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Ultrasound Examination (ultrasound + examination)
Kinds of Ultrasound Examination Selected AbstractsHigh-resolution sonography of sublingual spaceJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 2 2008P Jain Summary Ultrasound examination of the sublingual region is a non-invasive, safe, inexpensive and widely available procedure, unaffected by the amalgam in teeth which is a source of considerable artefact on CT and MRI images. With a little practice and good understanding of the anatomy, ultrasound can be a very helpful primary examination. If the lesion is clearly seen, no further imaging may be required. [source] Evidence for shoulder girdle dystonia in selected patients with cervical disc prolapseMOVEMENT DISORDERS, Issue 4 2002Georg Becker MD Abstract Some patients with cervical disc herniation suffer from persistent nuchal pain and muscle spasms after decompressive surgery despite the lack of clinical and radiological signs for actual spinal root compression. Sonographic examination of the brain in some of these patients showed increased echogenicity of the lentiform nuclei as described in patients with idiopathic dystonia. This has been linked to an altered Menkes protein level and copper metabolism. We suggest a relationship between persistent nuchal pain after adequate cervical disc surgery and dystonic movement disorders. Thirteen patients with persistent nonradicular nuchal pain after at least one cervical disc surgery and without evidence of continuing spinal root compression and 13 age-matched controls were included. All patients had a complete neurological examination, ultrasound, and MRI scan of the brain. In addition, Menkes protein mRNA levels of leucocytes were analyzed in patients and controls. All patients with persistent nuchal pain exhibited a constant tonic unilateral shoulder elevation associated with an ipsilateral hypertrophy of the trapezius muscle. Ultrasound examination showed an increased echogenicity of the lentiform nucleus in one patient unilaterally and in 10 patients bilaterally but in none of the controls. On MRI the T2-values of the lentiform nuclei were found to be higher in patients exhibiting a hyperechogenicity of the lentiform nuclei compared to controls (P = 0.01). In addition, Menkes protein mRNA levels were decreased in patients with cervical disc herniation (P = 0.03). Clinical, neuroimaging, and biochemical findings of this selected patient sample with chronic nuchal pain and muscle spasms after cervical disc surgery resemble alterations in patients with idiopathic cervical dystonia. This suggests a link between both disorders. A peripheral trauma to the nerve roots may precipitate dystonic movements in susceptible patients and chronic dystonic muscle contraction would account for the persistent nuchal pain. © 2002 Movement Disorder Society [source] Foreign body granuloma in the submental region due to fish bone: a case reportORAL SURGERY, Issue 1-2 2010X. Ding Abstract The purpose of this article was to describe the clinical and microscopic features of a foreign-body granuloma in submental region that resulted from a fish bone embedded in the floor of mouth. A 45-year-old female patient complained of a hard mass in submental region. Clinical examination showed a non-compressible, firm, fixed lump, painless on palpation. Ultrasound examination showed an internally uneven, uncircumscribed, hypoechoic mass with a steaky hyperechoic spot of 1.1 cm length in the center. A microscopic examination showed newly-formed granuloma, composed of lympocytes and epithelioid cells, and some microabscess with neurophiles. The final diagnosis was a foreign-body granuloma with fish bone. Even though foreign-body granulomas in submental region are rare lesions, surgeon should be familiar with their features and include them in the differential diagnosis of tissue masses. [source] Concurrent xanthogranulomatous orchiepididymitis and seminoma in the same testisPATHOLOGY INTERNATIONAL, Issue 1 2010J. Fernando Val-Bernal Xanthogranulomatous orchiepididymitis (XGO) is a rare inflammatory and destructive disease of the testis that may simulate testicular malignancy. To the authors' knowledge only 19 cases of XGO have been previously reported. Herein is reported the case of a 52-year-old man with XGO who presented with a left testicular mass and pyogenic discharge from the scrotum. Ultrasound examination indicated heterogeneous testicular areas suggestive of neoplasia. Testicular tumor markers were normal. Orchidectomy was performed and histopathology showed XGO and a concurrent, occult typical seminoma. As far as the authors know the coincidence of these two lesions has not been documented previously. XGO may mimic testicular malignancy and may coexist with it. Pathologists should be aware of this concurrence of lesions to avoid potential misdiagnosis. Wide sampling of the orchidectomy specimens with XGO is mandatory to exclude an occult seminoma. [source] Maternal serum biochemistry at 11,13+6 weeks in relation to the presence or absence of the fetal nasal bone on ultrasonography in chromosomally abnormal fetuses: an updated analysis of integrated ultrasound and biochemical screeningPRENATAL DIAGNOSIS, Issue 11 2005Simona Cicero Abstract Background Screening for trisomy 21 by a combination of maternal age, fetal nuchal translucency (NT) thickness and maternal serum free ,-hCG and pregnancy associated plasma protein-A (PAPP-A) at 11,13+6 weeks of gestation is associated with a detection rate of 90%, for a false-positive rate of 5%. Recent evidence suggests that in about 70% of fetuses with trisomy 21 the nasal bone is not visible at the 11,13+6 week scan and that the frequency of absence of