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Biomedical subjects

A Kristoffersson

Publications and source records attributed to A Kristoffersson.

At least 37 records · Page 2Linked to original sources
PubMed1990

Pre- and postoperative evaluation of renal function with five different tests in patients with primary hyperparathyroidism.

Renal function was investigated immediately before and 1 year following parathyroidectomy in 19 patients with moderate hypercalcaemia. On both occasions, all patients underwent five different tests of glomerular and tubular function: plasma creatinine, creatinine clearance, 51Cr-EDTA-clearance, beta 2-microglobulin excretion and the desmopressin test. Glomerular filtration rate, as assessed by plasma creatinine and clearance of both creatinine and 51Cr-EDTA, was normal in most patients, and was little affected by restoration of normocalcaemia. Renal concentrating capacity, as determined by the desmopressin test, was abnormally low in 14 of 19 patients, but increased significantly after surgery. It is concluded that serious renal damage is seldom encountered in present-day HPT patients, but that a treatable decrease in renal concentrating capacity often exists.

Adult↗
PubMed1990

Adrenocortical carcinoma. A retrospective study of a rare tumor with a poor prognosis.

A retrospective study was performed on 54 patients diagnosed as having adrenocortical carcinoma during 1974-1983. The initial symptoms were often diffuse: abdominal pain, weight loss, or fever, and more than 60% of the patients showed no evidence of overproduction of hormone. The median tumor diameter was 13 cm and almost half of the tumors had metastasized at diagnosis. A radical tumor resection could be performed in less than 50% of the patients, and at histopathological re-examination some tumors were not conclusively verified as malignant. Capsular invasion, nuclear pleomorphism and mitoses were found more commonly in patients who succumbed to the disease. Seven of 29 patients treated with chemotherapy showed an objective response and two of them are still alive and free of disease. The overall 5-year-survival rate was 19%, compared with 45% for patients with radically resected tumors. Patients with no biochemical signs of overproduction of adrenocortical hormone appeared to have a better prognosis than those with hormone excess. Together with increased use of ultrasound and computed tomography, a urinary steroid profile might hopefully contribute to earlier discovery of these often clinically silent tumors. However, it remains to be determined whether these diagnostic improvements, together with more aggressive surgery and adrenolytic chemotherapy, can improve the poor prognosis.

Adolescent↗
PubMed1989

Reduction of serum gonadotropin concentrations after parathyroidectomy.

Calcium, parathyroid hormone, follicle-stimulating hormone, luteinizing hormone, and estradiol were measured in 15 postmenopausal women with primary hyperparathyroidism before and 1 year after parathyroidectomy. Normalization of serum calcium concentrations (from 2.87 to 2.29 mmol/l) was followed by a highly significant fall in serum LH and FSH concentrations. No significant alteration occurred in plasma estradiol concentration.

Aged↗
PubMed1987

Gastrointestinal manifestations of hereditary haemorrhagic teleangiectasia.

Six out of 34 patients with gastrointestinal manifestations of hereditary haemorrhagic teleangiectasis (HHT) were found retrospectively. The diagnosis was established clinically, endoscopically, angiographically and/or at surgery. Major bleeding episodes originated from lesions in the stomach and duodenum. A few cases were also encountered with teleangiectasia in the small and large intestine and occasionally in the liver and lung. Repeated treatment with electrocoagulation was effective in controlling gastrointestinal bleeding in two of the patients. It is concluded that HHT should be considered as a potential cause of repeated and unexplained GI bleedings and that this diagnosis also should be kept in mind in patients with recurrent epistaxis.

Epistaxis↗
PubMed1987

Long-term effects of surgery for normocalcaemic hyperparathyroidism.

A retrospective study of the long-term effects of surgery for normocalcaemic hyperparathyroidism in 82 patients is presented. The median postoperative follow-up time was 96 months. In most of the patients recurrent renal calculi had been the main preoperative symptom, and intermittent peaks of hypercalcaemia were recognized in more than 50% of them. Of the 19 patients with severe tendency to calculus formation, 12 appeared to have been cured by parathyroidectomy. These cured patients were found at operation to have parathyroid adenoma or hyperplasia, or even normal glands. Preoperatively depressed renal function normalized in about 50% of cases, as assessed by the desmopressin test. No patient had paralysis of the recurrent laryngeal nerve, and all were normocalcaemic during follow-up. Parathyroid surgery should be considered for this category of patients, although it is very difficult to distinguish between those who stand to benefit and those who do not.

Adult↗
PubMed1987

Primary hyperparathyroidism in Northern Sweden.

