </span><span data-textwidth="126.86" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:133%; left:41.72px;top:61.32px;">subcapsular </span></p><p para="{bl:{ch:8226}}"><span data-textwidth="572.49" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.72px;top:87.24px;">•<span style="letter-spacing:11.48px"> </span>Hypovascular compared to liver (minor peripheral and </span><span data-textwidth="225.28" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:41.72px;top:113.17px;">internal enhancement)</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="257.92" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:133%; left:14.72px;top:139.09px;">•<span style="letter-spacing:11.48px"> </span>Everything else normal</span></p></div></div></div> <div class="sg" id="s519" data-sgid="Picture 4" style="z-index:2;left:378.00px;top:154.50px;width:296.88px;height:220.50px"> <img class="sg" src="23D4A44F.jpg" id="s519_i" style="z-index:1;left:0px;top:0px;width:297.33px;height:220.57px" > </div> <div class="sg" id="s524" data-sgid="Rectangle 5" style="z-index:5;left:221.70px;top:22.52px;width:282.57px;height:39.18px" data-valign="top" data-pointer-events="none"> <div id="s524_t" class="sg" style="z-index:2;left:-9.72px;top:-12.82px;width:292.29px;height:59.41px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="248.56" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.26px;top:11.90px;">•<span style="letter-spacing:8.60px"> </span>Capsular retraction</span></p></div></div></div> <div class="sg" id="s521" data-sgid="Straight Arrow Connector 2" style="z-index:2;left:363.24px;top:93.55px;width:41.46px;height:63.96px" data-pointer-events="none"> <img class="sg" src="FFD1D95E.png" id="s521_i" style="z-index:1;left:0px;top:0px;width:41.56px;height:64.12px" > </div> <div class="sg" id="s523" data-sgid="Straight Arrow Connector 2 (2)" style="z-index:4;left:435.13px;top:111.51px;width:41.46px;height:63.96px" data-pointer-events="none"> <img class="sg" src="B1582730.png" id="s523_i" style="z-index:1;left:0px;top:0px;width:41.56px;height:64.12px" > </div> <div class="sg" id="s522" data-sgid="Straight Arrow Connector 4" style="z-index:3;left:225.42px;top:116.80px;width:41.46px;height:58.67px" data-pointer-events="none"> <img class="sg" src="C2FDDC8A.png" id="s522_i" style="z-index:1;left:0px;top:0px;width:41.56px;height:58.81px" > </div> <div class="sg" id="s520" data-sgid="Picture 5" style="z-index:1;left:149.08px;top:99.55px;width:417.17px;height:241.13px"> <img class="sg" src="B9F818EA.jpg" id="s520_i" style="z-index:1;left:0px;top:0px;width:418.20px;height:241.73px" > </div> <div class="sg" id="s526" data-sgid="Rectangle 2" style="z-index:2;left:221.70px;top:16.52px;width:252.62px;height:39.18px" data-valign="top" data-pointer-events="none"> <div id="s526_t" class="sg" style="z-index:2;left:-9.72px;top:-12.81px;width:262.34px;height:59.43px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="209.91" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.26px;top:11.89px;">•<span style="letter-spacing:8.60px"> </span>Hypermetabolic</span></p></div></div></div> <div class="sg" id="s525" data-sgid="Picture 3" style="z-index:1;left:120.00px;top:74.00px;width:478.88px;height:254.00px"> <img class="sg" src="E09921DA.jpg" id="s525_i" style="z-index:1;left:0px;top:0px;width:479.81px;height:253.60px" > </div> <div class="sg" id="s528" data-sgid="Rectangle 4" style="z-index:4;left:221.70px;top:16.52px;width:408.41px;height:100.51px" data-valign="top" data-pointer-events="none"> <div id="s528_t" class="sg" style="z-index:2;left:-9.72px;top:-8.26px;width:418.13px;height:115.47px;"><div><p para="{bl:{ch:8226}}"><span data-textwidth="217.23" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.26px;top:11.42px;">•<span style="letter-spacing:8.60px"> </span>No intravoxel fat</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="169.34" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:156%; left:17.26px;top:41.67px;">•<span style="letter-spacing:8.60px"> </span>No cirrhosis</span></p><p para="{bl:{ch:8226}}"><span data-textwidth="218.91" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:17.26px;top:67.84px;">•<span style="letter-spacing:8.60px"> </span>No calcifications</span></p></div></div></div> <div class="sg" id="s527" data-sgid="Group 1" style="z-index:1;left:35.96px;top:148.29px;width:655.65px;height:191.91px"> <img class="sg" src="1CD67393.png" id="s527_i" style="z-index:1;left:0px;top:0px;width:657.27px;height:192.38px" > </div> <div class="sg