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Biomedical subjects

U M Hamper

Publications and source records attributed to U M Hamper.

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

Carcinoma of the prostate: value of transrectal sonography in detecting extension into the neurovascular bundle.

Detection of involvement of the neurovascular bundles (NVB) by tumor is important in deciding whether sexual function can be preserved in patients undergoing radical prostatectomy for prostatic cancer. The nerve branches innervating the corpora cavernosa have a rather constant association with the capsular arteries and veins of the prostate, forming the periprostatic neurovascular bundle, which can be identified intraoperatively and spared during radical surgery, thus preserving potency. We examined 160 patients with biopsy-proved clinical stage A or B adenocarcinoma with transrectal sonography before radical prostatectomy to determine how useful the procedure is for predicting tumor extension into the NVB. Correlation with pathologic serial sections was obtained in each patient. The sonograms depicted the NVB on both sides in 77 patients (50%), on the right side only in 13 (8%), and on the left side only in 36 patients (23%). In 29 patients (19%) neither neurovascular bundle could be identified on the sonograms. Ninety-one tumors in this series showed evidence of extraglandular spread pathologically, which was posterolateral or into the NVB in 70 tumors involving 82 hemispheres. Using transrectal sonography, we correctly identified invasion of the NVB in 54 cases and missed it in 28 cases. NVB invasion was predicted incorrectly with transrectal sonography in 51 cases; absence of involvement of the NVB was correctly predicted in 177 hemispheres. The sensitivity of sonography for predicting invasion of the NVB was 66%, with a specificity of 78% and an accuracy of 75%. Positive predictive values and negative predictive values were 51% and 86%, respectively. We conclude that transrectal sonography currently suffers from lack of sufficient spatial resolution to detect accurately invasion of the NVB.

Adenocarcinoma↗
PubMed1990

Cystic lesions of the prostate gland. A sonographic--pathologic correlation.

277 patients underwent biplane transrectal ultrasonography. Twenty-two patients (7.9%) showed evidence of one or more intraprostatic cystic lesions. Histologic correlation was available with total prostatectomy specimens in six patients and surgical drainage in two patients. Sonographically, 11 patients showed one, 6 patients two, and 5 patients three or more intraprostatic cystic lesions. The size of the lesions ranged from 2 to 30 mm, and the majority of lesions were located within the central portion of the gland or at the junction of central and peripheral regions of the gland. Histologically, among the eight pathologically confirmed patients the lesions corresponded to cystically dilated, epitheliallined prostatic glands, a reepithelialized cyst related to previous biopsy, a dilated utricle, and two intraprostatic abscesses. The cystic lesions in our series were not associated with carcinoma of the prostate, but represented either a growth phenomenon related to the presence of benign prostatic hypertrophy, inflammatory conditions (abscesses), or anatomical variants (utricle).

Abscess↗
PubMed1989

Determination of canine prostatic size in situ: comparison of direct caliper measurement with radiologic and transrectal ultrasonographic measurements.

The use of transrectal ultrasonography to estimate canine prostatic size in situ was evaluated and compared to that of direct measurement via calipers and an in situ radiologic procedure. The length, width, and depth of prostates were measured by transrectal ultrasound in both the transverse and sagittal planes from which prostatic volume was calculated. Prostatic volumes were subsequently transformed into prostatic weights using the following nomogram: prostatic Weight (g) = 0.602 x prostatic Volume (cm3) + 1.16. Prostatic weights estimated by ultrasound as well as by direct measurement with caliper were similar (P greater than 0.10) to the true gravimetric weight; however, prostate weights estimated by the radiological X-ray procedure were significantly (P less than 0.01) lower. The relationship between true gravimetric prostate weight and that estimated by ultrasound was described by the following regression equation: estimated weight (g) = 1.127 gravimetric weight (g) - 1.665; r = 0.900; P less than 0.001; n = 23. In summary, the results of this study demonstrate that transrectal ultrasonography can be used to accurately predict canine prostatic weight.

Animals↗
PubMed1989

Evaluation of transrectal ultrasound in the early detection of prostate cancer.

