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PubMed1984

Role of intraoperative manometry in renal artery compression by a pheochromocytoma.

A case of renal artery stenosis due to compression by a neurofibrous cord (histologically a pheochromocytoma) and resolved by the débridment of the vessel and angioplasty with a patch in the saphenous vein, is reported. After the compression has been relieved, the vessel appeared normal at inspection and palpation (pulsation); the manometric control, recorded distally and proximally to the area of compression by the pheochromocytoma showed a significant gradient of pressure that led to the exploration of the vessel, partially obstructed by a recent thrombus. These lesions were not detectable solely on inspection and palpation. It is stressed that a restored normal aspect after removal of the extrinsic pressure on the renal artery may not represent an equivalent optimal restoration of function. Only manometric control or rate of flow measurements are able to assess the efficacy of surgical reconstruction.

Adrenal Gland Neoplasms↗
PubMed1984

Purchase examinations for performance horses.

Performance horses should be thoroughly examined before sale to detect any defects that could render them unsuitable for the purchaser's intended use. With the horse in its stall, the eyes, nasolacrimal puncta, external ear canals and mouth are examined, the rectal temperature measured and the heart, lungs, trachea and sinuses auscultated. Moving the horse out of the stall, the head, parotid glands, mandibular lymph nodes, larynx, neck muscles, jugular veins and cervical vertebrae are inspected. The scapula, point of the shoulder, withers, tuber sacrale and point of the hip are palpated, after which the ventrum, tail, and pelvic and thigh muscles are examined. Structures of all limbs and feet are palpated and inspected for disease and evidence of past surgery. The horse is then worked, on a longe line and under saddle, to evaluate limb carriage and gait. Radiography and other diagnostic procedures are performed as indicated.

Animals↗
PubMed1984

[Clinical picture, therapy and prognosis of orolabial cancer with special reference to regional lymphatic drainage].

Upon classification according to the TNM system, most lip carcinomas fell into low T-categories whereas cancers of the oral cavity fell in high T-categories. The proportion of cases with palpable lymph nodes did not differ between the two sites although the extent of the palpation findings (N-category) did differ. In general differences in clinical behavior between the two locations were more apparent when a complex evaluation of all findings was undertaken. Lymph node metastases were divided into two categories whereby a more differentiated calculation of the frequency of metastasis was possible. The interpretability and accuracy of the palpation findings of regional lymph nodes corresponding to the TNM-classification is rather limited with respect to the occurrence of metastases. Patients with fixed lymph nodes or histologically confirmed or clinically certain metastases have a poor prognosis. The frequency of appearence of temporally-determined recurrences and late metastases as well as the average interval until appearence were essentially the same.

Humans↗
PubMed1984

Screening for early detection of radiation-associated thyroid cancer: a pilot study.

In the 1950s, approximately 20,000 Israeli children received scalp irradiation as treatment for tinea capitis (ringworm of the scalp). To evaluate the necessity and feasibility of early screening of these individuals for thyroid cancer, a small pilot program was undertaken. The examination consisted of a thorough palpation of the thyroid gland and the surrounding area. A 99mTc thyroid scan and thyroid function tests were performed on individuals in whom palpation suggested a nodular abnormality. A multidisciplinary committee then made a recommendation for or against surgery. A total of 443 persons were screened, and nodular abnormalities of the thyroid were detected in 24 (5.4%). Of these persons, nine displayed symptomatology or reported knowledge of a thyroid condition; despite this, three of them were not receiving treatment. This left 18 subjects--15 new cases and 3 previously untreated patients--needing follow-up care. Altogether nine persons were recommended for surgery, but one refused. All eight of the excised lesions were benign: four colloid nodules and four adenomas. While the screening program was feasible, the fact that no cancers were detected suggested that in a population exposed to a very low dose of radiation, thyroid screening may not be justified on a large scale.

Adult↗
PubMed1983

Inflammatory involvement of the temporomandibular joint. Diagnostic and therapeutic aspects and a study of individuals with ankylosing spondylitis.