sgTitle" id="s529" data-sgid="Rectangle 2" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s529_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="387.90" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:130.03px;top:17.71px;">Differential diagnosis</span></p></div></div></div> <div class="sg" id="s530" data-sgid="Rectangle 3" style="z-index:2;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s530_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:661.66px;height:278.76px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="308.57" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Lymphoma - primary</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="192.40" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:55.97px;top:58.64px;">– Query h/o HIV</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="416.58" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:19.97px;top:99.93px;">•<span style="letter-spacing:5.60px"> </span>Epithelial haemangiosarcoma</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="373.87" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:55.97px;top:145.06px;">– Wrong species! No thorotrast!</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="482.00" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:178%; left:19.97px;top:186.35px;">•<span style="letter-spacing:5.60px"> </span>Epithelioid hemangioendothelioma</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="325.14" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:156%; left:55.97px;top:231.48px;">– PET scan findings against</span></p></div></div></div> <div class="sg sgSubtitle" id="s531" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s531_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s532" data-sgid="Subtitle 4" style="z-index:1;left:77.90px;top:82.40px;width:570.19px;height:180.65px" data-valign="top" data-pointer-events="none"> <div id="s532_t" class="sg" style="z-index:2;left:0.00px;top:-10.52px;width:571.04px;height:191.88px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="203.19" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:189.74px;top:18.06px;">Epithelioid </span><span data-textwidth="429.55" class="sg nowrap f1" style="z-index:3;color:#FFFFFF;font-size:244%; left:70.32px;top:70.87px;">Hemangioendothelioma</span></p></div></div></div> <div class="sg" id="s534" data-sgid="Subtitle 4" style="z-index:2;left:53.92px;top:10.55px;width:648.08px;height:78.81px" data-valign="top"> <div id="s534_t" class="sg" style="z-index:2;left:-17.25px;top:-8.99px;width:665.34px;height:87.81px;"><div><p para="{spbf:0.20}"><span data-textwidth="574.06" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.54px;top:16.48px;"><u>Epithelioid Hemangioendothelioma</u></span></p></div></div><img class="sg" src="6A70A730.png" id="s534_tt" style="left:-17.25px;top:-8.99px;width:665.34px;height:87.81px;z-index:1" > </div> <div class="sg" id="s533" data-sgid="Content Placeholder 2" style="z-index:1;left:59.93px;top:70.44px;width:672.05px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s533_t" class="sg" style="z-index:2;left:-14.99px;top:-7.55px;width:687.87px;height:286.28px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="537.94" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.27px;top:15.17px;">• Rare tumor arising from vascular </span><span data-textwidth="240.76" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:200%; left:49.28px;top:58.38px;">endothelial cells</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="521.60" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:156%; left:58.28px;top:107.31px;">– composed of dendritic and epithelioid cells</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="490.40" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:156%; left:58.28px;top:147.64px;">– intermediate between hemangioma and </span><span data-textwidth="171.39" class="sg nowrap f1" style="z-index:9;color:#FFFFFF;font-size:156%; left:80.84px;top:181.24px;">angiosarcoma </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="216.76" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:200%; left:22.27px;top:224.49px;">• 60% women</span></p></div></div></div> <div class="sg" id="s536" data-sgid="Subtitle 4" style="z-index:2;left:53.92px;top:10.55px;width:648.08px;height:78.81px" data-valign="top"> <div id="s536_t" class="sg" style="z-index:2;left:-17.25px;top:-8.99px;width:665.34px;height:87.81px;"><div><p para="{spbf:0.20}"><span data-textwidth="574.06" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.54px;top:16.48px;"><u>Epithelioid