nasal bone differs in different ethnic groups. In addition, there is a relationship between absent nasal bone and nuchal translucency thickness. In a preliminary study we showed that while PAPP-A levels were lower and free ,-hCG levels were higher in trisomy 21 fetuses with an absent nasal bone, this difference was not statistically different. In fetuses with trisomy 13 and trisomy 18, there is also a high (57 and 67%) incidence of an absent nasal bone. The aim of this present study was to extend our examination of whether the level of maternal serum biochemical markers is independent of the presence or absence of the nasal bone in cases with trisomy 21 and to ascertain if any differences exist in cases with trisomies 13 and 18. Methods This study data comprised 100 trisomy 21 singleton pregnancies at 11,13+6 weeks of gestation from our previous study and an additional 42 cases analysed as part of routine OSCAR screening. A total of 34 cases with trisomy 18 and 12 cases with trisomy 13 were also available. Ultrasound examination was carried out for measurement of fetal NT and assessment of the presence or absence of the fetal nasal bone. Maternal serum free ,-hCG and PAPP-A were measured using the Kryptor rapid random access immunoassay analyser (Brahms Diagnostica AG, Berlin). The distribution of maternal serum free ,-hCG and PAPP-A in chromosomally abnormal fetuses with absent and present nasal bone was examined. Results The nasal bone was absent in 29 and present in 13 of the new trisomy 21 cases and in 98 (69%) and 44 respectively in the combined series. For the trisomy 18 cases, the nasal bone was absent in 19 (55.9%) cases and in 3 (25%) of cases of trisomy 13. There were no significant differences in median maternal age, median gestational age, NT delta, free ,-hCG MoM and PAPP-A MoM in trisomy 21 fetuses with and without a visible nasal bone, and similarly for those with trisomies 13 or 18. For a false-positive rate of 5%, it was estimated that screening with the four markers in combination with maternal age would be associated with a detection rate of 96% of cases with trisomy 21. For a false-positive rate of 0.5%, the detection rate was 88%. Conclusions There is no relationship between an absent fetal nasal bone and the levels of maternal serum PAPP-A or free ,-hCG in cases with trisomies 13, 18 or 21. An integrated sonographic and biochemical test at 11,13+6 weeks can potentially identify about 88% of trisomy 21 fetuses for a false-positive rate of 0.5%. Copyright © 2005 John Wiley & Sons, Ltd. [source] Possible human chimera detected prenatally after in vitro fertilization: a case reportPRENATAL DIAGNOSIS, Issue 11 2003B. Simon-Bouy Abstract Background Chimerism is the coexistence of more than one cell line in an individual, due to the fusion of originally separate zygotes. It has been very rarely described in humans. Methods A 36-year-old woman who was referred for in vitro fertilization (IVF) for unexplained infertility had three embryos transferred. Results Four weeks and five days after the transfer, ultrasound examination detected a single fetus in the uterus. Ultrasound examination at 17 weeks for metrorrhagia showed severe intrauterine growth retardation. Amniocentesis revealed a mixture of 46,XY and 46,XX clones. Histopathologic examination showed a dysmorphic fetus with female phenotype and severe growth retardation. Conclusions Although demonstration by fingerprinting has not been possible, fusion of two of the three transferred embryos (one male and one female) seems to be the most probable mechanism that could explain both cytogenetic and histopathologic observations. No chimera has yet been described after IVF. It would be interesting to collect any such observations from other IVF centers. Copyright © 2003 John Wiley & Sons, Ltd. [source] Integrated ultrasound and biochemical screening for trisomy 21 using fetal nuchal translucency, absent fetal nasal bone, free ,-hCG and PAPP-A at 11 to 14 weeksPRENATAL DIAGNOSIS, Issue 4 2003Simona Cicero Abstract Background Screening for trisomy 21 by a combination of maternal age, fetal nuchal translucency (NT) thickness and maternal serum free ,-hCG and pregnancy-associated plasma protein-A (PAPP-A) at 11 to 14 weeks of gestation is associated with a detection rate of 90% for a false-positive rate of 5%. Recent evidence suggests that in about 70% of fetuses with trisomy 21, the nasal bone is not visible at the 11th- to 14th-week scan (Cicero et al., 2001). The aim of this study was to examine whether fetal NT thickness and the level of maternal serum biochemical markers is independent of the presence or absence of the nasal bone, and to estimate the performance of a screening test that integrates the two sonographic and the two biochemical markers. Methods This was a retrospective case-control study comprising 100 trisomy 21 and 400 chromosomally normal singleton pregnancies at 11 to 14 weeks of gestation. Ultrasound examination was carried out for measurement of fetal NT and assessment of the presence or absence of the fetal nasal bone. Maternal serum free ,-hCG and PAPP-A were measured using the Kryptor rapid random-access immunoassay analyser (Brahms Diagnostica GmbH, Berlin). The distribution of fetal NT, maternal serum free ,-hCG and PAPP-A in trisomy 21 fetuses with absent and present nasal bone was examined. Results The nasal bone was absent in 69 and present in 31 of the trisomy 21 fetuses. There were no significant differences in median maternal age, median gestational age, NT delta, free ,-hCG MoM and PAPP-A MoM in trisomy 21 fetuses with and without a visible nasal bone. For a false-positive rate of 5%, it was estimated that screening with the four markers in combination with maternal age would be