PubMed Health⌕ Search

Biomedical subjects

A C Fleischer

Publications and source records attributed to A C Fleischer.

At least 91 records · Page 5Linked to original sources
PubMed1988

Elevated alpha-fetoprotein and a normal fetal sonogram: association with placental abnormalities.

This report documents the outcome of 25 pregnancies with elevated serum alpha-fetoprotein levels on two separate samplings despite normal anatomic appearance of the fetus on a detailed "consultative" sonographic examination. Six of these also had elevated amniotic fluid alpha-fetoprotein. All fetuses in this series were anatomically normal at time of delivery; one aborted fetus was triploid. Of the 25 pregnancies, 16 had sonographically demonstrable placental hemorrhage, eight retroplacental and eight subchorionic. One had hydropic changes in the placenta associated with triploidy. Of the subgroup of six pregnancies in which both serum and amniotic fluid values were elevated, one had a retroplacental hemorrhage, one had a subchorionic hemorrhage, and one had diffuse hydropic changes in the placenta. A control group of 112 patients with normal alpha-fetoprotein levels yielded four with small (less than 2 cm3) subchorionic hemorrhage. The occurrence rate of placental hemorrhage in women with elevated alpha-fetoprotein and normal fetus was 64%, whereas the control group of patients with normal alpha-fetoprotein had a 3.6% occurrence rate of placental hemorrhage. Sonographically detectable placental abnormalities may be associated with elevated alpha-fetoprotein in serum and/or amniotic fluid samples. Such abnormalities may occur because of fetomaternal admixture associated with placental hemorrhage and/or intraamniotic bleeding resulting from subchorionic hemorrhage.

Amniotic Fluid↗
PubMed1988

Transvaginal and transabdominal sonography of the endometrium.

The major applications of the sonographic depiction of the endometrium include the localization of the uterus relative to adnexal masses, determination of certain benign and malignant endometrial pathologies, and, potentially, as a parameter for consideration in gynecologic infertility. Transvaginal sonography affords detailed depiction of the endometrium and may provide future applications of sonography in endometrial disorders.

Endometrium↗
PubMed1987

Sonography of appendiceal intussusception.

A case in which appendiceal intussusception was diagnosed preoperatively by sonography is described. The sonographic finding of multiple concentric hypoechoic and hyperechoic rings was confirmed at laparotomy to be due to appendiceal intussusception. Demonstration of the sonographic coiled spring sign in the right lower quadrant should raise the possibility of appendiceal intussusception. The differential diagnosis is discussed.

Adult↗
PubMed1987

The role of sonography in pediatric gynecology.

Sonography has a major role in the evaluation of children with gynecologic disorders. The size, consistency, and origin of pelvic masses and the status of the internal genitalia can be evaluated. Sonography is useful in evaluation of children with precocious puberty because it can demonstrate adult-size ovaries in true precocious puberty, which distinguishes this from premature thelarche and adrenarche. Specific causes of precocious sexual development such as adrenal and ovarian tumors and cysts also can be diagnosed.

Child↗
PubMed1987

Myometrial invasion by endometrial carcinoma: sonographic assessment.

The depth of myometrial invasion by endometrial carcinoma was evaluated using real-time sonography (US) in 20 patients with histologically proved adenocarcinoma of the endometrium. In 14 of 20 (70%) cases, US-based estimation of the depth of myometrial invasion was within 10% of the actual measurement in the gross specimen. The US-based estimation of tumor invasion was low in seven patients, high in four patients, and agreed with pathologic findings (+/- 5%) in nine patients. In four patients with polypoid intraluminal extension of tumor, a deeply invasive tumor was suspected on US but was not found on pathologic examination. In 12 superficially invasive tumors, the continuity of the demarcating subendometrial halo was intact in nine and incomplete in three. In six patients with deeply invasive tumors, this zone was partially disrupted in four, totally disrupted in one, and intact in one. Errors of estimation of the depth of myometrial invasion on US most frequently occurred when a tumor had a significant intraluminal polypoid extension. Demonstration of a subendometrial halo usually indicated superficial invasion, whereas the absence of a halo was frequently associated with deep invasion.

Adenocarcinoma↗
PubMed1986

Magnetic resonance imaging of the breast: functional T1 and three-dimensional imaging.

