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A S Thurmond

Publications and source records attributed to A S Thurmond.

At least 19 recordsLinked to original sources
PubMed2000

Static and dynamic MRI of a urinary control intra-vaginal device.

The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra; and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal muscle; with an average angulation of 95 +/- 10 degrees with the pubis axis, laterally tilted in three of ten cases. In maximum straining with IVD bladder neck descent was lower by an average of 5.2 +/- 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 +/- 20 degrees (p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 +/- 4 mm. Posterior urethro-vesical angle was not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis.

Adult↗
PubMed1999

Tubal obstruction after ligation reversal surgery: results of catheter recanalization.

PURPOSE: To evaluate the role of transcervical fallopian tube catheterization in restoring tubal patency after ligation reversal surgery. MATERIALS AND METHODS: Twenty-four women with tubal obstruction after ligation reversal surgery underwent selective salpingography and tubal recanalization. RESULTS: Patency was established in 26 (68%) of 38 anastomotic tubes without complication. In the 13 patients who were followed up and who could conceive only via a recanalized anastomotic tube, there were six (46%) pregnancies: two (15%) successful uterine pregnancies, two (15%) early spontaneous abortions, and two (15%) tubal pregnancies. The mean time from procedure to conception was 2 months. CONCLUSION: Patency of fallopian tubes not visualized at hysterosalpingography after ligation reversal surgery can be established 68% of the time with selective salpingography. In some patients, selective salpingography can be therapeutic. If subsequent conception occurs in these patients, it occurs shortly after the catheterization procedure.

Abortion, Spontaneous↗
PubMed1999

Cesarean section scar as a cause of abnormal vaginal bleeding: diagnosis by sonohysterography.

A previously undescribed cause of abnormal uterine bleeding is presented. Nine of 310 women evaluated by sonohysterography for abnormal bleeding demonstrated an 8 to 17 mm gap in the anterior lower uterine segment myometrium at the site of prior cesarean deliveries. All women were premenopausal and had a history of 2 to 12 days of postmenstrual spotting. Presumably a lack of coordinated muscular contractions occurs around the cesarean scar, allowing the defect to collect menstrual debris. Subsequently, the debris leaches out through the cervix for several days after the majority of menstrual flow has ceased.

Adult↗
PubMed1997

Endoscopic transvaginal approach to the rabbit uterine cervix: improvement in the technique of selective tubal catheterization.

RATIONALE AND OBJECTIVES: The authors compared two methods of selective fallopian tube catheterization in female rabbits. METHODS: Technical success rates and procedure times in two groups of animals were compared. Group 1 consisted of 20 female rabbits catheterized with a fluoroscopic technique. Group 2 consisted of 55 rabbits catheterized with a combination of endoscopic and fluoroscopic guidance. RESULTS: The technique used in group 2 allowed a statistically significant reduction in the time required for cervical catheterization and the total procedural time (P < .01). There was a parallel statistically significant reduction in fluoroscopy time (P < .01). Technical success rates and adverse effects were similar for the two techniques. CONCLUSION: The combined endoscopic-fluoroscopic technique requires a shorter time than the established fluoroscopic technique and should be considered for future selective tubal catheterization experiments in rabbits.

Animals↗
PubMed1996

Focal calcifications in otherwise ultrasonographically normal ovaries.

PURPOSE: To analyze the natural history, clinical importance, and need for follow-up in patients with discrete calcifications in otherwise ultrasonographically (US) normal ovaries. MATERIALS AND METHODS: US scans obtained in 28 women with ovarian calcifications but without masses or other structural abnormalities were retrospectively reviewed. Follow-up findings were available in 15 women (mean age, 38.0 years; range, 26-72 years). RESULTS: Two of the 15 women had trilateral calcifications. Thus, 17 ovaries had focal calcifications. Histopathologic confirmation was obtained in 10 cases; follow-up US findings, five cases; and follow-up laparoscopic findings, two cases. In 13 (76%) of the 17 ovaries, calcifications were not clinically important. In four (24%) of the 17, the calcification was the initial or only manifestation of a neoplasm. Lesions were benign in all four of these ovaries: There was one dermoid, one mucinous cystadenoma, and two adenofibromas. CONCLUSION: Until more data are available, findings of calcifications in ovaries with otherwise normal US findings warrant some form of follow-up.

