Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PALPATION”

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 1,081 records · Page 60Linked to original sources
PubMed1995

Prevalence of goiter in Taiwanese adults: a preliminary study.

Although there have been many studies on the prevalence of goiters in Taiwanese school children, the goiter prevalence in Taiwanese adults is unknown. This is a preliminary study of the prevalence of goiter in adults admitted for health examinations to the National Taiwan University Hospital. The thyroid glands of 1,020 adults were palpated. Thyroid ultrasonography was also performed on all adults to confirm the palpation findings and to check goiter nodularity. Fine-needle aspiration cytology was done in nodular goiters with or without ultrasound guidance, depending on whether or not the thyroid nodules were easily located by palpation. The adult goiter prevalence was found to be 19.4% in males, 33.6% in females and 25% in total. Seven out of 1,020 adults (0.7%) had thyroid cancers diagnosed by aspiration cytology and confirmed by surgery and pathology. Of the seven adults with thyroid cancer one did not have a palpable goiter. The results show a high prevalence of goiter in these adults. Thyroid ultrasonography is useful for screening thyroid malignancy in adults. If thyroid nodules are detected, fine-needle aspiration cytology can be done with or without ultrasound guidance to confirm the malignancy.

Adult↗
PubMed1994

[Role of transesophageal echocardiography in tricuspid valve repair].

This paper reviews the role of echocardiography in tricuspid valve repair by analyzing the results of three clinical studies. The first investigation was performed for assessing the outcome of two surgical techniques in two groups of patients who underwent De Vega's suture annuloplasty or Carpentier ring implantation. The patients were studied by color Doppler echocardiography after a mean follow-up of 28.7 +/- 11.1 months. The results showed lower degree of tricuspid valve regurgitation in the group of patients who underwent De Vega annuloplasty. The second study demonstrates a new application of transesophageal echocardiography (TEE) for optimizing tricuspid valve annuloplasty. Twenty-three patients with moderate to severe tricuspid regurgitation underwent De Vega's annuloplasty. After cardiopulmonary bypass the tension on the suture was adjusted until the surgeon could not feel any regurgitant jet by the intraatrial palpation; subsequently, the tension was further adjusted under guidance of TEE. The data obtained by the traditional palpation were compared with the data obtained by TEE. A significant reduction of residual tricuspid regurgitation was obtained by TEE when compared to the data obtained by intraatrial palpation. The results showed that the use of TEE was able to optimize the De Vega's annuloplasty by reducing residual tricuspid regurgitation. The third study investigated tricuspid valve regurgitation commonly observed after orthotopic cardiac transplantation (HTX). Aim of the study was to assess the degree of regurgitation and its etiology. Twenty-five patients undergoing HTX were studied intraoperatively by TEE. The results showed that tricuspid regurgitation occurs in most patients immediately after HTX; it is correlated to the ratio recipient-donor right atrium; surgical techniques which reduce the recipient atrium may decrease the occurrence and the degree of tricuspid regurgitation. The above mentioned clinical investigations showed a many-sided role of TEE in tricuspid valve repair. It provides not only a useful diagnostic tool for evaluating residual regurgitation, but it may actively guide the surgical procedures and contribute to improve the surgical technique.

Adult↗
PubMed1995

Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients.

OBJECTIVE: To assess a bedside technique for diagnosing osteomyelitis. DESIGN: We prospectively assessed infected pedal ulcers for detectable bone by probing with a sterile, blunt, stainless steel probe. We then examined the relationship between detection of bone and the presence or absence of osteomyelitis that was defined histopathologically and/or clinically. SETTING: A tertiary care center. PATIENTS: Seventy-five hospitalized diabetic patients with a total of 76 infected foot ulcers were studied. RESULTS: Osteomyelitis was diagnosed in 50 instances (66%) and was excluded in 26 instances. Bone was detected by probing in 33 of 50 ulcers with contiguous osteomyelitis; in contrast, bone was probed in only four of 26 ulcers without contiguous osteomyelitis (P < .001). Bone detected on probing was visible in only three instances. Palpating bone on probing the pedal ulcer had a sensitivity of 66% for osteomyelitis, a specificity of 85%, a positive predictive value of 89%, and a negative predictive value of 56%. CONCLUSIONS: Palpation of bone in the depths of infected pedal ulcers in patients with diabetes is strongly correlated with the presence of underlying osteomyelitis. If bone is palpated on probing, specialized roentgenographic and radionuclide tests to diagnose osteomyelitis are unnecessary. Probing for bone should be included in the initial assessment of all diabetic patients with infected pedal ulcers.

