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Biomedical subjects

S Karstrup

Publications and source records attributed to S Karstrup.

At least 55 records · Page 3Linked to original sources

Sonography in soft-tissue trauma of the shoulder.

Seventy-five patients with soft-tissue trauma in the shoulder region were examined by ultrasonography. Normal conditions were found in 21 patients, distension of the acromioclavicular joint in 17, muscle hematoma or edema in 9, biceps tendinitis in 8, hematoma or partial rupture of the biceps tendon in 5, rupture of the biceps tendon in 1, and supraspinatus tendinitis or partial rupture in 14. A correlation was found between the sonography and clinical course; normal sonography was consistent with recovery in less than 1 week, whereas patients with pathologic changes in the supraspinatus or biceps tendon generally had symptoms for at least 1 month. We concluded that sonography is a useful diagnostic tool for evaluation of soft-tissue trauma in the shoulder.

Adolescent↗

Tetracycline for sclerosis of thyroid cysts. A randomized study.

In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery.

Cysts↗

Ultrasound diagnosis of cholangiocarcinoma at the confluence of the hepatic ducts (Klatskin tumours).

The findings on ultrasound of 31 consecutive patients with pathologically proven Klatskin tumours are reviewed. In all patients, ultrasound disclosed dilated intrahepatic bile radicles and normal common bile ducts. A well defined, rounded, solid tumour mass was detected in 11 (35%) patients. Compared with the findings at surgery or autopsy, ultrasound disclosed eight of 12 tumours presenting as extraductal masses. In 16 patients with tumour growth predominantly along the bile ducts, ultrasound disclosed poorly demarcated echogenic tissue high in the hepatic hilum in four cases. In only two patients was it possible to detect tumour spread. Ultrasound-guided, fine-needle aspiration biopsy was performed in seven patients revealing malignant cells in five cases and fine-needle tissue biopsy was performed in two cases revealing malignant tissue. The presence of intrahepatic dilated bile radicles with normal-sized common bile ducts should raise the possibility of a high bile duct carcinoma. If a tumour lesion is detected we suggest the use of ultrasound-guided, fine-needle biopsy.

Adenoma, Bile Duct↗

Parathyroid ultrasonography in patients with primary hyperparathyroidism.

Ultrasonography of the neck was performed in 42 consecutive patients with primary hyperparathyroidism (PHP). In 30 patients with subsequent neck exploration, ultrasonography localised 24 of 34 parathyroid tumours correctly (71%), and in 22 patients (73%) the diagnosis PHP was confirmed by identification of at least one parathyroid tumour. In 11 patients - who were not operated - ultrasonography disclosed a parathyroid tumour in four. Of all 42 patients, ultrasonography disclosed at least one parathyroid tumour in 26 (63%). The parathyroid tumours varied in echo pattern, and localisation difficulties were in particular related to associated nodular changes of the thyroid gland and the anatomic distribution of the enlarged parathyroid tissue.

Adenoma↗

Does prophylactic thyroxine treatment after operation for non-toxic goitre influence thyroid size?

In order to evaluate the influence of thyroxine treatment on thyroid volume after thyroidectomy for non-toxic goitre 110 consecutive patients were randomised to receive thyroxine (150 micrograms daily) or no treatment three months after operation. Thyroid volume determined by ultrasonography did not differ significantly between the two groups one year after operation. Nevertheless, a similar decrease in volume was seen from three to 12 months postoperatively in the thyroxine treated and no treatment groups (median 18 (range 8-70) ml to 16 (range 7-57) ml, and median 20 (range 9-72) ml to 17 (range 8-58) ml, respectively). Three patients (two given thyroxine) had recurrence of goitre within the observation period of one year. In this series thyroid volume decreased during the first postoperative year independently of thyroxine treatment. Hence it seems questionable whether postoperative thyroid function studies can identify patients at risk of recurrence of goitre after operation for non-toxic goitre and whether routine postoperative treatment with thyroxine is justifiable.

Adolescent↗

Percutaneous drainage of appendiceal abscess. An alternative to conventional treatment.

Twenty-seven consecutive patients with ultrasonically verified appendiceal abscesses, measuring from 2 to 10 cm in diameter, were studied. Ultrasonically guided percutaneous drainage was performed in 19 by means of one to five punctures, and in eight with one or two catheters. In 16 and 7 patients, respectively, the abscesses resolved without further intervention. Four patients were operated on, two for suspected (but unverified) abscess perforation, one for bowel obstruction, and one because of failed drainage, resulting in a success rate of 85 percent. Hospitalization ranged from 3 to 23 days; however, normal sonograms were not obtained until after nine to 62 days. Follow-up revealed no diagnostic errors. Two patients (8 percent) had recurrent appendicitis, and late sequelae were observed in four patients, three of these after surgery. Ultrasonically guided percutaneous drainage of appendiceal abscesses with the technique described is indicated whenever feasible, as a safe, gentle, and relatively atraumatic procedure with few complications and late sequelae.

