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Biomedical subjects

U M Hamper

Publications and source records attributed to U M Hamper.

At least 19 recordsLinked to original sources
PubMed1992

Intraoperative sonography of renal tumors.

Intraoperative sonography (7.5 MHz. transducer with Doppler probe) was used to evaluate renal masses in 41 kidneys to determine its correlation with pathological findings. This intraoperative determination of the extent of the renal lesion prompted occasional changes in surgical management. We conclude that intraoperative sonography is most useful in partial nephrectomy, and helps to determine the extent of tumor, multicentricity, venous extension and associated cysts. These findings may not be appreciated with intraoperative, visual inspection of the kidney.

Humans↗
PubMed1992

Fine-needle aspiration biopsy of abdominal lesions: diagnostic yield for different needle tip configurations.

Four fine-needle aspiration biopsy needles with different tip configurations were used in 133 patients with abdominal lesions. The 20-gauge needles were used in random sequence by several physicians. The specimen from each of the 522 needle passes was evaluated by two cytopathologists for adequacy to render a diagnosis and for the presence of cell block material. The Franseen needle produced a 16% and 9% better yield for diagnostic material than did the cut biopsy and spinal needles (P less than .05), respectively. The Westcott needle was better than the cut biopsy needle by 13%, and the spinal needle produced an 11% better yield than did the cut biopsy needle. Differences did not exist in liver biopsies but were present in pancreatic biopsies. The spinal needle was the least successful in yielding cell block material. Use of the cut biopsy needle resulted in the largest proportion of inadequate specimens, except its yield in cell blocks in the liver was 25% higher than that of the Westcott needle. The authors conclude that not all unusual designs for 20-gauge needle tips render results superior to those of the simple spinal needle.

Adolescent↗
PubMed1991

Bladder exstrophy-epispadias complex: prostatic evaluation by transrectal ultrasonography.

Seven patients with bladder-exstrophy-epispadias complex underwent high resolution prostatic ultrasonography in order to establish the presence and appearance of their prostate gland and seminal vesicles. Six patients had been born with classic bladder exstrophy, and one patient with complete epispadias. The size of the prostate gland was in the normal range in three patients. Three patients had small glands, and in one patient no prostatic tissue could be identified. Two patients showed an unusual position or echoappearance of their glands. The seminal vesicles in five patients were relatively large, contained multiple cystic spaces, and/or extended posteriorly and inferiorly to the prostate gland proper. Our study demonstrates that the prostate gland and seminal vesicles are present in patients with bladder exstrophy. The unusual appearance, position, and size in most patients, however, suggests faulty embryologic development or changes secondary to surgery reflecting the complex nature of the condition. Likewise, the enlarged seminal vesicles may indicate impaired drainage of these structures secondary to the initial bladder closure or subsequent bladder neck reconstruction.

Adolescent↗
PubMed1991

Retroperitoneal and pelvic CT of patients with AIDS: primary and secondary involvement of the genitourinary tract.

Although genitourinary tract disorders are common in acquired immunodeficiency syndrome (AIDS), little attention has been paid to their manifestations on computed tomographic (CT) scans. The authors reviewed the CT scans of 86 patients infected with the human immunodeficiency virus for CT manifestations of primary or secondary involvement of the genitourinary tract. Genitourinary tract abnormalities identified in the 86 patients included nephromegaly in 34 (40%), hilar adenopathy in 30 (35%), bladder wall thickening in 19 (22%), medullary hyperattenuation in 12 (14%), renal calcifications in seven (8%), adnexal masses in five (6%), hydronephrosis in four (5%), pyelonephritis in three (3%), renal abscesses in three (3%), and solid renal masses in three (3%). Although these abnormalities are seen on CT scans in many other diseases, in the AIDS patient they often indicate the presence of an AIDS-related renal disease or involvement of the genitourinary tract by an AIDS-related neoplasm or infection.

AIDS-Associated Nephropathy↗
PubMed1991

Capsular transgression of prostatic carcinoma: evaluation with transrectal US with pathologic correlation.

