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Biomedical subjects

M Bolkenius

Publications and source records attributed to M Bolkenius.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Segmental resection of the spleen and glueing with human fibrinogen - an alternative to splenectomy and autotransplantation (author's transl)].

Basing on exemplary case histories - trauma, benign tumour and staging of lymphogranulomatosis - the possibility of maintaining the function of splenic tissue by means of partial splenic resection is discussed. Indication, surgical approach including fibrin glueing and postoperative follow-up are described, taking recent literature into account, and are discussed as an alternative to splenectomy and autotransplantation.

Child↗
PubMed1982

[Various aspects of pediatric surgery in surgery of the spleen].

The method of partial splenectomy by applying fibrin glueing has become a safe surgical procedure thus opening new aspects of pediatric surgery of the spleen. Indications for partial splenectomy are discussed with special regard to Hodgkin's disease. The autotransplantation of splenic tissue--a localized form of iatrogenically induced splenosis--is considered as secondary to partial splenectomy since the arterial perfusion and the filter function of the spleen are not maintained. In cases, where partial splenectomy cannot be performed, splenic tissue should be placed in a retroperitoneal pouch of the splenic bed. The vulnerable infant omentum is rejected as a possible site of implantation since there is danger of spreading splenic tissue into the whole abdominal cavity inducing further complications by infections or neoplasma with splenic participation.

Age Factors↗
PubMed1981

Virilizing hepatoblastoma--significance of alpha-1-fetoprotein and human chorionic gonadotropin as tumor markers in diagnosis and follow-up.

Hepatoblastoma was diagnosed in a 12 month old boy presenting with hepatomegaly and isosexual precocious puberty. Preoperative levels of both alpha-1-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were highly elevated. The tumor was removed by hepatic trisegmentectomy. Tumor tissue contained high concentrations of AFP and HCG. On combination chemotherapy with cyclophosphamide (CYC), vincristine (VCR), adriamycin (ADR) and 5-fluorouracil (5-FU) HCG dropped over a period of 9 months to normal values. In contrast, AFP was undetectable following surgery. One year after initiation of therapy there is no clinical or radiological evidence of recurrence of the malignancy but the observation period is too short to draw any conclusions on the effect of therapy and the final outcome.

Carcinoma, Hepatocellular↗
PubMed1981

[Bone metastases in Wilms' tumor in relation to histologic grading (author's transl)].

86 patients with Wilms' tumor were treated in Heidelberg between 1951 and 1980. Using the histopathologic grading according to Hardwick and Stowens the sarcomatous tumor type has an unfavorable prognosis. All the patients in stage III to V developed metastases. In contrast to other types of Wilms' tumor these sarcomatous tumors do metastasize to bones, not primarily to the lung. Boys up to 5 years are mostly affected by the tumor. These were "cold" lesions in bone scan using different radionuclides on skeletal osteolytic metastases, which is limiting the application of scans to detect bone metastases in Wilms' tumor. A more aggressive chemotherapy should be given to improve prognosis of the sarcomatous type of Wilms' tumor.

Bone Neoplasms↗
PubMed1981

[Surgery of lung metastases in childhood (author's transl)].

Over the past 10 years 18 patients have been operated upon (sometimes repeatedly) because of pulmonary metastases. The primary tumour with pulmonary secondaries was usually an osteosarcoma or a Wilm's tumour. The indication for surgery and the result of treatment are discussed. The pre-operative diagnosis is helped considerably by ventilatory and perfusion isotope studies.

Child↗
PubMed1981

[Pre- and postoperative ultrasonography of portal circulation in portal hypertension in childhood (author's transl)].

The use of ultrasound investigation in children with portal hypertension is discussed and a 14 year old patient is presented. With this non-invasive investigation, the course, diameter and patency of the splenic vein can be demonstrated, repeated post-operative investigations showed a reduction in the size of the splenic vein of at least 2 mm. following patent spleno-renal anastomosis. The ultrasound technique is demonstrated.

Adolescent↗
PubMed1980

[Infantile portal hypertension. Experimental studies on the hemodynamics of various shunt models and clinical study of prehepatic infantile portal hypertension].

The experiments are based on an analysis of the literature on more than 2000 cases of portal hypertension in childhood. The purpose of the experimental model was to test and compare the hemodynamic effects of shunt operations performed in the clinic. In 24 dogs (29 +/- 5,7 kg) general and intestinal hemodynamics were measured during acute prehepatic portal hypertension before and after mesentericocaval, splenorenal, and splenocaval shunt. From the hemodynamic point of view the splenocaval shunt is superior because of its complete venous decompression of the region of spleen and cardia and greater blood flow to the liver. Furthermore shunt flow, and consequently volume load imposed on the general circulation, are significantly smaller in splenocaval shunt.

Animals↗
PubMed1979

[Animal experiments on the hemodynamics of prehepatic portal hypertension before and following various methods of portacaval anastomosis].

In 24 dogs (29 +/- 5,7 kg) general and intestinal hemodynamics were measured during acute prehepatic portal hypertension before and after mesentericocaval, splenorenal, and splenocaval (SCA) shunt. From the hemodynamic point of view the SCA is superior because of its complete venous decompression of the region of the spleen and cardia and a greater blood flow to the liver. Furthermore shunt flow, and consequently volume load imposed on the general circulation, is significantly smaller in SCA.

Animals↗
PubMed1979

[Portal hypertension - surgery during childhood (author's transl)].

Portal hypertension in children and infants is rare. It is caused in 75% of the cases by prehepatic obstruction of the portal vein, liver parenchyma being essentially unimpaired. Thus most of these cases may be cured, if the pathological hemodynamic situation can be corrected. The nature and extent of pathologic changes vary widely, thus the surgical approach has to be rather individual. The most important aim is to avoid esophageal bleeding but more has to be done to cure the underlying disease. 50 different surgical approaches have been described; when selecting one of these it has to be taken into account if and to what extent portal pressure has to be lowered, and how portal venous and hepatic arterial blood flow are to be influenced.

Arteriovenous Shunt, Surgical↗