The aims of this thesis were firstly to investigate the relationship between pain and tenderness to palpation of the temporomandibular joint (TMJ), radiographic changes of the joint and signs of inflammation in the synovial fluid and to compare the effects of intra-articular injections of a corticosteroid into the TMJ with occlusal treatment in patients with tenderness to palpation of the TMJ, secondly to study subjective, clinical and radiographic features in the stomatognathic system of individuals with ankylosing spondylitis (AS) in comparison with individuals without general joint symptoms or disease, and thirdly to study the observer variability of some variables used in the clinical examination of the stomatognathic system. Radiographic, cellular and biochemical signs of inflammation were frequently found in the TMJs of patients with longstanding pain and tenderness in this joint. Absence of radiographic changes of the TMJ did not, however, exclude the possibility of organic TMJ disease. Both intra-articular injections of corticosteroid combined with local anaesthetic and occlusal treatment showed a long-term palliative effect on subjective symptoms and clinical signs from the stomatognathic system. The clinical signs, however, showed a significantly better long-term response to the intra-articular injections than to the occlusal treatment. The prognosis for the intra-articular steroid injections was most favourable in patients without radiographic signs of TMJ remodelling or general joint symptoms. The ankylosing spondylitis study showed that subjective and clinical symptoms in the stomatognathic system and radiographic changes of the TMJ are more frequent in the individuals with AS compared to the other individuals. Most signs and symptoms in the stomatognathic system of the individuals with AS were correlated to the extension and severity of this disease. There was also a correlation between clinical and radiographic signs of inflammatory involvement of the TMJ and subjective and clinical symptoms from the stomatognathic system in the individuals with AS which was not found in the other individuals. Occlusal factors seemed to play a minor etiological role in the development of signs and symptoms from the stomatognathic system in both the individuals with AS and the other individuals. The methodological study showed that the intra-observer variability was generally lower than the interobserver variability. Maximal mouth opening capacity had the lowest observer variability in the clinical examination.

Adolescent↗
PubMed1978

Embryo transfer for cows with reproductive problems.

Surgical embryo recovery and transfer methods were applied to 25 cows and heifers with chronic reproductive problems. In 16 of the 25 animals, abnormalities could not be detected by palpation per rectum and, at laparotomy, the probable cause of low fertility was found to be oviductal obstructions or periovarian adhesions in 6 of them. Four pregnancies were obtained from 3 of these 6 animals. A definitive diagnosis was not obtained through laparotomy in the other 10 animals in this group; however, an abnormal uterine environment associated with senescence may have been responsible for low fertility in the older cows. Eighteen calves were obtained by embryo transfer from 8 of these 10 donor animals. The remaining 9 heifers and cows had lesions detectable by palpation per rectum. Chronic, purulent metritis was found in 2 cows, one of which produced 7 calves by embryo transfer. The other 7 had periovarian adhesions, and 8 calves were obtained from 2 of them. The adhesions in 6 of these 7 cows were attributable to cesarean section. Laparotomy was valuable for defining the extent of the adhesions and establishing a reliable prognosis in some cases.

Animals↗
PubMed1983

[10 cases of congenital cystic dilatation of the common bile duct].

Ten cases of congenital cystic dilatation of the common bile duct (including insufficiency form) were examined for mode of pancreatico-biliary anastomosis and cholangiographic findings. The results were as follows. Male to female ratio was 1:9 in this series. Regarding the mode of pancreatico-biliary anastomosis, type I (pancreatic duct flowing into common bile duct) tended to occur frequently in patients 30 years old or more, while type II (common bile duct flowing into pancreatic duct) in patients under 30 years old. With respect to clinical symptoms, no cases had triad (jaundice, abdominal pain and palpation of mass), but abdominal pain occurred in all the cases. Jaundice and palpation of mass were seen in 30% and 10% of the cases, respectively. Regarding the age at the onset and the duration of the disease, type I occurred in elderly cases with a longer duration of disease, while type II occurred in young cases with a shorter duration of disease. The degree of distention increased in proportion to the severity of the peripheral stenosis of the biliary duct. Complication with biliary tract carcinoma was seen in 2 type I cases. Among the type I cases, those with mild distention were considered to be insufficient form.

Adult↗
PubMed1983

Spontaneous endometriosis in a cynomolgus monkey (Macaca fascicularis).

An adult female Macaca fascicularis developed anorexia and minimal fecal production. Abdominal palpation was unrewarding. Rectal palpation revealed a rectal stricture and a large soft tissue mass in the area of the uterus. Clinical pathology tests were within normal limits. Exploratory surgery and histopathology confirmed a diagnosis of endometriosis.

Animals↗
PubMedDate not supplied

[Involution of the uterus following vaginal or abdominal delivery].

Involution of the uterus was observed in 77 puerperae by B-scan ultrasonography. In most cases the examinations were carried out several times on different days. Of all uterine dimensions (extension, circumferences, areal dimensions, volume index) the length proved particularly suitable for evaluating the involution. The other parameters offered no advantages. The findings covered 60 examinations following spontaneous labor and 137 following cesarean section. In both groups involution was completed by the 6th to 7th week after parturition. On the basis of mean values the course of involution was identical in the two groups, although there was considerable individual scatter. These findings, which do not correlate to the usual palpation findings in daily fundus checks on puerperae, may be explained by the different position of the uterus. Following spontaneous labor there is pronounced anteversion of the uterus and it is located lower. Following cesarean section it adopts a more extended position causing the fundus to be higher on palpation. It was also found that daily intramuscular injection of Syntocinon following cesarean sections has no measurable influence on the rate of involution.

