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Biomedical subjects

K K Lindfors

Publications and source records attributed to K K Lindfors.

At least 37 records · Page 2Linked to original sources
PubMed1989

Medullary carcinoma of the breast: mammographic and US appearance.

Medullary carcinoma of the breast is an uncommon tumor, which may mimic a benign mass at both mammography and ultrasonography (US). A total of 24 medullary carcinomas visible at mammography appeared as round or oval, noncalcified masses with varying degrees of marginal lobulation. In six of the 24 patients, US demonstrated well-defined masses with an inhomogeneous, hypoechoic texture. There was no attenuation of sound, and all lesions showed enhanced through transmission.

Adult↗
PubMed1989

Stab wounds to the neck: role of angiography.

Angiographic findings in 61 stab wounds to the neck were correlated with specific clinical findings. Eighteen of the stab wounds were associated with one or more major physical findings that included (a) pulse deficit, (b) active bleeding or expanding hematoma, (c) bruit or murmur, (d) neurologic deficit, or (e) hypotension. Of these 18 wounds, only two involved significant vascular injuries. The other 43 stab wounds were associated with minor physical findings, with the only indications for angiography being nonexpanding hematoma or proximity of trauma to major vessels. None of these 43 wounds involved significant vascular injury.

Adolescent↗
PubMed1989

Percutaneous cholecystostomy: an alternative to surgical cholecystostomy for acute cholecystitis?

Emergency percutaneous cholecystostomy was successfully performed in 39 of 40 attempted procedures in 37 hospitalized patients with possible acute cholecystitis. All cholecystostomies were performed with ultrasound guidance and preferentially with the transhepatic route, and all but four were performed at the patient's bedside. The patients had been hospitalized an average of 27 days before the procedure. Twenty-two of the 37 patients (59%) eventually died during hospitalization because of other medical or surgical problems. Only minor complications related to percutaneous cholecystostomy placement occurred in this series: catheter dislodgment without sequelae (n = 2) and significant abdominal pain (n = 2). Technical problems included guide-wire buckling during catheter insertion (n = 1) and failed attempted cholecystostomy (n = 1). Percutaneous cholecystostomy is a safe alternative to surgical cholecystostomy in the treatment of patients suspected of having acute cholecystitis.

Acute Disease↗
PubMed1988

Congenital cerebrospinal fluid-containing intracranial abnormalities: a sonographic classification.

Ultrasound is useful as a primary modality for diagnosis of complex nonhydrocephalic intracranial malformations. We present 10 cases of intracranial cerebrospinal fluid containing abnormalities that may be diagnosed by ultrasound. Congenital abnormalities presented include holoprosencephaly, hydranencephaly, agenesis of the corpus callosum with interhemispheric cyst, porencephaly, schizencephaly, and arachnoid cyst. Ultrasound may be used in the fetus or neonate in detecting and separating these abnormalities from hydrocephalus.

Abnormalities, Multiple↗
PubMed1988

Acute cholecystitis: diagnostic accuracy of percutaneous aspiration of the gallbladder.

Results of gallbladder bile aspiration and culture were correlated with presence or absence of acute cholecystitis in 36 patients to test the role of these procedures in hospitalized patients with sepsis. Diagnostic aspiration of the gallbladder was performed in 11 patients, and in the remaining patients a combination of percutaneous aspiration, percutaneous cholecystostomy, or cholecystectomy was used. Bile culture was not helpful in the prediction of acute cholecystitis, since results were not available for a minimum of 24-48 hours after aspiration. In addition, gram-stained smears and bile cultures suffered from low sensitivity (48% and 38%, respectively); consequently, a negative test does not allow the diagnosis of acute cholecystitis to be excluded. Bile aspiration of the gallbladder thus has a limited role in the diagnosis of this condition.

Acute Disease↗
PubMed1988

Type III congenital cystic adenomatoid malformation associated with elevated maternal serum alpha-fetoprotein.

Congenital cystic adenomatoid malformation Type III with fetal ascites was diagnosed in a 19-week fetus after finding an abnormally elevated maternal serum alpha-fetoprotein value during routine screening. This discovery led to early elective termination of pregnancy. Sonographic evaluation of the fetal thorax is recommended in all cases referred for ultrasound because of unexplained elevation of maternal serum alpha-fetoprotein.

Adult↗
PubMed1987

Stab wounds to the extremities: indications for angiography.

To ascertain the sensitivity of physical examination with respect to significant arterial injury, the angiographic findings of 61 stab wounds to the extremities were correlated with specific physical findings. In 25 injuries there were physical findings of major injury, including one or more of the following: pulse deficit, active bleeding or expanding hematoma, bruit or murmur, neurologic deficit, or hypotension. Of these 25 injuries, angiographic examination revealed significant vascular damage in 11. In 36 injuries physical findings indicated minor injury, with proximity to major vessels or nonexpanding hematoma being the only indication for arteriography. None of these patients had significant vascular injuries. Physical examination was found to be 100% sensitive in screening for significant vascular injuries. These results indicate that arteriography is unwarranted in stab wounds to the extremities if the only indications are proximity to major vessels or nonexpanding hematoma.

Adolescent↗
PubMed1987

Midtrimester screening for open neural tube defects: correlation of sonography with amniocentesis results.

Eight pregnancies with open neural tube defects were detected in 70 midtrimester patients referred for sonography and amniocentesis because of elevated maternal serum alpha-fetoprotein levels. Two cases of anencephaly were detected by sonography, aborted without amniocentesis, and confirmed by pathologic examination. Six cases of open spina bifida were detected through amniocentesis by elevation of alpha-fetoprotein and acetylcholinesterase levels. In only three of these six was the abnormality seen on sonography. All six pregnancies were terminated, and open spina bifida defects were confirmed on pathologic examination. Amniocentesis was 100% sensitive for diagnosis of open spina bifida, while sonography was only 50% sensitive. Our results indicate that, in patients with elevated serum alpha-fetoprotein and a normal fetal sonogram, amniocentesis should be performed to rule out open spina bifida.