Aged↗
PubMed1993

[Contribution of peroperative ultrasonography].

Ultrasonography, the most reliable examination for the morphological analysis of the thyroid gland, does nonetheless produce some false negative findings. This results in residual nodules after surgery, which will cause real recurrence. Such recurrence can best be avoided by systematic palpation of the entire thyroid gland with two fingers by the surgeon. The authors wanted to assess the merits of intraoperative ultrasonography relative to preoperative ultrasonography and to intraoperative palpation in a randomized prospective study, the results of which are presented in this paper. Intraoperative ultrasonography is most useful for doubtful preoperative ultrasonographic findings in which lesions are described as "heterogeneous parenchyma" or "hypoechogenic areas". Like preoperative ultrasonography, intraoperative ultrasonography allows clearly visualizing the thickness and amount of parenchyma remaining within a multinodular goiter. Performing this intraoperative exploration, either with palpation or ultrasound, or both, seems to be the best way to avoid residual nodules.

Adolescent↗
PubMed1993

Techniques for localization of pulmonary nodules for thoracoscopic resection.

Significant advances in surgical equipment, video monitoring, and endoscopic surgical techniques have expanded the role of thoracoscopy to include pulmonary resection. One limitation of the thoracoscopic technique is the loss of manual palpation to identify the nodule that is either too small or too deep beneath the pleural surface. We describe the techniques used in 300 thoracoscopic pulmonary resections that have aided in identification of pulmonary nodules. These techniques include careful preoperative assessment of the computed tomogram, preoperative injection of methylene blue, or a needle localizing system to identify the nodule. Intraoperative techniques include instrument palpation, digital palpation, and intraoperative ultrasonography. It should be possible to identify the majority of pulmonary nodules at the time of thoracoscopy with these localizing techniques. All nodules were successfully identified in our last 200 thoracoscopic resections.

Humans↗
PubMed1993

Interrater reliability of the Cybex EDI-320 and fluid goniometer in normals and patients with low back pain.

We compared the interrater reliability of the Cybex Electronic Digital Inclinometer-320a (EDI) and the fluid goniometer for measuring lumbar spine range of motion (ROM) in flexion, extension, and prone extension in adults not experiencing back pain and low-back pain patients. We also investigated whether prior palpation training improves reliability of lumbar ROM measurements using these tools. A repeated measures factorial design was used with a 6 x 6 Latin square to balance the order of testing. Twelve adults not experiencing back pain and six subacute low-back-pain patients were measured by two trained and one untrained therapist in all positions with both tools. The L1 and S2 spinous processes were palpated and marked for each measurement. Results of several three-way ANOVAs indicate that no significant differences exist between the tools for nonpatients or patients regardless of position. Using the Intraclass Correlation Coefficient both tools exhibited acceptable reliability under most conditions. The fluid goniometer exhibited better reliability for patients than nonpatients, although this pattern was not present with the EDI. With the exception of extension, prior palpation training did not improve measurement with either tool.

Adult↗
PubMed1996

[Pelvic floor conditioning with vaginal weights--post partum and in urinary incontinence].