Hemangioendothelioma</u></span></p></div></div><img class="sg" src="6A70A730.png" id="s536_tt" style="left:-17.25px;top:-8.99px;width:665.34px;height:87.81px;z-index:1" > </div> <div class="sg" id="s535" data-sgid="Content Placeholder 2" style="z-index:1;left:53.92px;top:82.40px;width:636.12px;height:267.50px" data-valign="top" data-pointer-events="none"> <div id="s535_t" class="sg" style="z-index:2;left:-14.99px;top:-7.55px;width:651.94px;height:275.76px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="317.45" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:22.28px;top:15.21px;">• May be aggressive </span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="595.18" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:200%; left:22.28px;top:67.06px;">• 30-50% with metastases at diagnosis</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="256.96" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:156%; left:58.29px;top:115.99px;">– 5 year survival 43%</span></p></div></div></div> <div class="sg sgTitle" id="s537" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s537_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.71px;">Imaging</span></p></div></div></div> <div class="sg" id="s538" data-sgid="Content Placeholder 2" style="z-index:2;left:41.94px;top:88.40px;width:660.07px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s538_t" class="sg" style="z-index:2;left:-9.69px;top:-5.26px;width:674.32px;height:273.47px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="567.70" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.96px;top:11.92px;">•<span style="letter-spacing:8.60px"> </span>Multiple coalescent solid nodules, located in a </span><span data-textwidth="613.30" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:43.96px;top:45.53px;">predominantly peripheral or subcapsular distribution</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="635.98" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:156%; left:16.96px;top:85.86px;">•<span style="letter-spacing:8.60px"> </span>Sometimes demonstrate a peripheral halo or target-</span><span data-textwidth="305.21" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:156%; left:43.96px;top:119.46px;">type enhancement pattern</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="572.49" class="sg nowrap f1" style="z-index:17;color:#FFFFFF;font-size:156%; left:16.96px;top:159.79px;">•<span style="letter-spacing:8.60px"> </span>Lesions adjacent to the capsule often produce </span><span data-textwidth="313.02" class="sg nowrap f1" style="z-index:20;color:#FFFFFF;font-size:156%; left:43.96px;top:193.40px;">hepatic <span style="color:#FFFF00;">capsular retraction</span></span></p></div></div></div> <div class="sg" id="s540" data-sgid="Subtitle 4" style="z-index:2;left:53.92px;top:16.52px;width:648.08px;height:78.84px" data-valign="top"> <div id="s540_t" class="sg" style="z-index:2;left:-17.25px;top:-8.97px;width:665.34px;height:87.81px;"><div><p para="{spbf:0.20}"><span data-textwidth="574.06" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:24.54px;top:16.49px;"><u>Epithelioid Hemangioendothelioma</u></span></p></div></div><img class="sg" src="6A70A730.png" id="s540_tt" style="left:-17.25px;top:-8.97px;width:665.34px;height:87.81px;z-index:1" > </div> <div class="sg" id="s539" data-sgid="Content Placeholder 2" style="z-index:1;left:35.96px;top:94.40px;width:648.08px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s539_t" class="sg" style="z-index:2;left:-12.72px;top:-6.85px;width:661.66px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="528.68" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.51px;">•<span style="letter-spacing:5.60px"> </span>Surgical resection or orthotopic liver </span><span data-textwidth="206.79" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:178%; left:46.97px;top:51.92px;">transplantation </span></p></div></div></div> <div class="sg" id="s541" data-sgid="Title 1" style="z-index:1;left:53.92px;top:125.77px;width:612.15px;height:87.81px" data-valign="middle" data-pointer-events="none"> <div id="s541_t" class="sg" style="z-index:2;left:0.00px;top:-5.26px;width:612.97px;height:114.03px;"><div><p para="{al:2}"><span data-textwidth="228.