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Journal of Diagnostic Medical Sonography 2000: Vol 16 Index PDF

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264 JDMS_ 16:264-265 November/December 2000 SUBJECT INDEX Volume 16, 2000 Abstract reviews, 42, 82, 133, 168, 212 Dysfunctional uterine bleeding, sonohysterographic vs. hys- Acute myelogenous leukemia, hepatic candidiasis in, 225 teroscopic evaluation of, 68 Adenocarcinoma, fallopian tube, 143 Africa, sonography in, 37 Echocardiography, contrast, 97 American Registry of Diagnostic Medical Sonographers of partial anomalous pulmonary venous return, 133 (ARDMS), task analysis survey of, 1 Ectopic pregnancy Anencephaly, of single fetus in twin gestation, 198 cervical, 110 Arterial dissection, carotid artery, 116, 234 ultrasound vs. surgical findings in, 60 Arteriovenous fistula, pseudoaneurysm in, thrombin injection Education, continuing, distance learning in, 148 for, 34 Electronic pacemaker, mirror image artifact from, 26 Artifacts, mirror image, from cardiac pacemaker, 26 Emergency medicine physicians, ultrasound training for, 119 Employee retention, 124 Bleeding, dysfunctional uterine, sonohysterographic vs. hys- Endovaginal ultrasonography teroscopic evaluation of, cost utility analysis of, 68 of cervical ectopic pregnancy, 110 Bonding, paternal-fetal, 237 of fallopian tube adenocarcinoma, 143 Brain lesion, in premature infant, unusual presentation of, 194 Erratum, 165 Exencephaly, 232 Cancer Extended field-of-view real-time ultrasonography, 103 fallopian tube adenocarcinoma, 143 renal, contrast-enhanced sonography in, 53 Fallopian tube adenocarcinoma, 143 testicular, ultrasound localization, for conservative Father-fetal bonding, 237 surgery, 191 Fetal demise, twin reversed arterial perfusion sequence and, 65 Candidiasis, hepatic, in acute myelogenous leukemia, 225 Fistula, arteriovenous, pseudoaneurysm in, thrombin injection Cardiac pacemaker, mirror image artifact from, 26 for, 34 Carotid artery dissection, 116, 234 Follow-up study of recent sonography graduates, 156 Carotid artery pseudoaneurysm, 202 Fournier’s gangrene, scrotal wall thickening and, 29 Cavernous transformation, in pancreatic pseudocyst, 23 Fracture, stress, of second metatarsal, 251 Cerebral luxury perfusion, in premature infant, unusual pre- Frame-one imaging, contrast enhancement with, 14 sentation of, 194 Certification examination, ARDMS task analysis survey for, 1 Gangrene, Fournier’s, scrotal wall thickening and, 29 Cervix, incompetent, 80 Gottesfeld Award winners, 81 Children, hip effusions in, 73 Graduates, recent, follow-up study of, 156 Cholesterolosis, 129 Graft body pseudoaneurysm, thrombin injection for, 34 Color Doppler ultrasonography, of twin reversed arterial per- fusion sequence, 65 Hepatic candidiasis, in acute myelogenous leukemia, 225 Common carotid artery dissection, 116, 234 Hip effusions, in children, 73 Common carotid artery pseudoaneurysm, 202 Hydrocele, infected, vs. Fournier’s gangrene, 29 Computed tomography of hepatic candidiasis, in acute myelogenous leukemia, lliac artery dissection, 234 225 Incompetent cervix, 80 of pancreatic pseudocyst, 23 Injection, thrombin, of AVF pseudoaneurysm, 34 Continuing education, distance learning in, 148 Intracranial lesion, in premature infant, unusual presentation Contrast agents, in renal sonography, 53 of, 194 Contrast echocardiography, 97 of partial anomalous pulmonary venous return, 133 Jeanty, Philippe, 160 Contrast-enhanced ultrasonography Joint effusions, hip, in children, 73 with frame-one imaging, 14 of renal masses, 53 Kidney, contrast-enhanced sonography of, 53 Cost utility analysis, of sonohysterography vs. hysteroscopy, for dysfunctional uterine bleeding, 68 Left common iliac artery dissection, 234 Letters to the editor, 13, 130, 166 Diabetic