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Biomedical subjects

K C Dewbury

Publications and source records attributed to K C Dewbury.

At least 19 recordsLinked to original sources
PubMed2005

Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications.

AIM: To determine the relation between warfarin use and the frequency of bleeding complications after biopsy of the prostate guided by transrectal ultrasound (TRUS). METHODS: Overall, 1022 consecutive patients with suspected prostatic disease were followed after biopsy. Warfarin and aspirin use was determined on the day of the procedure. A TRUS-guided biopsy was performed and patients were offered a questionnaire to complete 10 days after the procedure, to determine any immediate or delayed bleeding complications. Follow-up telephone calls were made to those who had not replied within the stipulated period. RESULTS: Of the 1000 patients who replied, 49 were receiving warfarin, 220 were receiving aspirin and 731 were not receiving any anticoagulant drugs. Of the 49 subjects reporting current use of warfarin, 18 (36.7%) experienced haematuria, compared with 440 (60.2%) of the patients receiving no anti-coagulant drugs who reported haematuria. This was statistically significant (p = 0.001). Of the group receiving warfarin, 4 (8.2%) experienced haematospermia whereas 153 (21%) of the group receiving no anticoagulant medication reported haematospermia. This difference also was statistically significant (p = 0.030). Rectal bleeding was experienced by 7 (14.3%) of the group receiving warfarin compared with 95 (13%) in the group without anticoagulant medication, but this was not statistically significant (p = 0.80). We also demonstrated that there was no statistically significant association between the severity of the bleeding complications and medication with warfarin. CONCLUSION: None of the group receiving warfarin experienced clinically important bleeding complications. Our results suggest that the frequency and severity of bleeding complications were no worse in the warfarin group than in the control group and that discontinuing anticoagulation medication before prostate biopsy may be unnecessary.

Aged↗
PubMed2000

Sonography of palpable breast cancer.

PURPOSE: Because of the increasing use of sonography to rule out cancer in women with palpable breast abnormalities, this study was performed to determine the rate of sonographically occult malignancy in this clinical setting. METHODS: Women who were recommended for biopsy based on mammographic and/or clinical findings underwent breast sonography. This study retrospectively analyzed the subset of patients with palpable malignant lesions. Lesions were classified as visible or occult on mammography and sonography. Patients without a tissue diagnosis of tumor were excluded. RESULTS: Of 1,346 masses that underwent biopsy or aspiration, 616 lesions were palpable, and of these, 293 were malignant. Sonography detected all 293 palpable malignant lesions (95% confidence interval for sensitivity, 99-100%). Eighteen lesions were mammographically occult. The median lesion size as determined by sonography was 1.8 cm; for the lesions that were mammographically occult, the median size was 1.6 cm. The most common histopathologic diagnosis for both groups of lesions was infiltrating ductal carcinoma. CONCLUSIONS: All palpable malignant breast lesions were visible by sonography in patients in whom a biopsy was recommended. However, we caution that until the false-negative rate of sonography for equivocal palpable abnormalities is determined prospectively, sonography cannot be accurately applied to rule out malignancy in this setting.

Adolescent↗
PubMed2000

Ultrasound appearances of testicular epidermoid cysts.

Benign testicular tumours are uncommon but if recognized can enable a conservative approach to surgery to be recommended. This pictorial review demonstrates the variety of sonographic appearances of testicular epidermoid cysts correlating them with pathological findings in 19 lesions, the largest reported imaged series to date. Atchley, J. T. M., Dewbury, K. C. (2000). Clinical Radiology 55, 493-502.

Age Factors↗
PubMed1998

The ultrasound appearances of intratesticular varicocoele.

Extratesticular varicocoele is a common clinical finding, with well recognized sonographic appearances. We report the ultrasound findings in a patient with intratesticular varicocoele (ITV), an extremely rare entity, which was an incidental finding during scrotal sonography. There are differences in both the imaging findings and clinical presentation from previously reported cases. The history of undescended testis and subsequent orchidopexy in our patient contribute to the aetiology of the ITV.

Adult↗
PubMed1996

Ultrasound imaging of the appendix testis and appendix epididymis.

The appendix testis and epididymis are well visualized on ultrasound examination. It is important to recognize the normal anatomy of the appendages to exclude them as a cause of pathology and confirm their presence as normal structures. We describe the appearances of the appendices testis and epididymis in fifty-one consecutive patients presenting to the Southampton Radiology Department. The appendix testis was identified on 80% of testes examined by ultrasound and the appendix epididymis on 6% of testes.

