Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ectopic”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed2000

Multiple ectopic parathyroid glands.

Parathyroid surgery to correct primary hyperparathyroidism is successful in 80 to 97 per cent of initial explorations. Failures are often linked to inability to locate ectopic parathyroid glands. Although ectopic parathyroid glands are relatively common (15%) multiple ectopic glands are rarely reported. We describe a case of multiple ectopic parathyroid glands and the intraoperative approach to their localization and review the anatomy and embryology of ectopic parathyroid glands. A 39-year-old woman presented with fatigue, lethargy, and depression. On biochemical evaluation she was noted to be hypercalcemic and hyperparathyroid. Preoperative parathyroid localization failed to identify abnormal parathyroid glands. At exploration three of four parathyroid glands, including an adenoma, were located in ectopic positions by a meticulous and systematic dissection. A careful exploration coupled with a thorough knowledge of parathyroid anatomy and embryology will produce successful surgical correction of primary hyperparathyroidism in greater than 95 per cent of patients even in the few patients with multiple ectopic parathyroid glands.

Adult↗
PubMed2002

[A case of secondary hyperparathyroidism with an ectopic intrathyroid gland successfully diagnosed and controlled by percutaneous ethanol injection therapy (PEIT)].

Secondary hyperparathyroidism (II HPT) is a major complication in chronic dialysis patients, and percutaneous ethanol injection therapy (PEIT) has become a useful alternative treatment for II HPT. However, the existence of ectopic parathyroid glands is a major problem when conducting PEIT. Ectopic parathyroid gland accepts 10-35% of II HPT, and the missing glands cannot be detected consistently by any imaging techniques, including scintigraphy. Intrathyroid parathyroid gland is as rare as about 1% and recurrence of missing glands after parathyroidectomy (PTx) has been reported in some cases. We report here a 52-year-old female in whom an ectopic parathyroid gland was defected successfully and intact-PTH controlled by tentative PEIT. At the first examination, a left parathyroid adenoma and a right thyroid goiter were pointed out by ultrasonography, CT and scintigraphy. PEIT was applied twice to the left parathyroid adenoma, but intact-PTH was not decreased. Ultrasonography, CT, 201Tl-99mTc subtraction scintigraphy and fine needle aspiration biopsy (FNAB) were performed again to search for the existence of ectopic glands. The results suggested that the right intrathyroid tumor was an ectopic parathyroid gland. Consequently, tentative PEIT was applied to the right intrathyroid tumor, and successful control of intact-PTH and serum Ca was eventually achieved. To our knowledge, this is the first reported case of secondary hyperparathyroidism with an ectopic intrathyroid gland that was successfully controlled by PEIT. In this case, it was suggested that tentative PEIT of intrathyroid tumor was a useful method for detecting an ectopic parathyroid gland.

Adenoma↗
PubMed2002

Ectopic pancreas with gastric outlet obstruction: report of two cases and literature review.

Ectopic pancreas is a rare entity and is usually an incidental finding in clinical practice. Most patients with an ectopic pancreas are asymptomatic, and if present, symptoms are non-specific according to the site of the lesion and different complications encountered. The most-common site is the stomach, accounting for 25%-38.2% of all patients. An asymptomatic ectopic pancreas is usually of no clinical importance, and there is no surgical indication in such a situation. However if there are complications caused by an ectopic pancreas, a variety of actions becomes necessary. We report 2 cases of ectopic pancreas with gastric outlet obstruction. The first case was a 41-year-old man who suffered from epigastric fullness and dyspepsia for 3 years. Endoscopic examination revealed a submucosal tumor measuring 2.5 cm in diameter in the prepyloric area. The second case was a 53-year-old man, who initially underwent a craniotomy to remove a pituitary adenoma, and laparotomy and duodenorrhaphy due to a perforated peptic ulcer. The postoperative course was not uneventful, and an upper gastrointestinal series showed a 2-cm intramural mass with a mucosal ulcer at the distal antrum. Both cases had symptoms and signs of gastric outlet obstruction, and both cases accepted subtotal gastrectomy with Billroth II anastomosis. A review of the literature revealed few cases of ectopic pancreas with gastric outlet obstruction. An ectopic pancreas must be considered in the differential diagnosis of gastric outlet obstruction.