pregnancy, macrosomia in, 76 Leukemia, acute myelogenous, hepatic candidiasis in, 225 Diagnostic challenge, 41, 80, 129, 166, 205, 251 Leydig cell tumor, ultrasonographic localization of, for con- Diagnostic medical sonography graduates, follow-up study of, servative surgery, 191 156 Distance learning, in continuing education, 148 Macrosomia, in diabetic pregnancy, 76 Doppler ultrasonography, color, of twin reversed arterial per- Magnetic resonance imaging, of hepatic candidiasis, in acute fusion sequence, 65 myelogenous leukemia, 225 264 JDMS_ 16:264-265 November/December 2000 SUBJECT INDEX Volume 16, 2000 Abstract reviews, 42, 82, 133, 168, 212 Dysfunctional uterine bleeding, sonohysterographic vs. hys- Acute myelogenous leukemia, hepatic candidiasis in, 225 teroscopic evaluation of, 68 Adenocarcinoma, fallopian tube, 143 Africa, sonography in, 37 Echocardiography, contrast, 97 American Registry of Diagnostic Medical Sonographers of partial anomalous pulmonary venous return, 133 (ARDMS), task analysis survey of, 1 Ectopic pregnancy Anencephaly, of single fetus in twin gestation, 198 cervical, 110 Arterial dissection, carotid artery, 116, 234 ultrasound vs. surgical findings in, 60 Arteriovenous fistula, pseudoaneurysm in, thrombin injection Education, continuing, distance learning in, 148 for, 34 Electronic pacemaker, mirror image artifact from, 26 Artifacts, mirror image, from cardiac pacemaker, 26 Emergency medicine physicians, ultrasound training for, 119 Employee retention, 124 Bleeding, dysfunctional uterine, sonohysterographic vs. hys- Endovaginal ultrasonography teroscopic evaluation of, cost utility analysis of, 68 of cervical ectopic pregnancy, 110 Bonding, paternal-fetal, 237 of fallopian tube adenocarcinoma, 143 Brain lesion, in premature infant, unusual presentation of, 194 Erratum, 165 Exencephaly, 232 Cancer Extended field-of-view real-time ultrasonography, 103 fallopian tube adenocarcinoma, 143 renal, contrast-enhanced sonography in, 53 Fallopian tube adenocarcinoma, 143 testicular, ultrasound localization, for conservative Father-fetal bonding, 237 surgery, 191 Fetal demise, twin reversed arterial perfusion sequence and, 65 Candidiasis, hepatic, in acute myelogenous leukemia, 225 Fistula, arteriovenous, pseudoaneurysm in, thrombin injection Cardiac pacemaker, mirror image artifact from, 26 for, 34 Carotid artery dissection, 116, 234 Follow-up study of recent sonography graduates, 156 Carotid artery pseudoaneurysm, 202 Fournier’s gangrene, scrotal wall thickening and, 29 Cavernous transformation, in pancreatic pseudocyst, 23 Fracture, stress, of second metatarsal, 251 Cerebral luxury perfusion, in premature infant, unusual pre- Frame-one imaging, contrast enhancement with, 14 sentation of, 194 Certification examination, ARDMS task analysis survey for, 1 Gangrene, Fournier’s, scrotal wall thickening and, 29 Cervix, incompetent, 80 Gottesfeld Award winners, 81 Children, hip effusions in, 73 Graduates, recent, follow-up study of, 156 Cholesterolosis, 129 Graft body pseudoaneurysm, thrombin injection for, 34 Color Doppler ultrasonography, of twin reversed arterial per- fusion sequence, 65 Hepatic candidiasis, in acute myelogenous leukemia, 225 Common carotid artery dissection, 116, 234 Hip effusions, in children, 73 Common carotid artery pseudoaneurysm, 202 Hydrocele, infected, vs. Fournier’s gangrene, 29 Computed tomography of hepatic candidiasis, in acute myelogenous leukemia, lliac artery dissection, 234 225 Incompetent cervix, 80 of pancreatic pseudocyst, 23 Injection, thrombin, of AVF pseudoaneurysm, 34 Continuing education, distance learning in, 148 Intracranial lesion, in premature infant, unusual presentation Contrast agents, in renal sonography, 53 of, 194 Contrast echocardiography, 97 of partial anomalous pulmonary venous return, 133 