To determine the ability of transrectal ultrasound to detect early localized prostate cancer, unsuspected (nonpalpable) cancer in the contralateral lobe of patients undergoing radical prostatectomy for clinically localized disease was evaluated. A total of 59 patients with palpable prostate cancer clinically confined to 1 lobe underwent transrectal ultrasound before radical prostatectomy and step-sectioning of the radical prostatectomy specimen. Transrectal ultrasound was performed with 5 or 7 MHz. real-time transrectal units. Pathological findings in these 59 cases revealed no tumor in the contralateral lobe in 34 (58%) and the presence of unsuspected tumor in 25 (42%). Transrectal ultrasound detected 13 of 25 unsuspected cancers for a sensitivity of 52%. Of 34 patients with no contralateral lobe lesion transrectal ultrasound was correct in 23 for a specificity of 68%. The positive and negative predictive values for transrectal ultrasound in this study group were 54 and 66%, respectively. There was no significant difference in the pathological size of the clinically suspected and clinically unsuspected cancers as measured by average largest dimension, and transrectal ultrasound sensitivity did not correlate with the size of the cancer. Based on careful sonopathological analysis, transrectal ultrasound may not be a good method to detect clinically unsuspected prostate cancer and the false positive rate would appear to be high.

Humans↗
PubMed1989

The computed tomographic spectrum of thoracic sarcoidosis.

Thoracic manifestations of sarcoidosis are well recognized on conventional radiographs. Less well known are the CT appearances of sarcoidosis. This article reviews the spectrum of CT findings in sarcoidosis; highlighting distributions of lymphadenopathy on CT, patterns of parenchymal involvement, and pulmonary complications of sarcoidosis as demonstrated by CT.

Humans↗
PubMed1989

Parasternal sonography of the internal mammary vessels: technique, normal anatomy, and lymphadenopathy.

Metastasis to the internal mammary lymph nodes adversely affects the disease-free interval and long-term survival in women with breast carcinoma. Since staging of disease in this lymphatic chain is rarely performed at the time of definitive surgical treatment, noninvasive methods have been advocated. The authors present their preliminary experience with a sonographic technique for evaluating the internal mammary lymph nodes, artery, and vein. Longitudinal and transverse images of the first through fourth parasternal rib interspaces were acquired with a 5.0- or 7.5-MHz linear-array real-time system. The method was evaluated prospectively in 36 control subjects and in seven patients (six with metastatic breast cancer and one with lymphocytic lymphoma) who had enlarged internal mammary lymph nodes at thoracic computed tomography (CT). The longitudinal scans routinely demonstrated the internal mammary vessels in the upper interspaces. Lymphatic structures were not identified in the control group. In contrast, sonographic findings corresponding to the CT findings of lymphadenopathy were present in all seven patients. The authors believe that parasternal sonography is a promising technique that merits further study.

Adult↗
PubMed1989

Etiologic factors in renovascular fibromuscular dysplasia. A case-control study.

The role of several factors that have been suggested as being of etiologic importance in renovascular fibromuscular dysplasia was examined in a case-control study of 33 patients with angiographically demonstrated fibromuscular dysplasia and 61 renal transplant donor control subjects with normal renal arteries. The factors studied included use of oral contraceptive agents or markers of sex hormone dysfunction, mechanical stress to the renal artery wall, human lymphocytic antigen (HLA) type, cigarette smoking, history of hypertension for more than 5 years, and family history of cardiovascular disease. The risk of fibromuscular dysplasia was significantly (p = 0.003) increased (odds ratio = 4.1, 95% confidence interval = 1.5-10.9) among cigarette smokers. A significant (p less than 0.001) dose-response relation was noted between cigarette use and the risk of fibromuscular dysplasia developing (odds ratio = 8.6 for those who had smoked more than 10 pack-years). Personal history of hypertension more than 5 years was also associated (odds ratio = 5.0, 95% confidence interval = 1.1-22.8) with a significantly (p = 0.036) increased risk for the development of fibromuscular dysplasia. HLA-DRw6 antigen was more common in the 33 fibromuscular dysplasia patients than in the 61 renal transplant donor control subjects (odds ratio = 3.00, p = 0.067) or a second group of 934 ambulatory control subjects (odds ratio = 2.51, p = 0.031). Adjustment for cigarette smoking increased the odds ratio to 5.0 (95% confidence interval = 1.3-19.6). There was a positive though not statistically significant (odds ratio = 1.7, p = 0.175) association noted between family history of cardiovascular disease and fibromuscular dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Prenatal diagnosis of sacrococcygeal teratoma: sonographic-pathologic correlation.

The prenatal sonograms of 15 fetuses with sacrococcygeal teratoma were reviewed to determine the sonographic appearance and the role of sonography in the obstetric management. Each tumor appeared as a large mass arising from the fetal rump. The teratomas exhibited three sonographic patterns: nine were mixtures of cystic and solid components in equal proportions, four were predominantly solid with a few scattered anechoic areas, and two were unilocular cystic masses. Calcifications were detected in six cases. There was no correlation between the sonographic appearance and the presence of immature or malignant components. Ultrasonography allowed visualization of an intraabdominal component in six cases and assessment of findings that were of prognostic importance. Prenatal detection and size determination of the external component can play an important role in planning obstetric management because fetuses with a large tumor should be delivered by cesarean section to avoid dystocia and catastrophic hemorrhage during delivery.