Adult↗
PubMed2002

The analogy in cell immunophenotype and parameters of cell cycle of ectopic thymus, normal thymus, and some acute lymphoblastic leukemia of T-phenotype.

In our study we described the immunophenotypic characteristics of an ectopic thymus found in an eight month old male baby. Comparing with the results of normal thymic cells we did not found any difference or abnormalities in the phenotype. A brief discussion of theories of histogenesis and possible differential diagnosis of ectopic thymus is included. The most common immune pattern of both, ectopic and normal thymuses, was expression of TdT,CD7,cCD3,CD1 and dual CD4/CD8. Early results of immunological examination confirmed by histopathology stated the diagnosis of ectopic thymus and excluded other causes (infection, trauma, neoplasm and congenital abnormalities). The study of both, ectopic and normal thymic tissue provides a perfect model for comparative analysis of some T-acute lymphoblastic leukemia (T-ALL). Both, thymocytes and some cases of our T-ALL (20 of 48 examined T-ALL) had a specific late cortical T-cell phenotype. We observed new qualities of both, thymic cells and T-ALL cells of a late cortical phenotype that resulted in cell populations localized in the so-called "empty spaces", in fluorescence histograms, that might be discriminated from internal T-cell populations with normal antigen expression. An important sign of T-ALL in common is to display aberrant marker combinations and the tendency to drop specific normal T-cell antigens. Aberrant markers were present in our study in a phenotypic group of a late cortical T-ALL in 11 cases (55.0%) of the 20 studied. As aberrant markers we observed mostly CD10, CD34, HLA-DR and CD13. Furthermore, the tendency to drop specific normal T-cell markers could be recognized in one case of a late cortical T-ALL in the form of TCRab and TCRgd absence. DNA analysis did not reveal any changes in proliferation index either in thymocytes (normal or ectopic), or in T-ALL of a late cortical T-cell phenotype. Based on our findings the clinical utility of comparing the results obtained from the immunophenotypic characterization of healthy hematopoietic and leukemia cells can be concluded. An exact and early diagnosis of hematopoietic disorders (ectopic thymus, T-ALL and T-NHL) and identification of identical phenotypic patterns at different times (for more exact minimal residual disease detection during and after therapy) could be obtained.

Antibodies, Monoclonal↗
PubMed1992

Ectopic acromegaly.

Ectopic acromegaly is a rare syndrome (less than 1% of acromegalic patients) caused by ectopic growth hormone-releasing hormone (GHRH) or growth hormone (GH)-producing tumors. Its recognition is clinically important because acromegaly may be a symptom of an aggressive tumor, and different therapeutic approaches are required. Most cases are caused by either extra- or intracranial GHRH-producing tumors, whereas in rare instances the underlying disease is an ectopic GH-secreting tumor. The routine evaluation of circulating GHRH in all acromegalic patients may allow its early recognition, because plasma levels greater than 0.3 ng/mL are virtually diagnostic of a GHRH-producing tumor (frequently a bronchial or pancreatic carcinoid), whereas suppressed levels may suggest an ectopic GH-producing tumor. In addition to classic imaging techniques, whole body scintiscan with labeled octreotide may help in the localization of ectopic tumors. Surgical removal of the ectopic tumor is the therapy of choice, but it is not always feasible because patients often present with widespread metastases. Patients with GHRH-induced acromegaly benefit from the administration of the long-acting somatostatin analog, octreotide, which reduces GH, IGF-I, and GHRH, and may shrink the ectopic tumor, its metastases, and the secondary pituitary enlargement.

Acromegaly↗
PubMed2005

[Influence of mifepristone and lilopristone on proliferation and expression of nuclear factor-kappa B of ectopic stromal cells in vitro].