To check on the efficacy of cone training 71 women were thoroughly examined six to eight weeks after spontaneous deliveries at various risk levels. Their pelvic floor was examined by palpation, inspection, manometry and gravimetry. All of them were re-examined in the same way after four to six weeks of daily cone training. Thirty women with moderate genuine stress incontinence (16) or stress/urge incontinence (14) were evaluated by the same procedure, independent of gestation. A control group included 20 women prior to and after conventional puerperal pelvic floor exercises and eight nulliparae of the same age prior to and after the same cone training, using a five-cone set. The number of puerperae not capable of voluntary pelvic floor contraction declined from 34 % before to 6 % after training. Optimum initial and posttraining responses, on the other hand, were exhibited by all nulliparae. Differences in childbirth risk for pelvic floor damage played a less important role than childbirth proper. Training related differences were of minor importance, as well, between cone and conventional exercise groups. Notwithstanding different initial values, all puerperae increased their contractility to 10 mm Hg on average, while the increase accomplished by nulliparae was from 15 mm Hg to 21 mm Hg. Cone Nos. 1-3 (20.0-45.0g) were most frequently required at the beginning of training and Nos. 3-5 (45.0-70.0 g) towards the end, for an average increase by one or two cone numbers. 25 % of the cone women and 35 % of the conventional exercise probands failed to complete the training, which was indicative of limited patient compliance after delivery. A positive correlation was found to exist between motivation and training success. Cone training also had positive effects on sexuality. It has proved to work well alternatively or complementary to conventional postpartum exercises and, therefore, may be recommended to all women who are not capable of holding with their pelvic floor vaginal cones of 20-70 g in the postpartum period. In women with urinary incontinence (UI) no pelvic floor response was recordable, prior to training, from five women (17 %). Response was not even recorded from eight women (21 %) by palpation. After training, the capability of voluntary and reflex contraction of pelvic floor muscles was restored in all women. The best post-training result was obtained from palpation (27 positive responses). Manometry and capability of the pelvic floor to hold vaginal cones were other suitable methods in this context: in 15 women (50 %) cone weights were extremely low at the beginning of treatment (Cone no. 1-2), while after treatment 19 women (63 %) held cones up to Nos. 4-5. All healthy women of the control group started with Cone No. 5. In conformity with postpartum groups average increase in pelvic floor contractility was from 5 mm to 10 mm Hg in UI patients. Twenty-four women (80 %) were cured from UI (57 %) or were improved (23 %). Twenty-six women asked for continuation of cone training. Pelvic floor conditioning, using vaginal cones, is a good alternative to poor acceptance or insufficient availability of conventional pelvic floor exercises in conservative treatment of urinary incontinence and descensus.

Adult↗
PubMed1996

[Diagnostic localization of insulinoma. Experiences with 25 patients with solitary tumors].

OBJECTIVE: The most effective way to localize the mostly small ( < 2 cm), benign and solitary insulinomas is still under discussion. Especially the evaluation of the different preoperative localization methods is not clarified. The aim of our study was to support the ongoing discussion in that matter. PATIENTS AND METHODS: In total 25 patients have been included in our study since 1987. All showed sporadic insulinomas and underwent surgery. The following preoperative localization methods had been used: ultrasonography (US): 25 patients, computed tomography (CT): 23 patients, somatostatin receptor scintigraphy (SRS): four patients since 1990, angiography: six patients, endosonography (ES): five patients since 1995, selective portal venous sampling (PVS): two patients, magnetic resonance imaging (MRI): four patients since 1993. All 25 patients underwent a bidigital palpation in combination with intraoperative ultrasonography (IOUS). Four of the 25 patients were reoperated and had a prior unsuccessful operation elsewhere. RESULTS: Preoperatively 19 of 25 insulinomas were localized (76%). The following sensitivity rates had been found: ultrasonography: 56%, computed tomography: 43%, endosonography: 100%, angiography: 66%, magnetic resonance imaging: 25%, selective portal venous sampling: 100%, somatostatin receptor scintigraphy: 0%. All 25 insulinomas were detected during operation, 100% by palpation in combination with intraoperative ultrasonography and 92% by palpation on its own. CONCLUSION: After an insulinoma is biochemically proven and after exclusion of a malignant metastasizing tumor by ultrasonography, all patients should be operated on. Intraoperative ultrasonography should be performed in any case. As other preoperative localization methods did not prove a convincing cost-utility-relation, one should not consider the usage of these methods before the initial operations. Before re-operations one should consider the use of costly pre-operative methods to localize insulinomas. Here endosonography and selective portal venous sampling are recommended as the first procedures of choice.