associated with a detection rate of 97%. For a false-positive rate of 0.5%, the detection rate was 90.5%. Conclusions An integrated sonographic and biochemical test at 11 to 14 weeks can potentially identify about 90% of trisomy 21 fetuses for a false-positive rate of 0.5%. Copyright © 2003 John Wiley & Sons, Ltd. [source] Insulin, insulin propeptides and intima-media thickness in the carotid artery in 58-year-old clinically healthy men.DIABETIC MEDICINE, Issue 2 2002Insulin Resistance study (AIR), The Atherosclerosis Abstract Aims To examine the relationship between specific (intact) insulin, insulin propeptides and subclinical atherosclerosis. Methods A cross-sectional study based on a stratified sampling of randomly selected, clinically healthy 58-year-old men (n = 391). Ultrasound examinations of the carotid arteries were performed with measurement of intima-media thickness (IMT) in the common carotid artery and in the carotid artery bulb. Fasting, cross-reacting plasma insulin (RIA), specific (intact) insulin, proinsulin, 32,33 split proinsulin and C-peptide were measured. Results Plasma concentrations of cross-reacting plasma insulin, specific insulin, proinsulin, 32,33 split proinsulin and C-peptide were univariately associated with common carotid artery IMT. Established risk factors such as blood pressure, smoking, apoB, triglycerides, body mass index (BMI), and waist,hip ratio were also related to IMT. After adjustment for smoking, apoB, blood pressure and triglycerides, cross-reacting plasma insulin, proinsulin and C-peptide but not specific insulin and split 32,33 proinsulin remained associated with carotid artery IMT. No associations remained after adjustment for BMI. Conclusions Fasting plasma proinsulin, C-peptide, and insulin by cross-reacting RIA was associated with common carotid artery IMT independent of several conventional risk factors for atherosclerosis. The multicollinearity between the insulin peptides and propeptides makes it difficult to clarify the exact role of each peptide. [source] Post-thyroid FNA testing and treatment options: A synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference,,DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2008Lester J. Layfield M.D. Abstract The National Cancer Institute (NCI) sponsored the NCI Thyroid Fine Needle Aspiration (FNA) State of the Science Conference on October 22,23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational Web site and several on-line discussion periods between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document addresses follow-up procedures and therapeutic options for suggested diagnostic categories. Follow-up options for "nondiagnostic" and "benign" thyroid aspirates are given. The value of ultrasound examination in the follow-up of "nondiagnostic" and "benign" thyroid aspirates is discussed. Ultrasound findings requiring reaspiration or surgical resection are described as are the timing and length of clinical and ultrasonographic surveillance for cytologically "benign" nodules. Options for surgical intervention are given for the diagnostic categories of "atypical/borderline," "follicular neoplasm," "suspicious for malignancy" and "malignant" (http://thyroidfna.cancer.gov/pages/info/agenda/). Diagn. Cytopathol. 2008;36:442,448. © 2008 Wiley-Liss, Inc. [source] Transesophageal and Transpharyngeal Ultrasound Demonstration of Reversed Diastolic Flow in Aortic Arch Branches and Neck Vessels in Severe Aortic RegurgitationECHOCARDIOGRAPHY, Issue 4 2004Deepak Khanna M.D. In the current study, we describe an adult patient with torrential aortic regurgitation due to an aortic dissection flap interfering with aortic cusp motion, in whom a transesophageal echocardiogram with the probe positioned in the upper esophagus and transpharyngeal ultrasound examination demonstrated prominent reversed flow throughout diastole in the left subclavian, left vertebral, left common carotid, and left internal carotid arteries. Another unique finding was the demonstration of aortic valve leaflets held in the fully opened position in diastole by the dissection flap as it prolapsed into the left ventricular outflow tract, dramatically documenting the mechanism of torrential aortic regurgitation in this patient. (ECHOCARDIOGRAPHY, Volume 21, May 2004) [source] Ultrasound Training for Emergency Physicians, A Prospective StudyACADEMIC EMERGENCY MEDICINE, Issue 9 2000Diku P. Mandavia MD Abstract. Objectives: Bedside ultrasound examination by emergency physicians (EPs) is being integrated into clinical emergency practice, yet minimum training requirements have not been well defined or evaluated. This study evaluated the accuracy of EP ultrasonography following a 16-hour introductory ultrasound course. Methods: In phase I of the study, a condensed 16-hour emergency ultrasound curriculum based on Society for Academic Emergency Medicine guidelines was administered to emergency medicine houseofficers, attending staff, medical students, and physician assistants over two days. Lectures with syllabus material were used to cover the following ultrasound topics in eight hours: basic physics, pelvis, right upper quadrant, renal, aorta, trauma, and echo-cardiography. In addition, each student received eight hours of hands-on ultrasound instruction over the two-day period. All participants in this curriculum received a standardized pretest and posttest that included 24 emergency ultrasound images for interpretation. These images included positive, negative, and nondiagnostic scans in each of the above clinical categories. In phase II of the study, ultrasound examinations performed by postgraduate-year-2 (PGY2) houseofficers over a ten-month period were examined and the standardized test was readministered. Results: In phase I, a total of 80 health professionals underwent standardized training and testing. The mean ± SD pretest score was 15.6 ± 4.2, 95% CI = 14.7 to 16.5 (65% of a maximum score of 24), and the mean ± SD posttest score was 20.2 ± 1.6, 95% CI = 19.8 to 20.6 (84%) (p < 0.05). In phase II, a total of 1,138 examinations were performed by 18 PGY2 houseofficers. Sensitivity was 92.4% (95% CI = 89% to 95%), specificity was 96.1% (95% CI = 94% to 98%), and overall accuracy was 94.6% (95% CI = 93% to 96%). The follow-up ultrasound written test showed continued good performance (20.7 ± 1.2, 95% CI = 20.0 to 21.4). Conclusions: Emergency physicians can be taught focused ultrasonography with a high degree of accuracy, and a 16-hour course serves as a good introductory foundation. [source] ALK probe rearrangement in a t(2;11;2)(p23;p15;q31) translocation found in a prenatal myofibroblastic fibrous lesion: Toward a molecular definition of an inflammatory myofibroblastic tumor family?GENES, CHROMOSOMES AND CANCER, Issue 1 2001Nicolas Sirvent A prenatal tumor located in the lumbar paravertebral area was discovered during a routine ultrasound examination at 32 weeks of pregnancy and surgically removed at 4 months of life. The histopathological diagnosis was first suggested to be an infantile desmoid fibromatosis. The tumor karyotype showed a three-way translocation involving both chromosomes 2 and a chromosome 11, t(2;11;2)(p23;p15;q31). Fluorescence in situ hybridization with a probe flanking the ALK gene at 2p23 demonstrated a rearrangement, as previously described in inflammatory myofibroblastic tumors (IMTs). In light of the genetic analysis, the histopathological diagnosis was revised to IMT, although inflammatory cells were scarce. IMTs are pseudosarcomatous inflammatory lesions that primarily occur in the soft tissue and viscera of children and young adults. Our report describes for the first time the occurrence of IMT during prenatal life. The ALK rearrangement may represent the molecular definition of a subgroup of mesenchymal tumors, not always with complete morphological features of IMT, similar to the model of EWS rearrangement in the Ewing sarcoma family of tumors. © 2001 Wiley-Liss, Inc. [source] Assessment of progestin-only therapy for endometriosis in macaqueJOURNAL OF MEDICAL PRIMATOLOGY, Issue 2008G. Maginnis Abstract Background, Endometriosis is a condition where endometrium-like tissue forms lesions at ectopic sites outside the uterus. In women, oral contraceptive pills and progestins are often prescribed as therapy for early stage endometriosis. In contrast, in macaques the disease is frequently advanced at the time of diagnosis and ovariectomy is the standard therapy. However, surgery is contraindicated in many patients. A review of 15 endometriosis cases over the past 10 years at the Oregon National Primate Research Center (ONPRC) revealed that 5 failed to show improvement after ovariectomy and were subsequently euthanized. Therefore, our goal was to assess the feasibility of treating endometriosis in macaques with chronic progesterone (P) as an alternative therapy for the disease. Methods, Seven adult rhesus macaques with advanced endometriosis were identified by clinical symptoms and endometriosis was confirmed by abdominal palpation, ultrasound examination, and/or aspiration of menstrual blood from abdominal cysts. The patients were chronically treated with Silastic capsules that released 5,7 ng P /ml in blood for up to 20 months. During treatment the patients were assessed daily and scored numerically for appetite, activity, attitude, abdominal discomfort and menstruation by the Clinical Veterinary staff. The patients were then re-examined by abdominal palpation and ultrasound for the disease at the end of treatment. Results, During the first 2 weeks of treatment, endometriotic symptoms improved significantly in all the patients (P < 0.05). This was associated with a significant increase in body weight and significant reduction in abdominal discomfort and menstrual bleeding. Two of the patients gradually developed increased symptoms of the disease after 5 months of treatment. Post-treatment abdominal examination revealed that 2/5 patients continued to have an abdominal mass even though symptoms were suppressed. Conclusions, We conclude that continuous P treatment of rhesus monkeys provides therapeutic benefit to reduce symptoms of endometriosis and may provide an option for cases where ovariectomy is contraindicated. Supported by RR-00163. [source] Parents' Experiences, Reactions and Needs Regarding a Nonviable Fetus Diagnosed at a Second Trimester Routine UltrasoundJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 4 2008Maria Ekelin ABSTRACT Objective: To conceptualize women's and their partners' experiences and ways of handling the situation before, during, and after second trimester ultrasound examination with the diagnosis of a nonviable fetus. Design: A grounded theory study. Setting: A Swedish regional hospital. Participants: Nine women and 6 men (n=15) were interviewed within a year of the event. Results: The core category was Unexpected change in life. Four categories that were encompassed by the core category emerged: (a) Deceived by a false sense of security; (b) Confronting reality; (c) Grieving; and (d) Reorientation. Conclusion: These parents were unprepared for the diagnosis of a nonviable fetus. In addition to the crisis reaction, they realized that the sense of security they had experienced was false. As different care givers were involved, the need for a care plan was evident. Support from care givers was a very important factor. [source] Primary omental ectopic pregnancyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2004Wai