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At least 811 records · Page 45Linked to original sources
PubMed1991

Methotrexate injection of tubal ectopic pregnancy. A logical evolution?

OBJECTIVE: To test the efficacy and possible side effects of a single 20 mg dose of methotrexate injected at the time of laparoscopy, in the treatment of tubal ectopic pregnancy. DESIGN: The study was a non-randomised non-blinded prospective clinical trial. SETTING: The study was carried out at two tertiary referral hospitals. PATIENTS: Eighteen patients with unruptured tubal ectopic pregnancies and in a stable haemodynamic condition were offered entry into the study and all of these agreed. INTERVENTIONS: At diagnostic laparoscopy, 20 mg of methotrexate in 0.8 mL was injected by fine needle in or around the ectopic gestation. MAIN OUTCOME: Patients were followed up as outpatients by serial blood tests until resolution of the ectopic pregnancy was demonstrated by a return of the level of beta-human chorionic gonadotrophin to the normal range. RESULTS: There was one failure of treatment. The ectopic pregnancy resolved in the remaining 17 patients. There were no side effects attributable to methotrexate and tubal patency was demonstrated in the eight patients tested by hysterosalpingography.

Adult↗
PubMed1986

Morphological aspects of the ectopic granule-like cellular populations in the albino rat hippocampal formation: a Golgi study.

Rat hippocampal formation was examined by the Golgi impregnation method. Three different ectopic granule-like populations of cells were differentiated: (1) Ectopic granule-like cells of the regio inferior, located in the stratum radiatum; one or two dendrites arose from the cell body and ran towards either the molecular layer of the fascia dentata or the stratum lacunosum-moleculare of the hippocampus, where they branched into secondary and tertiary dendrites. (2) Ectopic granule-like cells of the hilar region; this cell population showed bipolar and monopolar types of dendritic tree. Unipolar cells had dendrites oriented towards the granular layer where they branched profusely. Dendritic arborisation of bipolar cells was confined to the hilus. (3) Ectopic granule-like cells of the molecular layer; they showed several structural appearances depending on their location within the layer. Axonal tracts of ectopic granule-like cells gave rise to numerous collaterals; the main branch ran to the CA4 and CA3 hippocampal subregions. Several 'en passant' and mossy-like boutons were shown along this path.

Animals↗
PubMedDate not supplied

Reproductive outcome after multiple ectopic pregnancies.

Seventy-six patients with two or more ectopic pregnancies treated at the Department of Obstetrics and Gynecology, University Central Hospital, Tampere, Finland over a period of 14 years (1972-1985) were retrospectively analyzed. Conservative tubal surgery had originally been performed in 57% of patients with a repeat tubal pregnancy, and in 41% of control patients with a single tubal pregnancy. After two ectopic pregnancies, 53 patients were actively trying to conceive. Of these patients, 25% achieved delivery, 40% had a third ectopic pregnancy, and 35% did not conceive. Ipsilateral tubal pregnancy occurred in 83% after salpingotomy, in 88% after fimbrial evacuation, and in 47% after tubal resection. Conservative surgery was performed in 16 patients with only one tube where an ectopic pregnancy occurred; 25% had a term delivery, 25% had a repeat ectopic pregnancy, and 50% did not conceive. Follow-up of 19 patients after three tubal pregnancies showed that 16% delivered, 26% had a repeat tubal pregnancy, and 58% did not conceive. There was no significant difference between fertility results after salpingectomy and those after conservative surgery.

Adolescent↗
PubMed1989

Ectopic jejunal pacemakers and enterogastric reflux after Roux gastrectomy: effect of intestinal pacing.

The aims of this study were to determine whether ectopic pacemakers are present in the Roux limb of dogs after vagotomy and Roux gastrectomy, whether these pacemakers lead to enterogastric reflux, and whether abolishing the pacemakers with electric pacing might correct such reflex, were it to occur. In five dogs that had undergone gastric vagotomy and Roux gastrectomy and five dogs that had undergone gastric vagotomy and Billroth I gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was recorded during saline infusion (154 mmol/L NaCl) or nutrient (Meritene) infusion into the limb or the duodenum. Reflux of infusate into the stomach was determined via a gastric cannula. Tests in Roux dogs were done with and without limb pacing. Roux dogs showed ectopic pacemakers in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 76% of the recordings; Billroth dogs rarely had such pacemakers (p less than 0.001). Enterogastric reflux occurred in both groups of dogs but was greater during phase III of the interdigestive migrating myoelectric complex in Roux dogs (12% +/- 6%) than in Billroth dogs (3% +/- 1%; p less than 0.05). Pacing abolished the ectopic pacemakers in the Roux dogs and reduced enterogastric reflux from 12% +/- 6% to 3% +/- 2% when phase III was present (p less than 0.05). In conclusion, the Roux limb was driven by ectopic pacemakers that contributed to, but were not solely responsible for, jejunogastric reflux. Pacing abolished the ectopic pacemakers and decreased reflux when phase III was present in the limb.