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:191.76px;top:22.20px;">Next Case</span></p></div></div></div> <div class="sg sgTitle" id="s542" data-sgid="Title 1" style="z-index:1;left:47.95px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s542_t" class="sg" style="z-index:2;left:0.00px;top:-2.26px;width:648.93px;height:84.81px;"><div><p para="{al:2}"><span data-textwidth="576.22" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:222%; left:41.58px;top:15.91px;">Reginald Munden, MD, DMD, MBA </span></p></div></div></div> <div class="sg" id="s543" data-sgid="Picture 6" style="z-index:2;left:246.00px;top:84.63px;width:222.00px;height:274.25px"> <img class="sg" src="5A016770.jpg" id="s543_i" title="" alt="Munden photo.jpeg" style="z-index:1;left:0px;top:0px;width:222.25px;height:274.77px" > </div> <div class="sg sgTitle" id="s544" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s544_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="274.85" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:186.56px;top:17.71px;">Chest Case #2</span></p></div></div></div> <div class="sg" id="s545" data-sgid="Rectangle 3" style="z-index:2;left:35.96px;top:100.37px;width:648.08px;height:210.58px" data-valign="top"> <div id="s545_t" class="sg" style="z-index:2;left:0.00px;top:-7.53px;width:648.08px;height:218.10px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="303.41" class="sg nowrap f2" style="z-index:2;color:#FFFFFF;font-size:178%; left:176.60px;top:15.38px;">18-year-old boy born </span><span data-textwidth="431.71" class="sg nowrap f2" style="z-index:7;color:#FFFFFF;font-size:178%; left:112.50px;top:53.79px;">with congenital hip dislocation </span><span data-textwidth="406.75" class="sg nowrap f2" style="z-index:8;color:#FFFFFF;font-size:178%; left:124.99px;top:92.20px;">now with recurrent episodes </span><span data-textwidth="380.22" class="sg nowrap f2" style="z-index:9;color:#FFFFFF;font-size:178%; left:133.87px;top:130.61px;">of chest pain after yawning</span></p></div></div></div> <div class="sg" id="s546" data-sgid="Picture 2" style="z-index:1;left:120.00px;top:28.38px;width:480.00px;height:344.63px"> <img class="sg" src="1737F317.jpg" id="s546_i" style="z-index:1;left:0px;top:0px;width:480.55px;height:344.39px" > </div> <div class="sg" id="s547" data-sgid="Picture 2" style="z-index:1;left:372.00px;top:85.50px;width:333.00px;height:235.13px"> <img class="sg" src="5CC6DF7.jpg" id="s547_i" style="z-index:1;left:0px;top:0px;width:333.38px;height:235.60px" > </div> <div class="sg" id="s548" data-sgid="Picture 3" style="z-index:2;left:30.88px;top:85.50px;width:329.13px;height:237.63px"> <img class="sg" src="8767EC70.jpg" id="s548_i" style="z-index:1;left:0px;top:0px;width:329.65px;height:237.87px" > </div> <div class="sg" id="s550" data-sgid="TextBox 1" style="z-index:2;left:281.64px;top:12.70px;width:179.99px;height:42.15px" data-valign="top"> <div id="s550_t" class="sg" style="z-index:2;left:-9.72px;top:-5.15px;width:189.71px;height:59.29px;"><div><p><span data-textwidth="152.79" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.33px;top:11.29px;">1 month later</span></p></div></div></div> <div class="sg" id="s549" data-sgid="Picture 3" style="z-index:1;left:162.00px;top:52.50px;width:393.00px;height:327.13px"> <img class="sg" src="D0C03B09.jpg" id="s549_i" style="z-index:1;left:0px;top:0px;width:393.46px;height:327.20px" > </div> <div class="sg" id="s551" data-sgid="Picture 2" style="z-index:1;left:120.00px;top:28.38px;width:480.00px;height:344.63px"> <img class="sg" src="1737F317.jpg" id="s551_i" style="z-index:1;left:0px;top:0px;width:480.55px;height:344.39px" > </div> <div class="sg" id="s552" data-sgid="Picture 2" style="z-index:1;left:372.00px;top:85.50px;width:333.00px;height:235.13px"> <img class="sg" src="5CC6DF7.jpg" id="s552_i" style="z-index:1;left:0px;top:0px;width:333.38px;height:235.60px" > </div> <div class="sg" id="s553" data-sgid="Picture 3" style="z-index:2;left:30.88px;top:85.50px;width:329.13px;height:237.63px"> <img class="sg" src="8767EC70.jpg" id="s553_i" style="z-index:1;left:0px;top:0px;width:329.65px;height:237.87px" > </div> <div class="sg" id="s555" data-sgid="TextBox 1" style="z-index:2;left:281.64px;top:12.70px;width:179.99px;height:42.15px" data-valign="top"> <div id="s555_t" class="sg" style="z-index:2;left:-9.72px;top:-5.15px;width:189.71px;height:59.29px;"><div><p><span data-textwidth="152.79" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:17.33px;top:11.29px;">1 month later</span></p></div></div></div> <div class="sg" id="s554" data-sgid="Picture 3" style="z-index:1;left:162.00px;top:52.50px;width:393.00px;height:327.13px"> <img class="sg" src="D0C03B09.jpg" id="s554_i" style="z-index:1;left:0px;top:0px;width:393.46px;height:327.20px" > </div> <div