Biomedical subjects
Publications and source records attributed to J Krogh.
In a retrospective study during the last ten years of postoperative wound infections, six cases of late infections were found with a maximum latency of 30 years. A combination of non-absorbable suture materials together with underlying disease seems to have initiated the late formation of wound abscesses. The use of non-absorbable suture seems to involve a life long risk of infection.
In a retrospective study of 28 patients with vesico-intestinal fistula, the maximal diagnostic latency was eight years. The most common causes were diverticulitis (16 patients) and carcinoma of the colon (4 patients). Recurrent urinary tract infections with pneumaturia and/or faecaluria were found in 23 patients. The diagnosis was most accurately confirmed by cystoscopy and barium enema which showed evidence of a fistula in 20 patients. Patients suffering from diverticulitis were managed with excellent results while surgical intervention in malignancy was associated with brief survival. Diverting colostomy as a sole procedure in patients with infravesical obstruction involves the risk of rectal miction.
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A case of retroperitoneal varicose veins simulating neoplastic masses in a patient with unknown portal hypertension is presented. The radiological modalities of choice in differential diagnosis are briefly discussed. The use of contrast-enhanced computed tomography is recommended.
Histologic examination of the prepuces removed from 78 consecutive patients with phimosis was performed during a 2-year period. In 15 cases (14.2%), the typical changes of lichen sclerosus et atrophicus (LSA) were found. A different, distinct histologic pattern of fibrosis was noticed in six patients (7.7%). Clinically, the two conditions were indistinguishable and presented as severe, nonretractable phimosis. The largest group of the patients (46.2%) had histologically normal prepuces, but clinically they too had severe phimosis. Since phimosis especially in young boys may regress spontaneously, and since on the other hand LSA may evolve into squamous cell carcinoma, we conclude that treatment of phimosis should be planned according to its histologic pattern and not according to its monotonous clinical appearance.
A new case of appendicovesical fistula is reported. Usually a known cause is ulcerative colitis, morbus Crohn, malignancy of the appendix or as complication to perforated appendicitis, but in the described case there was no history of such previous illness. The only pathological finding was the presence of an abundant amount of nervous tissue in the appendix. It is concluded that a history of pneumaturia and/or recurrent urinary-tract infections must rise the suspicion of the presence of a fistula between the small or large intestine and the bladder.
A 63-year-old man presented with acute urinary retention due to a retrovesical cystic tumor. Investigation revealed mucinous prostatic adenocarcinoma with metastatic involvement of testis and epididymis. He was treated with retrovesical tube drainage, bilateral orchiectomy and epididymectomy and cyproterone acetate.
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A rare case of mesocolic hernia containing the descending colon is described in a 71-year-old man. The literature on lesser sac hernia is briefly reviewed and the pathogenesis symptoms and treatment are discussed.
Studies have been made on the abrasion by food of different restorative resins in standard Class 1 cavities in mandibular first molars of schoolchildren. The abrasion was recorded by measuring the increasing height of the exposed cavity walls. It was found that Sevriton Simplified was abraded more than Adaptic, that no difference in abrasion between Adaptic and Adaptic without filler could be demonstrated, and that Adaptic was abraded more than an experimental composite containing 30% by weight Aerosil, an ultra-fine SiO2 filler with a grain size of the order of 25-50 nm. The results are in accord with the findings in an initial study by one of the present authors, in which the fillings were placed in denture porcelain teeth. It is stressed that the conclusions of the present work are pertinent only to the type of abrasion studied, i.e. chewing of food without the possibility of direct contact between the fillings involved and the corresponding antagonists.
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Fourty patients with 32 hydroceles and 11 epididymal cysts were treated by aspiration and instillation of tetracycline. After a follow up period of 24-39 months the cure rate was 77%. Most of the early recurrences were the results of chemical inflammation and vanished spontaneously. This group should therefore not be operated on until three months after their initial treatment. As aspiration of the fluid had allowed palpation of the testis and cytological examination, only a small proportion of patients with recurrences wanted further treatment. We therefore recommend tetracycline sclerotherapy because it is quick, easy, safe, and effective in the long as well as the short term.
A case of gallbladder empyema associated with multiple complications caused by a delay in diagnosis is presented. Recent literature is reviewed especially emphasizing the clinical presentation with scanty physical signs. Greater awareness of the indolent and chronic presentation might reduce the considerable morbidity and mortality that are associated with delayed operative intervention.