One hundred twenty-five patients with biopsy proved clinical stage A or B prostatic carcinoma were evaluated with biplane transrectal ultrasonography (US) prior to radical prostatectomy. Sonograms were evaluated for capsular transgression of the tumor into the posterior and posterolateral aspects of the glands as manifested by local contour deformity and irregularity or interruption of the periprostatic fat echoes. Correlation of the findings at US with the findings at pathologic examination of the step sections was obtained, and the presence and depth of capsular penetration were assessed. Of the 250 halves or hemispheres of the prostate gland that were evaluated, capsular penetration was seen at pathologic examination in 86. US enabled correct identification of pericapsular tumor spread in 59 of the 86 hemispheres but did not depict pericapsular tumor spread in 27 hemispheres. Absence of pericapsular tumor spread was verified at pathologic examination in 149 of the 164 hemispheres that either did not have tumor or did not show pericapsular tumor spread. Pericapsular tumor spread was incorrectly diagnosed in 15 hemispheres. A positive US diagnosis of pericapsular tumor spread correlated moderately well with the depth of penetration demonstrated at pathologic examination. Transrectal US is an effective noninvasive procedure that demonstrates the presence of prostatic cancer.

Biopsy↗
PubMed1991

Stage A adenocarcinoma of the prostate: transrectal US and sonographic-pathologic correlation.

Results of transrectal ultrasound (TRUS) of the prostate and pathologic examination of specimens obtained at transurethral resection of the prostate (TURP) were compared in 29 patients with clinical stage A adenocarcinoma. Ten specimens contained no residual tumors larger than 5 mm in diameter; in the remaining 19 glands, 20 discrete cancers were found. At TRUS, 30 peripheral hypoechoic lesions were demonstrated, of which 11 corresponded to carcinoma at pathologic examination. Other hypoechoic peripheral zone lesions included a focal area of dilated acinar glands in 10 cases, post-TURP scarring with fingerlike projections of fibrosis in seven, dysplasia in one, and no correlation in one. Of nine tumors that were not detected prospectively at TRUS, eight were predominantly in the anterior zone and one was in the posterior peripheral zone but was isoechoic. Overall, the sensitivity of TRUS in the evaluation of clinical stage A lesions was 55% and the specificity was 37%. Clinical stage A carcinomas may be difficult to detect at US, and findings are often nonspecific. Any suspicious peripheral zone lesion should undergo biopsy with TRUS guidance before being diagnosed as malignant.

Adenocarcinoma↗
PubMed1991

Stage B adenocarcinoma of the prostate: transrectal US and pathologic correlation of nonmalignant hypoechoic peripheral zone lesions.

Various benign conditions have been found to cause hypoechoic lesions in the prostate gland, thus mimicking the sonographic appearance of early prostatic cancer. Transrectal sonograms in a large series of patients with biopsy-proved clinical stage B prostatic cancer were retrospectively reviewed to determine the pathologic correlate to benign hypoechoic peripheral zone lesions. Transrectal sonograms demonstrated hypoechoic lesions that did not represent cancer in 25 of 160 patients examined. All lesions were contralateral to the carcinoma. Pathologic correlation was found in 24 of the 25 lesions. The results of this study show that contralateral hypoechoic lesions in patients with pathologically proved prostatic cancer do not necessarily imply bilateral tumor involvement; they accounted for benign lesions that mimicked the sonographic appearance of malignant tumors and thus produced a false-positive rate for cancer in the contralateral lobe of 16% of patients (25 of 160) with clinical stage B cancer.

Adenocarcinoma↗
PubMed1990

Bright echogenic foci in early prostatic carcinoma: sonographic and pathologic correlation.

One hundred sixty patients with biopsy-proved clinical stage A or B prostatic carcinoma were examined with high-resolution transrectal ultrasonography prior to radical prostatectomy. All tumors showed either a hypoechoic or isoechoic echo pattern. However, 11 patients demonstrated evidence of focal bright echogenic areas at the periphery or within the center of a hypoechoic tumor. Coarse echogenic foci seen in seven patients corresponded pathologically to calcified corpora amylacea in benign tumors of the prostate gland either at the edge of the tumor or scattered throughout the tumor. Seven patients showed a fine, stippled echogenic pattern within the lesion. On a pathologic level, this pattern represented high-grade tumors with extensive central comedonecrosis and calcifications in five patients and an unusual deposit of small intraluminal crystalloid deposits in two patients. Combinations of echo patterns were observed in three patients. This study demonstrates that echogenic foci can be seen within predominantly hypoechoic tumor nodules. Coarse bright echoes, usually at the periphery of the tumor, suggest calcifications in benign prostate glands. Tumor calcifications and intraluminal prostatic crystalloid deposits were located more centrally and had a finer stippled sonographic appearance.