class="sg" id="s556" data-sgid="Rectangle 3" style="z-index:1;left:35.96px;top:58.44px;width:672.05px;height:294.43px" data-valign="top"> <div id="s556_t" class="sg" style="z-index:2;left:-9.72px;top:-5.26px;width:681.77px;height:299.69px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="554.37" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.97px;top:11.87px;">•<span style="letter-spacing:8.60px"> </span>Young male with spontaneous pneumothorax</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="338.22" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:52.97px;top:50.24px;">–<span style="letter-spacing:5.25px"> </span>Idiopathic, FLCN gene, smoking</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="430.39" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:156%; left:16.97px;top:86.77px;">•<span style="letter-spacing:8.60px"> </span>Pulmonary nodules with cavitation</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="409.63" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:52.97px;top:125.14px;">–<span style="letter-spacing:5.25px"> </span>Metastatic disease, treated metastases</span></p><p para="{in:3,bl:{ch:8226},spbf:0.20}"><span data-textwidth="453.19" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:88.98px;top:159.71px;">• Sarcoma, germ cell, adenocarcinoma, rena<span class="f1" style="font-size:83%; ">l</span></span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="124.59" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:133%; left:52.97px;top:194.27px;">–<span style="letter-spacing:5.25px"> </span>TB, fungal</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="158.31" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:133%; left:52.97px;top:228.84px;">–<span style="letter-spacing:5.25px"> </span>Septic emboli</span></p></div></div></div> <div class="sg" id="s557" data-sgid="Rectangle 3" style="z-index:1;left:29.95px;top:40.48px;width:678.06px;height:294.43px" data-valign="top"> <div id="s557_t" class="sg" style="z-index:2;left:-9.69px;top:-5.26px;width:687.75px;height:304.98px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="420.91" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:156%; left:16.95px;top:11.83px;">•<span style="letter-spacing:8.60px"> </span>Cavitary nodules and hemorrhage</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="469.52" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:52.95px;top:50.20px;">–<span style="letter-spacing:5.25px"> </span>Fungal infection – aspergillus, blastomycosis</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="206.80" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:52.95px;top:84.77px;">–<span style="letter-spacing:5.25px"> </span>Metastatic disease</span></p><p para="{in:3,bl:{ch:8226},spbf:0.20}"><span data-textwidth="567.09" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:88.96px;top:119.33px;">• Melanoma, sarcoma, renal, embryonic, angiocarcinoma</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="338.34" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:52.95px;top:153.90px;">–<span style="letter-spacing:5.25px"> </span>Vascular disorder – hematomas</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="386.70" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:156%; left:16.95px;top:190.43px;">•<span style="letter-spacing:8.60px"> </span>Congenital hip dislocation/ age</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="566.74" class="sg nowrap f1" style="z-index:18;color:#FFFFFF;font-size:133%; left:52.95px;top:228.80px;">–<span style="letter-spacing:5.25px"> </span>Connective tissue problem, no tracheal/airway disease</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="535.89" class="sg nowrap f1" style="z-index:20;color:#FFFFFF;font-size:133%; left:52.95px;top:263.37px;">–<span style="letter-spacing:11.97px"> </span>Hip dislocation, cavitary nodules, spontaneous ptx </span></p></div></div></div> <div class="sg" id="s558" data-sgid="Rectangle 3" style="z-index:1;left:35.96px;top:124.33px;width:660.07px;height:78.84px" data-valign="top"> <div id="s558_t" class="sg" style="z-index:2;left:0.00px;top:-7.53px;width:660.07px;height:86.36px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="520.65" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:200%; left:74.70px;top:15.27px;">Ehlers-Danlos Syndrome, Type IV </span></p></div></div></div> <div class="sg sgSubtitle" id="s559" data-sgid="Subtitle 2" style="z-index:1;left:119.83px;top:136.32px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s559_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:505.12px;height:117.85px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="245.08" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:129.57px;top:22.56px;">Diagnosis?