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At least 1,261 records · Page 70Linked to original sources
PubMed1981

The effect of manipulation of the prostate gland on serum prostate-specific acid phosphatase measured by radioimmunoassay.

We investigated the effects of digital prostatic palpation, cystoscopy, and biopsy of the prostate on the concentrations of serum prostate-specific acid phosphatase (PAP) measured by radioimmunoassay. Serum concentrations of PAP in patients with normal or hyperplastic prostates did not exceed the upper limit of our reference range (4 microgram per liter) during the 48 hr after digital prostatic palpation. The serum concentrations of PAP did not significantly increase in patients with carcinomatous prostates after digital examination of the prostate. Serum PAP did increase in patients with benign prostatic hyperplasia soon after cystoscopy of biopsy of the prostate. No diurnal variation in the serum concentrations of PAP during the follow-up of 48 hr was detected in the patient groups with normal, benign hyperplastic, or carcinomatous prostates not subjected to rectal examination.

Acid Phosphatase↗
PubMed1978

[Differential diagnosis of cardialgia].

Three hundred and sixty-six patients (281 males and 85 females) were examined, 316 of them complained of pain the heart and retrosternal pain. Bicycle ergometry was conducted in all cases and the soft tissues of the neck, chest, and shoulder girdle were palpated carefully. In patients with angina pectoris tolerance to physical exertion was clearly diminished while palpation did not reveal, as a rule, disorders of sensibility in the soft tissues of the chest and shoulder girdle. Patients with pain in the heart of a neurotic character tolerated physical exertion fairly well and often had increased sensibility of the soft tissues in the left side of the chest and shoulder girdle. The intensity of cardialgia may be judged objectively by the degree of soft tissue tenderness and its spread.

Adolescent↗
PubMed1984

Breast self-examination: importance of technique in early diagnosis.

Shortly after diagnosis of breast cancer 416 patients were interviewed about their use of screening procedures and the method of tumour detection. Although 72% reported that they performed breast self-examination (BSE), only 12% actually inspected and palpated their breasts monthly. BSE was not significantly associated with tumour size or involvement of the lymph nodes; however, thorough inspection was associated with smaller tumours, and careful palpation with the absence of palpable nodes. Of those who no longer or never had examined their breasts 40% reported having annual breast examinations by their physician and had significantly smaller tumours than did the others. Most of the women (86%) reported having detected their own tumours, and BSE did not significantly increase the likelihood of self-detection. The frequency of use of screening procedures was similar in a sample of women without breast cancer.

Adult↗
PubMed1981

Prevalence of functional disturbances and diseases of the stomatognathic system in 7-14 year olds.

An epidemiological investigation was carried out in Malmö/Sweden to determine the prevalence of symptoms and signs of functional disturbances and diseases of the stomatognathic system in children aged 7-14. Four-hundred and forty children (440) were randomly selected, interviewed and clinically examined. The interview revealed 36% with symptoms, 15% with recurrent headaches and 13% reported clicking sounds from the temporomandibular joints. Seventy-seven per cent (77%) of the children reported at least one of the following oral parafunctions grinding clenching lip- and cheek-biting, nail-biting or thumb-sucking. In the clinical examination occlusal interferences in RP were found in 79% and mediotrusion interferences in 78%. More than half of the children 64%, claimed pain on palpation of the temporomandibular joint muscles and more than one third (39%) claimed pain on palpation of the temporomandibular joint. It is concluded that children are suffering from diseases and functional disturbances of the stomatognathic system.

Adolescent↗
PubMed1981

Prevalence of functional disturbances and diseases of the stomatognathic system in 15-18 year olds.

Three hundred and nine teenagers were interviewed and clinically examined in an stomatognathic epidemiological study of young people aged 15-18 in Malmö, Sweden. The youngsters were randomly selected. Forty-one per cent (41%) claimed symptoms, 16% recurrent headaches and 17% had noticed clicking sounds from the temporomandibular joints. At least one of following parafunctions: grinding, clenching, lip- and cheek-biting, nailbiting were stated by 74% of the young adults. Occlusal interferences were found in 83% and mediotrusion interferences in 77%. More than half (55%) of the young people exhibited temporomandibular joint muscles tender on palpation and 34% stated that they experienced pain on palpation of the temporomandibular joints. It is concluded that there is a higher prevalence of symptoms among the young adults than among children (Nilner & Lassing 1981).

Adolescent↗
PubMed1982

Ten- to fourteen-year effect of screening on breast cancer mortality.