Jeanty, Philippe, 160 Contrast-enhanced ultrasonography Joint effusions, hip, in children, 73 with frame-one imaging, 14 of renal masses, 53 Kidney, contrast-enhanced sonography of, 53 Cost utility analysis, of sonohysterography vs. hysteroscopy, for dysfunctional uterine bleeding, 68 Left common iliac artery dissection, 234 Letters to the editor, 13, 130, 166 Diabetic pregnancy, macrosomia in, 76 Leukemia, acute myelogenous, hepatic candidiasis in, 225 Diagnostic challenge, 41, 80, 129, 166, 205, 251 Leydig cell tumor, ultrasonographic localization of, for con- Diagnostic medical sonography graduates, follow-up study of, servative surgery, 191 156 Distance learning, in continuing education, 148 Macrosomia, in diabetic pregnancy, 76 Doppler ultrasonography, color, of twin reversed arterial per- Magnetic resonance imaging, of hepatic candidiasis, in acute fusion sequence, 65 myelogenous leukemia, 225 SUBJECT INDEX 265 Metatarsal, second, stress fracture of, 251 Staff retention, 124 Methotrexate, for cervical ectopic pregnancy, 110 Stress fracture, of second metatarsal, 251 Mirror image artifact, from cardiac pacemaker, 26 Subclavian artery dissection, 234 Neonate, brain lesion in, unusual presentation of, 194 Task analysis survey, ARDMS, 1 Teachable moments, in obstetric ultrasonography, 242 Obstetric ultrasonography Testicular tumor, ultrasound localization, for conservative of cervical ectopic pregnancy, 110 surgery, 191 of ectopic pregnancy, ultrasound vs. surgical findings in, 60 TheFetus.net, 160 of exencephaly, 232 Thrombin injection, of arteriovenous fistula pseudoaneurysm, of incompetent cervix, 80 34 of macrosomia in diabetic pregnancy, 76 Training, ultrasound, for emergency medicine physicians, 119 paternal-fetal bonding and, 237 Transvaginal ultrasonography, of cervical ectopic pregnancy, of placenta percreta vs. pelvic varices, 183 110 teachable moments in, 242 Tumors of twin gestation with one anencephalic fetus, 198 fallopian tube, 143 of twin reversed arterial perfusion sequence, 60 renal, contrast-enhanced sonography of, 53 unforgettable moments in, 244 testicular, ultrasound localization, for conservative surgery, 191 Pacemaker, cardiac, mirror image artifact from, 26 Twin gestation, with one anencephalic fetus, 198 Pancreatic pseudocyst, with portal vein thrombosis and cav- Twin reversed arterial perfusion sequence, 60 ernous transformation, 23 Partial anomalous pulmonary venous return, 133 Ultrasonographers. See Sonographers Paternal-fetal bonding, 237 Ultrasonography Pediatric ultrasonography, for hip effusions, 73 in Africa, 37 Pelvic varices, vs. placenta percreta, 183 of brain lesion with unusual presentation, in premature Physicians, emergency medicine, ultrasound training for, 119 infant, 194 Placenta percreta, vs. pelvic varices, 183 of common carotid artery dissection, 116, 234 Polyps, cholesterol, 129 of common carotid artery pseudoaneurysm, 202 Portal vein thrombosis and cavernous transformation, in pan- contrast-enhanced creatic pseudocyst, 23 with frame-one imaging, 14 Pregnancy. See also Obstetric ultrasonography of renal masses, 53 diabetic, macrosomia in, 76 endovaginal ectopic of cervical ectopic pregnancy, 110 cervical, 110 of fallopian tube adenocarcinoma, 143 ultrasound vs. surgical findings in, 60 of hepatic candidiasis, in acute myelogenous leukemia, Premature infant, brain lesion in, unusual presentation of, 194 225 Pseudoaneurysm, common carotid artery, 202 obstetric. See Obstetric ultrasonography Pyloric stenosis, 41 of pancreatic pseudocyst, with portal vein thrombosis and cavernous transformation, 23 Real-time ultrasonography, extended field of view in, 103 of partial anomalous pulmonary venous return, 133 Renal masses, contrast-enhanced sonography of, 53 of pediatric hip effusions, 73 real-time, extended field of view