OBJECTIVE: To evaluate the effects of antiprogestins mifepristone and lilopristone on proliferation and expressions of nuclear factor-kappa B (NF-kappaB) of ectopic stromal cells in vitro. METHODS: The ectopic stromal cells of ovary were cultured in vitro. Methyl thiazolyl tetrazolium method was used to evaluate proliferative activity of ectopic stromal cells. Cells were divided into five groups according to drug concentration: control group, group I and group II of mifepristone and of lilopristone. The expressions of NF-kappaB P65 and NF-kappaB P65 mRNA of ectopic stromal cells were determined by immunocytochemistry and in situ hybridization of cell slice. RESULTS: Antiprogestins mifepristone and lilopristone were able to significantly suppress the proliferation of ectopic stromal cells in a time- and dose-dependent manner in vitro. The expressions of NF-kappaB P65 and NF-kappaB P65 mRNA of ectopic stromal cells in the control group were higher than that of group I and group II. Their expressions in mifepristone groups were higher than that of lilopristone groups. CONCLUSIONS: Antiprogestin mifepristone and lilopristone could significantly suppress the proliferation of ectopic stromal cells in a time- and dose-dependent manner in vitro. The action mechanisms may be associated with the suppression of expression of NF-kappaB P65 mRNA and NF-kappaB P65.

Adult↗
PubMedDate not supplied

Unexpectedly low ratio and falling incidence rate of ectopic pregnancy in Enugu, Nigeria, 1978-1981.

The demographic characteristics and subsequent pregnancy rate of women with tubal ectopic pregnancy have been investigated at the University of Nigeria Teaching Hospital, Enugu. The ratio of ectopic pregnancy to total births was 1:287. Ectopic pregnancy accounted for 6.2% of all gynaecological emergencies at the hospital and was the third most common of such emergencies. Nearly 69% of the women with ectopic pregnancy had delivered two or more babies previously, and the post-ectopic pregnancy conception rate was 19.54%. Surprisingly, the rate of ectopic pregnancy fell from 1:190 in 1978 to 1:480 in 1981. Ectopic pregnancy is not obviously influenced by maternal age or parity in Enugu, but is prevalent in women with previous pelvic inflammatory disease.

Adolescent↗
PubMed1985

Conservative microsurgical management of ectopic gestation.

The current management of ectopic gestation has been greatly affected by two apparent trends: a world-wide dramatic increase in its incidence; and a tendency for women to delay childbearing into later life. In the past, the objective of surgery for ectopic pregnancy was saving lives, and salpingectomy was the procedure of choice. At present, with improved methods of an early diagnosis, namely quantitative beta-HCG, ultrasonography, and laparoscopy, preservation of maximal reproductive potential of the affected women becomes a primary surgical goal. Conservative microsurgical approach with the reconstruction of the affected oviduct may be the procedure of choice. Following standard salpingectomy for ectopic gestation, two-thirds of such patients will not subsequently reproduce successfully. On the other hand, statistics indicate that microsurgical repair of the affected oviduct at the time of operation for an ectopic pregnancy will be followed by term pregnancy in 50 to 72% of patients. In this presentation, a variety of conservative surgical approaches are described and discussed. They represent a spectrum from operative laparoscopy to laparotomy with linear salpingotomy, segmental excision with or without an immediate anastomosis, to the management of tubal abortion. General principles of microsurgical techniques applicable to the management of unruptured ectopic gestation are outlined. The analysis of available data indicate that conservative approach is advantageous for preservation and enhancement of future reproductive potential of the affected patient. Since ectopic tubal gestation is an unqualified human reproductive disaster, preservation and restoration of normal pelvic architecture appears logical and applicable, especially in cases of chronologically older women whose first pregnancy is an ectopic location.

Fallopian Tubes↗
PubMed1979

The conservative surgical management of unruptured ectopic pregnancy.