Results from the randomized trial conducted by the Health Insurance Plan (HIP) to determine the efficacy of breast cancer screening with mammography and palpation are reported for longer periods than previously available. By the end of 10 years after entry, the study group's mortality due to breast cancer was about 30% below the control group's. Arithmetic gains due to screening were maintained through year 14; relative gains declined. With increases in the period of follow-up, cumulative survival rates among cases detected by mammography alone (palpation negative during screening), decreased more rapidly than rates among other subgroups, but survival rates for mammography cases remained relatively high. Study women aged 40-49 years at entry began to show lower breast cancer mortality than those in the control group as duration of follow-up increased. Reservations are advanced about the acceptance of this finding as evidence of the efficacy of screening under age 50 under the conditions of the HIP study. The reservations are based on the observation that the decrease of mortality among the study group aged 45-49 at entry is concentrated entirely among cases diagnosed after they reached 50 years of age.

Adult↗
PubMed1980

Methods of pregnancy diagnosis in sheep and goats.

Ninety percent accuracy in pregnancy diagnosis by ultrasonic techniques during the last half of gestation in ewes and does has been reported. Rectal abdominal palpation is relatively inexpensive and easy to perform in field conditions with more than 90% accuracy after 60 days of gestation. Pregnancy diagnosis and fetal count is possible by radiographic technique after the 90th and 70th day of gestation in ewes and does, respectively. Vaginal biopsy techniques have yielded an accuracy of 97% after the 40th day of gestation in ewes and progesterone assays after the 20th day of gestation have yielded 90% accuracy both in ewes and does. Direct palpation of the pregnant uterus via laparotomy after the 28th day of gestation in ewes has demonstrated less than 3% error.

Abdomen↗
PubMed1982

[Potentials of self-examination in detecting ovarian tumors].

The clinical picture and primary diagnosis of 739 benign, 114 border-case and 115 early-stage malignant ovarian tumors are discussed. It was established that 8.4-11% of patients had detected tumors themselves by palpation. The detection of tumors by a considerable number of patients provided a basis for developing practical recommendations on self-examination procedures, which include inspection of the abdomen, surface and deep palpation. Application of these procedures will contribute to better diagnosis of ovarian cancer.

Female↗
PubMed1995

Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis.

OBJECTIVE: Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. METHODS: Skin thickness was assessed by clinical palpation of 17 body areas on 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). RESULTS: Interobserver and intraobserver mean +/- within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 +/- 4.6 and 20.7 +/- 2.45, respectively. CONCLUSION: The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.

Humans↗
PubMed1995

Intraoperative sonography in patients with suspected liver metastases.

The correlation of preoperative sonography and intraoperative inspection and palpation of the liver with intraoperative sonography was studied in 77 patients. All underwent elective abdominal surgery for the treatment of verified malignant intra-abdominal tumours. Preoperative sonography findings differed from the intraoperative findings in 22 of the 77 patients (29%), intraoperative sonography being more reliable. Palpation differed from intraoperative sonography in 16 of 77 patients (21%), in three of whom the findings at intraoperative sonography altered therapy. Intraoperative sonography was most effective in detecting small previously undetected, nonpalable lesions deep in the liver parenchyma. There were no complications due to sonography. We recommend intraoperative sonography as a safe and diagnostically effective procedure for routine use in abdominal surgery.

Abdominal Neoplasms↗
PubMed1994

The contribution of ultrasonography to the differential diagnosis of breast cancer.

Overall consecutive breast abnormalities (259 carcinomas, 1820 benign) examined with breast ultrasonography (US) are reported. US sensitivity, specificity and positive predictive value were 67.6, 97.7 and 81.0%, resp. (the corresponding values were 57.9, 97.9 and 77.2% for palpation, 79.9, 93.5 and 73.7% for mammography, and 97.6, 92.6 and 87.6% for cytology). US sensitivity was unaffected by age, whereas it was strongly influenced by tumor size (pT1-76.1%; pT2-87.1%) and histologic type (intraductal-7.4%; invasive ductal/lobular-83.4%; invasive special types-64.1%). The features of the lesions at US were significantly associated with cancer (irregular margins, posterior acoustic shadowing) or benign lesions (anechoic structure, lateral shadowing, posterior acoustic enhancement) but had a limited diagnostic accuracy. Overall, US visualized 174 (benign-24, suspicious-150) of 188 palpable, and 32 (benign-7, suspicious-25) of 71 nonpalpable cancers. US contribution was determinant to final diagnosis in 4 of 7 cancers, missed at palpation and mammography, but was at least partially responsible for 8 unnecessary biopsies of benign lesions. A negative/benign US report contributed to avoid unnecessary biopsy in 71 suspicious cases at palpation/mammography. Routine US examination of clinical/mammographic abnormalities is recommended for the advantages of US-guided aspiration and to reduce the frequency of unnecessary biopsies.