Female↗
PubMed1988

Renal involvement in AIDS: sonographic-pathologic correlation.

Renal sonography was performed in 36 patients with clinical and/or laboratory evidence of AIDS, usually because of deteriorating renal function. In 15 patients, histopathologic specimens were reviewed to characterize renal pathologic changes underlying the sonographic findings. Sonographic evaluation included determination of renal size and cortical echogenicity according to a standard grading system. Pathologic specimens were evaluated for tubular and glomerular abnormalities. Sonography showed either normal-sized or enlarged kidneys with grade I cortical echogenicity in 13 patients (36%), grade II in three patients (8%), and grade III in five patients (14%). Fifteen patients (42%) had normal renal echogenicity. In addition to focal segmental glomerulosclerosis the pathologic examination showed different degrees of tubular abnormalities. Striking, irregularly dilated, infolded tubules with flattened epithelium and intratubular deposits of proteinaceous material, and sometimes cystlike formation involving the medulla and cortex, were seen in two patients with grade III kidneys, and mild dilatation of the tubules was seen in four patients with grade I disease. Moderate tubular dilatation was observed in one patient with grade I disease. No significant tubular abnormality was seen in one patient with grade I disease or in seven patients with normal renal echogenicity. Although glomerular changes contribute to the increase in renal echogenicity, we postulate that the main factors responsible for the increased echogenicity in AIDS nephropathy are the striking tubular abnormalities seen in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The variable sonographic appearances of ovarian teratomas: correlation with CT.

To better understand how the internal composition of ovarian teratomas influences their sonographic features, we compared their sonographic and CT appearances in 23 cases. Sixteen lesions had a mixed echo texture, with hypoechoic as well as echogenic components; two were anechoic and five were entirely echogenic. Correlation with the CT images showed that the fat present in most teratomas had variable sonographic appearances. Pure sebum was anechoic or hypoechoic, but fat intermixed with hair strands was echogenic and often attenuated the sound beam because of the numerous tissue interfaces created within the mass. The hypoechoic component of the teratoma corresponded, on CT, to low-attenuation fat in 12 tumors and to fluid in five. Most teratomas contained a dermoid plug, a protuberance arising from the tumor wall and containing hair follicles and often fragments of bone or teeth. On sonography, all dermoid plugs were seen as an echogenic mass, often associated with distal acoustic shadowing and protruding into the hypoechoic portion of the teratoma. When the dermoid plug was large and occupied most of the tumor, the entire teratoma appeared echogenic, with no discernible anechoic component. We found that three factors greatly affected the sonographic appearance of ovarian teratomas: the size of the dermoid plug, the presence and location of calcified elements, and the histologic composition of the fatty component.

Adult↗
PubMed1988

Comparison of transvaginal and transabdominal sonography in the detection of early pregnancy and its complications.

Ninety women with a positive pregnancy test and signs and symptoms of threatened abortion or ectopic pregnancy had endovaginal and abdominal sonography in order to compare the value of the two techniques for the detection of gestational abnormalities. Either a normal delivery occurred or surgical and/or pathologic confirmation of the diagnosis was available in all cases. Fifty-five women had normal intrauterine pregnancies, 22 had ectopic pregnancies, seven had blighted ova, and six had missed abortions. All 55 normal intrauterine pregnancies were detected by endovaginal sonography, while only 11 (20%) were diagnosed by transabdominal sonography. The yolk sac, fetal pole, and fetal heart motion were seen as early as 34 days from the last menstrual period with endovaginal sonography, compared with 42 days with transabdominal sonography. Fetal heart motion was detected with endovaginal sonography in fetal poles with a crown-rump length of 3 mm or greater, whereas the fetal pole had to be at least 6 mm before fetal heart motion could be detected with the transabdominal technique. In the 22 ectopic pregnancies, a specific diagnosis of an extrauterine sac containing a fetal pole with heart motion or yolk sac was possible in three cases with the endovaginal technique, but it was not possible in any case with transabdominal sonography. Both techniques showed that each of the seven patients with final diagnosis of blighted ova had a gestational sac that was 1.7 cm or larger without visualization of the fetal pole or yolk sac. All six missed abortions were detected by endovaginal sonography, but only three were diagnosed on transabdominal sonograms. Our findings show that endovaginal sonography is more sensitive than transabdominal sonography in the detection of early pregnancy and its complications.

