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Biomedical subjects

L Bergdahl

Publications and source records attributed to L Bergdahl.

At least 55 records · Page 3Linked to original sources

Prognosis of carcinoma of the breast in women under 25 years of age.

In 1960 to 1969 twenty six women below 25 years were operated on because of mammary carcinoma. All eighteen patients in stage 0 and I had a five-year cure. The corresponding rate for seven women in stage II was 43%. Of eight women with a poorly differentiated or anaplastic growth, 38% survived for more than five years. The corresponding figure for those with a well differentiated tumour was 100%. The prognosis in young women is thus good provided the malignant breast tumour is diagnosed and treated in good time, and it is better than that in elderly women.

Adenocarcinoma, Scirrhous↗

Gas flow in relation to blood flow in oxygenators. An evaluation of the new Shiley bubble oxygenator.

A new bubble oxygenator, designed by the Shiley Laboratories, which utilizes a low gas flow for oxygenation, was first tested in dogs and then in 100 clinical cases. For perfusion in adult patients, a gas flow as low as 0.6 litre oxygen per 1 litre blood has given adequate oxygenation and removal of carbon dioxide with no untoward effect on the blood, as compared with other oxygenators, including the membrane type.

Adult↗

Malignant tumors of the extrahepatic bile ducts.

A series of 76 patients treated for carcinoma of the extrahepatic bile ducts at three Swedish hospitals during the years 1952 to 1973 was studied. The mean age of the patients was 68 years. Gallstones were found in 22 patients, whereas 11 patients had undergone cholecystectomy earlier for gallstone disease. At operation widespread metastases were found less often in patients with cancer of the papilla of Vater than in patients with cancer of other locations. This is interpreted as indicating that patients with papillary carcinoma are treated in an earlier stagage of the disease. This interpretation is supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass supported by the finding that these patients had a longer length of survival after bypass operations (11.5 months). In spite of treatment in an early stage, survival after radical surgery was disappointingly short (4.6 months). On the other hand, patients with cancer located above the papilla of Vater survived for 6.8 months after bypass operations as compared with 23.3 months after rescetion. The possibilities of radical surgery should be considered carefully, especially in patients in whom the malignancy is located above the papillary region.

Adenocarcinoma↗

Thyroid carcinoma in children.

A study was made of 24 children under 15 years with thyroid cancer diagnosed during the years 1959-1967. None of the children had received irradiation treatment prior to diagnosis. Treatment took the form of surgery in combination with hormone and/or irradiation therapy. Of the 24 patients, only one died as a result of postoperative complications, even though 17% had lung metastases and 58% lymph gland metastases. The children were observed on average seven years, 10 months and the longest period of observation was 12 years, six months. The treatment recommended is total lobectomy on the affected side and subtotal on the opposite side. Cervical lymph glands with metastases are extirpated. Thyroid hormone treatment should be given immediately after surgery.

Adenocarcinoma↗

Carcinoid tumors of the appendix in children. A report of 25 cases.

Carcinoid tumors of the appendix in 25 children (21 girls, 4 boys) below 15 years corroborated the previously reported preponderance of females. 17 children were operated upon because of acute appendicitis, one because of oxyuriasis in the appendix and the remaining 7 because of diffuse recurrent abdominal pain. All the patients were subjected to appendectomy and one of them later also to right-sided hemicolectomy because of carcinoid in the margin of the resection of the appendix but not in the cecum. Despite deep infiltration of the wall of the appendix to the serosa in 9 children and lymph node metastases in one, no signs of a recurrence have been seen during follow-up of 5 to 17 years (mean 12 years).

Adolescent↗

Urologic complications following abdominoperineal resection of the rectum.

Perusal of the records of 111 consecutive patients who underwent abdominoperineal resection of the rectum for malignant diseases of the rectum or anal canal for postoperative urologic complications revealed that the urethra had been injured in two patients, the bladder in none, and the ureter in five. In only two of these last five patients was the late result of treatment of the ureteric injury satisfactory. The late result of treatment of the two urethra injuries was good. All the patients had been treated with an indwelling catheter for at least ten days after the operation. About one third of the patients still had disturbances of micturition two weeks after the operation, but only one required a permanent indwelling catheter.

Adult↗

Disease of the gallbladder in patients with normal cholecystograms.