Adult↗
PubMed1994

Absence of symmetry in superior articular facets on the first cervical vertebra in humans: implications for diagnosis and treatment.

OBJECTIVE: Little attention has been given to the craniovertebral articulations. Specifically, gross observations of variations of the superior articular facets on the atlas have not been described with respect to static and motion palpation findings. This study describes the anatomical variations of these facets and the clinical implications associated with asymmetrical structure. DESIGN: The superior articular facets of thirty human first cervical vertebrae were chosen for this study because the atlas constitutes the middle of the upper cervical complex and the atlanto-occipital joint contributes greatly to head movements. SETTING: The basic science research department of Logan College of Chiropractic, St. Louis, Missouri. SPECIMEN POPULATION: All available previously dissected anatomy laboratory and library specimens (30) were used in this study. All of the specimens were dry with intact facet surfaces and no regard was given to age, gender, or race. INTERVENTIONS: The atlases were studied out of situ and all soft tissue was removed so that the bony articular surfaces could be clearly viewed and photographed. MAIN OUTCOME MEASURES: Palpation and unaided visual examination were performed on 30 atlases. The shape, size, angle, texture, border, and number of superior articular facets on each atlas were recorded to determine symmetry. RESULTS: The classically described kidney-shaped facet was in fact an infrequent finding. Upon comparison of right and left sides, none (0%) of the facets were mirror images of symmetry, while 19 of the atlases (63%) had grossly asymmetrical facets, and 11 of 30 atlases (37%) had facets which were only slightly asymmetrical in regard to shape, border, depth and angle. Furthermore, 7 of the 19 grossly asymmetrical atlases (37%) had three or four separate superior articular facets. Three atlases had two facets on the left and one on the right, while two atlases had two facets on the right with a single facet on the left, and two atlases had four superior facets (two on each side). CONCLUSION: The validity of vertebral joint assessment based on the assumption of facet symmetry is challenged, impugning certain chiropractic theories and/or techniques which rely on symmetry as being "normal." To achieve symmetrical function, the anatomical structure must be symmetrical. Since true structural symmetry does not exist, true symmetry of segmental movement may not be possible.

Atlanto-Axial Joint↗
PubMed1994

Ultrasonographic diagnosis of urachal cyst in three calves.

In 3 calves with irreducible umbilical swelling attributable to urachal cyst, ultrasonography was helpful in establishing a definitive diagnosis. After surgical resection of the persistent urachus, 2 calves recovered without complications. In 1 calf in which the urachus had ruptured subcutaneously during forceful diagnostic palpation, additional surgical debridement of severe skin necrosis, caused by subcutaneous accumulation of urine in the umbilical region, was required. Most irreducible masses of the umbilical area of calves can be classified as attributable to infection, hematoma, or incarcerated umbilical hernia. Urachal cyst should always be considered in the differential diagnosis of an irreducible umbilical mass. Careful palpation of the umbilicus is indicated to avoid the potential complication of iatrogenic rupture of a urachal cyst.

Animals↗
PubMed1994

A comparison of breast self-examination and clinical examination.

Twenty-six female college students were trained to examine their breasts using the Mammacare Method. After training, participants were asked to demonstrate their breast self-examination technique for a competency evaluation. On average, 85% of the components of the palpation technique were correctly included in the participants' self-examinations, indicating that they had been trained competently. Breast self-examiners then were asked to palpate three breast models in search of embedded lumps. Thirteen health professionals were asked to examine the same breast models for lumps. The examination of the models by self-examiners was compared to that by health professionals. Breast self-examiners took longer to examine each model, and on average correctly identified significantly more lumps than health professionals. The two groups did not differ in number of false-positive findings. These results indicate that women adequately trained to perform breast self-examination can perform breast examinations at least as accurately as health professionals.

Adolescent↗
PubMed1993

Incidence and types of non-palpable thyroid nodules in thyroids removed for palpable disease.