</span></p></div></div></div> <div class="sg sgSubtitle" id="s560" data-sgid="Subtitle 4" style="z-index:1;left:41.94px;top:82.40px;width:654.09px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s560_t" class="sg" style="z-index:2;left:0.00px;top:-12.81px;width:654.94px;height:117.88px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="498.20" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:77.96px;top:22.47px;">Ehlers Danlos Type IV</span></p></div></div></div> <div class="sg" id="s561" data-sgid="Subtitle 4 (2)" style="z-index:2;left:59.93px;top:202.21px;width:618.13px;height:72.81px" data-valign="top"> <div id="s561_t" class="sg" style="z-index:2;left:0.00px;top:-10.56px;width:618.13px;height:93.80px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="402.43" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:107.86px;top:18.32px;"><u>Ehlers Danlos Type IV</u></span></p></div></div><img class="sg" src="424399AB.png" id="s561_tt" style="left:0.00px;top:-10.56px;width:618.13px;height:93.80px;z-index:1" > </div> <div class="sg" id="s563" data-sgid="Subtitle 4" style="z-index:2;left:59.93px;top:10.55px;width:618.13px;height:72.81px" data-valign="top"> <div id="s563_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:618.13px;height:93.80px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="402.43" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:107.86px;top:17.92px;"><u>Ehlers Danlos Type IV</u></span></p></div></div><img class="sg" src="424399AB.png" id="s563_tt" style="left:0.00px;top:-10.55px;width:618.13px;height:93.80px;z-index:1" > </div> <div class="sg" id="s562" data-sgid="Content Placeholder 2" style="z-index:1;left:59.93px;top:70.44px;width:642.07px;height:306.39px" data-valign="top" data-pointer-events="none"> <div id="s562_t" class="sg" style="z-index:2;left:-12.72px;top:-11.26px;width:655.65px;height:318.39px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="507.09" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:20.00px;top:14.04px;">•<span style="letter-spacing:5.61px"> </span>Inherited connective tissue disorder</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="600.23" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:178%; left:20.00px;top:56.28px;">•<span style="letter-spacing:5.61px"> </span>Defect in collagen or proteins that interact </span><span data-textwidth="177.27" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:178%; left:47.01px;top:90.85px;">with collagen</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="560.01" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:20.00px;top:133.10px;">•<span style="letter-spacing:5.61px"> </span>At least ten sub-types (most autosomal </span><span data-textwidth="134.30" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:178%; left:47.01px;top:167.67px;">dominant)</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="372.18" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:56.01px;top:209.44px;">– Type IV -Vascular Type (rare)</span></p><p para="{in:2,spbf:0.20}"><span data-textwidth="557.13" class="sg nowrap f1" style="z-index:17;color:#FFFFFF;font-size:156%; left:79.65px;top:246.41px;">COL 3A1 mutation results in type III procollagen</span></p></div></div></div> <div class="sg" id="s565" data-sgid="Subtitle 4" style="z-index:2;left:59.93px;top:10.55px;width:618.13px;height:72.81px" data-valign="top"> <div id="s565_t" class="sg" style="z-index:2;left:0.00px;top:-10.55px;width:618.13px;height:93.80px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="402.43" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:107.86px;top:17.92px;"><u>Ehlers Danlos Type IV</u></span></p></div></div><img class="sg" src="424399AB.png" id="s565_tt" style="left:0.00px;top:-10.55px;width:618.13px;height:93.80px;z-index:1" > </div> <div class="sg" id="s564" data-sgid="Content Placeholder 2" style="z-index:1;left:65.91px;top:76.44px;width:624.14px;height:267.47px" data-valign="top" data-pointer-events="none"> <div id="s564_t" class="sg" style="z-index:2;left:-12.69px;top:-6.85px;width:637.65px;height:275.02px;"><div><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="569.74" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.99px;top:13.47px;">•<span style="letter-spacing:5.61px"> </span>Type-IV amongst most