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Biomedical subjects

A Sivula

Publications and source records attributed to A Sivula.

At least 55 records · Page 3Linked to original sources
PubMed1978

Ultrastructural and steroidogenic characteristics of an androgen-producing adrenocortical tumour.

A 16-year-old female patient with an adrenal tumour was studied. Clinically she had progressive hirsutism, showed high urinary 17-oxosteroid excretion with normal plasma cortisol. Plasma C19-steroids, both unconjugated (including testosterone) and sulphate-conjugated, were greatly elevated. On surgical exploration an adrenal tumour was histologically an adenoma. On ultrastructural analysis the cells in all zones of the adjoining adrenal were considered normal. Although the tumour cells had the general appearance of a steroid-secreting cell their structure diverged from the cells of every subzone of the cortex. This was the case particularly with mitochondria and lipid inclusions. The only endogenous unconjugated steroids detected in the adjoining cortex were corticosterone and cortisol while in tumour tissue these were present in lesser amounts. The tumour tissue contained large amounts of C19-steroids, 11beta-hydroxy-androstenedione being quantitatively most significant. On the basis of the steroid profile an impaired defect of 21-hydroxylation in tumour cells leading steroid synthesis from corticosteroidogenesis to the C19 pathway is proposed.

Adenoma↗
PubMed1977

Secondary hyperparathyroidism and parathyroidectomy in terminal chronic renal failure.

Subtotal parathyroidectomy was performed on 34 patients with severe renal insufficiency. The indications were grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (metastatic calcifications, osteoporosis, fractures and subperiostal resorption). The serum calcium level was elevated in eight cases. The serum parathormone value was determined in 13 cases, it was elevated in all cases. Less than 500 mg tissue was removed in 12, between 500 and 6000 mg in 19 and over 6000 mg in 3 cases. Nodular hyperplasia was demonstrated in 11 and diffuse hyperplasia in 23 patients. The serum calcium and parathormone levels fell markedly after the operation, and pruritus, bone pains and mental disturbances were markedly alleviated. Complete recovery was achieved only by a successful renal transplantation, but the operation had often a favourable effect on the grave symptoms.

Adolescent↗
PubMed1976

Diagnostic aspects in 117 patients treated surgically for thyroid carcinoma.

A series of 117 patients operated on for thyroid carcinoma from 1969-1973 is compared with a previous series of 115 cases treated from 1956-1968, with the object of clarifying diagnostic aspects and indications for primary operation. In the group with papillary carcinomas there was a high peak of incidence among young patients both females and males aged 20 to 30 years. In the present series the incidence of metastases was less than in the previous series. Lymph node metastases in the neck were the only metastases in papillary and medullary carcinomas. The time interval between beginning of treatment and appearance of main symptoms had decreased noticeably. The pre- and peroperative diagnostic procedures employed made it possible to operate as the primary procedure in 78% of papillary, 100% medullary and 86% anaplastic tumours, but only in 52% of follicular carcinomas. The most common reason for diagnostic failure was that frozen section had not been performed during the primary operation. The value of both aspiration biopsy and frozen section was dependent on the histological type of the tumour; it was more reliable in papillary and anaplastic than in follicular carcinomas. The operability rate had not changed essentially, 94% of papillary and 85% of follicular, but only 24% of anaplastic primary tumours could be radically removed. The value of establishing a firm diagnosis is to be able to operate as a primary procedure in these tumours when less operative complications occur.

Adenocarcinoma↗
PubMed1976

A benign hepatocellular adenoma treated by extended right lobectomy.

A 19-YEAR-OLD WOMAN WITH A LARGE BENIGN HEPATOCELLULAR ADENOMA IS PRESENTED. The initial symptom was continuous anaemia demanding transfusions twice a month. Coeliac angiography revealed the hepatic tumour, which was thought to be malignant. Angiography produced permanent paraplegia as a complication. The tumour was radically removed by an extended right lobectomy. The weight of the operation specimen was 2200 g. Histologically the differential diagnosis layed between benign hepatocellular adenoma and hepatocellular carcinoma. Postoperative stricture of the common duct developed as a complication of T-tube and was successfully treated at reoperation. Liver function became totally restored after the operation and after 5 years' follow-up there has been no tumour recurrence. The very rare benign hepatocellular adenomas are discussed.

Adenoma↗
PubMed1976

A benign hepatocellular adenoma treated by extended right lobectomy.

A 19-year-old woman with a large benign hepatocellular adenoma is presented. The initial symptom was continuous anaemia demanding transfusions twice a month. Coeliac angiography revealed the hepatic tumour, which was thought to be malignant. Angiography produced permanent paraplegia as a complication. The tumour was radically removed by an extended right lobectomy. The weight of the operation specimen was 2200 g. Histologically the differential diagnosis layed between benign hepatocellular adenoma and hepatocellular carcinoma. Postoperative stricture of the common duct developed as a complication of T-tube and was successfully treated at reoperation. Liver function became totally restored after the operation and after 5 years' follow-up there has been no tumour recurrence. The very rare benign hepatocellular adenomas are discussed.

Adult↗
PubMed1976

The effect of hepatic dearterialization and re-dearterialization on carcinoid liver metastases.

A 48-year-old woman with severe carcinoid syndrome caused by multiple liver metastases was treated by hepatic dearterialization. After the operation, urinary 5-HIAA excretion fell transiently to normal levels and the patient was symptom-free for six months. After one year the symptoms of carcinoid syndrome had recurred and a re-dearterialization was performed. A favourable clinical effect was again achieved, but the relief of symptoms lasted only six months. The changes in urinary 5-HIAA excretion and SGOT, SGPT, bilirubin, alkaline phosphatase, cholesterol, PP activity as well as serum protein levels were uniform after both operations to an astonishing degree. Histological specimens taken at reoperation showed that the carcinoid metastases in the anterior parts of the liver were largely necrotic. The necrotic areas has peculiar features, e.g. the necrosis was partly incomplete and ghost like carcinoid structures could be seen.

Alanine Transaminase↗
PubMed1973

[Acute abdomen].

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Abdomen, Acute↗