Adolescent↗
PubMed1997

The painful foot, Part I: Common forefoot deformities.

The incidence of forefoot pain and deformity increases with age. Metatarsal stress fracture may be diagnosed by palpating each metatarsal head. Clinical diagnosis of interdigital neuroma is made by applying top-to-bottom pressure to the suspected interspace with one hand while applying side-to-side pressure across the forefoot with the other hand. Clinical examination of patients with bunion reveals pain on palpation of the erythematous prominent metatarsal head. Features of hallux limitus include pain or crepitus and decreased motion of the first metatarsophalangeal joint. Hammer digit syndrome may be caused by excessive pronation, supination, neuromuscular deformities or systemic disease. Pain that occurs beneath the sesamoid apparatus with weight bearing or palpation may indicate sesamoiditis. With early diagnosis, conservative therapy is often successful in the treatment of common disorders of the forefoot.

Foot Deformities↗
PubMed1997

[The incidence of multiple ovulations in Dutch warmblood mares].

In the period 1994-1996 1030 oestruses of Dutch Warmblood mares were evaluated on the incidence of multiple ovulations diagnosed by rectal palpation. Ultrasonography was not used. All follicles > 25 mm were noted. The examination was repeated every 48 hours. The incidence of multiple follicle development was 7.3%. In a group of 50 ultrasonographically diagnosed twin-pregnant mares only 14 (28%) had been detected by rectal palpation as a multiple ovulation. This suggests an incidence of multiple ovulations in Dutch Warmblood mares of 7.3 x 1/28 x 100 = 26%. Restrictions of rectal palpation are discussed. Ultrasonography is essential for the diagnosis of multiple ovulations. The importance of a good twin-prevention programme is emphasized.

Animals↗
PubMed1998

Intraoperative gamma probe detection of neuroendocrine tumors.

UNLABELLED: Previous studies of the intraoperative use of a handheld gamma probe to localize metastases and primary tumors of colorectal cancer have shown improved assessment of tumor spread and changes in surgical management based on added information gained by radioimmunoguided surgery. We conducted a prospective study to determine whether intraoperative radiodetection is able to reveal microscopic and occult disease of neuroendocrine tumors [medullary thyroid carcinomas (MTCs), gastroenteropancreatic (GEP) tumors]. METHODS: After the injection of 180 MBq [111In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe1]pentetreotide and/or 500 MBq 99mTc-dimercaptosuccinic acid (DMSA) (both for double-nuclide scintigraphy), preoperative somatostatin receptor imaging (12 patients with GEP tumors) and double-nuclide scintigraphy (10 patients with relapsing MTCs were performed. The results were combined with the information obtained from conventional imaging modalities (CT and sonography). Intraoperative radiodetection was performed 24 hr after administration of [111In-DTPA-D-Phe1]pentetreotide or 4 hr after the injection of 99mTc-DMSA using a handheld gamma probe. RESULTS: Intraoperative gamma counting localized 70 somatostatin receptor-positive lesions of GEP tumors, whereas preoperative receptor imaging visualized 74%, surgical palpation visualized 44% and radiological imaging modalities localized only 43%. In 10 patients with recurrent MTCs, the surgeon was successful in localizing and removing 30 tumor lesions using the gamma probe. Twenty-seven of 30 lesions demonstrated tumor involvement, whereas 3 lesions were false-positive (lymphadenitis). Double-nuclide scintigraphy revealed 67% (Octreoscan, 7 of 20; 99mTc-DMSA, 13 of 20), surgical palpation revealed 60% and conventional imaging methods (CT, sonography) revealed only 50% of all lesions detected intraoperatively by the handheld gamma probe. The smallest lesion identified by the handheld probe (not palpated by the surgeon) was a lymph node metastasis (5-mm diameter). CONCLUSION: The preliminary data show that intraoperative handheld gamma probe detection of microscopic and occult endocrine tumors is feasible and more sensitive than external scintigraphy and conventional imaging.