Cesarean Section↗
PubMed1983

Treatment of ovarian cyst in swine by intramuscular injection with luteinizing hormone-releasing hormone analogue.

The diagnosis of ovarian cyst was made in 53 anestrous sows, which were treated experimentally with luteinizing hormone-releasing hormone analogue (LH-RH-A). Each sow was injected intramuscularly with 200, 400, or 500 micrograms one to five times. She was examined by rectal palpation in the course of treatment. The blood levels of estrogen and progesterone were estimated in three of the treated sows. From changes in them was followed the process of healing of ovarian cyst. As a result, (1) the interval between the beginning of treatment and the appearance of estrus was 26.9 days on the average, the rate of appearance of estrus 60.4%, that of healing of ovarian cyst 71.6%, that of conception 70.2%, and the number of young of a littler 9.0 on the average. (2) In the three sows subjected to estimation, the blood progesterone concentration increased after injection with LH-RH-A to reach almost the same level as that estimated in the corpus-luteum stage. The time of increase after injection was almost identical with the time when the luteinization of ovarian cyst was found by palpation. In a sow which manifested normal estrus, no ovulation took place, but a cyst was formed in the ovary and the blood estrogen concentration maintained at a high level for 10 days after the beginning of estrus.

Animals↗
PubMed1984

Thread and sewing needles as gastrointestinal foreign bodies in the cat: a review of 64 cases.

Sixty-four cases of gastrointestinal linear foreign body in the cat were reviewed. Most of the cats were less than 4 years old. The most common clinical signs were persistent vomiting, partial to complete anorexia, and depression. Abdominal palpation by itself was rarely diagnostic. Diagnosis in approximately 75% of the cases was possible, however, by using a combination of oral examination and abdominal palpation. Survey radiography contributed to the diagnosis in 86% of the cases in which it was used, based on evidence of bowel plication, presence of tapered, enteric gas bubbles, gathering of the small intestine, peritonitis, intestinal needles, or bowel obstruction. Surgery (gastrotomy and multiple enterotomies) was necessary in 96.9% of the cases, and most of the cats so treated did well (83.9%). Approximately 50% of the cats with linear foreign body-induced bowel lacerations recovered.

Animals↗
PubMed1978

[Ultrasound in mammary diagnostics (author's transl)].

The technique of ultrasound tomography was tested in nearly 200 patients at our institute and was compared to mammography; therefrom additional information was obtained for the differentiation of tumors, the site of which had been unfavorable to mammography. Differential diagnosis of solid tissues and cysts also is possible in this way, especially in voluminous breasts which are a difficult case for palpation examination. Ultrasound may be helpful, too, in localization for exact puncture. As the final images have shown, gray-scale technique offers new possibilities, mainly with the single-scan taking less time and having undoubtedly a better resolving power. In diagnostics of early cancer or carcinoma in situ, of which, naturally, palpation findings are not existent, the method is inferior to mammography and certainly not yet satisfying. Even in the case of a known early carcinoma, having been localized by means of a positive mammogram, no sonographic correlative can as yet be found. At present, ultrasonic diagnostics is insufficient as a sole method for examination of the female breast; the technique is evidently useful, however, in case of special problems.

Breast Diseases↗
PubMed1980

Ovarian response to gonadotropin-releasing hormone in postpartum dairy cows.

Laparotomies were performed on 17 lactating dairy cows, milked twice daily, 12 or 13 days after parturition to observe gross ovarian structures. Five cows were randomly given an IM injection of saline solution and 12 cows were given 100 micrograms of gonadotropin releasing hormone (GnRH). A 2nd laparotomy was performed 3 days later to observe changes in ovarian structures. In addition, the genital tract was palpated per rectum 5 to 8 days after the 2nd laparotomy, and blood samples for hormonal analysis were obtained prior to each laparotomy and palpation per rectum. Eight of 12 cows given GnRH and 2 of 5 cows given saline solution had developing corpora lutea with prominent ovulation papilla at the time of the 2nd laparotomy. Luteinized follicles were not observed. In GnRH-treated cows, 7 of 7 cows with follicles greater than or equal to 15 mm ovulated after GnRH treatment compared (P less than 0.01) with 1 of 5 cows with follicles less than or equal to 10 mm. Increase in plasma progesterone was not observed in GnRH-treated cows not ovulating. Thus, GnRH induced ovulation in postpartum dairy cows that had large follicles at the time of GnRH treatment.

