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Biomedical subjects

P Pavlica

Publications and source records attributed to P Pavlica.

At least 55 records · Page 3Linked to original sources
PubMed1990

Correlation between prostate-specific antigen and prostate volume, evaluated by transrectal ultrasonography: usefulness in diagnosis of prostate cancer.

The authors calculated the volume of the prostate by transrectal ultrasonography and evaluated prostate-specific antigen (PSA) in 108 patients with benign prostatic disease or with clinically suspected carcinoma and in 35 normal subjects. In each case the PSA value was related to the corresponding gland volume (V), which gives a PSA/V index. 32 patients underwent transurethral resection, 23 underwent open prostatectomy and biopsy was performed in 53. Histological examination revealed benign prostatic hyperplasia in 63, prostatitis in 12 and carcinoma in 33. In normal subjects and in those with benign prostatic diseases, the mean PSA/V index was 0.090 and 0.099, respectively. In patients with prostatic carcinoma the ratio was 1.73. The authors propose that this ratio be used, as an alternative to the absolute value of PSA, to differentiate patients with benign and malignant diseases of the prostate.

Aged↗
PubMed1989

US-guided prostatic biopsy in 63 cases.

Over a 20-months period, 63 patients with prostatic lesions less than or equal to 2 cm in size, detected at palpation or at ultrasonography (US), were followed-up with US-guided transperineal biopsy. Within the nodules located in the peripheral parts of the gland, and still confined within the capsule, focal cancer, chronic prostatitis and benign atypical hyperplasia were detected, but typical echo patterns were not seen. All nodules located in the periurethral gland were benign hyperplasia. US-guided biopsy in all patients presenting with small, suspicious nodules or focal echo pattern changes, localized within the peripheral gland, is recommended.

Biopsy, Needle↗
PubMed1989

[Course of acquired renal cystic disease. An ultrasonic follow-up study].

The authors evaluated the evolution of acquired renal cystic disease with a 40-month US follow-up. Eighty-one patients were examined by US: 66 of them were hemodialysis patients, and 15 transplant recipients. Cystic kidney disease had progressed in 52/66 hemodialysis patients, whereas the picture was unmodified in 14/15 transplant recipients. As an explanation to the different evolution possibilities, the authors hypothesize that disease etiopathogenesis is to be sought in uremic toxic elements together with constitutional factors. Hemodialysis, prolonging the life of these patients, appears to facilitate the onset and/or evolution of the disease. On the contrary, kidney transplantation stops disease evolution, because it removes biologically active substances associated to uremia. In no cases new kidney tumors were found.

Adult↗
PubMed1989

[Carpal cysts in hemodialysis patients].

A new type of amyloidosis due to beta 2-microglobulin depositions has been recently described in long-term hemodialysis patients. This systemic complication mainly affects the osteoarticular system, with diffuse articular symptoms; among them carpal tunnel syndrome is the most frequent. The syndrome etiopathology is unknown, even though many causal factors have been identified, among which the repeated use of non-biocompatible dialytic membranes. The authors conducted a retrospective study of 138 hemodialysis patients, with mean dialytic age of 79.3 months, to evaluate both incidence and evolution of bone cysts involving the carpal bones. Bone cysts were detected in the hands of 18.8% of the patients at the beginning of dialytic treatment; their incidence was over 50% after 10 years of treatment. Their size and number showed a rapid progression after the 6th year of hemodialysis, and their features were not related to osteodystrophic bone lesions. The carpal tunnel syndrome appeared after several years and its incidence was 7.9%; a direct correlation was demonstrated with the size of carpal bone cysts. The influence of hemodialysis membrane type on the occurrence of hemodialysis-related amyloidosis was strong, but not exclusive.

Amyloidosis↗
PubMed1989

[Sarcomatoid nephrocarcinoma. Correlation of radiological, histopathological and prognostic features].