Three hundred and eleven patients with presumed hyperparathyroidism were operated upon between the years 1961 and 1983 at the two surgical clinics in Northern Sweden equipped with pathologic facilities. Eighty per cent were women. All of the patients were hypercalcemic. Parathyroid hormone (PTH) levels were elevated in 66 per cent of the patients. The correlation between serum calcium and PTH levels was only 0.38. Serum creatinine levels were normal in 92 per cent of the patients while renal concentrating ability was depressed in 79 per cent. The main patient symptoms were fatigue, mental disturbances and renal stones. Eighteen per cent were asymptomatic at the time of the operation. Most patients were diagnosed during in-hospital investigations. Many were also found to be hypercalcemic at regular outpatient controls. At operation, adenomas were found in 80 per cent, different kinds of hyperplasia in 15 per cent, normal histologic finding in 4 per cent, while cancer was found in less than 1 per cent of the patients. At follow-up study, 79 per cent were normocalcemic while 3 per cent were hypocalcemic and 11 per cent were still hypercalcemic--7.5 per cent were lost to follow-up study. Nine patients had a permanent paralysis of the recurrent laryngeal nerve.

Adenoma↗
PubMed1986

Drainage in uncomplicated thyroid and parathyroid surgery.

A randomized study of the value of drainage in thyroid and parathyroid surgery is presented. Fifty patients were provided with surgical drains and another fifty patients were allocated to a control group without drainage. Complications were few in either group and the rate of subjective discomfort from the collar incision was equally low in both groups. The observations suggest that the provision of drainage is not necessary after uncomplicated neck surgery.

Adolescent↗
PubMed1986

Persistent hypercalcemia after neck exploration--an analysis of 34 cases.

A retrospective analysis of 34 patients undergoing 45 re-explorations for persistent hypercalcemia is presented. Thirteen out of the 20 enlarged parathyroid glands were found at reoperation to be normally located, indicating that the initial exploration had been incomplete. A follow-up study of the reoperated patients showed that 25 (74%) were normocalcaemic. Three patients had permanent unilateral recurrent laryngeal nerve damage and 2 patients required calcium and/or vitamin D therapy. Ultrasonography was effective in the diagnosis and localisation of residual parathyroid adenoma in patients with persistent postoperative hyperparathyroidism.

Adenoma↗
PubMed1985

Comparison of ultrasonography and computed tomography in preoperative location of parathyroid adenomas.

The value of high-resolution real-time ultrasonography in locating parathyroid adenomas was compared with that of computed tomography (CT). In 21 patients with a single parathyroid adenoma verified at neck exploration, preoperative ultrasonography and CT detected the adenoma in 15 and 11 cases, respectively. Ultrasound gave false-positive results in four patients and false-negative in two, whereas CT was false-positive in four patients and false-negative in six. Most false-positive reports were due to misinterpretation of small thyroid nodules. For acceptable accuracy both methods require an experienced radiologist. Technical and interpretive problems seem to be somewhat less frequent with ultrasonography than with CT. Ultrasonography has therefore become the method of choice for preoperative location of enlarged parathyroid glands at our hospital, and CT is used as a complementary procedure, e.g. when a mediastinal adenoma is suspected.

Adenoma↗
PubMed1985

Primary hyperparathyroidism in pregnancy.

The history of a pregnant woman with primary hyperparathyroidism is presented. The patient underwent successful operation during the second trimester and the subsequent pregnancy and delivery were completely normal. Previously, 72 women with an established diagnosis of hyperparathyroidism in pregnancy are reported in the English literature. Twenty-three women underwent operation during pregnancy and 18 normal children were born. Fifty women with a total of 79 pregnancies during a hyperparathyroid state bore 35 normal children while 40 births had different kinds of complications. It is thus clearly documented that the risk of severe fetal complications is much higher if the hyperparathyroidism is left untreated than if the mother undergoes operation during the pregnancy. Therefore when the diagnosis is established the mother should undergo operation, if possible during the second trimester, which minimizes the complication rate significantly in both mother and child. Correction of the hypercalcemic state enables the development of adequate parathyroid gland function in the baby.

Adenoma↗
PubMed1985

Acute intestinal obstruction and splenic hemorrhage due to metastatic choriocarcinoma. A case report.

Choriocarcinomas are rare malignancies which occasionally cause acute abdominal symptoms, mainly in the form of hemorrhage. We here describe a patient with metastatic choriocarcinoma presenting as acute intestinal obstruction and splenic hemorrhage. This seems to be the first report in the literature of a choriocarcinoma causing invagination of the small intestine. The abdominal manifestations of the neoplasm are briefly discussed.

Acute Disease↗
PubMed1985

Primary hyperparathyroidism. Relationship between surgical technique and postoperative calcium levels in patients with single parathyroid adenomas.