Adult↗
PubMed1996

Case report: multiple highly reflective foci in the renal parenchyma are not specific for pseudoxanthoma elasticum.

A characteristic appearance of highly reflective foci in the renal parenchyma has been reported in patients with pseudoxanthoma elasticum. We describe a similar patient but in addition have found two patients with a similar appearance on ultrasound who have no other evidence of the condition. The appearance of highly reflective foci in the renal parenchyma is not therefore specific for pseudoxanthoma elasticum.

Adult↗
PubMed1995

Case report: multiple epidermoid cysts of the testes--the ultrasound appearances.

Epidermoid cysts are uncommon tumours of the testes representing approximately 1% of all testicular tumours. Their importance lies in the fact that they are completely benign and can be treated by local excision, thereby saving the patient an orchidectomy. We describe a case in which the patient had multiple epidermoid cysts involving both testes and faced possible bilateral orchidectomy.

Adult↗
PubMed1994

The role of ultrasound scanning.

Abdominal abscess, if left untreated, has a high mortality rate. Inadequate means of diagnosis and localization was responsible for this high mortality. Ultrasound now provides a simple non-invasive procedure permitting diagnosis with a high degree of sensitivity, although specificity is less commonly achieved. Abscesses do not have absolutely specific features, but given the appropriate clinical context and fine needle aspiration a diagnosis can be made in virtually 100% of cases, i.e. if the lesions can be identified and not obscured by bowel gas and examinations are not rendered difficult by surgical wounds and dressings. Diagnostic aspiration and therapeutic drainage are readily carried out using ultrasound guidance. Ultrasound is also of value in following the progress of lesions.

Abdominal Abscess↗
PubMed1993

Ultrasound appearances of the rete testis.

Improved technology enables better visualization of normal anatomical structures. The rete testis is now visible as an ill-defined echo-poor region at the testicular hilum, sometimes with arboriform projections into the parenchyma. In a retrospective review of 100 cases of non-inflamed testes, the rete testis was seen in 18%. The anatomy was confirmed by scanning post-mortem specimens in a waterbath, marking the echo-poor region and then studying the histology. The spectrum of ultrasound appearances of the normal rete testis is presented. The rete testis can be distinguished easily from pathology because the parenchyma remains otherwise homogeneous and normal in appearance.

Humans↗
PubMed1992

Ischaemic colitis: clinical, radiological and pathological correlation in three cases.

The clinical and plain radiographic findings in three patients presenting with ischaemic colitis are presented. The radiographic signs were atypical in that featureless dilatation of the large bowel was present with no evidence of gas within the bowel wall or 'thumbprinting', and changes were not localized to the left colon. No thrombotic or embolic vascular occlusion was evident on examination of the resected specimens. We attempt to correlate the pathological and radiological findings, and emphasize the importance of considering this diagnosis in elderly patients who have a dilated featureless colon on plain radiographs.

Aged↗
PubMed1992

Ultrasonic attenuation in fibroadenoma of the breast.

Fifteen patients are described who attended out Breast Screening Programme, and were found to have sclerosed fibroadenomas, the imaging of which raised the possibility of carcinoma. In six of these a reflective zone between a mass lesion and distal acoustic shadowing might have been used to infer the benign diagnosis.

Adenofibroma↗
PubMed1991

Ultrasound of the common bile duct in patients undergoing cholecystectomy.

One hundred patients undergoing cholecystectomy underwent ultrasonography of the biliary tree on the day prior to surgery. At operation a per-operative cholangiogram was performed unless stones were palpable in the duct. Pre-operative biliary ultrasonography accurately identified dilatation of the common bile duct (sensitivity 96%, specificity 95%) but was less accurate at detecting common duct stones (sensitivity 36%, specificity 98%). Thirty three percent of patients with dilated ducts on ultrasound did not have stones in the duct, while 20% of patients with common duct stones had normal sized ducts. We conclude that ultrasonography alone cannot reliably select patients who require exploration of the common bile duct, or select patients for operative cholangiography. Although pre-operative demonstration of common bile duct dilation is an absolute indication for operative cholangiography, by itself it does not indicate the need for exploration.

Adult↗