Thirty-two patients with breast abnormalities and 10 normal volunteers were examined with magnetic resonance imaging (MRI) utilizing a 0.5-Tesla superconducting magnet imaging system. Sagittal, coronal, and transverse breast imaging with the 50-cm body coil and with a specialized 16 X 8 cm breast coil allowed the evaluation of a single breast. Soft-tissue contrast was clearly apparent using proton density-weighted, T1 weighted, calculated T1 images. In addition, the feasibility and potential clinical utility of three-dimensional color imaging was evaluated using computer-based interactive algorithms for edge detection of the breast and for abnormal structures within the breast. MR scan data were correlated with conventional xeromammography, ultrasound, clinical, data, and pathological specimens. In vivo and in vitro breast imaging was evaluated in a feasibility study. It was concluded that MR imaging is a most sensitive modality for the identification of breast lesions, especially when the adjacent normal tissue is primarily fat. There does appear to be significant overlap in soft-tissue contrast when the adjacent breast parenchymal tissue is fibrocystic in nature. The T1 parameter may be a relatively specific measure for identifying a malignant breast mass.

Adolescent↗
PubMed1986

Sonographic depiction of the endometrium during normal cycles.

Pelvic sonograms were performed every 2-3 days in 10 volunteers in order to study changes in thickness and texture that occur in the normal endometrium. A total of 75 sonograms were performed. The accuracy of sonographic estimates of endometrial thickness was also evaluated in eight patients who underwent hysterectomy for reasons unrelated to the uterus. The majority of sonographic measurements of endometrial thickness in these patients were within 1 mm of the actual thickness as measured in the unfixed specimen. In all of the individuals studied, sonography was able to depict changes in the thickness and texture of the endometrium which corresponded to the various phases of its development. Specifically, the average thicknesses of the endometrium were greater in the secretory phase (3.6 +/- 1.4 mm) than in the proliferative phase (2.9 +/- 1.0 mm) (p less than or equal to 0.05). The texture of the endometrium varied throughout the cycle with the hypoechoic texture slightly more common than echoic in the proliferative phase, whereas the echogenic appearance was most common in the secretory phase. Those technical factors which optimized sonographic depiction of the endometrium are discussed, as well as the possible clinical applications of the sonographic depiction of normal and abnormal endometria.

Adult↗
PubMed1986

Transabdominal and transvaginal endosonography: evaluation of the cervix and lower uterine segment in pregnancy.

The clinical value of conventional transabdominal and transvaginal sonography (endosonography) for the evaluation of the cervix and lower uterine segment between 14 and 36 weeks' gestation was evaluated in 20 unselected obstetric patients. Sonographic evaluation of the cervix and lower uterine segment was adequately depicted in 76% with the transabdominal technique compared to 83% with the transvaginal approach. According to set guidelines, these preliminary results suggest that the transvaginal technique may be superior in obtaining an adequate evaluation of the lower uterine segment and cervix and may offer an advantage of not depending on a fully distended bladder for evaluation.

Abdomen↗
PubMed1986

Sonography of the endometrium during conception and nonconception cycles of in vitro fertilization and embryo transfer.

The thickness of the endometrium was compared in 15 patients who conceived and 15 who did not with an in vitro fertilization and embryo transfer (IVF-ET) protocol after ovulation induction with human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG). There was no statistically significant difference (P = 1.0) in the endometrial thickness in the conception versus the nonconception group. Average estradiol (E2) values and number of mature follicles were also not statistically different in the two groups (P = 0.78, P = 0.81). There was a slightly significant difference in the number of embryos transferred in the conception versus nonconception groups (2.5 versus 1.9, P = 0.005). However, the most significant difference between the conception and nonconception groups was the total number of oocytes retrieved (4.4 versus 2.8, P = 0.005). These findings indicate that there are no sonographically detectable differences in the endometrial thickness in patients who achieve pregnancy versus those that do not when given a similar ovulation induction regimen of hMG/hCG for IVF-ET.

Chorionic Gonadotropin↗
PubMed1986

Ultrasound versus digitally directed prostatic needle biopsy.

During an 8-month period 55 patients with suspected but unproved prostatic carcinoma were entered randomly into a study designed to evaluate the effectiveness of ultrasound-directed transperineal needle biopsy of the prostate. Each patient was biopsied with and without ultrasound assistance; the method used first was determined randomly. Of the 15 patients diagnosed as having adenocarcinoma only 9 were proved by conventional transperineal biopsy, whereas ultrasound-guided biopsy was accurate in all 15 patients (p less than 0.005). Transrectal ultrasound guidance significantly improves the yield of transperineal needle biopsy when it is performed for suspected malignancy.