Chung Wong Abstract Omental ectopic pregnancy is a rare form of ectopic pregnancy. Presented here is a case primary omental ectopic pregnancy according to Studdiford's criteria. This patient presented with epigastric pain and anemia without vaginal bleeding, lower abdominal or pelvic pain. Pregnancy status was confirmed after admission. Transvaginal ultrasound examination revealed intrauterine contraceptive device in situ and a large amount of free peritoneal fluid, but no intrauterine sac or adnexal mass. Laparoscopy was performed but pelvic pathology did not account for the 2500 mL of haemoperitoneum. Laparotomy was carried out and partial omentectomy was performed. [source] Congenital splenic cyst: A case report and review of the literatureJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 4 2001NS Kabra Abstract: There are very few cases of antenatally diagnosed congenital splenic cyst described in literature. The present case of congenital splenic cyst was first suspected on ultrasound examination at 20 weeks of gestation and followed subsequently. Its exact location in the spleen was found on postnatal ultrasound examination. The aetiology, differential diagnosis, complications and management strategies of this lesion are also discussed . [source] Renal transplant recipients are at high risk for both symptomatic and asymptomatic deep vein thrombosisJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 5 2006D. POLI Summary.,Background:,Venous thromboembolism (VTE) is one of the thrombotic complications that can occur in patients receiving renal transplantation (RT). The prevalence of VTE in RT patients is, however, undefined. Objectives: To evaluate the rate of a first episode of VTE in a series of 538 consecutive RT recipients admitted to our institution, the timing of occurrence of the thromboembolic events after transplantation, and the rate of recurrence after thromboprophylaxis withdrawal. Risk factors for recurrence were also evaluated, particularly in relation to the type of the first event (symptomatic or asymptomatic). Results:,During follow-up, 47 of 518 patients (28 males, 19 females; 9.1%) developed a first episode of VTE at a median time of 17 months (range 1,165 months) after kidney transplantation. Cancer was associated with the occurrence of VTE (odds ratio 4.8). Seventeen of 43 patients (39.5%) with deep vein thrombosis were asymptomatic and the diagnosis was made during routine ultrasound examination. Twenty-two patients (46.8%) experienced a recurrence of VTE. A relevant rate of recurrence was documented amongst patients with a first episode of both symptomatic (53%) and asymptomatic (23.5%) VTE. Conclusion:,This study confirms that RT patients are at high risk of symptomatic and asymptomatic VTE and that this risk persists even after several years. Patients who experience VTE are at high risk of recurrence after thromboprophylaxis withdrawal. [source] Gastric Neoplasia in HorsesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2009S.D. Taylor Background: Gastric neoplasia of horses is incompletely described. Objective: Provide history, clinical signs, and clinicopathological and pathological findings associated with gastric neoplasia in horses. Animals: Twenty-four horses with gastric neoplasia. Methods: Retrospective study. History, clinical signs, and clinicopathological and pathologic findings in horses diagnosed histologically with gastric neoplasia were reviewed. Results: Horses ranged in age from 9 to 25 years (median 18 years at presentation). There was no apparent breed or sex predisposition. The most common presenting complaints were inappetance (17/24), weight loss (14/24), lethargy (7/24), hypersalivation (7/24), colic (5/24), and fever (5/24). The most consistent clinical signs were tachypnea (10/19), decreased borborygmi (8/19), and low body weight (7/17). Useful diagnostic tests included rectal examination, routine blood analysis, gastroscopy, abdominocentesis, and transabdominal ultrasound examination. Anemia was the most common hematologic abnormality encountered (7/19), and hypercalcemia of malignancy was seen in 4/16 horses. Squamous cell carcinoma was the most common tumor identified (19/24), and was most often (14/19) found as a single ulcerated, necrotic mass in the nonglandular portion of the stomach. Other gastric neoplasms encountered were leiomyoma (n=2), mesothelioma (n=1), adenocarcinoma (n=1), and lymphoma (n=1). Metastatic neoplasia was found in 18/23 horses. The median time from onset of clinical signs to death was 4 weeks, and all horses died or were euthanized because of gastric neoplasia. Conclusions: Squamous cell carcinoma is the most common primary gastric neoplasia in horses. The survival time after diagnosis of gastric neoplasia in horses is short. [source] Use of Electrohydraulic Lithotripsy in 28 Dogs with Bladder and Urethral CalculiJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2008A. Defarges Background: Electrohydraulic lithotripsy (EHL) has been used as an alternative to cystotomy in human medicine to remove urinary calculi. This prospective study evaluated the efficacy and safety of EHL to remove urinary calculi in dogs. Hypothesis: EHL is an efficient and safe method of treatment of bladder and urethral calculi in dogs. Methods: Dogs presented between January 1, 2005 and June 1, 2007 with lower urinary tract calculi diagnosed by radiographs or ultrasound examination were included in the study. Physical examination, CBC, biochemistry, urinalysis, and urine culture were performed at presentation. EHL and voiding urohydropulsion were performed under general anesthesia. Patients received IV fluids for 12 hours after which they were rechecked by ultrasound examination and discharged with antibiotics