Action Potentials↗
PubMed1989

[Two cases of male ectopic ureter with hydroureter].

Male ectopic ureters are relatively rare. We herein report two cases of male ectopic ureter. In case 1 a 34-year-old man had left renal hypertrophy incidentally found by ultrasonography. In case 2 a 58-year-old man had the chief complaint of urinary retention. These two patients had ectopic ureters opening into the posterior urethra with hydroureter and renal hypoplasia (Thom I), and nephroureterectomy were performed. There are 105 cases of male ectopic ureter in the Japanese literature. The type of the disease (according to Thom's classification), age distribution, opening site, associated abnormalities and treatment of male ectopic ureter were discussed.

Adult↗
PubMed1989

[A new method for treating ectopic pregnancy with methotrexate].

Due to diagnostic methods of the last decades, such as laparoscopy, ultrasonography and radioimmunoassays, early diagnosis of pregnancy and also of ectopic pregnancy became available. Management of ectopic pregnancy has been conservative tubal surgery so far. Local Methotrexate treatment of ectopic pregnancy was reported only recently. The authors treated successfully two cases of ectopic tubal pregnancy with locally administered 50 mg Methotrexate. One of the tubal pregnancies occurred after IVF, and the other one following GIFT. After local Methotrexate treatment both patients are without any complaints or symptoms. This new method in the treatment of early diagnosed ectopic pregnancy is emphasized and prosed.

Administration, Topical↗
PubMed1989

[Ectopic ureterocele].

An analysis of 43 clinical observations helped to establish three variants of ectopic ureterocele: ectopic ureterocele of the accessory ureter, ectopic ureterocele of the doubled ureter. Ectopic ureterocele always brings about obstruction of the ureter. Ectopic ureterocele of the accessory ureter was treated by making anastomosis between the accessory ureter and the main ureter with a removal of all the accessory ureter and dissection of ureterocele. The operation of heminephrureterectomy or dissection of ureterocele with resection of the paracystic part of the ureter were performed with antireflux utererocystoanastomosis.

Adult↗
PubMed1989

Ectopic jejunal pacemakers and gastric emptying after Roux gastrectomy: effect of intestinal pacing.

The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that occurs. In six dogs that underwent vagotomy and Roux gastrectomy and in four dogs that underwent vagotomy and Billroth gastrectomy (controls), myoelectric activity of the Roux limb or duodenum was measured during gastric emptying of a 500 kcal mixed meal of 99mTc-labeled cooked egg and 111In-labeled milk. Roux dogs were tested with and without pacing of the Roux limb. Roux dogs showed ectopic pacemaker in the Roux limb that drove the pacesetter potentials of the limb in a reverse, or orad, direction during 57% of the postprandial recordings. Billroth dogs had no ectopic pacemakers (p less than 0.05). Liquids emptied more slowly in Roux dogs (half-life (t1/2) = 121 +/- 15 minutes) than in Billroth dogs (t1/2 = 43 +/- 9 minutes; p less than 0.05), but solids emptied similarly in both groups of dogs (t1/2 approximately 8 hours). Pacing the Roux limb abolished the ectopic pacemakers, restored the slow emptying of liquids to the more rapid rate found in the Billroth dogs (t1/2: paced Roux, 72 +/- 15 minutes; Billroth, 43 +/- 9 minutes; p greater than 0.05) and did not change emptying of solids. The conclusion was that ectopic pacemakers present in the Roux limb after vagotomy and Roux gastrectomy drove the limb in a reverse direction and slowed emptying of liquids after the operation. The defect was corrected by pacing the Roux limb in a forward direction.

Anastomosis, Roux-en-Y↗
PubMed1985

Radionuclide turnover studies on ectopic thyroid glands--case report and survey of the literature.