In contrast with what has widely been assumed, disease of the gallbladder sometimes remains undertected by even repeated cholecystography or cholegraphy. Chronic cholecystitis, gallstones, and acalculous cholesterolosis can escape detection by roentgenography of the gallbladder. Of 4,000 patients subjected to cholecystectomy between 1962 and 1973, the cholecystogram had been normal in only two. The range of indications for the operation has since been widened. Patients with typical symptons of gallbladder disease or recurrent pancreatitis of unknown origin have been operated on despite a normal cholecystogram. Within as short a period as eight months, an additional six patients with a normal cholecstogram have been operated on at our hospitals. Treatment consisted of cholecystectomy also in the four patients in whom no stones could be palpated in the gallbladder. Gross and microscopic examination of the gallbladder in these patients revealed cholesterolosis. When last seen, seven of the eight patients were still symptom-free an average fifteen months after the operation.

Acute Disease↗

Carcinoma of the colon in children: a report of six new cases and a review of the literature.

Of six children with carcinoma of the colon, none had ulcerative colitis or a family history of carcinoma of the colon or colonic polyposis. In 75 cases traced in the literature, a common early symptom of carcinoma of the colon in children is acute, crampy abdominal pain. At laparotomy for suspected appendictis, the possibility of the acute pain being due to carcinoma of the colon should be borne in mind. Otherwise the symptoms of carcinoma of the colon in children do not differ substantially from those in adults. The prognosis is unfavorable; in only 2.5% of the cases on record did the children survive 5 yr after the operation.

Abdomen, Acute↗

Primary carcinoma of the appendix.

Primary adenocarcinoma of the appendix is rare and less than 200 cases are on record. The present material consisted of 20 cases collected from different hospitals. The cases are described in respect of sex and age-distribution, symptoms, treatment and prognosis. Of 7 patients with malignant mucocele, 6 subjected to appendectomy only, were still alive 5 years after the operation. Of 12 patients with colonic type of adenocarcinoma, 3 had been treated with appendectomy only. Of these, 2 were still alive 5 years after the operation. The remaining 9 patients had undergone right hemicolectomy. Only one of them was alive 5 years after the operation. A compilation of a further 39 cases garnered from the literature, however, showed that 60% had survived at least 5 years after right hemicolectomy, compared with 46% after appendectomy alone. Appendectomy alone is probably a sufficiently radical operation for malignant mucocele provided the tumor has not grown through the submucosa and that it is confined to the tip of the appendix. Right hemicolectomy is indicated for the colonic type of adenocarcinoma.

Adenocarcinoma↗

Carcinoid tumours of the biliary tract.

Data on 13 patients, including two not previously reported, with carcinoid tumours of the biliary tract are reported. In ten of them the primary tumour was located in the gallbladder and in three in the biliary duct. No specific symptoms were recorded, and the carcinoid syndrome has not been reported in carcinoid tumours of the biliary tract. In five patients the tumour was first found at autopsy. Metastases were found in three patients at operation or autopsy. Cholecystography can show either a functioning or a non-functioning gallbladder. Some patients had concretions in the gallbladder. The prognosis appears to be good, and one of the patients reported survived 20 years with metastases.

Aged↗

[Carcinoma as an unexpected histologic diagnosis in gallbladder disease (author's transl)].

In 32 of 120 patients with carcinoma of the gallbladder the disease was not diagnosed before microscopic examination. These 32 patients were afterwards examined in respect of those factors possibly capable of influencing the prognosis. The diagnosis proved successful in 11 patients in whom the tumour was confined to the mucosa und the submucosa. 3nly 4 of these patients died from a recurrence. From 21 patients with all the layers of the wall of the gallbladder, being involved none survived the operation for more than 2 1/2 years. In cases of carcinoma confined to the mucosa and submucosa surgical treatment should include not only cholecystectomy, but also wedge resection of the liver with a free margin of tissue and adequate nodal dissection as well.

Adult↗

Carcinoma of the pancreas.

