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Biomedical subjects

B Schepps

Publications and source records attributed to B Schepps.

30 records · Page 2Linked to original sources
PubMed1995

Contemporary diagnostic approaches for nonpalpable carcinoma of the breast: the role of the radiologist.

Over the past 25 years the radiologist's role in the diagnosis of breast cancer has expanded from merely confirming the clinical suspicion of neoplasm to detecting occult nonpalpable tumors and now percutaneously obtaining tissue for histologic assessment. The cancer the radiologists discover is smaller in size and earlier in stage, allowing more conservative surgical approaches. This, coupled with adjuvant radiation therapy and chemotherapy, is producing newly demonstrated mortality reduction in this disease so feared by American women.

Biopsy, Needle↗
PubMed1994

Benign circumscribed breast masses. Mammographic and sonographic appearance.

Mammography is an excellent screening tool for the detection of breast masses. One of the goals of the radiologist is to separate benign breast masses warranting no intervention from the indeterminate and malignant masses that require histologic evaluation. Thorough mammographic and sonographic work-up of lesions detected at screening will reduce the number of biopsies performed and increase the true positive biopsy rate. By systematically evaluating a breast mass as to its density location, size, margins, and interval change, one can separate benign lesions from those requiring additional work-up and those that will require a biopsy diagnosis. Any features suggesting malignancy should prompt histologic assessment. For many women, FNAB or large-core needle biopsy, guided either stereotactically or sonographically, will not only reduce the morbidity associated with excisional biopsy but also decrease the cost of evaluating questionable lesions found at screening. Ultrasound examination will further reduce the number of biopsies by separating cysts from solid and indeterminate lesions that require further evaluation. What rate of carcinoma in biopsy specimens should be the mammographer's guideline? Ciatto et al found in his series a 30% positive predictive value for mammography in detecting carcinoma. In the author's opinion, a goal to strive for should be in the range of 40%. The mammographer's experience and confidence as well as patient's compliance with follow-up recommendations will help the mammographer reach this goal.

Adult↗
PubMed1989

Grade I hydronephrosis: pulsed Doppler US evaluation.

This study was undertaken to determine whether the presence of blood vessels could mimic the appearance of grade I hydronephrosis on sonograms and thus cause false-positive readings. One hundred consecutive patients with grade I hydronephrosis were examined. Sample volumes were obtained with pulsed Doppler ultrasonography (US) at the site of the greatest separation of the central renal sinus echoes to determine if the separation was fluid accumulating in the collecting system, as in obstruction, or if the separation was actually caused by vessels that mimic hydronephrosis. Vascular structures accounted for the separation of the sinus echoes in 43% of patients. In patients 12 years of age or younger, this frequency rose to 61%. The simple procedure of evaluating the renal sinus echo separation with pulsed Doppler US should decrease the frequency of false-positive diagnoses of hydronephrosis and thus diminish the need for further confirmatory testing.

False Positive Reactions↗
PubMed1989

Iatrogenic changes at the venotomy site after percutaneous placement of the Greenfield filter.

To determine the prevalence of iatrogenic abnormalities associated with percutaneous delivery of Greenfield filters, the authors prospectively evaluated 69 peripheral veins used for filter placement in 68 patients. Of the 69 venotomy sites, 63 were not associated with preexisting thrombosis and were evaluated with compression and Doppler ultrasound within 1 week of placement and over 13-541 days. New thrombosis developed at the puncture site in nine of 63 sites (14.3%), although clinical suspicion of clot was raised in only one patient. Fifty-four sites (85.7%) showed no evidence of acute deep venous thrombosis, even though three patients had signs and symptoms suggestive of thrombosis. During the follow-up, most new thromboses resolved, yielding a 96.3% long-term patency rate. The authors conclude that postplacement increase in symptoms of venous stasis and occlusion may not correlate with placement site thrombosis. New filters should be evaluated for their ability to capture potential pulmonary emboli while maintaining caval patency and for mechanical and biologic stability because placement site complications occur at low rates and resolve in most cases.