severe sub-types</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="486.57" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:178%; left:19.99px;top:63.88px;">•<span style="letter-spacing:5.61px"> </span>Characteristic facial features, thin </span><span data-textwidth="411.91" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:178%; left:47.00px;top:102.29px;">transparent skin, easy bruising</span></p><p para="{bl:{ch:8226},spbf:12.00}"><span data-textwidth="577.06" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:178%; left:19.99px;top:152.70px;">•<span style="letter-spacing:5.61px"> </span>Rupture of the arteries, uterus, intestines</span></p><p para="{in:2,bl:{ch:8211},spbf:12.00}"><span data-textwidth="414.79" class="sg nowrap f1" style="z-index:13;color:#FFFFFF;font-size:156%; left:56.00px;top:203.11px;">– Average life expectancy 48 years</span></p></div></div></div> <div class="sg sgTitle" id="s566" data-sgid="Title 1" style="z-index:1;left:35.96px;top:16.52px;width:648.08px;height:68.29px" data-valign="middle" data-pointer-events="none"> <div id="s566_t" class="sg" style="z-index:2;left:0.00px;top:-6.82px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="144.62" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:251.73px;top:17.71px;">Imaging</span></p></div></div></div> <div class="sg" id="s567" data-sgid="Content Placeholder 2" style="z-index:2;left:35.96px;top:82.40px;width:666.05px;height:279.46px" data-valign="top" data-pointer-events="none"> <div id="s567_t" class="sg" style="z-index:2;left:-12.72px;top:-14.96px;width:679.62px;height:295.13px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="583.65" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:178%; left:19.97px;top:13.94px;">•<span style="letter-spacing:5.60px"> </span>Pulmonary manifestations are uncommon</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="234.04" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:55.97px;top:51.35px;">–<span style="letter-spacing:5.25px"> </span>Pneumo/hemothorax</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="172.11" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:55.97px;top:80.15px;">–<span style="letter-spacing:5.25px"> </span>bulla formation</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="178.83" class="sg nowrap f1" style="z-index:11;color:#FFFFFF;font-size:133%; left:55.97px;top:108.96px;">–<span style="letter-spacing:5.25px"> </span>cavitary lesions</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="259.48" class="sg nowrap f1" style="z-index:15;color:#FFFFFF;font-size:133%; left:55.97px;top:137.77px;">–<span style="letter-spacing:5.25px"> </span>saccular bronchiectasis</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="359.58" class="sg nowrap f1" style="z-index:19;color:#FFFFFF;font-size:133%; left:55.97px;top:166.57px;">–<span style="letter-spacing:5.25px"> </span>sequelae of recurrent hemoptysis</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="252.29" class="sg nowrap f1" style="z-index:23;color:#FFFFFF;font-size:133%; left:55.97px;top:195.38px;">–<span style="letter-spacing:5.25px"> </span>tracheobronchomegaly</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="347.46" class="sg nowrap f1" style="z-index:26;color:#FFFFFF;font-size:133%; left:55.97px;top:224.18px;">–<span style="letter-spacing:5.25px"> </span>repeated episodes of pneumonia</span></p><p para="{in:2,bl:{ch:8211},spbf:0.20}"><span data-textwidth="241.96" class="sg nowrap f1" style="z-index:29;color:#FFFFFF;font-size:133%; left:55.97px;top:252.99px;">–<span style="letter-spacing:5.25px"> </span>fibrous pseudotumors</span></p></div></div></div> <div class="sg sgTitle" id="s568" data-sgid="Title 1" style="z-index:1;left:41.94px;top:10.55px;width:648.11px;height:68.26px" data-valign="middle" data-pointer-events="none"> <div id="s568_t" class="sg" style="z-index:2;left:0.00px;top:-6.84px;width:648.93px;height:93.92px;"><div><p para="{al:2}"><span data-textwidth="361.50" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:244%; left:143.25px;top:17.93px;">Acknowledgements</span></p></div></div></div> <div class="sg" id="s569" data-sgid="Text Placeholder 1" style="z-index:2;left:89.88px;top:70.44px;width:222.67px;height:39.15px" data-valign="bottom" data-pointer-events="none"> <div id="s569_t" class="sg" style="z-index:2;left:0.00px;top:-1.56px;width:223.49px;height:51.15px;"><div><p para="{spbf:0.20}"><span data-textwidth="45.73" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-weight:bold; font-size:133%; left:101.31px;top:8.98px;">Yale</span></p></div></div></div> <div