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Biomedical subjects

S Torp-Pedersen

Publications and source records attributed to S Torp-Pedersen.

At least 37 records · Page 2Linked to original sources
PubMed2001

Ultrasound and Power Doppler findings in jumper's knee - preliminary observations.

OBJECTIVE: to examine a group of high risk athletes, for signs of inflammation in jumper's knee (JK) by gray-scale ultrasonography (US) and color/Power Doppler findings in JK. SUBJECTS AND METHODS: eighteen high-elite basketball players participated in the investigation after a match. Seven players were examined by ultrasound before the match as well. The players were clinically examined for signs of JK and filled in a questionnaire concerning previous and present knee symptoms. RESULTS: clinical signs of JK were found in 13 knees. Of these knees, ten had hypoechoic areas and six had Power Doppler flow. Four players reported symptoms of JK and clinical examination suspected the same. Three of them had both hypoechoic areas and Power Doppler flow. Fourteen players were asymptomatic at the time of examination but both hypoechoic areas and Power Doppler flow was found in the patellar tendons of four players. No correlation was found between clinical findings, symptoms of JK and US findings - including Power Doppler. The risk of type II error in this material is considerable. CONCLUSION: an association between gray-scale US and color/Power Doppler was found in JK which may suggest an inflammatory component to be a part of the pathogenesis of JK.

Basketball↗
PubMed2001

Guidance by ultrasound of intra-articular injections in the knee and hip joints.

OBJECTIVE: To develop and assess a stable method for ascertaining the placement of intraarticular injections for osteoarthritis (OA) in the hip and knee. METHODS: Injections into the hip or knee joint with e.g. hyaluronan or cortisone were performed under the guidance of ultrasound. For this purpose an Acuson Sequoia apparatus and a 8-15 MHz transducer were used. After perforation of the capsule with a 21 G needle, 0.5-1 ml of atmospheric air and 1 ml lidocain 1% was injected with simultaneous recording of the ultrasound signals. This procedure was undertaken before the injection of the medication through the in situ needle. RESULTS: In the hip joint the injected air could readily ascertain the placement of the injection with a sharp echoic contrast forming on the ultrasound picture respecting the joint cavity. In the knee joint the procedure gave the best results in joints which have a small amount of fluid in either the suprapatellar bursa or in a pouch regularly observed over the lateral joint margin. However, also in some so-called 'dry' knee joints the air could be traced in the bursa by ultrasound. CONCLUSION: By the injection of air, it is possible to test the placement of intraarticular injections in both hip and knee joints. This procedure will give a supplementary documentation of the injection as compared to a mere ultrasonographic demonstration of the position of the needle in the joint. The method is proposed as a tool for both learning purposes and quality assurance in daily therapy.

Adjuvants, Immunologic↗
PubMed2001

Quantitative ultrasonography in rheumatoid arthritis: evaluation of inflammation by Doppler technique.

OBJECTIVE: To evaluate ultrasonographic methods, including the Doppler technique, as measures of synovial inflammation in finger joints of patients with rheumatoid arthritis. METHODS: Ultrasonography was performed with a high frequency transducer (13 MHz). Evaluation of the sonographic data was conducted by two independent observers and included measurement of synovial area and thickness (grey tone ultrasound), vascularisation (power/colour Doppler), and indices of the intra- and extrasynovial arterial flow (spectral Doppler). The flow pattern was estimated by the indices of pulsatility (PI) and resistance (RI). RESULTS: The sonographic measurements of joint space were reproducible with intraobserver, intraclass correlation coefficients (ICC) 0.82-0.97 (p<0.0001) and interobserver ICC 0.81 (p<0.0001). The mean (SD) fraction of the synovium vascularised in the patients was 0.15 (0.15). The synovial blood flow was characterised by a diastolic flow-that is, the flow persisting during the diastole. The mean (SD) PI was 1.92 (1.18) and RI 0.70 (0.13). The estimated vascular fraction correlated with the erythrocyte sedimentation rate (ESR) (r(s)=0.53, p=0.03). The relative Pi (rPi), an estimate of an abnormally low resistance to vascularisation, correlated with both ESR (r(s)=-0.557, p<0.05) and Health Assessment Questionnaire score (r(s)=-0.584, p<0.05). After an injection of contrast Levovist the vascular fraction increased, while no difference in PI and RI was observed. CONCLUSION: Ultrasonography is a reliable tool for estimating the size of the joint space and the synovial activity measured by the degree of vascularisation and pattern of flow. Ultrasonography may be useful in monitoring the synovial inflammation in rheumatoid arthritis.