in, 103 Scope of Practice for Diagnostic Ultrasound Professional, 206 of scrotal wall thickening, 29 Scrotal wall thickening, Fournier’s gangrene and, 29 in testicular tumor localization, for conservative surgery, Second metatarsal, stress fracture of, 251 191 Sonographers training in, for emergency medicine physicians, 119 continuing education for, distance learning in, 148 unforgettable moments in, 244 recently graduated, follow-up study of, 156 Uterine bleeding, dysfunctional, sonohysterography vs. hys- retention of, 124 teroscopy for, cost utility analysis of, 68 scope of practice for, 206 Sonohysterography, vs. hysteroscopy, for dysfunctional uter- Varices, pelvic, vs. placenta percreta, 183 ine bleeding, cost utility analysis of, 68 STATEMENT OF OWNERSHIP, MANAGEMENT, AND CIRCULATION (Act of August 12, 1970; Section 3685; Title 39 United States Code) Date of Filing— October 1, 2000. Title of Publication—Journal of Diagnostic Medical Sonography; Frequency of Issue—Bimonthly; Annual Subscription Price—$103.00; Location of Known Office of Publication—Lippincott Williams & Wilkins, Inc., 12107 Insurance Way, Hagerstown, MD 21740; Location of the Headquarters or General Business Offices of the Publisher—Lippincott Williams & Wilkins, Inc., 530 Walnut Street, Philadelphia, PA 19106; Publisher—Lippincott Williams & Wilkins, Inc., 530 Walnut Street, Philadelphia, PA 19106; Editor—Julia A. Drose, University of Colorado Health Science Center, 4200 East Ninth Avenue, Denver, CO 80267; Managing Editor—Karyn Crislip, Lippincott Williams & Wilkins, 530 Walnut Street, Philadelphia, PA 19106; Owner—Society of Diagnostic Medical Sonographers, 12770 Coit Road, Suite 708, Dallas, TX 75251; Known Bond Holders, Mortgagees, and other security holders owning or holding 1 percent or more of the total amount of bonds, mortgages, or other securities—None. A. Total no. of copies printed (net press run), average 13,067, actual 13,000. B. Paid and/or requested cir- culation. Paid/requested outside-county mail subscriptions stated on form 3541, average 10,618, actual 8,149; 2. Paid in-county subscriptions, average N/A, actual N/A; 3. Sales through dealers and carriers, street vendors, counter sales, and other non-USPS paid distribution, average N/A, actual N/A; 4. Other classes mailed through the USPS, average N/A, actual N/A. C. Total paid and/or requested circulation [sum of B (1), (2), (3), and (4)], average 10,618, actual 8,149. D. Free dis- tribution by mail (samples, complimentary, and other free). Outside-county as stated on form 3541, average 427, actual 410; 2. In-county as stated on form 3541, average N/A, actual N/A; 3. Other classes mailed through the USPS, average N/A, actual N/A. E. Free distribution outside the mail (carriers or other means), aver- age N/A, actual N/A. F. Total free distribution (sum of D and E), average 427, actual 410. G. Total distribution (sum of C and F), average 11,045, actual 8,559. H. Copies not distributed, average 2,022, actual 4,441. I. Total (sum of G and H), average 13,067, actual 13,000. J. Percent paid and/or requested circulation, average 96%, actual 95%. I certify that the statements made by me above are correct and complete. Michael Wells, Manager, Periodicals Operations. 