Female↗
PubMed1987

Update on prostatic ultrasound.

Although there is good evidence that carcinomas of the prostate are usually seen as echopenic masses within the external zone of the prostate, it is unclear how often an echopenic mass has an origin other than carcinoma of the prostate. Technical problems at the periphery of the gland not uncommonly create echopenic areas on an artifactual basis. Whether ultrasound will prove to be a satisfactory screening method for the detection of carcinoma of the prostate is yet to be decided. Prospective studies are in progress, but it has not yet been established whether prostate screening is a worthwhile procedure. The best possible equipment is required to detect these subtle lesions; cheap equipment will probably not give adequate results.

Aged↗
PubMed1987

Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients.

The sonograms of 26 patients (19 adults and seven children) with pathologically proven diagnoses of primary adrenocortical carcinoma were evaluated. Clinical corroboration was obtained in all cases. The size of the lesions ranged from 3 to 22 cm. The five smaller lesions (3-6 cm) showed a homogeneous echo pattern, similar to renal cortical echogenicity. The 21 larger lesions varied in echo texture, having a heterogeneous appearance with focal or scattered echopenic or echogenic zones representing areas of tumor necrosis, hemorrhage, and/or, rarely (19%), calcification. Even the largest lesions were fairly well delineated, often with a lobulated border. Few (7/26 or 27%) showed a surrounding echogenic thin capsulelike rim. All five small lesions showed clinical evidence of endocrine activity. Larger lesions were hormonally active less often (9/21 or 43%). Twelve patients (46%) showed no sign of endocrine activity and presented with symptoms such as fever, weight loss, abdominal discomfort, abdominal mass, hematuria, and hypertension. In the pediatric and adolescent age group (0-16 years), all tumors were hormonally active, while only seven (37%) of tumors in the adult population (17-69 years) were hormonally active. Unfortunately no echo pattern was characteristic enough to allow differentiation of adrenal adenoma from carcinoma. Smaller lesions are more likely to be benign, and larger lesions with areas of necrosis, hemorrhage, and calcification are more likely to be malignant.

Adolescent↗
PubMed1986

Prostatic evaluation by transrectal sonography with histopathologic correlation: the echopenic appearance of early carcinoma.

Fifty-two patients with clinical stage A and B carcinomas of the prostate were imaged by ultrasound (US) transrectally with a 5-MHz linear array transducer and transabdominally with a 3-MHz sector scanner prior to radical prostatectomy. The fresh specimens of 44 prostate glands were scanned in a water bath with a 5-MHz linear array transducer in multiple planes. In all cases, histopathologic correlation was obtained. Prostatic carcinoma presented as an echopenic lesion in 54% of the specimens, as a slightly hypoechoic area in 22%, and could not be identified in 24% because of its isoechoic characteristics. In contrast to many previous reports, no instance of echogenic cancer was observed.

Adenocarcinoma↗
PubMed1986

The echogenic focus in prostatic sonograms, with xeroradiographic and histopathologic correlation.

The sonograms of 42 patients scanned before and after radical prostatectomy were reviewed, giving specific attention to echogenic foci. All patients had clinical stage A or B adenocarcinoma of the prostate. Comparison of the scans with xeroradiographic and histopathologic studies showed all echogenic foci, with or without acoustic shadowing, to represent prostatic calcifications. Calcifications were located in the central portion of the gland exclusively, either immediately adjacent to the urethra or at the margins of the "internal gland", separate from the peripheral location of small tumors. With carcinomatous spread toward the urethra, calculi were found surrounded by tumor. This was considered a result of secondary involvement rather than dystrophic tumor calcification. Prostatic calcifications seem unrelated to the development of adenocarcinoma but must be recognized to prevent erroneous interpretation.

Calcinosis↗
PubMed1986

Pulmonary hamartoma: CT findings.

Forty-seven patients with a proved (n = 31) or presumed (n = 16) diagnosis of pulmonary hamartoma were studied prospectively by thin-section computed tomography (CT). CT criteria for hamartoma included a diameter of 2.5 cm or less, a smooth edge, and focal collections of fat or fat alternating with areas of calcification. No case of cancer (n = 283) or metastatic disease (n = 72) fulfilled these criteria. Seventeen hamartomas with no detectable calcium or fat were not diagnosed by means of CT. Two other lesions contained diffuse calcium deposits. In 28 lesions, a CT diagnosis of hamartoma was based on the detection of fat (n = 18) or calcium plus fat (n = 10). Twelve such cases were proved histologically by means of thoracotomy or needle biopsy; the remainder, including eight in asymptomatic patients aged 65 years or older, were managed with conservative follow-up.

Adult↗