A 72-yr-old woman who had previously undergone partial thyroidectomy for "toxic goiter" and subhyoid gland resection presented with signs and symptoms of ectopic lingual thyroid at the base of the tongue. The combination of lingual subhyoid and pretracheal thyroid is a rarity with only three cases reported. Discovery of ectopic thyroid tissue should raise suspicion of other ectopic thyroid tissues along the path of embryologic migration from its origin to the porta hepatis. This may necessitate assessment of radionuclide uptake and imaging of numerous areas. Sodium levothyroxine is the mainstay of therapy. In patients with obstructive symptoms, 131I ablation of the ectopic thyroid tissues has proven successful and may be more advantageous than surgery. In addition, radioiodide studies during ablation therapy gave new information that the ectopic lingual thyroid had more rapid iodide turnover compared with the postsurgical pretracheal thyroid gland.

Aged↗
PubMed1988

Ectopic bone formation after total hip arthroplasty.

Ectopic bone formation (EBF) is a well-known complication of total hip arthroplasty (THA). The etiology and pathogenesis are still obscure. An analysis of 119 consecutive patients with 129 primary THAs was performed to identify factors predisposing to ectopic bone formation, its frequency, and its effect on the results. Gender (male) and the duration of the operative procedure were statistically significant factors in the development of ectopic bone, which occurred in 63% of hips. The effect of grade III EBF on THA was a limited range of movement. Both local and systemic factors seem to play a role in the development of ectopic bone. Gentle handling of tissues may be important if the rate of ectopic bone is to be reduced.

Female↗
PubMedDate not supplied

Unusual presentation on the right side of ectopic testicular spleen.

An unusual case of right-side testicular spleen is presented. Although described as early as 1889, all cases except one were described to have occurred on the left side. This report documents a second case of extra-testicular spleen occurring on the right side. Since ectopic spleen is an extra-testicular mass and invariably benign, it must be recognized and considered in the primary differential diagnosis of any intrascrotal mass. Since ectopic intrascrotal spleen occurs in the majority of clinical cases under 20 years of age, a preoperative diagnosis of ectopic spleen will prevent possibly unnecessary radical testiculectomy in this age group. Radioactive sulphur colloid will localize in the ectopic spleen, and therefore this modality can be used as an additional preoperative diagnostic tool. Since ectopic testicular spleen was found in up to 25% of all reported cases during orchiopexy and/or herniorrhaphy repair, this entity must be familiar to general and urological surgeons.

Adult↗
PubMed1985

Ectopic pregnancy.

Ectopic pregnancy is no longer dependent on laparotomy for definitive diagnosis. When patients present with massive hemoperitoneum, the diagnosis is usually obvious; but most patients do not present this way, so diagnostic aids are required. Culdocentesis is associated with unusually high false-negative and false-positive results. Laparoscopy is accurate but is an invasive procedure unwarranted in most cases for diagnosis. Although it is unusual to make the diagnosis of unruptured ectopic pregnancy by ultrasonography alone, when ultrasonography is combined with quantitative beta-subunit determinations of human chorionic gonadotropin, many ectopic pregnancies can be diagnosed before rupture occurs. The treatment of the woman with a ruptured ectopic pregnancy and in shock is immediate laparotomy and salpingectomy. Salpingostomy with removal of the ectopic mass and preservation of the tube may enhance a patient's subsequent fertility and may be useful in carefully selected women.

Diagnosis, Differential↗
PubMedDate not supplied

Ectopic hormone production by malignant tumors.

Malignant tumours of nonendocrine tissues may produce ectopic hormones. The most likely mechanism is depression of genes which code for hormones. Ectopic hormones are invariably peptides, and each is identical to some peptide product of an endocrine gland. However, the majority of ectopic hormones occur as biologically inactive precursors or subunits and therefore remain occult unless they are specifically sought. When appropriate assays are made for such inactive forms, it is found that ectopic production of hormone-like peptides occurs frequently. Clinical syndromes result only in the relatively rare patients in whom a biologically active form is synthesized in large quantities. Laboratory research in this area improves our understanding of genetic control mechanisms in neoplasia. Ectopic hormones may be of limited use in diagnosis of cancer, especially when multiple markers are measured simultaneously.

Chorionic Gonadotropin↗
PubMedDate not supplied

Femoral stem failure and ectopic bone formation in total hip arthropalsty: four case reports.