The relationship between extent of surgery and calcium levels 6-12 months postoperatively has been analysed in 177 patients in whom a parathyroid adenoma was found at exploratory surgery of the neck. The analysis showed that the frequency of postoperative hypocalcaemia and the need of longterm calcium and vitamin D supplements increased if macroscopically normal glands were extirpated and/or biopsied in addition to removal of the adenoma. It was also shown that the frequency of postoperative hypercalcaemia was similar in patients in whom the peroperative histopathological examination of macroscopically normal glands showed normal cellularity or hyperplasia. The data favour a more conservative approach in parathyroid surgery.

Adenoma↗
PubMed1983

Cimetidine does not correct circulating calcium and parathyroid hormone in primary hyperparathyroidism.

Thirteen patients with primary hyperparathyroidism were treated for 4-8 weeks with the H2-blocker cimetidine at a daily dose of 1 g. The drug had no effect on the serum concentrations of calcium or parathyroid hormone, nor did any of the patients improve clinically during the period of treatment. The recently reported efficacy of cimetidine in primary hyperparathyroidism is strongly questioned by the present results.

Adult↗
PubMed1976

Ampicillin polymers as elicitors of passive cutaneous anaphylaxis.

The ability of ampicillin polymers to elicit passive cutaneous anaphylaxis (PCA) reactions in guinea pigs was analyzed. Mediating antibodies were raised in rabbits against a crude preparation of 6-aminopenicillanic acid (6-APA). It was found that large ampicillin polymers were potent elicitors, 1,000-fold better than benzylpenicillin polymers. Small polymers in high concentrations did not elicit PCA reactions but inhibited the activity of the larger polymers. This inhibition was more pronounced that that of ampicillin monomer. High molecular weight of ampicillin polymer in the amount of 0.1% in an ampicillin solution manifested its PCA activity. The tendency of ampicillin to polymerize, particularly when kept in solution, makes this observation worth considering. The PCA reactions described were penicilloyl-specific as verified by immunosorbent experiments.

Ampicillin↗
PubMed1976

The binding properties of rabbit antibodies against various penicillins as studied by immunoprecipitation, indirect haemagglutination and radiometric immunoassay.

Rabbit antibodies raised against protein conjugates of azidocillin (AzO), ampicillin (AmpO), benzylpenicillin (BPO) and crude 6-aminopenicillanic acid (6-APA) gave rise to two precipitation lines in immunoprecipitation tests against penicillin protein conjugates where the carrier was unrelated to the immunogens. This pattern verifies extensive cross-reactions between penicillins, which have previously been reported. The use of AzO-coated rabbit red cells in indirect haemagglutination (IHA) inhibition tests showed good reactivity (a) between the inhibitor AzO and antibodies raised against AzO, AmpO and BPO, (b) between the inhibitor AmpO and antibodies raised against AmpO and BPO, (c) between the inhibitor BPO and antibodies raised against BPO. When BPO-coated red cells were used, AzO, AmpO and BPO inhibited the IHA activity of antibodies against the BPO. Varying IHA results were obtained using differently conjugated rabbit red cells. Thus antibodies against AmpO gave higher titres when using AzO- than BPO-coated red cells while for antibodies against BPO the opposite was noted. The radiometric assay utilizing AzO-serum albumin as tracer as well as reference substance resulted in significantly higher values for antisera against AzO and AmpO compared with those for antisera against crude 6-APA. Antisera against BPO were not analysed in this respect. Furthermore, there was poor correlation between the results obtained with the indirect IHA technique and the radiometric immunoassay.

Ampicillin↗
PubMedDate not supplied

Clinical characteristics, treatment and survival in patients with pancreatic tumors causing hormonal syndromes.

Eighty-five patients with endocrine pancreatic tumors associated with clinical syndromes of hormone excess were retrospectively analyzed regarding symptomatology, means of diagnosis, and results of surgical and medical treatment during follow-up of 3-18 years (median 8 years). The combination of angiography and computed tomography was most successful in pre-operative localization of both primary tumors and metastases. Surgery provided long term cure in 39 of 44 patients with benign islet cell lesions, the majority having insulinomas. Forty-one patients had malignant tumors, which at the time of diagnosis or operation were associated with liver and/or regional lymph gland metastases in 56% and 24%, respectively. Sixteen patients with metastatic disease and/or very large tumors were considered inoperable, 5 patients underwent palliative resection of their malignant tumors, while grossly radical tumor removal was accomplished in 20 patients. Long-term cure was achieved in 5 patients by excision of primary tumors and localized liver or lymph gland metastases. Half of the patients, particularly those with insulinoma, gastrinoma, or vipoma, showed response to streptozotocin, in combination with other cytostatics, for a median of 24 months or a response to interferon for a median of 10 months. The overall 5-year and 10-year survival among the patients with malignant islet cells tumors was 54% and 28%, respectively. Absence of liver metastases at time of operation/diagnosis, smaller size of the primary tumor, grossly radical tumor resection as well as response to medical therapy predicted the more favorable survival.

Adenoma, Islet Cell↗