Carcinoma, Medullary↗
PubMedDate not supplied

Pre-operative evaluation of cervical adenopathies in tumours of the upper aerodigestive tract.

BACKGROUND: Carcinomas of the upper aerodigestive tract are characterized by a high incidence of local metastasis in the neck. The presence of lymph node metastasis represents the most unfavorable prognostic factor for these tumors. A diagnostic routine is needed in order to identify the highest number of neck metastasis, thereby optimizing the selection of patients eligible for surgical neck treatment and reduce costs and length of hospital stay. MATERIALS AND METHODS: Our study analyzes the sensibility, specificity, and diagnostic accuracy of clinical examination, echography (US), computed tomography (CT) in cervical metastasis detection by comparing them with the histopathological examination of the neck dissection specimens (pN) in 53 patients suffering from carcinoma of the upper aerodigestive tract. RESULTS: Clinical examination: sensibility 82.1%; specificity 80%; diagnostic accuracy 81.1%; US with a cut off point for minimal adenopathy diameter of 0.5 cm 92.8% sensibility, 60% specificity, 77.3% diagnostic accuracy; US with cut off point 1 cm 82.1% sensibility, 80% specificity, 81.1% diagnostic accuracy; US with cut off point 1 cm, also considering round shape or multiplicity of the adenopathy: 82.1 sensibility, 80% specificity, 81.1% diagnostic accuracy; CT with cut off point 0.5 cm: 92.8% sensibility, 32% specificity, 64.1% diagnostic accuracy; CT with cut off point 1 cm: 85.7% sensibility, 64% specificity, 75.4% diagnostic accuracy; CT with cut off point 1 cm, also considering central necrosis, extracapsular spread, multiplicity of the adenopathy 89.2 sensibility, 60% specificity, 75.5% diagnostic accuracy. CONCLUSIONS: By relating the results obtained from preoperative methods to the anatomopathological analysis of the surgical specimens we can draw the following conclusions: a) a neck positive to palpation in a subject with carcinoma of the upper aero digestive tract must be submitted to neck dissection. Such patients have an 81.1% likelihood of having a metastasis. In these patients the use of radiologic studies of the neck must be restricted to cases with uncertain involvement of retropharingeal, mediastinic, paratracheal lymph nodes or in the follow-up after treatment; b) a neck negative to palpation in a subject with carcinoma of the upper aero digestive tract, must be further investigated. The US and the CT must use a cut-off point of 1 cm to consider a neck positive. Radiologic criteria for malignancy, i.e., multiplicity, roundish shape, central necrosis and capsular invasion do not significantly increase the diagnostic accuracy of the radiographic methods; c) the combined use of US and CT does not offer significant advantages in the detection of metastasis, in any case CT is preferable when primary tumor has to be evaluated; d) the assessment of patients that are negative to palpation and to US and to CT must consider the parameters linked with primary tumor, such as site and size, Broder's grading, Invasive Cell Grading, and thickness.

Head and Neck Neoplasms↗
PubMed2000

Ultrasonography-guided fine-needle aspiration for the assessment of cervical metastases.

