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At least 1,171 records · Page 65Linked to original sources
PubMed1995

Double burst stimulation for monitoring neuromuscular blockade for tracheal intubation.

Responses to double burst stimulation were palpated every 15 s after intravenous administration of vecuronium 0.2 mg.kg-1 in 60 adult patients under anaesthesia. Intubating conditions and neuromuscular responses to tracheal intubation were assessed at disappearance of one or both palpable responses to double burst stimulation in groups of 30 patients randomly divided, although in group A patients, tracheal intubation could be performed at disappearance of one palpable response to double burst stimulation; 27 out of 30 patients (90%) had mild to moderate bucking on intubation. In this group, only five patients (16.66%) had good intubating conditions. In group B, where tracheal intubation was attempted at disappearance of both palpable responses, intubating conditions were good in 28 out of 30 patients (93.33%) and there was no response to tracheal intubation in 26 out of 30 patients (86.66%). Palpation of evoked response to double burst stimulation can be used to predict intubating conditions and neuromuscular response to tracheal intubation with nondepolarising muscle relaxants such as vecuronium.

Adult↗
PubMed1997

Detection of accidental oesophageal intubation. Role of the anaesthetic assistant.

Three situations in which an anaesthetic assistant might be able to detect accidental oesophageal intubation during or immediately after intubation were assessed. These were: firstly, whilst applying cricoid pressure, secondly, whilst applying gentle palpation over the trachea just above the suprasternal notch and, thirdly, after intubation by means of a 'roll test'. During cricoid pressure, tracheal intubation was correctly diagnosed in all of 10 cases. However, deliberate oesophageal intubation was only detected in six out of 10 cases. During suprasternal palpation, three cases out of 10 oesophageal and three cases out of 10 tracheal intubation were misdiagnosed. In the 'roll test', two out of 10 tracheal and five out of 10 oesophageal intubations were misdiagnosed. In conclusion, no method could be relied on entirely and may indeed give false reassurance. Nonetheless, any doubt expressed about the tracheal tube position by the assistant should be taken seriously and a careful check made.

Adolescent↗
PubMed1989

The long-term outcome of thyroidectomy for sporadic non-toxic goitre.

To study the long-term outcome after thyroidectomy, 113 sporadic non-toxic goitre patients who underwent thyroidectomy in our hospital in the period 1974-1983, were studied. Five patients complained of recurrent goitre; a goitre was found on inspection and palpation in these five and in 15 others. There were no differences between the 20 patients with goitre and the 93 patients without goitre with regard to sex, age, duration of goitre, indication and type of thyroidectomy, postoperative thyroid hormone medication, period of follow-up, and T4, T3, or TSH plasma values at the time of follow-up examination. Twenty-three patients complained of voice changes since thyroidectomy. In a case control study, included in this follow-up study, 19 patients with goitre, i.e. thyroid size I and II as estimated by inspection and palpation (cases), and 16 patients without goitre, i.e. thyroid size OA and OB (controls), were studied in more detail. No difference between cases and controls was found in any of the above mentioned parameters that could explain the recurrence of goitre. Thyroid volume (median) was greater in the cases (34.1 ml, range 7.9-83.4) than in the controls (10.3 ml, range 2.5-48.7) (P less than 0.001), although a considerable overlap between the two groups was observed. One or more thyroid nodules were found in 89.5% of the cases and in 62.5% of the controls (NS). Serum thyroid growth stimulating immunoglobulin (TGI) was present both in cases (68%) and controls (50%). TGI was present in high titres in all five patients who complained about recurrent goitre.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Screening for lymph nodes in the neck with ultrasound.

In a study of the value of ultrasound in staging patients with head and neck malignancies, we performed ultrasound of the neck. The results of this investigation were compared with palpation. A fine needle aspiration biopsy and/or histologic examination was carried out on lymph nodes which were found. One hundred and six patients were included in this study. In 44 of the patients no lymph nodes could be detected, either on palpation or by ultrasound examination. In the other 62 patients all palpable lymph nodes were also demonstrated by ultrasound. However, in 20 patients with negative palpatory findings, ultrasound revealed lymph nodes: 11 metastases and 9 benign nodes. In 40 patients an ultrasound guided fine needle aspiration biopsy (UGFNAB) was performed. In 85% of these patients a cytological diagnosis could be made. From these results we conclude that ultrasound and UGFNAB are of considerable value in staging head and neck malignancies.

Biopsy, Needle↗
PubMed1992

Sex differences in signs and symptoms from masticatory and other muscles in 19-year-old individuals.