Adult↗
PubMed1995

Percutaneous gastrostomy guided by ultrasound and fluoroscopy.

Percutaneous gastrostomy, utilizing a dedicated catheterization kit, with a combination of ultrasonographic (US) and fluoroscopic guidance, was carried out in 27 patients. The main indication for gastrostomy was the need for nutritional support in malignant esophageal stricture. After distending the stomach with water via a nasogastric tube, the gastric antrum was punctured under US guidance and a guide wire was inserted, followed by fluoroscopically guided tract dilatation and insertion of a 2.5-mm Cope-loop catheter. In all patients but one (96%) the procedure was successfully completed in one or 2 attempts. Two complications occurred: one case of a small subcutaneous abscess near the puncture site, and one late incident of dislodgement of a catheter without string-loop fixation, which had been inserted at a catheter exchange after 6 weeks. Percutaneous gastrostomy guided by US and fluoroscopy is a safe and efficacious alternative to endoscopic and surgical gastrostomy.

Adult↗
PubMed1994

Prostatic enlargement, symptomatology and pressure/flow evaluation: interrelations in patients with symptomatic BPH.

INTRODUCTION: Benign prostatic hyperplasia (BPH) is the most common pathologic condition to afflict the aging male. Many patients with symptomatic BPH undergo prostatectomy without rigorous evaluation. Three concepts should be considered before any treatment of a patient with symptomatic BPH; Prostatic enlargement, symptomatology and bladder outflow obstruction. PATIENTS AND METHODS: The study comprised 188 consecutive patients with symptomatic BPH, all eligible after pressure/flow examination. One-hundred-seventy-four of the patients answered the DAN-PSS questionnaire, 140 of the patients had their prostate size measured by transrectal ultrasonography. One-hundred-fifty-three patients were able to perform a free flow measurement upon arrival. Uroflowmetry, symptomatology and prostate size were matched with the results of pressure/flow examination. RESULTS: Neither uroflowmetry, symptomatology nor prostate size correlated well with bladder outlet obstruction. The positive predictive value for infravesical obstruction was 88% if a maximum flow rate under 10 ml/s was used. Symptomatology could not be used to differentiate between patients with bladder outlet obstruction and patients without obstruction. The positive predictive value for infravesical obstruction was 76% if a prostate volume over 40 ml was chosen. DISCUSSION: The purpose of diagnostic evaluation in patients with BPH, is to identify precisely the pathophysiology underlying the patients condition, so that rational therapy can be selected. CONCLUSION: The disease entity of BPH is characterized by the interaction of prostate enlargement, the subjective symptom complex of prostatism, and urodynamic infravesical obstruction. Since it is impossible to interpolate from one to another of these conditions, a comprehensive evaluation of a patient with symptomatic BPH should include an assessment of all of these conditions.

Adult↗
PubMed1994

Imaging in the diagnosis and assessment of prognosis in localized prostate cancer. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993.

As part of a WHO consensus conference on diagnosis and prognostic parameters in localized prostate cancer, a working group of experts discussed the role of various modern imaging techniques. Special attention was focused on transrectal ultrasound (TRUS) in combination with biopsies, magnetic resonance imaging (MRI) using endorectal coil and recent advances in these techniques. Some experimental techniques, especially hormone receptor scintigraphy and positron emission tomography were also discussed and new results were presented. We concluded that MRI seems to be superior to other imaging techniques in the preoperative assessment of local tumor stage. TRUS defends its place in the diagnostic armament; it is easily combined with multiple biopsies, the results of which are important in the assessment of the biological aggressiveness of prostate cancer. The present development in the field of nuclear medicine may result in techniques for in vivo characterization of tumors and will most certainly have important implications for diagnosis of prostate cancer in the future.

Animals↗
PubMed1994

Transabdominal and endoluminal ultrasonic scanning of the lower ureter.