and anti-inflammatory drugs for 5 days. All patients were reevaluated 1, 3, and 6 months after presentation by physical examination, urinalysis, and ultrasonography. Results: Twenty-eight dogs (19 males, 9 females) presented with bladder or urethral calculi or both underwent lithotripsy. Their median weight was 8.3 kg. Calcium oxalate calculi were present in 22 dogs, struvite in 4, and mixed calculi in 2. Fragmentation was done in the bladder (23 dogs) and in the urethra (12 dogs). Calculus-free rate was higher for urethral than for bladder calculi in males and higher for bladder calculi in females than in males. No major complications were reported. Twelve dogs relapsed within 6 months. Conclusions: Results of this study support the use of EHL as a minimally invasive treatment for bladder calculi in females and for urethral calculi in male dogs. [source] Neurologic Dysfunction in Hypothyroid, Hyperlipidemic Labrador RetrieversJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2007Christina L. Vitale Background: Hypothyroidism has been associated with a variety of neurologic signs, but the mechanism for this association is not completely understood. Hypothyroidism also is associated with hyperlipidemia that predisposes to atherosclerosis, increased blood viscosity, and thromboembolic events. Objective: The objective is to characterize neurologic signs potentially associated with hyperlipidemia and atherosclerosis in canine hypothyroidism. Animals: This study used dogs referred to North Carolina State University Veterinary Teaching Hospital for evaluation of neurologic signs. Materials and Methods: A retrospective study was conducted in which medical records of dogs with neurologic signs and a diagnosis of hypothyroidism and hyperlipidemia were reviewed. Details of the history, presenting signs, results of routine blood tests, thyroid tests, cerebrospinal fluid (CSF) analysis and diagnostic imaging, and response to therapy were compiled. Results: Three Labrador Retrievers and one Labrador Retriever cross fit the inclusion criteria. All dogs were hypothyroid and severely hyperlipidemic. Neurologic signs included tetraparesis, central and peripheral vestibular signs, facial paralysis, and paraparesis. Two dogs had an acute history and rapid resolution of signs consistent with an infarct, the presence of which was confirmed in 1 of the dogs by magnetic resonance imaging. Two dogs had chronic histories of cranial neuropathies and paraparesis. One of these dogs had evidence of iliac thrombosis and atherosclerosis on ultrasound examination. All dogs improved with thyroid hormone supplementation. Clinical Relevance: Labrador Retrievers may be predisposed to the development of severe hyperlipidemia in association with hypothyroidism. One possible consequence of severe hyperlipidemia is the development of neurologic signs due to atherosclerosis and thromboembolic events. [source] Homocysteine levels and sustained virological response to pegylated-interferon ,2b plus ribavirin therapy for chronic hepatitis C: a prospective studyLIVER INTERNATIONAL, Issue 2 2009Guglielmo Borgia Abstract Background: Chronic hepatitis C affects about 3% of the world's population. Pegylated interferon (IFN) , plus ribavirin is the gold standard treatment. Methylenetetrahydrofolate reductase(MTHFR) is a key enzyme in the metabolism of homocysteine. MTHFR gene polymorphisms and high levels of homocysteine are associated with a high degree of steatosis and fibrosis, conditions associated with a low sustained virological response (SVR) rate. Aims: To evaluate whether MTHFR polymorphisms and homocysteine levels are predictors of the outcome of treatment in 102 prospectively enrolled patients with chronic hepatitis C naive to treatment. Methods: Patients were treated with pegylated interferon ,-2b plus ribavirin. All patients underwent blood tests, assessment of homocysteine, vitamin B12, folate, hepatitis C virus (HCV)-RNA levels, screening for MTHFR gene polymorphisms and liver ultrasound examination. Results: Homocysteine levels were deranged (>16 ,mol/L) in 10.5% of MTHFR wild-type patients vs 40.3% of non-wild-type patients (P=0.015). Homocysteine levels were 14.4 ,mol/L in SVR patients and 15.5 ,mol/L in non-SVR patients (P=0.049). The SVR rate was 40.0% in MTHFR wild-type patients, 52.0% in heterozygote mutants and 39.3% in homozygote mutants (P=0.467). At logistic regression analysis, genotypes 2 and 3 (odds ratio: 12.328, 95% confidence interval: 3.390,44.837, P=0.0001), homocysteine <16 ,mol/L (odds ratio: 3.397, 95% confidence interval: 1.033,11.177, P=0.044) and aspartate aminotransferase (AST) levels <48 U/L (odds ratio: 3.262, 95% confidence interval: 1.125,9.458, P=0.029) were independent predictors of SVR. Conclusions: In patients with chronic hepatitis C, homocysteine levels are associated with the outcome of pegylated-IFN, plus ribavirin treatment, while polymorphisms of MTHFR are not. [source] Ultrasound detection of spontaneous hepato-cellular carcinomas in X/myc bitransgenic miceLIVER INTERNATIONAL, Issue 6 2004W. Mai Abstract: Aims: To evaluate trans-abdominal ultrasound for the detection of Hepatocellular carcinoma (HCC) in a bitrasgenic murine (X/myc) model using a commercially available high-frequency ultrasound unit. Methods: Sixty-one female animals were included in this study. These animals were submitted to a single ultrasound examination of the liver under general anesthesia (isoflurane), and then euthanized. Results of ultrasound were compared with necropsy and histopathology. Results: The lesions demonstrated a fairly consistent aspect (oval- or round-shaped, well-defined hypoechoic homogeneous lesions), and lesions as small as 2 mm were identified. For detection of hepatic