Biomedical subjects

J Olofsson

Publications and source records attributed to J Olofsson.

At least 127 records · Page 7Linked to original sources

PubMed1983

Acute epiglottitis in children: experiences with tracheotomy and intubation.

Acute epiglottitis is one of the most serious and potentially fatal conditions dealt with in paediatric laryngology. The infectious agent is mostly Haemophilus influenzae. An active and planned treatment to secure the airway is necessary to reduce the morbidity and mortality. The 'watch and wait' attitude should be abandoned. Tracheotomy or intubation should be performed. Mostly literature today is in favour of intubation. However, both tracheotomy and intubation can be used, and if properly managed the complication rate with both methods is low. This series comprised 102 children of whom 79 were tracheotomized and 23 were intubated. No differences could be found between intubation or tracheotomy time (2.3 and 2.9 days respectively) or in hospital stay (6.7 and 6 days). The complication rate was low in both groups except for subcutaneous and mediastinal emphysema in the tracheotomy group but these did not cause any serious problems.

Adolescent↗

PubMed1983

Single-cell DNA measurement in hyperplastic, dysplastic and carcinomatous laryngeal epithelia, with special reference to the occurrence of hypertetraploid cell nuclei.

Single-cell DNA fluorometry was performed on smear preparations from 57 histologically verified lesions from the vocal cords. Special attention was paid to the detection of hypertetraploid cell nuclei, which may be considered neoplastic markers, since they are not present in normal vocal cord epithelium. Hypertetraploid nuclei were not found in hyperplastic or mildly dysplastic epithelia but were found in 4 of 14 specimens of moderate dysplasia and in 5 of 19 specimens of severe dysplasia. The presence of hypertetraploid nuclei was associated with more frequent recurrences and progression of disease. Hypertetraploid cell nuclei were found in 9 of 15 invasive carcinomas and in this group were associated with a worse prognosis. The proliferative activity was 1.7% for hyperplasia and mild dysplasia, 3.1% and 2.8%, respectively, for moderate and severe dysplasia and 7.6% for squamous-cell carcinoma.

Cell Nucleus↗

PubMed1982

Facial fractures: a review of 922 cases with special reference to incidence and aetiology.

During a 10 year period (1969-1978) 922 patients with facial fractures were hospitalized at the Department of Otolaryngology, Jönköping Central County Hospital, Sweden. Eighty percent were men. The peak incidence occurred at the age of 21-30 years. The yearly number of facial fractures was doubled between 1969 and 1974, after which no marked increase was noted. The aetiologies of the fractures were fights (28%), traffic accidents (23.5%), sport activities (17.4%). There was a comparatively low number of work related facial fractures in this study (8.1%). Front seat passengers, car drivers and cyclists represented a great portion of the traffic injury group. The number of fractures caused by traffic accidents decreased after 1974, a fact that may be due to the safety-belt law.

Accidents, Traffic↗

PubMed1982

Hyperplasia, keratosis, dysplasia and carcinoma in situ of the vocal cords--a follow-up study.

Comparison of reported series of laryngeal lesions is complicated by the inconsistency in the terminology. The classification of these lesions should logically be based on the degrees of dysplasia, as this has a bearing on the prognosis. The material for this study consisted of 193 patients with hyperplasia and/or keratosis, with or without mild dysplasia (Group I), moderate dysplasia (Group II), and severe dysplasia and carcinoma in situ (Group III). They were treated over a 14-year period (1966-1979) at Linköping University Hospital. Of the 98 patients in Group I available for follow-up, 23 had repeat excisions. Moderate dysplasia developed in 3 patients, severe dysplasia in 2, and invasive carcinoma in another 2 within 3 and 3.5 years; they both underwent laryngectomy. Among the 24 patients in Group II available for follow-up, severe dysplasia developed in 3 and invasive carcinoma in 3 up to 13 years after the initial diagnosis, all but one (with severe dysplasia) received a full course of radiotherapy, on one case total laryngectomy was subsequently performed for recurrent carcinoma. Of the 39 patients with severe dysplasia and carcinoma in situ 16 were given primary radiotherapy; 4 of these developed invasive carcinoma; 3 of them underwent total laryngectomy and one partial laryngectomy. Excision or stripping of the vocal cords was the primary treatment in 23 cases; 5 of these developed invasive carcinoma; 2 of them underwent total laryngectomy. Diffuse lesions and well differentiated forms of severe dysplasia caused most problems and had the highest incidence of invasive carcinoma irrespective of the form of treatment. Patients with hyperplasia, keratosis, dysplasia and carcinoma in situ should be carefully followed up, as invasive carcinoma may develop many years after the initial diagnosis.

Adolescent↗

PubMed1982

Laryngeal carcinoma: problems in diagnosis and classification.