Abscess↗

Ultrasonically guided percutaneous inactivation of parathyroid tumours.

Four patients with hyperparathyroidism and one parathyroid tumour detected ultrasonically were treated by ultrasonically guided percutaneous injection of ethanol (96%) into the tumour. Normocalcaemia was achieved for a follow-up of 10 months in one patient and of 3 months in another. One patient had a lowered serum calcium level for a follow-up of 5 months. One patient showed no clinical response to treatment but was subsequently shown to have multiglandular involvement at surgical exploration. Ultrasonically guided percutaneous inactivation of solitary parathyroid tumours as an alternative to surgery is discussed.

Adult↗

Thyroid size and goitre frequency in hyperthyroidism.

Thyroid function, the clinical occurrence of goitre and thyroid gland volume, ultrasonically determined, were investigated in 310 consecutive untreated patients with hyperthyroidism. Of 173 patients with Graves' disease (39%), 67 had no goitre, while 53 patients (31%) had a normal thyroid volume. Twenty-three of 91 patients with multinodular glands (25%) had no goitre and ten patients (11%) had a normal thyroid volume. Of 46 patients with solitary autonomous nodules (7%), three had no goitre while six (13%) had a normal thyroid volume. Out of all the hyperthyroid patients (30%), 93 had no clinically detectable goitre, and 69 (22%) had a normal thyroid volume. The lack of a goitre in a large portion of patients with hyperthyroidism could be responsible for delayed diagnosis and subsequent treatment of these patients.

Adolescent↗

Evidence of cyclic alterations of thyroid size during the menstrual cycle in healthy women.

Serum levels of thyroxine, triiodothyronine, triiodothyronine resin uptake, thyroxine-binding globulin, thyrotropin, and ultrasonically determined thyroid gland volume were investigated weekly in 11 healthy women during a normal menstrual cycle, and in five healthy men once a week for 5 consecutive weeks. In the men the thyroid volume was unaltered. In the women, however, a mean variation in thyroid volume of approximately 50% between minimum values (15.4 +/- 3.1 ml, day 9) and maximum values (24.4 +/- 4.8 ml, day 23) was found (p less than 0.01), although no significant differences in the other thyroid variables could be demonstrated. The menstrual cycle seems to be associated with cyclic alterations of thyroid size in healthy women unexplained by alterations in thyroid function variables. This information should be taken into account when goiter frequency, goitrogenic action of drugs, and goiter treatment effects are evaluated.

Adolescent↗

Ultrasonic visualisation of the inflamed appendix.

A prospective ultrasonic study of the right lower abdominal quadrant was performed in 46 patients prior to appendicectomy. Ultrasonography revealed an inflamed appendix in 24 out of 29 patients with appendicitis and excluded its presence in 16 out of 17 patients without appendicitis. The ultrasonic pattern of the inflamed appendices appeared as echo-poor/echo-free lesions with lack of movement. In six of seven patients with perforated appendices, ultrasonography revealed free intra-abdominal fluid in addition to bowel disease. The possible value of abdominal ultrasound in patients with suspected acute appendicitis is discussed.

Adolescent↗

Compensated 131I-therapy of solitary autonomous thyroid nodules: effect on thyroid size and early hypothyroidism.

Thyroid function and thyroid gland volume, ultrasonically determined, were investigated in 27 hyperthyroid patients with solitary autonomous thyroid nodules before and during one year after 131I-treatment. Total thyroid volume decreased gradually from 40.9 +/- 3.5 ml (mean +/- SEM) before treatment to 23.9 +/- 1.8 ml (P less than 0.001) at 3 months after 131I-treatment. No further change was observed. All but two patients received only one dose of 131I, and in spite of a significant decrease also of the non-adenoma side of the gland, none became hypothyroid. We conclude that 131I-therapy has an important place in the treatment of solitary autonomous thyroid nodules since all our patients became euthyroid within 3 months, only 2 of 27 patients needed more than one dose of 131I, no cases of hypothyroidism occurred, and thyroid volume was substantially decreased.

Adenoma↗

Concomitant thyroid disease in hyperparathyroidism. Reasons for unsatisfactory ultrasonographical localization of parathyroid glands.

Ultrasonic localization of enlarged parathyroid glands has been attempted in a consecutive series of 23 patients with primary hyperparathyroidism. Seven of 15 patients with operatively verified diagnosis, had predictive ultrasound scans (47% consistency) and 10 of 16 adenomas were identified (63%). A possible explanation for these unsatisfactory results could be a high incidence of coexisting nodular thyroid lesions, and significantly enlarged thyroid glands in these patients.

Adenoma↗