OBJECTIVE: To assess the value of ultrasonography (US) combined with fine-needle aspiration (FNA) cytology for the investigation of lymph node metastases in patients with head and neck cancer. DESIGN: Comparison of clinical examination (palpation) and preoperative US-FNA examination results of cervical nodes in a sample of patients with head and neck cancer. The histological features of the neck dissection specimens are used to validate these 2 variables. SETTING: A head and neck oncology service in a tertiary referral hospital. PATIENTS: A consecutive sample of 56 patients with head and neck squamous cell carcinoma, first seen between April 1, 1996, and July 30, 1998, who had neck dissections performed after the US-FNA examination. INTERVENTION: Cervical US-FNA preoperatively, followed by elective or therapeutic radical modified or selective neck dissection. MAIN OUTCOME MEASURES: The histological examination results of subsequent neck dissection specimens are used to determine the sensitivity, specificity, and accuracy of US-FNA for individual nodes. Second, the results of node staging by clinical examination and US-FNA examination are compared. RESULTS: The sensitivity was 89.2%; specificity, 98.1%; and accuracy, 94.5%. Correct node stages were obtained in 52 (93%) of the patients using US-FNA compared with 34 (61%) using palpation. CONCLUSIONS: Ultrasonography combined with FNA is a highly accurate technique for the investigation of cervical lymph node metastases. A more accurate diagnosis may result in more appropriate treatment, particularly in a setting with limited resources. Retropharyngeal nodes, micrometastases, and lymph nodes smaller than 4 mm are limitations of US-FNA. Ultrasonography combined with FNA is a useful technique for the staging of head and neck cancer.

Biopsy, Needle↗
PubMed1997

Preoperative diagnosis of carcinoma of the breast: Is a "cost-cutter" algorithm tenable?

BACKGROUND: Decision making in favor of conservative breast surgery is dependent upon the accuracy of preoperative evaluation of tumor stage, of which imaging modalities occupy a pivotal role. Systematic studies correlating the relative accuracy of various evaluating strategies are few, but remain vital means of making the optimal selection of diagnosis and subsequent treatment option. In this study, we evaluated the relative efficacy of: (1) palpation (P), (2) ultrasonography (US), and (3) bilateral mammography (MG) of the breast and axilla. METHODS: In a prospective study, 109 female patients undergoing a modified radical mastectomy were subjected to a preoperative diagnostic assessment protocol involving palpation, ultrasonography, and bilateral mammography of the breast and axilla. Subsequently the preoperative findings were correlated to the postoperative histopathological reports. Cancer-specific criteria evaluated were tumor size, location, histologic type, histoarchitecture, and calcification, as well as status of regional nodes. Patient-specific criteria included age, size, and density of the breast and presence of associated benign breast disease. Percentage sensitivity, specificity, and positive and negative predictive values were determined for MG, US, and P as well as MG + P and US + P. RESULTS: In assessment of the primary tumor, P, MG, and US showed an overall sensitivity of 88%, 92%, and 90%, respectively; MG + P and US + P had a sensitivity of 99% each. In nodal assessment, P, MG, and US showed an overall sensitivity of 88%, 69%, and 77%, respectively; MG + P and US + P had a sensitivity of 90% and 94%, respectively. Mammography understaged the tumor, whereas US and P overstaged tumors as well as nodes. US was particularly better than MG in younger women, smaller breast size, denser breast consistency, with or without associated benign breast disease, and cystic or necrotic tumors with invasive ductal histology. In addition, US was comparable to MG in most of the other criteria as well. Disadvantages of US over MG were its complete inability to detect microcalcification and certain intraductal cancers. CONCLUSION: We conclude that: (1) the combination of US and P provides equivalent preoperative efficacy as MG, (2) the combination is more cost-effective preoperative assessment for subsequent selection of therapeutic modality, and (3) in certain well-defined circumstances discussed by us, mammography is most useful and should be considered as the imaging modality of choice.

Adult↗
PubMed1997

Comparison of ultrasound-fine needle aspiration and computed tomography in patients undergoing elective neck dissection.

BACKGROUND: Ultrasound of the neck with fine needle aspiration (US-FNA) of suspicious lymph nodes has potential advantages over other radiologic techniques as a screening method for the NO neck in head and neck cancer. METHODS: Twenty-five patients with head and neck cancer who underwent both US of the neck with FNA of any suspicious lymph nodes and neck computed tomography (CT) prior to elective neck dissection were studied. The majority of patients had squamous cell carcinoma (SCC) of the upper aerodigestive tract. Histopathologic results of the neck specimens were compared with each screening technique (palpation, US, US-FNA, CT). RESULTS: Computed tomography (87.9%) and US-FNA (84.9%) had similar overall accuracy in terms of screening the NO neck in our study and were superior to palpation (69.7%) and US alone (72.7%). Specificity was 100% for both CT and US-FNA, with a sensitivity of 60% for CT and 50% for US-FNA. Ultrasound-FNA and CT showed false-negative examinations on virtually the same cases. CONCLUSIONS: Overall, US-FNA was comparable to CT in screening the NO neck in our study. The choice of which modality to employ for imaging the clinically negative neck depends on a number of factors, including the location and clinical extent of the primary tumor as well as the experience and preference of the head and neck surgeon and radiologist.