Adult↗
PubMed1995

Circumvallate placenta: sonographic diagnosis.

We prospectively identified 12 patients who had a shelf at the margin of the placenta consistent with the diagnosis of circumvallate placenta. Ten patients were followed to delivery and three placentas were sent for pathologic analysis. Circumvallate placenta was diagnosed by gross inspection in all three but was confirmed by microscopic analysis in only two. One of these patients had placental abruption and cesarean delivery for fetal distress at 27 weeks. Circumvallate placenta is another cause of uterine band, sheet, or shelf. The finding can be associated with a normal obstetric outcome but may predispose to placental complications.

Abruptio Placentae↗
PubMed1995

Salpingitis isthmica nodosa: results of transcervical fluoroscopic catheter recanalization.

OBJECTIVE: To investigate the role of transcervical tubal catheterization in diagnosis and treatment of proximal tubal obstruction associated with salpingitis isthmica nodosa. DESIGN: Retrospective case study. SETTING: University hospital and outpatient radiology practice. PATIENTS: Fifty-two women with proximal tubal obstruction associated with salpingitis isthmica nodosa. INTERVENTION: Selective salpingography and catheter recanalization using fluoroscopic guidance. MAIN OUTCOME MEASURES: The number of tubes visualized to the fimbria as a percentage of the tubes with proximal tubal obstruction on the initial hysterosalpingogram was determined as a measure of diagnostic efficacy. To evaluate the treatment potential of catheter recanalization, the patients were grouped according to tubal status at the conclusion of the procedure and subsequent pregnancies were evaluated. RESULTS: Forty-seven of 65 tubes (72%) with proximal tubal obstruction were recanalized successfully. Among the 19 women who were able to conceive only via a recanalized salpingitis isthmica nodosa tube, there were 6 live births (32%) and two tubal pregnancies (10%). CONCLUSION: Selective salpingography allows complete tubal diagnosis in almost three fourths of patients with proximal tubal obstruction and salpingitis isthmica nodosa. The radiographic diagnosis of salpingitis isthmica nodosa may be pressure dependent. Intrauterine pregnancies occur via recanalized salpingitis isthmica nodosa tubes, therefore catheter recanalization may be attempted before tubal microsurgery or IVF in patients with proximal tubal obstruction and associated salpingitis isthmica nodosa.

Adult↗
PubMed1994

Transcatheter tubal sterilization in rabbits. Technique and results.

RATIONALE AND OBJECTIVES: A potential method of nonsurgical tubal sterilization was tested in rabbits. METHODS: Metal coils were designed which could be placed into the uterotubal junction using transvaginal fluoroscopic fallopian tube catheterization. These metal coils were successfully placed unilaterally in the uterotubal junction of 32 rabbits. The contralateral fallopian tube and uterus were used as a control. The rabbits were bred, and the presence of pregnancies was confirmed by palpation. RESULTS: In 21 rabbits (66%), the coil stayed in place. Sixteen rabbits had multiple gestations on the side without the coil and no gestations on the side with the coil. Three rabbits had gestations on both sides, even though the coil was in place, and two rabbits never conceived. In 11 rabbits (34%) the coil was dislodged as early as 5 days and as late as 18 weeks after the procedure. Five of these 11 rabbits had bilateral embryos, 4 had embryos only on the side contralateral to where the coil had been, and 2 never conceived. CONCLUSIONS: The metal coil does prevent conception if it stays in place at the uterotubal junction. However, the coil failed to prevent pregnancy in 3 of 19 rabbits, and was dislodged in 11 rabbits, giving an overall failure rate for contraception of 44%.

Animals↗
PubMed1994

Localization of contraceptive implant capsules for removal.