Animals↗
PubMed1982

Acquired inguinal hernia in the horse: a review of 27 cases.

Twenty-seven cases of acquired inguinal hernia in the horse were reviewed. The history, clinical signs, treatment, and complications were summarized. Mortality was 25.9%. Only 13 or the 27 cases were diagnosed prior to admission. With early diagnosis and treatment, mortality should approach zero. In 24 of these cases, the hernia was strangulated. In each case, the signs were colic, a firm slightly enlarged testicle in the scrotum, and small intestine displacement through the inguinal ring, as determined via rectal palpation. In was concluded that palpation of the scrotum and inguinal rings should be performed on every stallion with colic. The importance of early diagnosis in decreasing mortality was illustrated by the comparison of nonsurvivors to survivors.

Animals↗
PubMed1982

Cephalgia secondary to neuroma in a patient with ankylosing spondylitis: a case report.

A case is presented in which a 26-year-old male with intermittent headaches of many years duration, presents to the Arlington chiropractic Clinic for evaluation and therapy. Routine palpation of the painful area reveals a small mass in the region of the greater occipital nerve. Microscopic examination of the tumor after surgical removal suggests neuroma formation. Headaches did not recur. This patient also experienced exacerbations and remissions of vague low back pain with no radiation. A sacroiliitis was both clinically and radiographically evident. These findings, a positive HLA B27 and the consistent symptom complex allowed a diagnosis of ankylosing spondylitis to be ascertained. It is concluded that palpation of the painful area is a vital portion of the physical examination and must be included in all evaluations. This case also demonstrates that the diagnosis of one problem does not preclude the presence of others. When one condition is diagnosed and therapy is instituted, diagnostic suspicion must not be relaxed.

Adult↗
PubMed1981

Torsion of the spermatic cord in a horse.

A 360-degree torsion of the left spermatic cord was diagnosed in a 2 1/2-year-old Quarter Horse colt. Clinical signs included abdominal discomfort, with slight elevations in heart and respiratory rates. The scrotum on the left side was moist and edematous. The left testicle was enlarged, firm, and retracted slightly toward the abdominal cavity. The colt resented palpation of the testicle. On rectal palpation, the left vaginal ring and the structures passing through the ring were edematous and painful to pressure. Surgical correction was achieved by emasculation. The tail of the epididymis and an elongated portion of the body of the epididymis were attached to the left testicle by an unduly long mesorchium. The caudal ligament of the epididymis and the proper ligament of the testis were elongated. These anatomic variations may have predisposed to torsion of the spermatic cord.

Animals↗
PubMed1980

[Use of ultrasound in presurgical differential diagnosis of gynaecological tumours (author's translation)].

Ultrasonographic bistable compound A-B scanning was used in presurgical examinations of 53 gynaecological tumour patients. Ultrasonographic diagnosis proved to be superior to palpation for its better characterisation of the tumour by size, location, shape, consistency, and general description. It provided safe presurgical information in 23 per cent of those cases in which palpation had failed to yield satisfactory findings. -Tumours were correctly described by ultrasonography in 63 per cent of all cases, largely accurately in 28 per cent, and largely inaccurately in nine per cent. -Interpretation of typical ultrasonograms and of those likely to give problems in differential diagnosis as well as their proper integration with the overall clinical approach are discussed.

Diagnosis, Differential↗
PubMed1995

[Fertility in mares after disturbed or undisturbed puerperium; evidence from clinical, microbiologic and hormone analysis].

Because of the mare's ability to conceive very soon post partum a thoroughly performed control of the puerperal period is of particular importance. In addition to cytological and histological examinations of the uterus, rectal palpation and vaginoscopic inspection as well as microbiological examinations of uterine swabs and the evaluation of the mare's hormonal status during the puerperal period provide useful information which can be used either prognostically or to initiate a specific therapy. 55 mares were examined on days 3, 6 and 9 post partum. Rectal palpation, vaginoscopic inspection, microbiological examination of uterine swabs and determination of progesterone-(P4)- and estradiol-(E2)-levels in the peripheral blood were performed on all the three days. On day 18 after the last breeding the mares were checked for pregnancy by ultrasonic echography. We observed many cases of heavy bacterial contamination of the uterine contents during the puerperal period up to the foal heat. Especially coliforms and beta-hemolytic streptococci were often found. However, these contaminations could not be proven to interfere with fertility rates during the first post partum estrus periods. Dystocia and retained placenta had a strong influence on the hormonal situation of mares during the puerperal period. In addition to this we found disturbed involution of the genital system in these mares. Much higher pregnancy rates at foal heat were detected after a rapid onset of ovarian activity post partum especially during May, June and July, compared to mares with delayed onset of ovarian activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