Premalignant and malignant laryngeal lesions still offer great problems in diagnosis and classification. Early diagnosis is of the utmost importance for a good functional therapeutic result. Microlaryngoscopic techniques have increased the number of premalignant lesions which have been found. Diagnostic aids may be used e.g. toluidine blue staining and exfoliative cytology. Toluidine blue staining compared to the histological findings in 272 biopsy specimens showed an overall sensitivity of 91% but a specificity of only 52%. Exfoliative cytology compared to the histological findings in 420 cases showed an overall sensitivity of 83% and a specificity of 84%. Photometry on the histologic sections allows objective evaluation of nuclear hyperchromasia and polymorphism, which may otherwise by marked microscopically, especially in well differentiated lesions. Full use must be made of our diagnostic tools in classifying invasive carcinomas to enable selection of the most appropriate treatment. Laryngography is the best method to assess vertical tumor involvement. Computed tomography gives information about deep tumor extension and spread of tumor outside the larynx. However, the strength and weaknesses of computed tomography have to be further assessed by comparison with whole organ sections in the transverse plane.

Aged↗

PubMed1982

The role of smear cytology in laryngeal diagnosis.

There may be great difficulty especially in diffuse lesions, in obtaining representative laryngeal biopsy specimens. Therefore the reliability of laryngeal smear cytology was evaluated in comparison with the histologic diagnosis. The cytologic specimens were taken during 520 microlaryngoscopic examinations (direct technique). The sensitivity of the direct cytologic method in the detection of moderate dysplasia, severe dysplasia-carcinoma in situ, and invasive carcinoma was 45% (17/38), 83% (59/71), and 93% (137/147), respectively. A false negative cytologic reading was more frequent after radiotherapy. The specificity of the direct cytologic technique in the detection of histologically "benign" lesions was 80% (210/264). In 23 patients cytologic smears were obtained at mirror laryngoscopy (indirect technique). Both the direct and indirect cytologic tests are easy to perform, quick, and may be of diagnostic value in laryngeal diagnosis, especially in screening examinations. However, cytology cannot supersede the histological examination of biopsy specimens.

Carcinoma↗

PubMed1981

Exfoliative cytology in laryngology: comparison of cytologic and histologic diagnoses in 350 microlaryngoscopic examinations--a prospective study.

In a prospective study comprising 350 microlaryngoscopic examinations, the reliability of exfoliative cytologic diagnosis was evaluated in comparison with the histologic findings. In 157 of 190 lesions with histologically moderate and severe dysplasia, carcinoma in situ, and invasive carcinoma, the cytologic smears were positive. The sensitivity of the exfoliative cytologic method in the detection of "malignant" lesions was thus 83%. False-negative smears were more common after radiotherapy and in the group with moderate dysplasia. In 134 of 160 histologically benign lesions, the cytologic evaluation was negative. The specificity of the smear test was thus 84%. In at least one case the cytologic examination disclosed true malignancy that had been overlooked at biopsy.

Biopsy↗

PubMed1981

HISTOSCAN: computer program for cytophotometry in tissue sections and its application in the evaluation of nuclear atypia.

The grading of nuclear atypia has a great and well recognized value when predicting the malignancy of neoplastic processes. Although the basic criteria for the grading are generally agreed upon, in the individual case, the final judgement is to some extent still a matter of subjectivity, which naturally impairs reproducibility. The present paper describes a method for quantification of variability of nuclear size and Feulgen-stainability. By plotting the mean optical density against the area value in a scatter-diagram, a cluster is obtained, the size of which reflects the degree of nuclear atypia. The measurements are performed in tissue sections using stage scanning cytophotometry. A computer program--HISTOSCAN--has been developed which enables measurements in highly cellular tissues. The system is also insensitive to the influence of light scattering, a factor of importance when measuring in tissue sections. The performance of the program is tested in both imprints and tissue sections.

Animals↗

PubMed1981

Computed tomography in carcinoma of the larynx and piriform sinus.

The conventional methods of examination do not furnish a complete picture of deep extension of carcinoma of the larynx and piriform sinus. Often the only sign of deep invasion is vocal cord fixation. The purpose of this study was to ascertain whether further information in this respect might be provided by computed tomography. The results of examinations by this technique were assessed on the basis of the findings in whole-organ serial sections in the transverse plane in 8 patients with laryngeal and 2 with piriform sinus carcinoma. In 2 further patients not undergoing operation, the findings yielded by CT were compared to the laryngoscopic assessment and the findings at a clinical follow-up after a full course of radiotherapy. CT adds valuable information on the deep invasion of the tumour, especially spread lateral to the arytenoid cartilage, to the laryngeal framework and outside the larynx.

Aged↗

PubMed1981

Extramedullary plasmacytoma of the larynx.

Extramedullary plasmacytomas, indistinguishable histologically from multiple myeloma, are fairly uncommon tumors, which are most frequently located in the upper airways. However, the larynx is rarely involved. Ten per cent of reported cases have multiple lesions. The patient reported here had a plasmacytoma of the right false vocal cord which was removed by laryngofissure one month after irradiation treatment (50 Gy) since the tumor showed only a slight regression. Tonsillectomy was performed for another plasmacytoma of the left tonsil. The patient has now been followed for seven years, and there has been no evidence of systemic disease.