The purpose of this study was to determine the number, size and types of non-palpable and ultrasound undetected thyroid nodules in thyroid glands removed for a single palpable nodule. Twenty patients undergoing partial (hemi- and subtotal) thyroidectomy and 40 patients having a total thyroidectomy were analyzed. Patients had no more than one palpable nodule, no cervical adenopathy and no history of previous thyroid surgery. An ultrasound was performed routinely within four months of surgery. Forty-six nodules were detected by final pathology in the partial thyroidectomy group but only 42% were detected by palpation and 59% by ultrasound. The median diameter of non-palpable and ultrasound undetected partial thyroidectomy nodules was 0.5 cm and all were benign except for one case of lymphoma. Pathology detected 186 nodules in the total thyroidectomy group although palpation only detected 22% of these and ultrasound 42%. The median diameters of the benign and malignant non-palpable nodules were 0.4 cm and 0.25 cm respectively. Most of the undetected nodules in the total thyroidectomy group were benign but there were 20 non-palpable and 18 ultrasound undetected papillary carcinomas.

Adolescent↗
PubMed1993

[Clinical diagnosis of breast cancer].

Every clinical breast examination requires a careful history and the inspection and palpation of the breast. The inspection enables us to recognize remarkable external variations of the breast, and with the manual examination it is possible to palpate nodes and indurations. Very important for an early detection of a carcinoma of the breast is self-examination. Finally, also the diagnostic of the secretion of the ducts of the mammary gland is part of a clinical examination of the breast.

Breast↗
PubMed1996

A prospective study of six methods for detection of hepatic colorectal metastases.

Many techniques are available for the identification of patients with hepatic colorectal metastases. The accuracy and clinical relevance of transabdominal ultrasound (US), computed tomography (CT), static scintigraphy, dynamic scintigraphy (HPI), intraoperative ultrasound (IOUS) and manual palpation, in the detection of intrahepatic colorectal metastases were assessed in 73 consecutive patients presenting with colorectal carcinoma; 39 were male and 34 female with a mean age of 68 years (range 43-90 years). In 33 patients either intraoperative ultrasound or palpation were omitted owing to emergency presentation (n = 14) or subsequent non-operative management (n = 19). All six investigations were completed in 40 patients. Computed tomography and hepatic perfusion scintigraphy (HPI) were the most sensitive, detecting over 90% of lesions, the others identifying approximately 80% of lesions, Specificity in all methods, apart from dynamic scintigraphy, was over 80%. Contrast-enhanced CT would appear to remain the most accurate method available. However, if the prognostic ability of HPI is confirmed on subsequent follow-up, the accuracy of HPI will rise with time, whereas that of CT will fall. Intraoperative ultrasonography took time to perform and did not alter the management of any patient within the study. We suggest that its use is limited to those patients in whom resection is contemplated, where the vascular anatomical detail provided may be invaluable.

Adult↗
PubMed1996

[Thoracoscopic wedge resection of small pulmonary nodules--evaluation of Endofinger and colored collagen injection techniques for localization of pulmonary nodules].

We analyzed problems occurring during thoracoscopic resection of small pulmonary nodules less than 2.0 cm in size and evaluated the Endofinger and colored collagen injection techniques, which are new methods for localization of pulmonary nodules. The Endofinger is a device for thoracoscopic palpation and the colored collagen is a long-lasting point marker, composed of 1.0% athelocollagen, methylene blue and contrast medium. Twenty five consecutive patients (male: female = 13:12, mean age 59.0 years) underwent thoracoscopic wedge excision of pulmonary nodules. The mean diameter of the nodules was 1.3 cm (range: 0.4-2.0 cm) and the mean distance from the pleural surface to the nodules, as assessed by CT scan, was 1.1 cm (range: 0-3.8 cm). Methods of pulmonary nodule identification were thoracoscopic inspection only (4 cases), palpation through min-thoracotomy (13 cases), Endofinger (2 cases) and Endofinger with colored collagen injection guided by CT scan (6 cases). In all cases where location was difficult to identify, the nodule diameter was less than 1 cm and the distance from the pleural surface to the nodule was greater than 1 cm. The Endofinger and colored collagen injection techniques have made it easier to localize small pulmonary nodules, decreasing the frequency of cases where additional thoracotomy is necessary. Seven of 25 nodules were revealed to be so-called early peripheral lung cancers, but no relapses were found in any of these cases following pulmonary resection. The new Endofinger and colored collagen injection techniques are useful in the localization of small pulmonary nodules, making thoracoscopic wedge resection of help in early diagnosis and treatment of pulmonary malignancy.

Biopsy↗