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Biomedical subjects

C A Wesen

Publications and source records attributed to C A Wesen.

4 recordsLinked to original sources
PubMed1999

The advanced breast biopsy instrumentation (ABBI) experience at a community hospital.

The Advanced Breast Biopsy Instrumentation (ABBI; U.S. Surgical Corp., Norwalk, CT) system is the newest technology available for the evaluation and diagnosis of nonpalpable breast lesions. It requires the breast imaging specialist, often a radiologist, to localize the suspicious lesion to x, y, and z coordinates in a digital mammogram unit. The coordinates are then used by the surgeon to operate and direct the ABBI biopsy device around the lesion to obtain an excisional biopsy. Mammographic confirmation of the specimen is then immediately obtained. First introduced in the United States in April 1996, the ABBI system is aimed at rivaling the previously relied upon methods of needle-localized and core needle breast biopsies. In this study, we analyzed the first 15 months of use of the ABBI system in a community hospital to evaluate its applicability and efficacy in the diagnosis of nonpalpable breast lesions. Eighteen surgeons and three radiologists performed a total of 230 cases on 223 patients (seven patients had bilateral breast biopsies). The lesions biopsied included 114 clustered microcalcifications, 115 masses, and 1 retained guidewire from a previous needle-localized breast biopsy. The average time for the complete procedure was 65 minutes. Breast cancer was identified in 36 patients (36 of 230, 15.7%) and 1 additional patient had an incidental finding of lobular carcinoma in situ. The malignancies included 20 cases of invasive ductal carcinoma, 12 cases of ductal carcinoma in situ, and four cases of invasive lobular carcinoma. Overall, 84 per cent of the patients had a definitive benign diagnosis and required no further surgical treatment of their mammographic finding. There have been no known missed lesions after use of the ABBI procedure. In conclusion, our experience has shown the ABBI system to be a valuable option in the management of selected patients with nonpalpable breast lesions.

Adult↗
PubMed1986

Fibromuscular dysplasia of the carotid arteries.

Fibromuscular disease of the carotid artery was identified in 30 patients, which represented 3.2 percent of all patients who had cerebral angiography at Brooke Army Medical Center in the 6 year period from 1978 to 1984. Focal neurologic events were the presenting symptoms in 63 percent of the patients. The majority of the patients were treated with antiplatelet therapy, and eight patients had a total of 10 carotid artery dilatations. The only patients with recurrent symptoms were those who received either no treatment or antiplatelet therapy. There were no recurrent symptoms in the operated patients. This study suggests that surgical treatment for the symptomatic patient may prevent recurrent symptoms with an acceptably low morbidity and mortality. There was, however, no indication that prophylactic dilation of the fibromuscular disease in the asymptomatic patient was beneficial. Fibromuscular dysplasia of the carotid arteries is often associated with intracranial aneurysms, and surgical therapy rather than antiplatelet therapy may be advisable in patients who have intracranial aneurysms. Patients with concomitant atherosclerosis of the carotid artery bifurcation should be treated like any patient with atherosclerotic disease and an endarterectomy should be performed with carotid dilatation when indicated. Fibromuscular disease of the carotid artery is an infrequent angiographic finding that is associated with focal and global neurologic symptoms. Most patients can be effectively treated with antiplatelet drugs with no recurrent symptoms, however, for persistent or progressive symptoms, some patients will require surgical dilatation of the carotid artery. Fibromuscular disease of the carotid artery may lead to catastrophic symptoms of stroke or intracranial hemorrhage if left undiagnosed or untreated.

Adult↗
PubMed1982

Prostatism and inguinal hernia.

We reviewed a series of 70 patients who had transurethral resection of the prostate to determine the incidence of inguinal hernia. We found inguinal hernias in 20% of the patients, a figure significantly higher than in the general population. In 47% of the patients a hernia was present on admission or herniorrhaphy had been done previously. Urine flow rate has been previously found to be an excellent screening measurement for prostatism, a concept confirmed by this series. Because benign prostatic hyperplasia has associated morbidity and because its presence is not desirable in patients having herniorrhaphy, urine flow rate is advocated as a routine screening test for prostatism in patients with inguinal hernias.

Aged↗