Adenocarcinoma↗
PubMed1990

Pelvic masses: aspiration biopsy with transrectal US guidance.

Biplanar, transrectal ultrasound guidance was used in the transrectal aspiration of two pelvic abscesses, one recurrent tumor, and one sterile, nonmalignant fluid collection. This method provides an alternative path that allows precise localization for aspiration biopsy of pelvic masses.

Abscess↗
PubMed1990

Carcinoma of the prostate: value of transrectal sonography in detecting extension into the neurovascular bundle.

Detection of involvement of the neurovascular bundles (NVB) by tumor is important in deciding whether sexual function can be preserved in patients undergoing radical prostatectomy for prostatic cancer. The nerve branches innervating the corpora cavernosa have a rather constant association with the capsular arteries and veins of the prostate, forming the periprostatic neurovascular bundle, which can be identified intraoperatively and spared during radical surgery, thus preserving potency. We examined 160 patients with biopsy-proved clinical stage A or B adenocarcinoma with transrectal sonography before radical prostatectomy to determine how useful the procedure is for predicting tumor extension into the NVB. Correlation with pathologic serial sections was obtained in each patient. The sonograms depicted the NVB on both sides in 77 patients (50%), on the right side only in 13 (8%), and on the left side only in 36 patients (23%). In 29 patients (19%) neither neurovascular bundle could be identified on the sonograms. Ninety-one tumors in this series showed evidence of extraglandular spread pathologically, which was posterolateral or into the NVB in 70 tumors involving 82 hemispheres. Using transrectal sonography, we correctly identified invasion of the NVB in 54 cases and missed it in 28 cases. NVB invasion was predicted incorrectly with transrectal sonography in 51 cases; absence of involvement of the NVB was correctly predicted in 177 hemispheres. The sensitivity of sonography for predicting invasion of the NVB was 66%, with a specificity of 78% and an accuracy of 75%. Positive predictive values and negative predictive values were 51% and 86%, respectively. We conclude that transrectal sonography currently suffers from lack of sufficient spatial resolution to detect accurately invasion of the NVB.

Adenocarcinoma↗
PubMed1990

Cystic lesions of the prostate gland. A sonographic--pathologic correlation.

277 patients underwent biplane transrectal ultrasonography. Twenty-two patients (7.9%) showed evidence of one or more intraprostatic cystic lesions. Histologic correlation was available with total prostatectomy specimens in six patients and surgical drainage in two patients. Sonographically, 11 patients showed one, 6 patients two, and 5 patients three or more intraprostatic cystic lesions. The size of the lesions ranged from 2 to 30 mm, and the majority of lesions were located within the central portion of the gland or at the junction of central and peripheral regions of the gland. Histologically, among the eight pathologically confirmed patients the lesions corresponded to cystically dilated, epitheliallined prostatic glands, a reepithelialized cyst related to previous biopsy, a dilated utricle, and two intraprostatic abscesses. The cystic lesions in our series were not associated with carcinoma of the prostate, but represented either a growth phenomenon related to the presence of benign prostatic hypertrophy, inflammatory conditions (abscesses), or anatomical variants (utricle).

Abscess↗
PubMed1989

Determination of canine prostatic size in situ: comparison of direct caliper measurement with radiologic and transrectal ultrasonographic measurements.

The use of transrectal ultrasonography to estimate canine prostatic size in situ was evaluated and compared to that of direct measurement via calipers and an in situ radiologic procedure. The length, width, and depth of prostates were measured by transrectal ultrasound in both the transverse and sagittal planes from which prostatic volume was calculated. Prostatic volumes were subsequently transformed into prostatic weights using the following nomogram: prostatic Weight (g) = 0.602 x prostatic Volume (cm3) + 1.16. Prostatic weights estimated by ultrasound as well as by direct measurement with caliper were similar (P greater than 0.10) to the true gravimetric weight; however, prostate weights estimated by the radiological X-ray procedure were significantly (P less than 0.01) lower. The relationship between true gravimetric prostate weight and that estimated by ultrasound was described by the following regression equation: estimated weight (g) = 1.127 gravimetric weight (g) - 1.665; r = 0.900; P less than 0.001; n = 23. In summary, the results of this study demonstrate that transrectal ultrasonography can be used to accurately predict canine prostatic weight.

Animals↗
PubMed1989

Evaluation of transrectal ultrasound in the early detection of prostate cancer.