Pain and tenderness of masticatory muscles are often related to muscle tenderness elsewhere in the body. It has been shown that women are more prone to musculoskeletal disorders than men. We sought to determine whether sex differences of muscular symptoms were established by the age of 19. The subjects comprised 51 boys and girls who received a questionnaire regarding the function of their masticatory system, frequency of headache, and neck, shoulder and low back pain. Their masticatory system was examined, and neck and shoulders were palpated. For all variables in the questionnaire girls reported symptoms more often than the boys. Of the subjects 50% had tender chewing muscles upon palpation. Again the girls had the most. There was good correlation between reports of pain in one area as compared to others. The number of clinically tender neck and shoulder muscles correlated with the number of tender masticatory muscles. It was concluded that girls presented more muscular symptoms than boys.

Adult↗
PubMed2004

Recognition of internal derangements.

One of the most common symptoms of temporomandibular disorders is an internal derangement (ID). The aim of this study was to test the inter-observer reliability of the recognition of IDs by means of auscultation, palpation or both. To that end, 120 women and 100 men were screened by two trained examiners for the presence of IDs. Anterior disc displacement was diagnosed in 14% of the cases and hypermobility in 12%. In 4% of the cases, the ID was classified as 'other'. The inter-rater reliability (Cohen's kappa) was moderate for the presence of an ID for all techniques, while for the classification into type, an almost perfect reliability was found for the combined technique. It was concluded that the type of ID can best be established with the combination of auscultation and palpation; for the establishment of an ID as such, any of the three techniques would suffice.

Adolescent↗
PubMed1996

Relationship between grade of varicocele and the response to varicocelectomy.

BACKGROUND: Although several studies indicate that larger varicoceles are associated with greater impairment of spermatogenesis, others suggest that the response to surgery is independent of varicocele size. In order to elucidate these seeming contradictions, correlations between the preoperative evaluation of varicoceles and improvement in semen quality after varicocelectomy were investigated. METHODS: Forty men with left unilateral varicocele, followed for at least 6 months after varicocelectomy, were included in this study. The relationships between the grade of varicocele by palpation, Doppler examination, ultrasound, or scintigraphy were correlated with a postoperative improvement in sperm density or sperm motility. RESULTS: Greater improvement in sperm density was observed in the patients with a large varicocele graded by palpation or measured by ultrasound, and greater improvement in sperm motility was observed in the patients with high uptake of radioactivity in the left side by scrotal scintigraphy. CONCLUSION: An improvement in semen quality after varicocelectomy is greater in patients with a large varicocele than in the patients with a small one. The significance of surgical repair of a small varicocele should be reconsidered.

Angiography↗
PubMed1995

Three-dimensional recording and description of motions of the shoulder mechanism.

A measurement technique is presented for recording positions of the bones of the shoulder mechanism, i.e., thorax, clavicula, scapula and humerus, in 3-D space, based on palpating and recording positions of bony landmarks. The palpation technique implies that only static positions can be measured. Accuracy of retrieving bony landmarks is checked on-line using rigid body assumptions. The measurement error is calculated afterwards and is comparable with cinegraphic methods. Axial rotation of the clavicula is estimated by minimizing rotations in the acromioclavicular joint. A number of motion definitions is compared by means of interindividual variation and subjective interpretability. Two useful definitions are proposed for describing motions of the shoulder mechanism. Four conditions have been recorded: abduction and anteflexion of the humerus both with and without additional weight in the hand. Abduction and anteflexion result in large differences in scapular and clavicular motions. The effect of additional weight in the hand on the position of the shoulder girdle is negligible.

Adult↗
PubMed1995

Magnetic-resonance imaging techniques for detection of elasticity variation.

The relative success of manual palpation in the detection of breast cancer would suggest that a method for remote palpation resulting in a measurement of tissue elasticity could provide a diagnostic tool for detecting cancerous lesions deeper within the breast. This presumption is based in part on the excellent contrast between neoplastic and normal tissue due to the large (orders of magnitude) relative variation in the shear elastic modulus. By comparison, the bulk deformational modulus maintains the same value to within 20% for most soft tissues. A specific method of magnetic-resonance imaging (MRI) which measures tissue displacements has been used in experiments with a phantom containing regions of increased Young's modulus as a demonstration. The spatial modulation of magnetization technique uses the displacement of a spatial grid pattern caused by spin saturation to track regional motion. Mathematical reconstruction of the distribution of elastic moduli is shown for select examples. Any modality, e.g., MRI, ultrasound, etc., which can detect local tissue motion with sufficient spatial resolution can be used and therefore the results presented here should give an indication of the utility of such motion tracking techniques to future measurement of tissue elasticity.

Biophysical Phenomena↗
PubMed2002

The reliable measurement of radial pulse: gender differences in pulse profiles.