With the earlier and more accurate diagnosis of ectopic pregnancy based on rapid beta-subunit pregnancy tests and the use of ultrasound and laparoscopy, the percentage of diagnosed unruptured ectopic pregnancies is rapidly increasing. This, coupled with the earlier treatment of pelvic inflammatory disease, the use of IUDs, and increasing numbers of tubal plastic surgery, caused the authors to evaluate the problem of conservative management of ectopic pregnancy. In this study 98 patients at the Yale-New Haven Hospital who had ectopic pregnancies between 1972 and 1977 are evaluated. Fifty of these patients underwent a salpingectomy or salpingo-oophorectomy. Forty-eight patients underwent salpingostomy. This represents an increase in the conservative surgery rate from 8 to 35.5%. The overall term viable pregnancy rate was 40%, along with a 10% repeat ectopic rate. There was no advantage as far as term viable pregnancy when comparing salpingostomy and salpingectomy. Conservative surgery did not increase the repeat ectopic rate. Salpingostomy is therefore recommended in unruptured ampullar ectopic pregnancies in order to preserve reproductive function. If current trends continue, this will be an increasingly important problem. The statistics are based on a 73% follow-up, with all patients actively trying to conceive.

Castration↗
PubMedDate not supplied

Ectopic bone formation following low friction arthroplasty of the hip.

Ectopic bone formation after low friction arthroplasty (LFA) occurs nearly three times as often in males as in females and, in significant amounts, in 10 per cent of the total number of patients. The more limited the range of motion preoperatively, the more severe the degree of ectopic bone formation. The diagnosis does not closely relate to ectopic bone formation though the incidence is highest in osteoarthritis. The removal of osteophytes does not increase the incidence of ectopic bone formation. Trochanteric osteotomy in the surgical exposure is not an important cause of ectopic bone formation. A patient with ectopic bone after LFA on one side has a 92 per cent chance of developing it in a subsequent LFA on the opposite side. Systemic factors appear to play a dominant role in the production of ectopic bone.

Adult↗
PubMed1989

Preventing ruptured ectopic pregnancy with a single serum progesterone.

Retrospective data on patients with documented ectopic pregnancies have demonstrated the potential usefulness of serum progesterone in decreasing the time to diagnosis. We report a prospective trial utilizing serum progesterone in the emergency department of a large city-county hospital. Sixty-seven ectopic pregnancies were document in the 582 patients screened; 54 (80.6%) had a progesterone level less than 15 ng/ml. Only one (1.5%) ruptured ectopic pregnancy was associated with a progesterone level greater than 25 ng/ml. There were 387 documented or presumed normal intrauterine pregnancies, 41 (10.6%) had progesterone concentrations of less than 15 ng/ml and 236 (61%) had a progesterone level greater than 25 ng/ml. We decreased minimum time of diagnosis from 48 to 72 hours to less than 24 hours by use of a progesterone screening protocol. During this time the percentage of ruptured ectopic pregnancies decreased from 79.2% to 38.8% (p less than 0.05). Because of its simple interpretation and 24-hour maximum delay, we conclude that the determination of serum progesterone should be used for ectopic pregnancy screening in all patients at risk for ectopic pregnancy, or at any time when the diagnosis is in question.

Algorithms↗
PubMed1991

The role of Chlamydia trachomatis and Neisseria gonorrhoeae in the aetiology of ectopic pregnancy in Gabon.

OBJECTIVE: To study the association between ectopic pregnancy and Chlamydia trachomatis and Neisseria gonorrhoeae. DESIGN: A prospective observational study with two comparison groups. SETTING: A general hospital in Franceville, Gabon. SUBJECTS: Forty-five women with ectopic pregnancies and two comparison groups each of 45 women, one at 5 to 12 and the other at 32 to 41 weeks gestation. MAIN OUTCOME MEASURES: Serum levels of IgG and IgA antibodies to C. trachomatis (L1 and rMOMP) and N. gonorrhoeae (pili) in all the women. In the women with ectopic pregnancy peritoneal adhesions were scored and in 40 women samples of tube were cultured for organisms being studied. RESULTS: IgG and IgA antibodies to C. trachomatis (L1) were detected in 84% of the ectopic group and 53 and 39% of the comparison groups (P less than 0.0001). IgG and IgA antibodies to N. gonorrhoeae occurred in 49, 28 and 18% and 49, 28 and 26% of the groups but the differences were not statistically significant. Adhesions were positively associated with the antibodies. C. trachomatis was cultured from the tubes of 71% of the women with ectopic pregnancy. CONCLUSIONS: Infection with chlamydia, and probably with N. gonorrhoeae, is an important factor in the causation of ectopic pregnancy in Gabon.