266 JDMS 16:266-267 November/December 2000 AUTHOR INDEX Volume 16, 2000 Adebayo, B.: A Follow-Up Study of Diagnostic Medical Hedrick, W.R.: Extended Field of View Real-Time Ultra- Sonography Graduates, 156 sound: A Review, 103 Hubacz, D.A.: The Role of Ultrasound in the Management of Barr, R.G.: see Peterson, C.L. a Twin Gestation with One Fetus Affected with Anen- Berg, R.: see Rama, K. cephaly, 198 Best, C.D.: Sonographic Diagnosis of Exencephaly, 230 Best, G.A.: Dissection of the Common Carotid Artery, 116 Johnson, T.M.: The Role of Ultrasound in Assessing Arterial Bieker, T.: Sonographic Evaluation of a Pancreatic Pseudocyst Dissection: Location and Extension, 234 in Conjunction with Portal Vein Thrombosis and Cav- ernous Transformation, 23 Kammerer-Doak, D.: see Rogers, R.G. Bierig, $.M., Chapman, J.V., Newman, C., Zuck, V.: Contrast Kawamura, D.M., Boyce, K.E., Shung, K.K., Calton, S.S.: Echocardiography in Clinical Practice: Integration of Con- Ultrasound Physics and Instrumentation in Clinical Prac- trast Echocardiography, 97 tice and Application: An RDMS Task Survey, 1 Boyce, K.E.: see Kawamura, D.M. Khoury, M.: see Rama, K. Bray, J., Gardner, K.: Diagnostic Challenge, 166 Bryant, $.0., Drose, J.A., Rubinstein, D., Cajade-Law, A.: Layton, G.A.: see Stephenson, S.R. Unusual Appearance of a Neonatal Brain Lesion, 194 Little, K.: see Stephenson, S.R. Burton, E.B.K.: Sonographic Evaluation of an Anembryonic Cervical Pregnancy Treated with Methotrexate, 110 Magner, R., Clagett, G.: Diagnostic Challenge Byrn, E: see Rogers, R.G. Manning, M., Ressler, E.: Diagnostic Challenge, 129 Meacham, R.B., Childs, $.J.: Testis Conservation in the Set- Cajade-Law, A.: see Bryant, $.O. ting of Intratesticular Tumor: The Role of Intraoperative Carlton, S.S.: see Kawamura, D.M. Ultrasound Guidance, 191 Chapman, J.V.: see Bierig, $.M. Merton, D.A.: An Easily Implemented Method to Improve Childs, S.J.: see Meacham, R.B. Detection of Ultrasound Contrast in Body Tissues: Frame- Clagett, G.: see Magner, R. one Imaging, 14 Coffin, C.: see Russ, P.D. Messina, L.P., Craigo, S.: Prenatal Diagnosis of Twin Reversed Cohen, H.L.: see Safriel, Y. Arterial Perfusion Sequence, 65 Colaiuta, E.: see Rama, K. Miller, M.: see Rogers, R.G. Conway, S.: see Rogers, R.G. Milligan, C.L.: see Hedrick, W.R. Craig, M.: Philippe Jeanty and The Fetus.net, 160 Moffatt, M.: see Estell, T. Craig, M.: Retaining Staff Sonographers, 124 Craig, M.: Sonographers on Safari, 37 Moffatt, M.D., Pantelic, M.V., Zylak, C.: Hepatic Candidiasis Complicating Acute Myelogenous Leukemia: Sonographic, Craig, M.: Unforgettable Ultrasound Moments II, 234 CT, and MRI Findings, 225 Craigo, S.: see Messina, L.P. Newman, C.: see Bierig, S.M. Drose, J.A.: see Bryant, $.O. Nichols, S.: see Rama, K. Drose, J.A.: see Scalf, T.C. Estell, T., Moffatt, M.: Diagnostic Challenge, 80 Pantelic, M.V.: see Moffatt, M.D. Evans, K.D., Sachs, L.: Effectiveness of a Sonography Dis- Peterson, C.L., Barr, R.G.: Contrast-Enhanced Sonography in tance-Learning Event for Continuing Medical Education Patients with Renal Pathology, 53 Premec, K.: Diagnostic Challenge, 41 Credit, 148 Evans, K.D.: A Cost Utility Analysis of Sonohysterography Price, $.M.: Sociopolitical Symposium: Ultrasound Education Compared with Hysteroscopic Evaluation for Dysfunc- for Emergency Medicine Physicians, 119 tional Uterine Bleeding, 68 Rama, K., Greene, K., Nichols, S., Berg, R., Khoury, M., Flynn, L.: see Rama, K. Colaiuta, E., Flynn, L.: Ultrasound-guided Thrombin Injec- Freeman, A.: The Influences of Ultrasound-Stimulated tion of an AVF Pseudoaneurysm, 34 Paternal—Fetal Bonding and Gender Identification, 237 Rasmussen, T.L.: The Use of Ultrasound to Identify Fetuses with Macrosomia in Diabetic Pregnancies: A Review of Gardner, K.: see Bray, J. Current Literature, 76 Green, K.: see Rama, K. Ressler, E.: see Manning, M. Rogers, R.G., Kammerer-Doak, D., Miller, M., Byrn, E, Con- Hall, R.: see Rogers, R.G. way, S., Hall, R.: A Comparison of Ultrasound and Surgi- Having, K.: Obstetrical Sonography: Opportunities for cal Findings in Suspected Ectopic Pregnancy, 60 “Teachable Moments” in Patient Care, 232 Rubinstein, D.: see Bryant, S.O. Hedrick, W.R., Milligan, C.L.: Mirror Image Artifact Pro- Russ, P.D., Tomaszewski, G., Coffin, C.: Pelvic Varices Mim- duced by Cardiac Pacemaker, 26 icking Placenta Percreta at Sonography, 183 AUTHOR