This study was undertaken to determine whether healthy adults exhibited characteristic pulse profiles. Pulse characteristics measured for 83 women and 65 men included presence at the Traditional Chinese Medicine (TCM) locations (Cun, Guan, Chi); and depth (superficial, middle, deep), overall pulse force, relative pulse force, pulse width and pulse rhythm. Most subjects had similar values for many of the characteristics investigated including relative pulse force at the three traditional palpation locations (Cun, Guan and Chi), pulse width and pulse rhythm. There were some significant gender differences. The pulse was present beyond Chi in 90% of males compared with 56% of females. Female pulses tended to be less forceful compared with males. However, with the exception of overall force, there was little support for TCM assumptions of gender differences in pulse such as in left/right balance. There was some support for the use of the TCM palpation locations Cun, Guan and Chi to discriminate between pulses since there was significant differences in manifestations of some pulse characteristics among these locations.

Adult↗
PubMed1979

The use of the starch grain and phenolsulphonphthalein tests to investigate infertile cows.

The starch grain and phenolsulphonphthalein (PSP) tests were used to investigate the patency of the fallopian tubes in five "repeat breeder" cows. Evidence of tubal lesions was determined in three cows on rectal palpation. Using the starch grain test, bilateral occlusion was determined in three animals, left sided occlusion was determined in one and right sided occlusion in another. Using the PSP test there was evidence of bilateral occlusion in two of the four coes which were tested. In four cows the genital organs were examined visually and by palpation at laparotomy and in two cows tubal occlusion was confirmed when they were flushed with saline, and patency restored. In one animal both ovaries were almost completely encapsulated, while in the fourth adhesions involving the fimbriae occluded the ostia. There were broken down and this cow was the only one which subsequently conceived.

Animals↗
PubMed1982

Monitoring pre-service reproductive status in dairy cows.

Combinations of oestrus detection, ovarian palpation and milk progesterone assays were used to monitor pre-service reproductive status of cows in two dairy herds over two successive years. Non-cyclical cows were identified as having no luteal tissue in their ovaries on two occasions 10 days apart. Absence of luteal tissue was determined by the presence of basal mild progesterone initially followed either by a repeat of this result or by failure to palpate a corpus luteum per rectum. In the period 32 to 56 days post partum the number of non-cyclical cows on farm A years 1 and 2 was eight out of 31 (25 . 5 per cent), and 10 out of 62 (16 . 1 per cent) and on farm B years 1 and 2 was 10 out of 68 (14 . 7 per cent) and 11 out of 85 (12 . 9 per cent) respectively. The farm A herd was high yielding, (average lactation 6380 litres), whereas the farm B herd was of average yield (4717 litres). In both herds 60 day milk yield was not related to cyclical status of pre-service cows. There was however a trend toward a greater proportion of young cows being non-cyclical. With the exception of a prolonged calving to conception interval for farm A in year 1, whether a pre-service cow was cyclical or not had no effect on when the cow was first served or on when the animal conceived. The routine incorporation of pre-service monitoring to herd fertility control programmers may however be of value in recognising the incidence of non-cyclical cows and giving an early indication of oestrus detection efficiency.

Animals↗
PubMed1982

Breast metastases from extramammary malignancies.

Metastatic foci to the breast from a wide variety of primary malignancies appear on mammograms as circumscribed spheroid shadows with only slightly irregular margins, and without evidence of microcalcifications, spiculations, or other signs of desmoplastic response that characterize many primary scirrhous carcinomas. In the cases studied, there was close correlation between the size of the metastatic lesion at palpation and mammography, a feature also characteristic of the well-circumscribed carcinomas. This is not the case with most scirrhous breast carcinomas, whose associated desmoplastic reaction results in an apparent larger size by palpation than observed on mammography.

Breast Neoplasms↗
PubMed1992

Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection.

Between 1977 and 1989, 102 of 1,145 patients treated with lumpectomy and radiation as an alternative to mastectomy required subsequent biopsy for suspected ipsilateral recurrence. The authors reviewed the mammograms of 58 of those patients for whom at least two sets of mammograms were available, including one set obtained within 3 months of the subsequent repeated biopsy. Of 38 biopsy-proved recurrences, 13 (34%) were detected with mammography alone, 17 (45%) with palpation alone, and eight (21%) with both mammography and palpation. While standard mammographic criteria for biopsy were followed, distortions and calcifications inherent to posttreatment appearances necessitated judicious modifications. As anticipated, sensitivities and positive predictive values showed more impairment within the lumpectomy quadrant. In addition, all cases of purely in situ cancer were detected solely with mammography. Mammography plays an important complementary role to physical examination in posttreatment follow-up. On the basis of these findings, a follow-up algorithm for the ongoing evaluation of these patients was developed.

Adult↗
PubMed1995

Pressures in a simulated breast subjected to compression forces comparable to those of mammography. Work in Progress.