Implanted contraceptive capsules occasionally cannot be removed by means of palpation with local dissection, and imaging guidance is necessary. The authors report obtaining a single antero-posterior radiograph of the upper arm followed by sonography to localize the capsule and to allow precise marking of the skin over the capsules. The method can be performed quickly and is inexpensive and effective, allowing the localization and removal procedures to be scheduled independently.

Adult↗
PubMed1994

Selective tubal sterilization in rabbits: experience with a hydrogel combined with a sclerosing agent.

PURPOSE: To test a method of nonsurgical sterilization. MATERIALS AND METHODS: A hydrogel that forms an in situ plug by phase inversion of a polymer solution was placed into fallopian tubes of eight rabbits by means of transvaginal rabbits by means of transvaginal fluoroscopic fallopian tube catheterization. The rabbits were bred, and the presence of embryos was confirmed with palpation and at autopsy. RESULTS: Seven of the eight rabbits became pregnant. Six of these rabbits contained embryos in the control uterus but not in the uterus on the side of the hydrogel injection. The seventh rabbit had embryos in both uteri, but the hydrogel had been expelled. All seven tubes that contained hydrogel showed evidence of acute and chronic salpingitis and a foreign-body reaction. The tube from which hydrogel had been expelled and the eight control tubes were not inflamed. CONCLUSION: Transcervical catheter methods of tubal occlusion and sterilization are promising, but a non-reactive material is needed.

Acrylonitrile↗
PubMed1994

An improved method of needle localized biopsy of nonpalpable lesions of the breast.

We have created a modified technique of localization biopsy of the breast that more easily identifies the position of the wire tip after placement and before biopsy. After wire placement, metallic skin markers are placed on the nipple and wire entry site. The patient is then positioned on a roentgenography table in the same position to be used during biopsy. A supine roentgenogram of the breast is obtained. At the time of the biopsy, this roentgenogram is aligned with the corresponding markers on the skin of the patient and the position of the wire tip is noted. A curvilinear incision along Langer's lines can then be made at that site. This procedure was used in 53 consecutive biopsies of nonpalpable mammary lesions. In all instances, the biopsy incisions were independent of the wire insertion sites and in each instance, the lesion was excised in a single specimen. Compared with other techniques, our method is simple, inexpensive, requires no special equipment and results in only a minimal increase in radiation dose to the breast (50 millirad). The decrease in the amount of tissue dissection without decreasing accuracy afforded by our technique can improve compliance with the American Cancer Society's recommended surgical guidelines for breast preservation therapy.

Biopsy, Needle↗
PubMed1993

Transvaginal ultrasonographic findings in surgically verified ectopic pregnancy.

OBJECTIVE: Our purpose was to evaluate transvaginal ultrasonographic findings in ectopic pregnancies for positive ultrasonographic sign(s). STUDY DESIGN: Eighty-nine patients admitted with an ectopic pregnancy from September 1987 through September 1989 were retrospectively reviewed. Sixty-nine had undergone transvaginal ultrasonography within 10 days before surgery. The ultrasonographic examinations were reviewed by four radiologists. RESULTS: Ultrasonography revealed adnexal masses in 54 patients (78%). Thirty-six masses had an appearance consistent with an adnexal ring. Twenty-four adnexal rings demonstrated a thin sonolucent area surrounding the ring, a "halo sign" (67%). A control group of 116 intrauterine pregnancies were evaluated by ultrasonography. Forty-one women had adnexal cysts. Twenty-seven of these had an adnexal ring; only two of these had halos. CONCLUSION: The halo sign is presumptive evidence of a living ectopic pregnancy and, when identified, may allow earlier diagnosis and intervention.

Adnexa Uteri↗
PubMed1993

Use of hydrophilic guide wires in the fallopian tubes: effect on sperm survival and mouse embryo development.

Hydrophilically coated guide wires from two different manufacturers were tested in vitro for potential use in the fallopian tubes. Incubation of the guide wires and scrapings from the guide wires with sperm and with mouse embryos did not show any deleterious effect on sperm survivability or embryo development. These "slippery" guide wires may prove useful for fallopian tube catheterization.

Animals↗