Biomedical subjects

D P Otchy

Publications and source records attributed to D P Otchy.

5 recordsLinked to original sources

PubMed1992

The importance of stabilizing the specimen taken at needle localized biopsy of the breast for microcalcifications.

The specimen from a needle localized biopsy of the breast must be compared with its roentgenogram to locate the area of microcalcification within the specimen. Any errors in aligning the specimen to its roentgenogram could result in failure to sample and microscopically examine the area of the microcalcifications. The results of the current study show the importance of maintaining the orientation and position of the specimen from the time the roentgenogram is taken until it is examined by the pathologist. Each of 45 consecutive specimens taken at biopsy were secured to a square of cardboard immediately after excision from the breast to maintain the orientation of the specimen during the process of roentgenography. The histologic findings of this group (group 2) were compared with the preceding 87 biopsies (group 1) in which no effort had been made to immobilize the specimen for a roentgenogram. The presence of microcalcifications was confirmed roentgenographically in all the specimens of each group. Histologic confirmation of the presence of microcalcifications was obtained in 42 of 45 specimens in group 2 and only 71 of 87 in group 1 (p = 0.035). Thirty-one per cent of specimens in group 2 contained a carcinoma compared with 10 per cent in group 1. We conclude that fixing the position of the specimen after excision improves the ability of the pathologist to locate the suspicious area of microcalcifications within the specimen. This may lead to an increase in the yield of these biopsies and the identification of occult carcinomas that might otherwise be missed.

Adult↗

PubMed1992

Properitoneal synthetic mesh repair of recurrent inguinal hernias.

Safe reconstruction of the inguinal floor is the goal of any operation for repair of groin herniation. Operating in the properitoneal space avoids dissection of the scarred cord, and the incidence of testicular complications is markedly lowered. This study reports our experience with placing synthetic mesh between the peritoneum and the deficient inguinal floor for the repair of recurrent hernias of the groin area. During a five year period, 84 men underwent repair of 100 recurrent inguinal hernias using the properitoneal approach. Fifty-four patients had repair of a unilateral recurrent hernia, 16 had repair of a bilateral recurrent hernia and 14 had repair of both a recurrent hernia and a contralateral primary hernia. Postoperative complications occurred in six patients. No testicular complications were observed. Postoperative follow-up study ranged from six months to five years. There were only three recurrent hernias after this repair. All occurred within the first six months postoperatively. The properitoneal approach for repair of recurrent groin hernias using prosthetic mesh safely creates a new "fascia transversalis" with a low rate of recurrence and effectively eliminates testicular complications.

Adult↗

PubMed1991

Multiple, giant fibroadenoma.

Multiple, giant fibroadenomas are histologic and clinical variants of "juvenile" or "giant" fibroadenomas. These tumors are rare and occur mainly in adolescent and young adult black females. The individual lesions are well encapsulated with a histologic pattern primarily of the "juvenile" type, although cases of the "adult" type have been reported. A high incidence of recurrence is noted upon local excision, although this may decrease as the patient becomes older. Management options include local excision with reconstruction, reduction mammoplasty, and simple mastectomy with reconstruction. A case is described of this condition with review of the literature.

Adenofibroma↗

PubMed1990

Effect of mass screening mammography on staging of carcinoma of the breast in women.

In 1980, our institution began a screening mammography program. A retrospective review was done to document whether or not implementation of this program significantly changed the method of discovery of carcinoma of the breast and the stage of carcinoma of the breast at presentation in the patients we studied. Women diagnosed with carcinoma of the breast during a three year period, prior to the institution of the screening program (group 1) were compared with a similar set of patients diagnosed after establishment of the program (group 2). There were 165 patients in group 1 and 181 in group 2. The vast majority of cancers for those in group 1, 84.2 per cent, were discovered at self-examination, as compared with 46.3 per cent for those in group 2. Forty-eight per cent of the cancers for those in group 2 were first discovered by mammography as compared with 6.1 per cent in group 1. There was no statistical difference in the number of patients presenting with stage O, III and IV disease. The percentage of patients presenting with stage I disease rose significantly after the establishment of the mammography program (16.4 per cent in group 1 to 41.5 per cent in group 2). Findings from this study confirm that a mammographic screening program can have a marked effect on lowering the stage of carcinoma of the breast at presentation. The current recommendations for screening mammography should be implemented. Doing so will result in earlier detection and improved survival in this group of patients.

Breast↗

PubMed1987

The malpositioned Greenfield filter: lessons learned.

It is essential that a malpositioned Greenfield filter be recognized as such immediately. Three of the 21 Greenfield filters inserted in the current study were malpositioned. One was placed in the right renal vein, one in the right common iliac vein, and another in the right inferior vena cava in a patient with caval duplication and left ileofemoral thrombosis. A review of the postprocedure radiographs was performed. It was found that two of the three malpositioned filters were at an appropriate vertebral level, and, therefore, this single criteria was inadequate to judge proper filter positioning. A more reliable parameter was the maximal diameter of the open legs of the filter. The mean diameter of the legs in the correctly positioned filters was 29.9 mm compared with 19.0 mm for the malpositioned filters. The authors recommend that the diameter of the filter legs be measured on all postprocedure radiographs. If this diameter is not 30 +/- 4 mm (two standard deviations), then malposition of the filter should be suspected, regardless of the vertebral level at which the filter lies.

Adult↗