PURPOSE: To determine the magnitude and distribution of pressures in breast models subjected to mammographic compression forces. MATERIALS AND METHODS: A vinyl-wrapped, unleavened-bread-dough breast model was compressed. Pressures in the dough models were measured with a strain gauge connected to a water-filled sensor. RESULTS: Under broad compression, pressures were uniform (range, 2.76-22.06 kPa [0.4-3.2 psi]). Spot compression increased pressures by as much as 60%. Pressures dropped sharply outside of paddle margins. No pressure differentials were found near small, deep simulated masses. The pressure of large masses increased by 50% when subjected to full compression force. Vigorous digital palpation resulted in a pressure of more than 41.40 kPa (6 psi). CONCLUSION: General pressures were mild and uniform. Internal pressures varied inversely with the area to which force was applied. Pressure dissemination was restricted by the cohesive binder and allowed zones of greater pressure to form directly under the applied force. The surrounding matrix disseminated pressure and protected small masses; large masses, bearing the force of the paddle, were exposed to greater pressure. Digital palpation administered high pressures.

Biomechanical Phenomena↗
PubMed1998

Role of thermography in the diagnosis of undescended testes.

OBJECTIVES: The location of an undescended testis is important for the choice of therapy. Ultrasonography cannot serve as a stand-alone screening method in the management of the undescended testis because of its limited sensitivity and accuracy. The aim of this study was to clarify the diagnostic value of thermography in the patients with undescended testes. METHODS: We evaluated prospectively 28 patients with 36 undescended testes from January 1995 to December 1996. The patients' ages ranged from 16 to 39 months with a mean age of 26.3 +/- 8.2 months. In addition to physical palpation by a pediatric surgeon, ultrasonography and thermography were performed for screening the locations of retained testes. RESULTS: The diagnostic rates were 63.9% (23/36) by palpation, 65.7% (23/35) by ultrasonography and 54.5% (18/33) by thermography. The results of the three diagnostic methods showed no significant difference by Fisher's exact test. Of the 17 higher located testes (inguinal canal and above external ring) 7 were palpable, 8 were identified by ultrasonography, 10 were detected by thermography. Of the 7 nonpalpable testes and testes not detected by ultrasonography, 5, including 2 intra-abdominal testes, were identified by thermography. CONCLUSION: It is suggested that thermography can play a role in locating high undescended testes which are nonpalpable and not detected by ultrasonography.

Child, Preschool↗
PubMed2002

Sonographic evaluation of the puerperal uterus: correlation with manual examination.

OBJECTIVES: To document uterine involution after vaginal delivery and cesarean section by abdominal sonography and to compare the efficacy of manual examination and ultrasonography. STUDY DESIGN: Postpartum manual and sonographic assessment of uterine involution was performed in 120 patients following vaginal and cesarean delivery with an attempt to build a database of changes in uterine dimensions. The patients' reports on the intensity of uterine contractions and vaginal bleeding were compared to the results of sonographic imaging. RESULTS: Palpation revealed proper uterine involution in 80 and 25% of patients after vaginal delivery and cesarean section, respectively. It could not be performed in 2.5% after vaginal delivery compared to 50% after cesarean section. Uterine length was found to be significantly greater after cesarean section than after vaginal delivery (p = 0.0001), and the anterior uterine wall was significantly thinner than the posterior wall (p = 0.0001). Uterine length was significantly greater in the presence of blood accumulation in the uterine cavity (20.7 cm), than when the uterus was empty (18.8 cm) (p = 0.001). In correlating between the patient's report of intense bleeding and the sonographic picture of blood in the uterine cavity sonography had a sensitivity of 0.56 and a specificity of 0.83, whereas the patients' reports had a positive predictive value of 0.22. The difference in information provided by the patients versus that provided by sonography was highly significant (p = 0.001, chi(2) test). CONCLUSION: Within 3 days after delivery, patients particularly those having had a cesarean section, should undergo uterine sonographic scanning and manual palpation to evaluate involution and presence of blood in the uterine cavity.

Adult↗
PubMed2002

Massive bleeding from Dieulafoy's lesion of the small intestine in a child--therapy for the bleeding from gastrointestinal tract out of endoscopic observation.

Dieulafoy's lesion is recognized as a submucosal artery associated with a minute mucosal defect and a rare cause of severe gastrointestinal hemorrhage. Especially, that of distal jejunum or ileum is extraordinarily rare. It is very difficult to detect the lesion in these parts. We experienced massive bleeding from Dieulafoy's lesion of the distal jejunum in a 12-year-old girl. Preoperative angiography and intraoperative palpation detected the point of bleeding. She was rescued by partial jejunectomy. Compiled reports suggested that careful palpation was useful for detection of the location of the bleeding point, which was enhanced as vascular dilatation by the angiogram, during the operation comparatively.

Arteries↗