I.v. urography is often insufficient for visualization of the intramural and juxtavesical portion of the ureter. In 30 consecutive patients (July 1st 1993-January 31st 1994) where i.v. urography was inconclusive, but had evoked suspicion of pathology in--or adjacent to--the lower ureter, abdominal ultrasound (including color Doppler) and endoluminal (transrectal or -vaginal) ultrasound were performed. A final diagnosis was obtained in 26: Ureteric stone (14), prostatic cancer (4), bladder cancer (2), stricture of ureteric orifice (1), TURB sequelae (1), ureterocele (1), bladder stone (1), detrusor hypertrophy (1), normal ureter (1). Abdominal ultrasound scanning gave more, same, and less information than i.v. urography in 8, 8, and 10 cases, respectively. In 14 of 22 cases abdominal color Doppler revealed a unilateral abnormal "ureteral jet"--in 13 of the cases on the side with suspected obstruction. Endoluminal ultrasound scanning gave more, same, and less information than i.v. urography in 20, 4, and 2 cases, respectively. The 20 cases where endoscanning gave more information included detection of 14 distal ureteric stones. In 3 cases it identified other types of distal obstruction, in two cases it determined the length of cancer obstruction and in one it detected the presence of ureteral dilatation. It is concluded, that endoluminal ultrasound of the ureter is indicated when i.v. urography evokes suspicion of pathology in the intramural or juxtavesical part of the ureter.

Abdomen↗
PubMed1993

Interstitial hyperthermia of colorectal liver metastases with a US-guided Nd-YAG laser with a diffuser tip: a pilot clinical study.

Ultrasound (US)-guided interstitial hyperthermia performed with the neodymium yttrium aluminum garnet laser with a diffuser tip involves placement of a laser fiber in solid tissue followed by irradiation from within the center of the tumor to be treated. The authors previously described the development of a US-guided technique that permits simultaneous interstitial laser irradiation and temperature measurements, with real-time US monitoring. With the use of a dedicated diffuser tip modification of the bare laser fiber, it has proved possible to produce spherical coagulations with a diameter comparable to that of liver metastases of clinical relevance. This technique was used in 11 patients with 16 colorectal liver metastases, 12 of which were radically ablated. Real-time US and interstitial temperature monitoring during treatment had a positive predictive value of 86% and negative predictive value of 100% in judging the final result. The technique is feasible, effective, and safe, but the effect on patient survival must be tested in future randomized clinical studies.

Adult↗
PubMed1992

Preoperative investigations for suspected pelvic masses.

Ultrasound examination was performed on 307 patients admitted to Herlev Hospital, Copenhagen, for suspicion of a pelvic tumor. Of these, 194 were operated on, 38 (19.6%) having a malignant tumor and 156 with benign conditions. A solid tumor was suspected in 72 patients on whom intravenous pyelography, barium enema, cystoscopy and rectoscopy were performed, although 11 did not undergo an intravenous pyelography and 12 did not undergo a barium enema. Intravenous pyelography, barium enema, rectoscopy and cystoscopy very seldom gave unsuspected information and never changed the indications for operation. Ultrasound examination of the kidneys, urinary tract, bowel system, liver and retroperitoneum as a complementary investigation to the gynecologic examination of the pelvic tumor gave the same information as did the barium enema, intravenous pyelography, rectoscopy and cystoscopy. Therefore, we conclude that these investigations should be carried out only in patients with symptoms from the urinary tract or the bowel system. Instead, we suggest that ultrasound examination of a pelvic mass also include an examination of the kidneys, urinary tract, bowel system, liver and retroperitoneum.

Adolescent↗
PubMed1991

Determination of prostate volume with transrectal US for cancer screening. Part I. Comparison with prostate-specific antigen assays.

To investigate whether radiologists can objectively define a high-risk group for prostate cancer, the researchers measured gland volume and compared it with results of a screening blood test, prostate-specific antigen (PSA) assay. A total of 768 men, aged 55-71 years, were self-referred to two prostate cancer screening programs using transrectal ultrasound (US) and digital rectal examination. In patients with no evidence of cancer, statistically significant increases in mean PSA values were noted with increasing gland volume ranges (P less than .05). PSA values in patients with cancer were more likely to exceed the volume-adjusted 95th percentile (mean + [1.65.standard deviation]) than those in patients with negative biopsy results (P less than .005). Patients with PSA values above the volume-adjusted 95th percentile have an estimated risk for prostate cancer up to nine times that of the general screening population. The researchers conclude that knowledge of transrectal US gland volume and prostate-specific antigen assay type are important objective variables for future prostate cancer screening programs. The volume-adjusted 95th percentiles presented may help guide cost-effective management of current early detection efforts.

Aged↗
PubMed1991

Ultrasound of the prostate and its use for guided biopsy.

The development of ultrasound diagnostics of the prostate is described. With modern ultrasound technique in combination with guided biopsy transrectal ultrasound (TRUS) is a powerful diagnostic means and very likely today's best screening tool (if screening would be regarded as feasible). The author advocates transrectal core biopsy instead of fine-needle aspiration biopsy as histology does not have false positives and forms a firmer basis for grading.