Fifteen patients with sarcomatoid renal cell carcinoma were studied from 1975 through 1987. For each case the radiological, sonographic (US), and histopathological features were reviewed. Neither ivp nor US detected any specific patterns, though demonstrating frequently-necrotic and infiltrating masses. Angiography and/or CT were more useful because they allowed the staging of the tumors and the evaluation of their vascularity. In particular, a frequent correlation was observed between the degree of vascularity and the percentage of sarcomatoid component at histopathology. Sarcomatoid renal cell carcinoma were hypo-avascular in 7 cases and hypervascular in 8. Six of the 7 hypo-avascular cases had a high percentage of sarcomatoid tissue (greater than 50%) and were highly malignant. Seven of the 8 hypervascular neoplasms had a low percentage of sarcomatoid component and presented radiological features similar to clear/granular cell tumors. The survival of the patients with sarcomatoid tumors was much shorter than that of the patients with other kidney carcinomas. Among sarcomatoid tumors, prognosis was worst for the patients with hypo-avascular neoplasms.

Adult↗
PubMed1989

[Ultrasonography in syringocele of the male urethra (ultrasound-urethrography)].

The authors have studied 5 patients with syringocele--or cystic dilatation of the excretory ducts in Cowper's glands--using a 7.5 MHz linear high-definition US probe. The urethra was distended with a saline solution introduced through a small Foley's balloon catheter placed in the navicular fossa. Longitudinal and transverse scans were employed at both the penis and the perineal region. The syringocele appears on US scans as a tubular image at the bulbous urethra, parallel to the urethral canal, with a "double tube" appearance. It is easily differentiated from urethral stenosis, while it may be confused with congenital urethral duplication, which is extremely uncommon. US with a small-part probe can be considered an useful imaging technique and a valid alternative to conventional radiology, especially in young patients, to avoid high dose exposure.

Adult↗
PubMed1989

[Surgical ultrasonography of the seminal vesicles in andrologic pathology. Research in progress].

The authors describe their experience with percutaneous transperineal puncture (PTP) of the seminal vesicles in andrologic pathologic conditions, using transrectal US guidance. Three cases are reported: 2 anomalies of the genital ducts and one prostatic-vesicular abscess. In the first two cases PTP allowed a diagnosis to be reached on the basis of the analysis of vesicular fluid. Moreover, the examination allowed the selection of the patients to be submitted to surgery for seminal duct anomaly (endoscopic resection of the colliculus seminalis). In cases 1 and 3 PTP allowed the aspiration of the fluid from a cyst in the left ejaculatory duct and from a prostatic-vesicular abscess, respectively. These procedures were facilitated using US guidance. The clinical possibilities and utility of PTP have not yet been completely defined. The authors suggest a diagnostic protocol to be used in the presence of azoocytospermia, where US must be performed only in patients with excretory infertility. The present paper must be considered a work in progress. Further study is required to identify the clinical indications of interventional US of the seminal vesicles in patients with andrologic pathologic conditions.

Abscess↗
PubMed1989

[Obstructive bladder neck syndrome in women].

Primary bladder neck obstruction in women is quite rare and its symptoms--dysuria, frequency, and urgency--are equivocal. Routine radiological investigations alone do not allow a diagnosis to be made, due to the lack of simultaneous measurements of detrusor pressure and urine flow. A precise diagnosis is thus to be obtained by synchronous video urodynamic studies which allow the depiction of nonfunneling or tight bladder neck during the entire phase of detrusor contraction, of bladder trabeculae and diverticula, vesico-ureteral reflux, long micturition time and incomplete voiding. When these radiological signs are associated with a rise in detrusor voiding pressure over 60 cm of water and with peak urine flow lower than 15 ml/s, the diagnosis of bladder neck obstruction is unquestionable, and the appropriate pharmacologic/endoscopic treatment can be administered.

Adult↗
PubMed1988

[Papillary nephrocarcinoma: radiographic and echographic aspects].

Between 1976 and 1987, 395 patients with kidney tumors were studied with radiological techniques and sonography. In 37 cases (9.4%) histopathology diagnosed pure papillary renal cell carcinoma. Analyzing the radiographic patterns of these neoplasms, the authors observed constantly diminished vascularity (100%), frequent calcifications (35.1%) and necrotic areas (51.3%). Such X-ray features are not specific: nevertheless, their coexistence is strongly suggestive of papillary renal cell cancer. No consistent US pattern was found; however, necrotic areas were easily demonstrated in most cases. It must be stressed how patients with papillary carcinoma experienced a longer postoperative survival; it has not yet been established whether such favorable behavior is due to low biological aggressiveness or to earlier diagnosis.