nodules per mouse the sensitivity was 75%, the specificity was 100% and the accuracy was 88.5%. For detection of hepatic focal lesions per lesions the overall sensitivity was 60%, the specificity was 97%, and the accuracy was 75.9%. Contrast-enhanced harmonic ultrasound imaging did not improve the identification of the lesions in our experimental conditions. Conclusion: High-frequency ultrasound appears to be an efficient tool allowing new possibilities to use this animal model and evaluate new therapies in longitudinal studies, which are much more powerful. [source] Changes in bladder neck geometry and closure pressure after midurethral anchoring suggest a musculoelastic mechanism activates closureNEUROUROLOGY AND URODYNAMICS, Issue 3 2003Peter Petros Abstract Aims The aim of this study was to investigate the anatomical origins and clinical significance of cough pressure transmission ratio (CTR) by using virtual-operation (VO) techniques. Methods Thirty-four patients underwent perineal ultrasound examination, standard urethral pressure cough testing both with and without unilateral midurethral anchoring (VO), all tests being performed without urethral elevation. In eight patients where there was no change in CTR, a one-sided fold of suburethral vagina (VO) was taken (pinch test) and the CTR repeated. Results After midurethral anchoring, maximal urethral pressure increased from a mean of 33.25 cm H2O to a mean of 58.06 cm H2O (P,<,0.0001) and restoration of anatomy was noted in all 11 patients who had obvious funneling on straining. Conversion of a <100% CTR to >100% CTR in the proximal urethra was observed in 14 of 22 patients (P,<,0.005), with no significant change noted in the distal urethra. Further conversion of CTR was noted in six of the remaining eight patients with unilateral plication of suburethral vagina (pinch test). Conclusions A musculoelastic closure mechanism most likely activates urethral closure. CTR is most likely an index of changed intraurethral area, not necessarily closure, and may be a more sensitive objective test than perineal ultrasound for diagnosing urethral narrowing, especially when used with virtual-operation techniques. Neurourol. Urodynam. 22:191,197, 2003. © 2003 Wiley-Liss, Inc. [source] Ultrasound control for presumed difficult epidural punctureACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2001T. Grau Background: The efficacy of epidural anaesthesia depends on the accurate identification of the epidural space (ES). Abnormal anatomical conditions may make the procedure difficult or impossible. The aim of this study was to investigate whether pre-puncture ultrasound examination of the spinal anatomy might be beneficial in expected cases of difficult epidural anaesthesia. Methods: We used digital ultrasound equipment with a 5-MHz transducer to assess the anatomy of the ES and the posterior parts of the spinal column. We examined 72 parturients with abnormal anatomical conditions who were scheduled for epidural anaesthesia. The women were randomised into two equal groups. In all patients, the standard loss of resistance technique was used. In the ultrasound group, an ultrasound examination of the appropriate spinal region was conducted prior to epidural puncture. ES depth seen on the ultrasound images was compared to the ES depth measured by the needle. We compared the number of puncture attempts with the standard method (control group) to the number of attempts under ultrasound guidance. Results: Ultrasonography significantly improved operating conditions for epidural anaesthesia. The maximum VAS scores and patient acceptance were significantly better. Conclusions: With ultrasound measurement of the ES depth, the quality of epidural anaesthesia was enhanced. [source] Assessing number-specific error in the recall of onset of last menstrual periodPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2000D.K. Waller The goal of this investigation was to determine whether women who did not report preferred numbers for their last menstrual period (LMP) may be a group of women who are particularly careful in keeping track of their menstrual cycles and therefore have more accurate LMP dating , based on a comparison with ultrasound examinations. We also sought to estimate the frequency with which preferred numbers are reported in different sources of data and for different subgroups of women. First, we examined the 1987 California birth certificates in which LMP was collected at the time of birth (n = 504 853). We also examined the records of 43 880 women participating in the California Alpha-fetoprotein (AFP) Screening Program between 1986 and 1987, for whom gestational ages based on both early ultrasound examination and LMP were collected before 20 weeks of gestation. In the 1987 California birth certificates, seven numbers,1, 5, 10, 15, 20, 25 and 28,were recorded more frequently than expected. An estimated 12.9% of these records had preferred numbers. The most frequently recorded number was 15, occurring 2.5 times more often than expected (P < 0.01). In the data of the AFP Screening Program, the same seven numbers were preferred, and approximately 7.9% of records were affected by number preference. Comparisons with measurements of gestational age based on ultrasound demonstrated that LMP-based gestational ages in which non-preferred numbers are reported for the LMP are slightly more accurate than those in which preferred numbers are reported (P < 0.01). In most cases, number preference appears to introduce small errors into measurements of gestational age, probably as a result of rounding. Thus, the effect of number preference may be primarily of interest to research studies in which small errors in the measurement of gestational age