To determine the ability of transrectal ultrasound to detect early localized prostate cancer, unsuspected (nonpalpable) cancer in the contralateral lobe of patients undergoing radical prostatectomy for clinically localized disease was evaluated. A total of 59 patients with palpable prostate cancer clinically confined to 1 lobe underwent transrectal ultrasound before radical prostatectomy and step-sectioning of the radical prostatectomy specimen. Transrectal ultrasound was performed with 5 or 7 MHz. real-time transrectal units. Pathological findings in these 59 cases revealed no tumor in the contralateral lobe in 34 (58%) and the presence of unsuspected tumor in 25 (42%). Transrectal ultrasound detected 13 of 25 unsuspected cancers for a sensitivity of 52%. Of 34 patients with no contralateral lobe lesion transrectal ultrasound was correct in 23 for a specificity of 68%. The positive and negative predictive values for transrectal ultrasound in this study group were 54 and 66%, respectively. There was no significant difference in the pathological size of the clinically suspected and clinically unsuspected cancers as measured by average largest dimension, and transrectal ultrasound sensitivity did not correlate with the size of the cancer. Based on careful sonopathological analysis, transrectal ultrasound may not be a good method to detect clinically unsuspected prostate cancer and the false positive rate would appear to be high.

Humans↗
PubMed1989

The computed tomographic spectrum of thoracic sarcoidosis.

Thoracic manifestations of sarcoidosis are well recognized on conventional radiographs. Less well known are the CT appearances of sarcoidosis. This article reviews the spectrum of CT findings in sarcoidosis; highlighting distributions of lymphadenopathy on CT, patterns of parenchymal involvement, and pulmonary complications of sarcoidosis as demonstrated by CT.

Humans↗
PubMed1989

Parasternal sonography of the internal mammary vessels: technique, normal anatomy, and lymphadenopathy.

Metastasis to the internal mammary lymph nodes adversely affects the disease-free interval and long-term survival in women with breast carcinoma. Since staging of disease in this lymphatic chain is rarely performed at the time of definitive surgical treatment, noninvasive methods have been advocated. The authors present their preliminary experience with a sonographic technique for evaluating the internal mammary lymph nodes, artery, and vein. Longitudinal and transverse images of the first through fourth parasternal rib interspaces were acquired with a 5.0- or 7.5-MHz linear-array real-time system. The method was evaluated prospectively in 36 control subjects and in seven patients (six with metastatic breast cancer and one with lymphocytic lymphoma) who had enlarged internal mammary lymph nodes at thoracic computed tomography (CT). The longitudinal scans routinely demonstrated the internal mammary vessels in the upper interspaces. Lymphatic structures were not identified in the control group. In contrast, sonographic findings corresponding to the CT findings of lymphadenopathy were present in all seven patients. The authors believe that parasternal sonography is a promising technique that merits further study.

Adult↗
PubMed1989

Etiologic factors in renovascular fibromuscular dysplasia. A case-control study.

The role of several factors that have been suggested as being of etiologic importance in renovascular fibromuscular dysplasia was examined in a case-control study of 33 patients with angiographically demonstrated fibromuscular dysplasia and 61 renal transplant donor control subjects with normal renal arteries. The factors studied included use of oral contraceptive agents or markers of sex hormone dysfunction, mechanical stress to the renal artery wall, human lymphocytic antigen (HLA) type, cigarette smoking, history of hypertension for more than 5 years, and family history of cardiovascular disease. The risk of fibromuscular dysplasia was significantly (p = 0.003) increased (odds ratio = 4.1, 95% confidence interval = 1.5-10.9) among cigarette smokers. A significant (p less than 0.001) dose-response relation was noted between cigarette use and the risk of fibromuscular dysplasia developing (odds ratio = 8.6 for those who had smoked more than 10 pack-years). Personal history of hypertension more than 5 years was also associated (odds ratio = 5.0, 95% confidence interval = 1.1-22.8) with a significantly (p = 0.036) increased risk for the development of fibromuscular dysplasia. HLA-DRw6 antigen was more common in the 33 fibromuscular dysplasia patients than in the 61 renal transplant donor control subjects (odds ratio = 3.00, p = 0.067) or a second group of 934 ambulatory control subjects (odds ratio = 2.51, p = 0.031). Adjustment for cigarette smoking increased the odds ratio to 5.0 (95% confidence interval = 1.3-19.6). There was a positive though not statistically significant (odds ratio = 1.7, p = 0.175) association noted between family history of cardiovascular disease and fibromuscular dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