INDEX 267 Sachs, L.: see Evans, K.D. Tomaszewski, G.: see Russ, P.D. Safriel, Y., Cohen, H.L., Torrisi, J.: Ultrasound Imaging of Torrisi, J.: see Safriel, Y. Scrotal Wall Thickening and Its Significance in the Diag- nosis of Fournier’s Gangrene in Older Men, 29 Zabala, V.A.: The Role of Ultrasound in the Diagnosis of Joint Scalf, T.C., Drose, J.A.: Ultrasound Diagnosis of a Common Hip Effusions in Small Children, 73 Carotid Artery Pseudoaneurysm, 202 Zuck, V.: see Bierig, $.M. Scotton, M.: Contrast Echocardiography in the Diagnosis of Zylak, C.: see Moffatt, M.D. Partial Anomalous Pulmonary Venous Return, 113 Shung, K.K.: see Kawamura, D.M. Stephenson, S.R., Layton, G.A., Little, K.: Sonographic Appearance of Primary Fallopian Adenocarcinoma, 143 Answer to Diagnostic Challenge ondary to hyperemia may also be seen surrounding the area. Stress fracture of second metatarsal At the completion of the healing process, an DISCUSSION irregular contour of the bony, secondary to a cicatrix, will be seen. Ultrasound is not the modality of choice for In this case, the original radiograph did not evaluating bone fractures. However, with the show a fracture. This is not unusual with stress advent of higher frequency, broad bandwidth fractures. The radiograph taken one week later transducers, superficial bone abnormalities may did show a small fracture line in both an anteri- be detected. Ultrasound may be particularly help- or-posterior (Fig. 1) and lateral (Fig. 2) projec- ful in accessing subtle bony fractures accompa- tions. The ultrasound of the second metatarsal nied by swelling, because these can be missed by (Fig. 3) showed callus formation (arrow) with plain radiograph. ' acoustic shadowing at the site of the fracture. Fractures undergo healing in several phases. Hypoechoic areas within the surrounding tissue, Hematoma forms secondary to the injury. This consistent with edema, were also appreciated. accounts for the initial swelling that accompanies The sonographic appearance of callus forma- these injuries. Over time, connective tissue cells tion can be appreciated even more when com- and subsequently cartilage cells develop within pared to the image of the normal third metatarsal the hematoma. This gives rise to an irritation cal- (Fig. 4). lus, which gradually converts to a hard fixation Sonography is not the modality of choice to callus.’ The callus serves to stabilize the fracture. evaluate bone fractures. It may however provide The healing process is complete when the callus useful information in the evaluation of the heal- formation calcifies. ing process. Additionally, it may aid in detecting Sonography may be used to evaluate any of the secondary signs of small fractures that are these stages. In the early stages of fracture heal- not visible on a plain film radiograph. ing, hematoma will appear sonographically as a hypoechoic area that alters the adjacent muscles. Color Doppler may show blood vessels proximal References to and within the fracture site.’ In the setting of a compound fracture, dis- 1. Wang CL, Shieh JY, Wang TG, Hsieh FJ: Sonographic detection of occult fractures in the foot and ankle. J Clin placement of the bone itself may be visualized. Ultrasound 1999;27(8):421-425. This is usually not possible with a stress fracture. . Rizzatto G, Abbona M, Mininel G: Bone and callus, in As callus formation occurs and calcifies, an Solbiati L, Rizzatto G (eds), Ultrasound of Superficial echogenic area proximal to the fracture, which Structures: High frequencies, Doppler and interventional attenuates the sound beam, will be present. Areas procedures. Edinburgh: Churchill Livingstone, 1995, pp of inflammation and increased blood flow sec- 375-382.

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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.