will have a significant impact on findings. [source] Metaplastic breast carcinoma with melanocytic differentiationPATHOLOGY INTERNATIONAL, Issue 9 2009Antonia Bendic Metaplastic carcinoma of the breast is a rare heterogeneous malignancy, accounting for <1% of all invasive breast carcinomas, in which adenocarcinoma is found to coexist with an admixture of spindle, squamous, chondroid or bone-forming neoplastic cells. Metaplastic breast carcinoma composed of both epithelial and melanocytic elements is rare, and only seven cases have been reported so far. Reported herein is the case of a 38-year-old woman with a nodular mass in her left breast suspicious of malignancy, discovered during routine ultrasound examination. After histological and immunohistochemical examination of the resected tumor mass, initial diagnosis was collision tumor: ductal invasive carcinoma and metastatic melanoma. The patient underwent quadrantectomy, chemotherapy and radiotherapy. At 6 years follow up the patient was alive and healthy, without local recurrence or metastases. After revising slides and the literature, in addition to patient follow up, it was concluded that this case represents metaplastic carcinoma with melanocytic differentiation. [source] Hepatoblastoma in a child with progressive familial intrahepatic cholestasisPEDIATRIC TRANSPLANTATION, Issue 6 2005A. Richter Abstract:, End-stage liver cirrhosis because of metabolic or infectious diseases predisposes to hepatic malignancies like hepatocellular carcinoma. We report the first case of hepatoblastoma incidentally detected in the explanted liver of a 2-yr-old child undergoing liver transplantation for cirrhosis because of progressive familial intrahepatic cholestasis (PFIC). The diagnosis was difficult to obtain. The hepatoblastoma was not seen on ultrasound examination of the cirrhotic liver. As we could confirm retrospectively, alpha fetoprotein (AFP) was found elevated prior to transplantation. Two years after successful transplantation, there are no signs of malignancy detectable by clinical and radiological methods. We conclude from this case that PFIC may induce hepatoblastoma and that children with liver cirrhosis should undergo routine screening of serum AFP concentration. [source] Down syndrome screening using first-trimester combined tests and contingent use of femur length at routine anomaly scanPRENATAL DIAGNOSIS, Issue 8 2010Laurent J. Salomon Abstract Objective The objective of this study was to evaluate the performance of the contingent use of femur length (FL) at routine mid-trimester scan in screening for Down syndrome (DS) in women having previously undergone first-trimester screening with disclosure of risk estimates. Methods Data from a prospective screening trial for DS in a population of 21 492 women with 80 observed DS were used. The performance of a contingent screening strategy based on adding short FL (FL < 5th percentile) as a soft marker in women at intermediate first-trimester risks was evaluated through simulated data. Results In our population, the median (25th,75th percentile) maternal age was 30.7 years (28.0,33.9; range: 18.0,46.3). The median (25th,75th percentile) gestational age at ultrasound examination was 12 weeks 3 days (12 weeks and 12 weeks 6 days; range: 11 weeks to 13 weeks 6 days). Contingent screening allowed an improvement in screening performance. For example, using a first-trimester risk cut-off of 1/100 and an intermediate-risk population within (1/1000, 1/100) for the search of FL, a sensitivity (Se) of 88.4% at a 3% false-positive rate (FPR) was reached. With a cut-off of 1/200 and an intermediate-risk population within (1/1000, 1/200), screening would allow an Se of 92.3% at a 4% FPR. Conclusions Contingent screening could be used following first-trimester combined screening followed by second-trimester ultrasound soft markers. This could identify indications for early invasive testing in the highest risk cases and would allow efficient and simple ultrasound-based screening in the second trimester. This would provide an 88.4% Se for a 3% FPR, at no additional cost as compared to first-trimester combined screening and routine mid-trimester scan. Copyright © 2010 John Wiley & Sons, Ltd. [source] Increased nuchal translucency in euploid fetuses,what should we be telling the parents?PRENATAL DIAGNOSIS, Issue 2 2010C.M. Bilardo Abstract Nuchal translucency (NT) measurement between 11 and 14 weeks' gestation is an undisputed marker for aneuploidies. When conventional karyotyping is normal, enlarged NT is a strong marker for adverse pregnancy outcome, associated with miscarriage, intrauterine death, congenital heart defects, and numerous other structural defects and genetic syndromes. The risk of adverse outcome is proportional to the degree of NT enlargement. Although the majority of structural anomalies are amenable to ultrasound detection, unspecified genetic syndromes involving developmental delay may only emerge after birth. Concern over these prenatally undetectable conditions is a heavy burden for parents. However, following detection of enlarged NT the majority of babies with normal detailed ultrasound examination and echocardiography will have an uneventful outcome with no increased risk for developmental delay when compared to the general population. Counseling should emphasize this to help parents restore hope in normal pregnancy outcome and infant development. Copyright © 2010 John Wiley & Sons, Ltd. [source] Prenatal diagnosis of a 11q deletion syndrome associated with unilateral hydronephrosis diagnosed by 3D ultrasound examinationPRENATAL DIAGNOSIS, Issue 12 2007Magdalena Sanz-Cortes No abstract is available for this article. [source] | ||||||||||||||||||||||||||||||||||||||||