Antibodies, Bacterial↗
PubMed2005

Ectopic pregnancy: presentation and risk factors.

OBJECTIVE: To describe the clinical features and risk factors in ectopic pregnancy. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: The study was conducted in Unit III of the Department of Obstetrics and Gynaecology, Civil Hospital, Karachi from January 2002 to December 2003. PATIENTS AND METHODS: A total of 38 women diagnosed with ectopic pregnancy were included in the study. Data was retrieved from the charts of all the patients diagnosed with ectopic pregnancy through a structured proforma. The variables studied included age, parity, symptoms and signs, risk factors, treatment and associated maternal morbidity. RESULTS: Among the clinical features, the most common presenting symptom was abdominal pain in 37 (97.3%) patients whereas history of amenorrhea and vaginal bleeding were found in 28 (73.6%) and 22 (57.8%) patients respectively. The most common physical sign was tenderness: abdominal tenderness in 28 (73.6%) and pelvic tenderness in 23 (60.5%) patients. Cervical excitation was only present in 19 (50%) patients. Risk factors were present in 23 patients (60.5%), the most frequent being infertility in 9 patients (23.6%). Other risk factors were tuberculosis in 6 patients (15.7%), previous ectopic pregnancy in 3 (7.8%) and previous tubal surgery in 1 (2.6%) patient. History of IUCD was present in 1 (2.6%), injection Depo-provera in 4 (10.5%) and OCP in 3 (7.8%) patients. History of D & C and C-section were present in 7 (18.4%) and 4 (10.5%) patients respectively. CONCLUSION: Abdominal pain was the single most consistent feature of ectopic pregnancy. Risk factors may not always be present. Therefore, ectopic pregnancy should be suspected in every woman of reproductive age who presents with unexplained abdominal pain, irrespective of amenorrhea and vaginal bleeding and whether risk factors were present in the past history or not.

Adolescent↗
PubMed2000

Cervical ectopic pregnancy. Diagnosis with endovaginal ultrasound examination and successful treatment with methotrexate.

Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervical canal. Diagnosis and treatment of cervical ectopic pregnancy has changed dramatically in the last 15 years. Before 1980, the diagnosis commonly was made when dilation and curettage for presumed incomplete abortion resulted in unexpected hemorrhage. Emergency hysterectomy usually ensued. Cervical ectopic pregnancy is now commonly diagnosed on a first-trimester ultrasound examination. The family physician practicing obstetrics must consider the diagnosis of cervical ectopic pregnancy in women with first-trimester vaginal bleeding or pelvic pain to permit early diagnosis and fertility-saving treatment. A case report of diagnosis and successful medical management of a cervical ectopic pregnancy is presented. The literature on the epidemiology, causes, diagnosis, and treatment of cervical ectopic pregnancy is reviewed.

Abortifacient Agents, Nonsteroidal↗
PubMed1998

Sonographic endometrial three-layer pattern in symptomatic first-trimester pregnancy: not diagnostic of ectopic pregnancy.

PURPOSE: We evaluated a recent report that suggested that a "3-layer" appearance of the endometrium on sonography is diagnostic of ectopic pregnancy in symptomatic pregnant patients. METHODS: We reviewed the log of pelvic sonograms performed to rule out ectopic pregnancy in women presenting with first-trimester bleeding and/or pain during a 29-month period. Medical records and sonograms of patients without sonographic evidence of intrauterine pregnancy were reviewed to determine final diagnoses and whether the 3-layer pattern was present. RESULTS: One hundred twenty patients with available follow-up had no sonographic evidence of intrauterine pregnancy. Fifty-nine (49%) had ectopic pregnancy. An endometrial 3-layer pattern was noted sonographically in 15 patients (13%), of whom 6 (40%) had ectopic pregnancy. As a diagnostic sign of ectopic pregnancy, the endometrial 3-layer pattern had a sensitivity of 10.2%, specificity of 85.2%, positive predictive value of 40%, negative predictive value of 50.5%, and accuracy of 49.2%. CONCLUSIONS: The endometrial 3-layer pattern is neither sensitive nor specific for the diagnosis of ectopic pregnancy.