Biopsy, Needle↗
PubMed1980

Specimen radiography and preoperative localization of nonpalpable breast cancer.

Specimen radiography with or without needle localization should become standard procedure when breast biopsy is performed solely on the basis of mammographic findings. Without these techniques, surgery may prove useless. Over a five-year period from 1974 through 1978, a series of 423 specimen radiographs were done at Memorial Sloan-Kettering Cancer Center for questionable mammographic calcifications or, in a few instances, nonpalpable masses. One hundred and twenty-six proved to be carcinoma, but they represent only 4% of the total number of cancers treated during this period of time. Most breast cancers are still being detected by palpation or palpation combined with mammography. The cancers needing specimen radiography or needle localization are the truly minimal lesions with the best prognosis. With present day techniques, radiation dosage from mammography is extremely low. Its continued use should be encouraged if mammography is to have any impact on breast cancer survival rates. High quality mammograms, interpretation by experienced radiologists, and close coordination of the efforts of the radiologists, surgeon, and pathologist can make possible the detection of increasing numbers of these minimal cancers.

Biopsy↗
PubMed1985

Screening for carcinoma of the prostate. Rectal examination, and enzymatic and radioimmunologic measurements of serum acid phosphatase compared.

Veterans (n = 771, 54-76 years of age) from the Second World War, who attended a rehabilitation program arranged by the state between the years 1979 and 1983, were screened for prostatic cancer by rectal examination of the prostate and by measurement of serum prostate-specific acid phosphatase (PAP) concentration and enzyme activity (total and tartrate-labile). Nine cases with prostatic cancer confirmed by needle biopsy were found. Serum PAP concentrations were elevated in five of the nine cancer patients and rectal examination was positive in six of them, whereas the serum PAP concentration was elevated and rectal examination was positive simultaneously only in two patients. Serum PAP concentrations were elevated in 25 patients without prostatic cancer, and rectal palpation of the prostate resulted in 21 false-positive findings. The enzyme activity of serum acid phosphatase was not elevated in any of the nine patients diagnosed as having prostatic cancer. The predictive value of a positive finding in serum PAP concentration (16.7%) or rectal palpation of the prostate (22.2%) in this unselected, asymptomatic population was similar and low. Both tests together gave additive information.

Acid Phosphatase↗
PubMed1988

Gallium 67 imaging in monitoring lymphoma response to treatment.

The value of gallium 67 (Ga) imaging in monitoring lymphoma response to treatment was assessed in 25 patients with Ga-avid tumors and compared to body computed tomography (CT), chest radiographs, and palpation of tumor infiltrated peripheral lymph nodes. Ga imaging was negative in 95% (20/21) of the patients who were clinically considered to be in remission and in whom treatment was stopped. The disease did not recur during a follow-up of 12 to 26 months in 15 patients. Six patients developed recurrence of the disease 3 to 12 months after treatment was stopped. In all six patients Ga imaging became positive again at the time of the appearance of active disease. In the group of patients in remission, CT was negative in 57% (11/19), chest x-rays in 55% (6/11) and peripheral lymph nodes were palpated in none of the patients (13/13). In four patients that did not achieve remission after treatment, Ga scans were positive. Ga imaging appears useful in monitoring lymphoma response to treatment. This is probably because Ga imaging monitors tumor cell viability, whereas body CT and chest radiographs show the tumor mass, which may consist of fibrotic or necrotic tissue.

Adolescent↗