Femoral Vein↗
PubMed1988

Ultrasound evaluation of cholelithiasis in the morbidly obese.

The ability to detect gallstones in the morbidly obese population has been questioned in recent literature. Utilizing state-of-the-art, real-time ultrasound equipment, 44 morbidly obese patients were examined prior to gastric exclusion surgery and concomitant cholecystectomy. The 91% sensitivity and 100% specificity of gallstone detection in this series matches the results for the general population. This study provided the unique opportunity to evaluate a large number (34) of negative ultrasound examinations, with subsequent surgical confirmation yielding a negative predictive value of 97%. This confirms the continued role of ultrasound in the evaluation of cholelithiasis.

Adolescent↗
PubMed1987

Deep venous thrombosis: US assessment using vein compression.

To assess vein compressibility as a simple ultrasound (US) technique to determine the presence of venous thrombi, 51 patients undergoing contrast material venography of the lower extremity because of a clinical suspicion of deep venous thrombosis (DVT) also underwent high-resolution US evaluation of the veins. DVT was diagnosed on 28 venograms. In 25 patients US studies demonstrated non-compressibility of the veins, indicating the presence of clot. In 23 patients with normal venograms, US examinations demonstrated total compressibility of the veins, indicating the absence of DVT. Clots below the knee were not depicted by US. In this study US had a sensitivity of 89% and a specificity of 100%.

Adolescent↗
PubMed1986

Renal obstruction in patients with ileal loops: US evaluation.

Ultrasound (US) is often employed as a screening test for hydronephrosis in the nondiverted kidney and has been used recently to evaluate the diverted kidney, specifically ileal loops, for obstruction. The utility of US in evaluating obstruction in patients with ileal loops has apparently not been previously explored. During a 2-year period, 87 kidneys drained by an ileal loop diversion were examined with US because of clinical indications of possible renal obstruction. In 33 kidneys, no hydronephrosis was seen on sonograms, and no obstruction was later proved; in 51 kidneys, shown by US to be hydronephrotic, only 19 (37%) were obstructed. Three left kidneys were not visualized with US. The percentage of hydronephrotic kidneys subsequently shown to be obstructed increased rapidly as the US appearance progressed from grade 1 (20%) to grade 3 (80%). In this series, US had a 100% sensitivity and a 50% specificity in evaluating patients with ileal loops for renal obstruction. Thus, for the adult patient, a direct contrast evaluation of the collecting system is suggested; for the pediatric patient, initial use of US is justified as a means to avoid radiation exposure.

Humans↗
PubMedDate not supplied

Mammography-related anxiety: effect of preprocedural patient education.

OBJECTIVES: To determine the effect of preprocedural education on mammography-related anxiety. MATERIALS AND METHODS: A total of 613 women undergoing mammography were surveyed regarding anxiety about the procedure and expected results. Half the study population watched an educational videotape and half watched an entertaining movie in the waiting room. RESULTS: Anxiety levels about results were significantly higher than anxiety levels about the procedure (P <.001). There was no difference in procedural or cancer anxiety levels among women shown the educational tape and those shown the entertaining movie. CONCLUSION: The fear of discovering breast cancer generates most of mammography-related anxiety. Preprocedural education did not affect procedural or cancer-related anxiety.

Adult↗
PubMedDate not supplied

Radiation exposure to patients receiving routine scoliosis radiography measured at depth in an anthropomorphic phantom.

Concern about the amount of radiation received during scoliosis evaluation and treatment led us to measure radiation exposure in an anthropomorphic phantom to determine the increased risk of breast cancer in young women with scoliosis. Assuming that 22 radiographic examinations were performed over the course of scoliosis treatment, the increased relative risk of breast cancer was determined to be 0.22% in these patients.

Adolescent↗