class="sg" id="s571" data-sgid="Text Placeholder 2" style="z-index:4;left:413.46px;top:70.44px;width:108.81px;height:39.15px" data-valign="bottom" data-pointer-events="none"> <div id="s571_t" class="sg" style="z-index:2;left:-7.46px;top:-1.56px;width:117.09px;height:51.15px;"><div><p para="{spbf:0.20}"><span data-textwidth="59.77" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-weight:bold; font-size:133%; left:15.03px;top:8.98px;">Other</span></p></div></div></div> <div class="sg" id="s572" data-sgid="Content Placeholder 3" style="z-index:5;left:335.56px;top:106.36px;width:318.53px;height:233.83px" data-valign="top" data-pointer-events="none"> <div id="s572_t" class="sg" style="z-index:2;left:-7.45px;top:-3.81px;width:338.79px;height:246.62px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="309.29" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.91px;top:9.51px;">•<span style="letter-spacing:11.48px"> </span>Michelle McDonough (Mayo </span><span data-textwidth="193.47" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:41.91px;top:38.32px;">Clinic Jacksonville)</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="175.58" class="sg nowrap f1" style="z-index:5;color:#FFFFFF;font-size:133%; left:14.91px;top:72.89px;">•<span style="letter-spacing:11.48px"> </span>Javier Beltran </span><span data-textwidth="237.88" class="sg nowrap f1" style="z-index:7;color:#FFFFFF;font-size:133%; left:41.91px;top:101.69px;">(Maimonides, Brooklyn)</span></p><p para="{bl:{ch:8226},spbf:0.20}"></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="150.62" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.91px;top:170.83px;">•<span style="letter-spacing:11.48px"> </span>“Chip” Dodd</span></p><p para="{spbf:0.20}"><span data-textwidth="164.79" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:41.91px;top:205.40px;">(Univ Colorado) </span></p></div></div></div> <div class="sg" id="s570" data-sgid="Content Placeholder 2" style="z-index:3;left:107.85px;top:100.37px;width:318.53px;height:282.46px" data-valign="top" data-pointer-events="none"> <div id="s570_t" class="sg" style="z-index:2;left:-7.43px;top:-3.82px;width:326.80px;height:292.98px;"><div><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="184.47" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:133%; left:14.56px;top:9.51px;">•<span style="letter-spacing:11.48px"> </span>Richard Bronen</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="187.47" class="sg nowrap f1" style="z-index:4;color:#FFFFFF;font-size:133%; left:14.56px;top:44.08px;">•<span style="letter-spacing:11.48px"> </span>Tamir Freidman</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="188.55" class="sg nowrap f1" style="z-index:6;color:#FFFFFF;font-size:133%; left:14.56px;top:78.65px;">•<span style="letter-spacing:11.48px"> </span>Andrew Haimes</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="136.46" class="sg nowrap f1" style="z-index:8;color:#FFFFFF;font-size:133%; left:14.56px;top:113.22px;">•<span style="letter-spacing:11.48px"> </span>Gary Israel</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="174.50" class="sg nowrap f1" style="z-index:10;color:#FFFFFF;font-size:133%; left:14.56px;top:147.78px;">•<span style="letter-spacing:11.48px"> </span>Liane Philpotts</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="185.19" class="sg nowrap f1" style="z-index:12;color:#FFFFFF;font-size:133%; left:14.56px;top:182.35px;">•<span style="letter-spacing:11.48px"> </span>Ami Rubinowitz</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="145.10" class="sg nowrap f1" style="z-index:14;color:#FFFFFF;font-size:133%; left:14.56px;top:216.92px;">•<span style="letter-spacing:11.48px"> </span>Gordon Sze</span></p><p para="{bl:{ch:8226},spbf:0.20}"><span data-textwidth="191.67" class="sg nowrap f1" style="z-index:16;color:#FFFFFF;font-size:133%; left:14.56px;top:251.49px;">•<span style="letter-spacing:11.48px"> </span>Vahe Zohrabian </span></p></div></div></div> <div class="sg sgSubtitle" id="s581" data-sgid="Subtitle 7" style="z-index:1;left:107.85px;top:124.33px;width:504.30px;height:104.21px" data-valign="top" data-pointer-events="none"> <div id="s581_t" class="sg" style="z-index:2;left:0.00px;top:-12.82px;width:505.12px;height:117.88px;"><div><p para="{al:2,spbf:0.20}"><span data-textwidth="255.64" class="sg nowrap f1" style="z-index:2;color:#FFFFFF;font-size:300%; left:124.27px;top:22.56px;">Thank  You</span></p></div></div></div>