Hoarseness↗

PubMed1980

Angiography in laryngeal carcinoma.

Angiography was performed in 8 patients with laryngeal carcinoma. The findings suggest that angiography can provide useful information on deep tumour invasion but further experiences are required before any definite conclusions can be drawn.

Angiography↗

PubMed1980

Malignant degeneration of a juvenile laryngeal papilloma--a follow-up study.

The patient, a non-smoking woman aged 51, had been suffering from recurrent juvenile papilloma for 38 years. After eight years during which there was increasing atypia, an extensive malignant papillary tumor, with extralaryngeal spread, was diagnosed. Only seven cases of malignant degeneration of non-irradiated juvenile laryngeal papilloma have been reported; at least four were heavy smokers.

Carcinoma, Squamous Cell↗

PubMed1979

Toluidine blue. An aid in the microlaryngoscopic diagnosis of glottic lesions?

The value of toluidine blue staining in vivo in the diagnosis of glottic lesions was examined by comparing the results obtained in a series with the histological findings. This material included 272 biopsy specimens from the vocal cords (202 microlaryngoscopic examinations). In 148 of these, the changes were classified as "malignant" (moderate and severe dysplasia and carcinoma) and in 124 as "benign." The sensitivity of the staining test in detection of malignant lesions was 91%. Among 13 false-negative results (9% of the malignant group), there was keratosis in 11. The overall specificity of the staining tests was 52%. The false-positive lesions displayed "benign" pathological alterations, such as inflammation and ulceration. False-positive findings were more common after radiotherapy. A correct diagnosis of malignancy on the basis of positive staining was more frequent the greater the intensity of staining.

Aged↗

PubMed1979

Chondrosarcoma of the larynx.

A chondrosarcoma arising in the posterior cricoid plate is presented. The tumour gave rise to increasing inspiratory stridor: laryngectomy was performed. The tumour consisted of loose cartilaginous tissue with great predominance of highly differentiated cartilage cells and only small areas with nuclear polymorphism. This complicated the differential diagnosis between chondroma and highly differentiated chondrosarcoma. From the fact that the patient died from massive pulmonary metastases 3 1/2 years later, it is evident that the degree of malignancy of cartilaginous tumours should be determined even on small polymorphic foci. The DNA histogram for the foci of the laryngeal tumour with atypia differed distinctly from those for benign chondroma and normal cartilage, but resembled those of the pulmonary and splenic metastases and of a nasal chondrosarcoma. Photometric examination may provide an aid in the difficult differential diagnosis between chondroma and highly differentiated chondrosarcoma.

Chondrosarcoma↗

PubMed1979

Pharyngocutaneous fistulae following total laryngectomy.

Postoperative pharyngocutaneous fistula formation is a troublesome complication in head and neck surgery and occurred in 8 out of 53 patients following a total laryngectomy (15%). The incidence falls within the lower range of that reported in the literature (6-66%). Different factors which may influence the formation of fistulae were analysed. Factors which seem to increase fistula formation are previous full dose radiotherapy (Co60), residual carcinoma and surgical technique.

Adult↗

PubMed1979

Radiologic assessment of laryngeal carcinoma. A clinico-pathologic comparison based on whole-organ serial sections.

In 33 patients with laryngeal carcinoma operated upon with laryngectomy, a comparison has been made of the findings yielded by radiography and microlaryngoscopy and a microscopic examination using whole-organ serial sectioning. The radiographic examinations were conventional films, tomography and laryngography. Radiography supplemented in microlaryngoscopy with information of clinical importance. Surface extension of the tumour was fairly accurately assessed preoperatively whereas deep infiltration was not. Major destruction of the anterior part of the thyroid cartilage was correctly diagnosed.

Humans↗

PubMed1979

Arterial anatomy in the normal larynx and in laryngeal carcinoma. Radiography of specimens.

For a correct selection of patients with laryngeal carcinoma for surgery, especially when partial surgery is contemplated, it is important to ascertain the extent of deep tumour invasion. The usual radiologic methods and microlaryngoscopy have shortcomings in this respect. Angiography of normal specimens demonstrated that the arterial anatomy is fairly constant and characteristic. Specimens from carcinoma patients displayed vascular abnormalities related to deep invasion, as demonstrated at microscopic examination.

Adult↗

PubMed1979

Hyposensitization in allergic seasonal rhinitis as evaluated by rhinomanometry.

Hyposensitization with Allpyral extracts was performed in 38 patients suffering from seasonal allergic rhinitis. An objective evaluation of the clinical course was obtained by rhinomanometry. After one year of hyposensitization therapy, 55% of the patients (21 out of 38) showed an improvement, and after the 3-year follow-up this figure had increased to 76% (19 out of 25 patients continuing with the treatment for this period). For the patients' subjective appraisal of the therapy the respective figures were 76 and 92%.

Adolescent↗