Adenocarcinoma↗
PubMed1986

Ectopic pregnancy: a malpractice paradigm.

Subtle sonographic findings and other nonspecific clinical presentations often lead to missed diagnoses that can have significant legal implications. This communication discusses current diagnostic and laboratory methods used to evaluate patients with a suspected ectopic pregnancy in light of the concepts of "missed lesions" as they relate to negligence and malpractice theory.

Female↗
PubMed1986

Transrectal sonography of benign and malignant prostatic lesions.

Using linear-array transrectal prostate sonography, malignant lesions in 43 patients and benign lesions in 74 patients were evaluated. Prostate sonography was sensitive to textural changes produced by both benign and malignant diseases. However, there was considerable overlap in the sonographic appearances of benign and malignant lesions, and there were no sonographic features that reliably predicted malignancy. Hyperechoic areas were present in 58% of the carcinomas, while 19% were purely hypoechoic. Lesions containing hypoechoic foci that were posterior or posterolateral had a high incidence of cancer. The results confirm the need to biopsy all suspicious palpable lesions of the prostate.

Adenocarcinoma↗
PubMed1986

Sonographic findings in abdominal pregnancy.

The sonograms of 20 proven cases of abdominal pregnancy were evaluated to determine the frequency of specific abnormalities associated with this condition. The most frequent and reliable finding was separation of the uterus from the fetus (90%). Extrauterine placenta (75%) and oligohydramnios (45%) were next in frequency. Other features such as fetal parts close to the maternal abdominal wall (25%), failure to visualize myometrium between the fetus or placenta and maternal bladder (15%), abnormal fetal lie (25%), poor visualization of the placenta (25%), and maternal bowel gas impeding fetal visualization (25%) were noted.

Adult↗
PubMed1986

Sonographic depiction of normal and abnormal endometrium with histopathologic correlation.

The sonographic appearance of the endometrium was correlated to histopathologic findings in 38 patients who underwent hysterectomy. The thickness was accurately assessed by sonography (within +/- 1 mm) in 33 of 38 patients. The hypoechoic halo which surrounds the endometrium was found to represent the inner third of the myometrium which is relatively vascular and compact. In postmenopausal patients who are not receiving hormonal replacement, an endometrium of greater than 5 mm should be considered abnormal. Several causes of abnormally thick endometrium were encountered in this study, including endometrial carcinoma, hyperplasia, adenomyosis, hematometria, mucometria, and pyometria. Sonography was found to be accurate in determining the depth of myometrial invasion in adenocarcinoma.

Adult↗
PubMed1985

Plasma 6-keto prostaglandin F1 alpha and thromboxane B2 in sick preterm neonates.

To determine if vascular abnormalities in preterm neonates might be related to vasoactive prostaglandins, stable prostacyclin (6-KPGF1 alpha) and thromboxane A2 (T X B2) metabolites in arterial blood were measured at less than or equal to 6 hours after birth and at 24, 48, and 72 hours using a radioimmunoassay. Neonates of less than 32 weeks gestation (N = 26) were diagnosed as having either the idiopathic respiratory distress syndrome (IRDS, N = 15) or pulmonary edema (PE, N = 11), and were also grouped according to the presence or absence of intracranial hemorrhage (ICH, N = 11) or patent ductus arteriosus (PDA, N = 10). Initial plasma 6-KPGF1 alpha was greater in neonates with ICH (0.23 +/- 0.04 ng/ml, mean +/- SE) than without ICH (0.11 +/- 0.04, p less than 0.05). Neonates with both ICH and IRDS (N = 8) had significantly elevated T X B2 at all sampling times compared to neonates with IRDS and no ICH (N = 7). Both T X B2 and 6-KPGF1 alpha increased with time in those with major ICH. Among neonates without ICH, 7 with IRDS had higher initial 6-KPGF1 alpha (0.19 +/- 0.07 ng/ml) and lower T X B2 (0.15 +/- 0.04 ng/ml) than 8 with PE (0.04 +/- 0.01 and 0.37 +/- 0.09 ng/ml, respectively). The initial 6-KPGF1 alpha (0.024 + 0.003 ng/ml), measured in neonates with PE and without PDA or ICH (N = 6), was significantly less than the corresponding value in the other neonates (0.201 +/- 0.036 ng/ml) (N = 20).

6-Ketoprostaglandin F1 alpha↗