Study of hospital records of 146 patients with carcinoma of the pancreas from 1952 to 1971 revealed that 74 per cent had had abdominal pain and 65 per cent jaundice. Abdominal pain was the commonest symptom of carcinoma of the head as well as of the body and tail. Diabetes mellitus was four times as common among the patients with carcinoma of the pancreas as among the population in general. The interval between the onset of symptoms and diagnosis of the disease was the same in both decades of the 20-year period, but the survival time after operation was longer in the second 10-year period. Pancreatoduodenectomy was possible in only four of the 138 patients operated on, and one of them died postoperatively. The three patients who survived the operation survived significantly longer than the 87 in whom an anastomosis had been established between the bile ducts and the intestine. Forty-one patients were subjected to surgical exploration only. No difference in survival time was found between the two last-mentioned groups.

Adenocarcinoma↗

Insulomas and multiple endocrine neoplasia.

Seventy-eight patients with insuloma diagnosed between 1959 and 1968 in Sweden were studied for neoplasia in other organs. Twenty-one patients had beta-cell islet tumors, 14 Zollinger-Ellison's syndrome and non-beta-cell islet tumors, while no endocrine activity was demonstrated in 43 patients. Of the last-mentioned group, 9 patients had co-existing disease of other endocrine organs. In 10 patients, non-endocrine organs were found to be affected by malignant diseases. It appears probable that the tissue of the pancreatic islets, like parathyroid tissue, can react with hyperplasia with a later development of adenoma, secondary to tumors in other organs.

Adenoma, Islet Cell↗

Retained bile duct stones.

Residual bile duct stones were found in 69 out of 4078 patients subjected to cholecystectomy. In 5 of these patients the outcome of the residual stones was unknown, but in 64 patients the complete course of events could be followed. In 32 patients the stone(s) were lodged in the intrahepatic ducts; in 15 patients the stones were overlooked owing to incomplete or technically unfeasible post-explorative cholangiographies; in 12 patients the stones were not visualized in good peroperative cholangiograms and in 5 patients the stones were misinterpreted as air bubbles. Spontaneous passage of the retained stones was verified in 24 patients. In 40 patients re-exploration was performed. Organic changes in the bile duct wall, a large (greater than or equal to 10 mm) and solitary stone were factors that precluded spontaneous passage. Re-exploration of residual bile duct stones, especially during the first month after the primary surgery, was found hazardous. If possible re-exploration should not be performed earlier than 4-6 weeks after the primary operation.

Aged↗

On the etiology of "primary" hyperparathyroidism.

A study of 92 patients operated on for primary hyperparathyroidism revealed that the condition was secondary to renal disease, thyrotoxicosis or malignancy in 35. Review of the literature revealed no reports of experimental studies on the relationship between hyperparathyroidism and thyrotoxicosis or malignancy. In renal disease, however, the author's own investigations show that the traditional concept of hypocalcemia as the most important factor in the development of parathyroid hyperfunction should be rejected. The parathyroid glands probably can be stimulated by various factors in "primary" hyperparathyroidism. Recent studies on the etiology of primary hyperparathyroidism are discussed and it is concluded that the term "primary" should be avoided as the disease is so often secondary.

Adult↗

Volvulus of the cecum.

A series of 37 patients with cecal volvulus treated at three different Swedish hospitals during the years 1952-1973 is presented. The symptoms, physical findings and radiologic features are presented. The associated factors found at operation are described and their possible role in provoking torsion is discussed. In 5 patients the idagnosis did not become clear untio autopsy. Thirty-two patients were subjected to operation. The operation consisted of detorsion in 11 cases, cecopexy in 10, cecostomy in 3 and cecopexy plus cecostomy in 3 patients. The remaining 5 patients were subjected to right sided hemicoloectomy. Of these 5 patients one died postoperatively. There were 6 postoperative deaths after other forms of surgery. The survivors were followed, and the mean followup period was 7 years. There was recurrence in only two patients, both treated with cecopexy. The controversial problem of the preferable surgical method is discussed and a review is given of results in series reported during the last 15 years. It was concluded that when the bowel is viable, cecopexy is the treatment of choice while hemicolectomy should be performed in cases with gangrene.

Adolescent↗

Giant cell lesion of the mandible in coincidental hyperparathyroidism and hyperthyroidism.

A patient with hyperparathyroidism, thyrotoxicosis and a giant cell lesion of the mandible is reported. The hyperparathyroidism was secondary to renal hypoplasia and/or thyrotoxicosis. A review of the literature revealed other cases with giant cell lesions and secondary hyperparathyroidism. This study indicates that giant cell lesions are not specific for primary hyperparathyroidism.

Female↗