Amniocentesis↗
PubMed1987

Ultrasound needle guidance for amniocentesis in pregnancies with low amniotic fluid.

In six pregnancies accompanied by oligohydramnios (three cases) or decreased amniotic fluid and maternal obesity (three cases), needles specifically designed for use with ultrasound were successfully utilized in combination with real-time ultrasound guidance for amniocentesis. There was successful fluid retrieval in all six, with two requiring more than one needle pass. All three cases accompanied by oligohydramnios later resulted in fetal death. In the three cases accompanied by decreased amniotic fluid and maternal obesity, the amniocentesis results were helpful in ensuring the existence of a normal pregnancy. A specially designed ultrasound needle used in combination with a real-time guidance system is helpful in the performance of difficult amniocentesis.

Amniocentesis↗
PubMed1986

Breast cancer metastasis to intramammary lymph nodes.

Metastatic disease to the intramammary lymph nodes from breast cancer may be seen mammographically. In the four cases reviewed, the affected intramammary lymph nodes were enlarged (1 cm or greater in diameter), homogeneous, and well circumscribed. All lacked the lucent center or hilar notch characteristic of benign intramammary nodes. Differentiation of malignant from benign causes of intramammary lymph node enlargement, such as inflammation or hyperplasia, is impossible by mammography. Biopsy is recommended for all intramammary lymph nodes of 1 cm or greater that are not fat infiltrated unless the patient clearly has an associated dermatitis or mastitis. Metastatic disease to the intramammary lymph nodes may be the first clinical and/or mammographic sign of breast cancer and may significantly affect prognosis.

Aged↗
PubMed1986

Fetal omphalocele and gastroschisis: pitfalls in sonographic diagnosis.

The prenatal sonographic findings in 10 infants with omphalocele or gastroschisis diagnosed either by sonogram or by physical examination at birth are reviewed. There were six true-positive diagnoses, as well as two false-positive and two false-negative diagnoses by sonography. The false-positive cases resulted from confusion of umbilical cord with extruded bowel (1 case) and oligohydramnios coupled with improper scanning technique (1 case). The false-negative cases resulted from poor documentation of fetal anatomy (1 case) and confusion of extruded bowel with umbilical cord (1 case). These pitfalls may be avoided by using optimal scanning technique with documentation of fetal anatomy and pulsed Doppler sonography.

Abdomen↗
PubMed1985

Thymic cysts in mediastinal Hodgkin disease.

Three cases of proved thymic cysts associated with mediastinal Hodgkin disease are presented. Two illustrate regression of lymphoma with chemotherapy but persistence of thymic cysts. The third case demonstrates a thymic cyst in untreated Hodgkin disease. These cases suggest that such cysts are probably neither coincidental with nor a consequence of therapy but are probably related to initial thymic involvement by Hodgkin disease.

Adult↗
PubMed1985

Whole-breast US imaging: four-year follow-up.

Between March 1980 and April 1981, 1,140 women underwent physical examination, xeromammography, and whole-breast ultrasound (US) using a whole-breast water path system. Results of each study were interpreted independently by separate observers in a blind fashion. Biopsy revealed 125 cancers in 127 breasts. Findings were considered to be suspicious for carcinoma in 199 women based on physical examination, in 201 based on mammograms, and in 255 based on US scans. Physical examinations were able to reveal 91% (115/127) of the cancers, reflecting the referral nature of the population, and failed to detect 12 lesions. Mammograms disclosed 94% (119/127) of the cancers, including 12 clinically occult lesions, but did not show eight palpable cancers. US scans disclosed only 64% (81/127) of the cancers, all of which were palpable. In a 4-year follow-up, no cancers have appeared in the group that had suspicious findings by US only. We conclude that US should not be used routinely to screen women for breast cancer.

Adult↗
PubMed1985

CT evaluation of local and regional breast cancer recurrence.

The accuracy of physical examination is compared with that of computed tomography (CT) of the chest in determining the extent of disease in 42 patients with local and/or regional recurrence of breast cancer. Of the 33 patients with clinical evidence of chest wall recurrence, 16 (49%) had areas of disease visible by CT that were clinically unsuspected. Similarly, in the nine patients who presented with supraclavicular and/or axillary recurrence, five (56%) had additional sites of involvement discovered on CT. Since many of these patients are treated with radiotherapy, the information gained by CT of the chest can be of great value in treatment planning.

Breast Neoplasms↗
PubMed1984

Impact of thoracic computed tomography on radiation therapy planning in Hodgkin disease.

Over 5 years, CT of the thorax was performed on 53 patients with Hodgkin disease and mediastinal lymphadenopathy prior to the institution of therapeutic irradiation. Information obtained from CT prompted major alterations in the plan of therapy in 11 of 53 (21%) of the patients. These included changes of treatment portal size, the addition of localized boost therapy, and a revision of diagnosis.

Combined Modality Therapy↗
PubMed1984

Occult breast abnormalities: percutaneous preoperative needle localization.

The results of 500 preoperative radiographically guided localizations for occult breast lesions over a period of more than 5 years are described. Of the total, 117 (23.4%) were found to be malignant. Biopsy was prompted by abnormal calcifications in 41% (203/500) of the cases and by occult masses, areas of architectural distortion, or asymmetry in 59% (297/500). of 74 patients with carcinoma who underwent axillary lymph node sampling, 78% (58/74) were free of metastatic involvement.

Biopsy, Needle↗