In 4 cases of fracture of the femoral stem in total hip arthroplasty (THA), 3 were preceded by clinical and radiographic evidence of loosening and the last was not. Each developed a significant amount of ectopic bone. Stem failure in THA is a continuum progressing in some cases from ectopic bone formation and calcar resorption to stem loosening. An association between ectopic ossification and stem loosening is determined by grading the quantity of new bone not only by the amount but also by its spatial relationship with the implant. Observation on a large number of cases by the method of DeLee, Ferrari, and Charnley is required to prove or disprove the effect of ectopic bone on stem failure. In any case, patients who develop ectopic bone should be restricted in their activities.

Aged↗
PubMed1981

The use of radiation to discourage ectopic bone. A nine-year study in surgery about the hip.

Patients who had total hip arthroplasty were categorized according to the risk of development of ectopic bone. Radiation therapy was administered after operation to those considered to be at high risk of formation of ectopic bone. The dosage used was 2,000 rads given in ten fractions (875 rets). Forty-eight hips in forty-two patients were treated from 1970 to 1977. Massive formation of ectopic bone did not occur in any hip when the radiation was given relatively early after operation. Thus, we believe that radiation aids in the prevention of formation of ectopic bone. Radiation was found to be of doubtful value, however, hence the ectopic bone was visible on radiography.

Adult↗
PubMed1995

Preoperative thyroid ultrasonography and fine-needle aspiration cytology in ectopic thyroid.

Ectopic thyroid tissue is a rare entity. The occurrence of a thyroid carcinoma in such aberrant thyroid tissue has been reported, but is very rare. Surgical excision is considered the treatment of choice in managing the lesions associated with ectopic thyroid. If the ectopic thyroid is excised, all the thyroid may have been ablated, resulting in permanent hypothyroidism. We report two cases of ectopic thyroid in emphasizing the importance of thyroid ultrasonography and fine-needle aspiration (FNA) cytology in evaluating ectopic thyroid before surgery.

Adult↗
PubMed1993

Nonlinear predictive interpolation. A new method for the correction of ectopic beats for heart rate variability analysis.

Heart rate variability (HRV) analysis is a technique that uses the beat-to-beat variations in RR intervals as a measure of the level of activity of the autonomic nervous system. However, the presence of ectopic beats can alter measures of HRV by introducing mathematical artifact and thus, prevent accurate determinations of HRV. Simple exclusion of those portions of data that contain ectopy from analysis inappropriate because (1) it can lead to a substantial reduction in the amount of data available for analysis and (2) if the presence (and frequency) of ectopic beats is correlated with specific alterations in autonomic tone, then the utilization of only ectopy-free data for analysis will lead to bias in the measures. For this reason, methods for the correction of ectopic beats have been devised and applied in the determination of HRV. The authors therefore propose a new method for the correction of ectopic beats: nonlinear predictive interpolation. Using the fact that beat-to-beat changes in heart rate occur in a deterministic fashion as the only assumption, the authors apply the methods of chaos theory in order to locate ectopy-free portions of the RR interval sequence that describe trajectories in phase space that are locally similar to that of the ectopy-containing segments. The authors then determine which of these trajectories most closely approximates that of a particular ectopy-containing segment, and use it to determine replacement RR intervals for the ectopic beats.

Arrhythmias, Cardiac↗
PubMed1993

The relationship between new ion channels and ectopic discharges from a region of nerve injury.

Changes in ectopic discharges from axons in an injured nerve were examined while agents that interact with ion channels were applied to the site of the nerve injury. Tetraethylammonium (TEA) greatly facilitated spontaneous ectopic discharges or evoked ectopic firing in previously silent axons. Tetrodotoxin, an Na+ channel blocker, completely blocked spontaneous discharges. Verapamil, La3+, and Mn2+, agents that interact with Ca2+ channels, blocked spontaneous discharges and depressed the responses evoked by TEA, noradrenaline and high concentration of K+. Increasing Ca2+ levels facilitated ectopic discharges and this effect was blocked by La3+ and Mn2+. Normal axons (from uninjured nerves) were insensitive to all the effects seen in the axons from the injured nerve. These results suggest that following nerve injury the membrane of the regenerating sprout contains new ion channels, particularly Ca2+ channels, and that these channels are responsible for the generation of ectopic discharges.

Animals↗