Adult↗
PubMed1980

Ectopic pregnancy and myoma uteri: teratogenic effects and maternal characteristics.

Morphological data from 3,614 well-preserved human embryos derived from artificial termination of pregnancy were used to determine whether ectopic implantation or enlarged myomas could enhance the prevalence of localized malformations of the embryo. The frequency of malformed embryos was 11.6% among 43 recovered from ectopic pregnancies, 6.2% among 97 from myomatous pregnancies, and 3.3% among 3,474 from normally implanted pregnancies not complicated by myomas. Unilateral amelia in the ectopic cases and caudal dysplasia in the myoma cases were significantly increased. Both malformations were quite unusual in the control group. It is argued that spatial restrictions could be a teratogenic agent in human embryos. Mothers of both ectopic and myoma cases were on average much older than mothers of the control specimens, and those with myomas had a higher frequency of previous pregnancy wastages. Ectopic pregnancy was found to be associated with lowered parity, previous ectopic pregnancy, and maternal smoking and drinking. These associations are discussed and interpreted in relation to etiology of each of the two conditions.

Abortion, Habitual↗
PubMed2005

Evaluation of the relationship between endometrial thickness and failure of single-dose methotrexate in ectopic pregnancy.

OBJECTIVE: To test the hypothesis that endometrial stripe thicker than 12 mm increases treatment failure of single-dose methotrexate for the management of ectopic pregnancy. STUDY DESIGN: Seventy-three patients with ectopic pregnancy and measured pretreatment endometrial stripe were divided into two groups based on the endometrial stripe thickness (> 12 mm or < or = 12 mm). All patients were candidates for single-dose methotrexate treatment. Variables analyzed between the two groups were endometrial stripe thickness, initial beta human chorionic gonadotropin level (hCG), size of the ectopic mass, presence of fetal heart tones, previous ectopic pregnancy, and clinical outcomes. RESULTS: Sixty patients had endometrial stripe thickness < or = 12 mm and 13 patients > 12 mm. The two groups were similar in initial hCG, size of ectopic mass, presence of fetal heart tones and rate of previous ectopic pregnancy. The failure rate was significantly higher in the group with endometrial stripe > 12 mm compared to the group < or = 12 mm (n=7, 53% vs. n=3, 5%, P<0.01). The endometrial stripe was significantly thicker in the group with endometrial stripe thickness > 12 mm compared to the group < or = 12 mm (mean +/- SD, 17.64+/-5.82 mm vs. 7.69+/-2.82 mm, P<0.01). CONCLUSION: Endometrial stripe thicker than 12 mm increases the risk for treatment failure with single-dose methotrexate.

Abortifacient Agents, Nonsteroidal↗
PubMed1987

Ethmozine (moricizine HCl): a promising drug for "automatic" atrial ectopic tachycardia.

Atrial ectopic tachycardia is an uncommon life-threatening supraventricular tachycardia in children and is resistant to usual antiarrhythmic drugs. Whereas the cellular mechanism of atrial ectopic tachycardia is unknown, atrial ectopic tachycardia may be due to a form of automaticity. Moricizine HCl has been used primarily for ventricular rhythm disturbances; the drug depresses abnormal automaticity and delayed after-depolarizations but has little effect on normal automaticity. Because of this property, we have used moricizine HCl in 4 patients with atrial ectopic tachycardia. As evidenced by continuous 24-hour Holter monitoring, moricizine HCl was successful in suppressing atrial ectopic tachycardia in each patient. During a limited follow-up (6 months) no side effects have occurred. Moricizine HCl is a promising primary drug for atrial ectopic tachycardia.

Adolescent↗