Adult↗
PubMed1988

[Diverticula of the female urethra. A radiological and ultrasound study].

The authors analyzed the clinical, radiographic and sonographic findings of diverticulum of the female urethra, reporting on 47 cases. Lower urinary tract infections, urgency and post-urinary dribbling were the most common symptoms. Either voiding cystourethrography or positive pressure urethrography was carried out in all patients, while US was performed in 18 cases only. Radiographs showed diverticula to be usually solitary (87%); their size ranged from 1 to 3 cm (72%). They were most commonly found in the mid-third of the urethra (83%), and stones were present in 12.7% of patients. Suprapubic and transrectal US demonstrated cystic lesions, usually dyshomogeneous, located under the bladder base and the uterine cervix. The authors believe that both examinations should be performed, as they provide with complementary information. X-ray study allows the evaluation of the exact number and position of diverticula, while US demonstrates both the extension of inflammatory changes and the size of diverticula not completely filled during voiding cystourethrography.

Adolescent↗
PubMed1988

[Lacunae of the occipital bone. Radiological aspects of normal anatomical variants].

Sixteen patients with lacunar alterations of the squamous occipital bone were studied in various radiographic projections; in many cases tomography and technetium 99m bone scan studies were also performed. In 7 cases lacunae in the cerebral fossa were observed, with an average diameter of 3 cm. These defects were due to a thinning of the inner table of the theca. In 9 cases smaller lacunae were demonstrated bilaterally, which were more radiolucent, isolated or confluent, located in the area corresponding to the internal occipital protuberance at the ridges of the cruciform eminence. The latter were representative of diploic venous lakes, as best demonstrated in lateral projection. This kind of lacunae are considered as anatomic variants, because no bone destruction is demonstrable, as confirmed by technetium scintigraphy.

Adult↗
PubMed1988

[Has echography modified the occurrence of kidney carcinoma? Considerations on 316 cases].

An analysis of 316 renal carcinomas over an 11-year period has shown an increase in the incidence of tumors per year, together with a progressive decrease in the size of the lesions at the time of diagnosis. This effect occurred especially after the introduction of renal ultrasonography in diagnostic practice. The tumor size is an important prognostic factor, because the 5-year survival rate was 80% for tumors less than 5 cm and 30% for tumors greater than 10 cm. Ultrasonography might thus represent a screening method for renal carcinoma in patients over 50 years of age, if it were possible to define risk groups.

Humans↗
PubMed1988

[Ureteral obstruction secondary to aortofemoral bypass].

Hydroureteronephrosis is reported as a frequent late complication of aorto-femoral bypass grafts in patients with aorto-iliac obstruction. To define the actual incidence of this potentially critical complication, renal ultrasonography (US) was performed on 79 asymptomatic patients who had previously undergone aortic reconstruction, after a mean interval of 71.6 months. Unilateral hydronephrosis was found in 6 cases (7.6%). Dilatation was mild or moderate (grade I or II) in 4 cases, and severe (grade III) in 2. Ivp was performed in this selected group: hydronephrosis was mild in 3 patients with ureteral stenosis where the iliac limb of the graft crossed the ureter. In 2 cases nonfunctioning kidneys were demonstrated corresponding to severe sonographic hydronephrosis. These 2 patients underwent anterograde and retrograde pyelography, that showed the site and extent of the obstruction. One patient was a false positive because of obstruction of pyelo-ureteral junction. Even though X-rays showed high sensitivity and specificity in detecting this complication of aorto-femoral reconstruction, US is noninvasive and less expensive and does not require contrast medium. A routine pre- and post-operative ultrasound study is suggested in patients undergoing by-pass surgery to early recognise ureteral obstruction and to avoid irreversible renal damage.

Aged↗