Biopsy↗
PubMed1991

Ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia: an in vitro study.

Ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia is a new technique that involves placement of a laser fiber in solid tissue under ultrasound guidance followed by irradiation from within the area to be treated. We have previously described a diffuser tip modification of the bare laser fiber, that proved to produce spherical coagulations of predictable size. In the present paper we describe the development of an ultrasonically guided technique which permits simultaneous laser irradiation and interstitial temperature measurements under real time ultrasound monitoring. The laser lesion appeared on the ultrasound image as a hyperechoic area growing in size with time as energy was applied. Macroscopically the laser lesion emerged as a sphere with a central cavity delineated by a rim of charred tissue and beyond this a larger zone of whitish coagulation. The correlation coefficient (Pearson's r) between ultrasonically and macroscopically measured diameter of the laser lesion was calculated to r = 0.89. It is concluded that ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia may have a potential as a tool in the future treatment of ultrasonically visible neoplasias like liver metastases and prostate cancer.

Animals↗
PubMed1991

Ultrasonically guided fine-needle biopsies from adrenal tumors.

Ultrasonically guided fine-needle biopsies were performed from 28 adrenal lesions in 28 patients. In 15 patients adrenal enlargement was an incidental finding. In 17 of 18 (94%) patients with metastatic spread combined cytological and histological examination disclosed secondary malignancy, and in 4 of 5 patients with primary neoplastic disease the combined microscopic examination concluded primary neoplasia. However, it was not possible to classify these lesions as being of a malignant or a benign nature. A false positive diagnosis of a hepatocellular carcinoma of the clear cell type was made in one case. In all 5 patients with non-neoplastic adrenal lesions cytological and histological examinations concluded non-neoplastic disease. Electron microscopy was of special benefit in two cases of a non-Hodgkin's lymphoma and a pheochromocytoma. Using ultrasonically guided biopsies it is possible to differentiate between adrenal lesions due to metastatic spread and adrenal lesions due to primary neoplasia or non-neoplastic disease. Compared to other imaging techniques ultrasonically guided punctures of adrenal masses is a simple procedure giving important diagnostic information.

Adrenal Gland Neoplasms↗
PubMed1991

US-guided fine needle biopsy of solid renal masses--comparison of histology and cytology.

We report on 134 fine needle biopsies in 127 patients with an ultrasound finding suggesting renal malignancy. Biopsy was performed guided by dynamic ultrasound using an 0.6 mm aspiration needle for cytology and an 0.8 mm Surecut needle for histology. The retrieval rate for cytology was 97.8% compared to 79.1% for histology. Sensitivity for cytology and histology was 89.4% and 70.6%, respectively. The specificity of cytology was 85.4% giving a predictive value of a positive result of 91.6%. Specificity and positive predictive value for histology were both 100%. We conclude that fine needle aspiration biopsy from renal masses in our hands carries too high a false positive rate to be clinically safe. We recommend that fine needle histological biopsy replaces the aspiration biopsy in case of renal masses.

Biopsy, Needle↗
PubMed1991

Ultrasound versus intravenous urography in the initial evaluation of patients with suspected obstructing urinary calculi.

A consecutive series of 102 patients admitted to the radiology department for emergency intravenous urography (IVP) due to suspected obstructing urinary calculus, had an ultrasound scanning (US) performed immediately prior to the requested IVP. The scannings were performed by US-specialists who had access to all patient data except the IVP result. IVP diagnosed renal outlet obstruction in 53 of the 102 cases. This was correctly diagnosed by US in 50 cases. In three cases where IVP described acute obstruction ("white kidney") no dilatation was visible on US. The false negative rate concerning obstruction was thus 6%. No false positive US investigations occurred. Five cases of uretero-pelvic stenosis were correctly diagnosed at both investigations. 18 kidney stones--two being obstructing--were found at both investigations. IVP diagnosed 40 of 46 ureteral stones. The remaining stones were diagnosed by other means (retrograde pyelography, ureteroscopy). US only visualized 18 ureteral stones. The overlooked stones were all less than 5 mm in size, the major part being situated in the middle and lower ureter. We conclude that US plays a role in the initial evaluation of patients with suspected obstructing urinary calculi. If obstruction is diagnosed emergency IVP may be substituted by an elective investigation or even omitted. If no obstruction is diagnosed IVP must be performed in order to rule out non-dilated obstruction. IVP remains the gold standard for visualization of the urinary tract in patients with suspected acute obstruction.

Acute Disease↗