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Biomedical subjects

S Adamsen

Publications and source records attributed to S Adamsen.

At least 55 records · Page 3Linked to original sources
PubMed1989

Prospective evaluation of human chorionic gonadotropin in the treatment of cryptorchidism.

Of 158 boys consecutively referred for undescended testis, 77 were found to have true cryptorchidism. Human chorionic gonadotropin (HCG) was given to 60 boys (63 undescended testes) in a dose of 5,000 U (patient age 4-6 years) or 10,000 U (7-9 years). The parents of seven others preferred direct referral for orchiopexy. Minor side effects occurred in 18 boys. Significant increase in weight increment velocity was seen among 7-9-year-olds. Descent of testis occurred in 59% (95% cl 46-71%), with the incidence significantly higher in the older group. Mobile testes were more likely to descend. At surgery following failed HCG treatment, hernia or hydrocele was unexpectedly found in 77% of cases, and 19% of the testes were ectopic in the superficial inguinal pouch. The risk of repeat orchiopexy was not less than in a previous series of primary orchiopexy. Although surgery could be avoided in approximately half of the patients in this series, it is not yet decisively established if HCG should be used diagnostically or therapeutically. Improved pre-treatment identification of ectopia and hernia is required.

Child↗
PubMed1988

Factors affecting the outcome of orchiopexy for undescended testis.

Orchiopexy was performed on 135 testes in 121 patients aged up to 15 (median 6) years who had no previous inguinal surgery or hormonal treatment. Hypoplasia at the time of orchiopexy (34/135) was significantly less common when the testis was in or peripheral to the superficial inguinal ring than when it was intracanalicular. The position did not influence the outcome of surgery or the risk of postoperative hypoplasia (9 cases). At follow-up 87% of the testes were in the scrotum. Reoperation was required for four of nine which were anchored to the femoral skin or with suture through testis and scrotal wall. Tension on the spermatic cord significantly increased the failure risk. Simultaneous herniotomy was associated with 15%, and dissection only (including excision of the vaginal process remnant) with 6% orchiopexy failure. Retroperitoneal dissection to avoid tension on the cord significantly reduced the failure rate without increasing the risk of postoperative hypoplasia. Orchiopexy performed with optimal technique by experienced surgeons is a safe and effective alternative to hormonal treatment.

Adolescent↗
PubMed1986

Duplication of the extensor carpi ulnaris tendon.

Three cases are presented, in which an anomalous tendon slip between the extensor carpi ulnaris tendon and the extensor apparatus of the fifth finger was found. One of the patients was a violinist, who had serious impairment of the left wrist joint and the small finger due to the anomaly. The symptoms disappeared after excision.

Adult↗
PubMed1985

Reproducibility and diagnostic value of Hemoccult-II test. A colonoscopic evaluation in asymptomatic patients.

Inter-observer agreement rate in double readings of 246 Hemoccult-II tests was 0.88 (Kappa analysis). The slides were not rehydrated. The Hemoccult-II test was performed immediately before 748 total colonoscopies in asymptomatic patients after previous polypectomy or radical surgery for cancer to estimate the diagnostic value of the test in mass screening, accepting a higher prevalence of neoplasia in the study group but realizing that colonoscopy can only be performed in high-risk groups. Another purpose was to investigate the possibility of replacing colonoscopy with Hemoccult-II in surveillance after previous adenoma or cancer. The 79 colonoscopies after a positive test showed cancer in 3, adenomas in 13, and other intestinal pathology in 34 cases. The 669 colonoscopies after negative tests showed cancer in 1, adenomas in 67, and other pathology in 141 cases. In conclusion, the test cannot be used as a guideline for colonoscopy in follow-up programs for patients who have had adenomas, since it missed 84% of the new cases in the present series. The test does not exclude the presence of colorectal carcinoma, but the risk of cancer is probably several times less in patients with negative tests (1 of 669) than in patients with positive tests (3 of 79), which may justify the use of the Hemoccult-II test for mass screening in asymptomatic populations.

Adenoma↗
PubMed1984

Acceptability and compliance in screening for colorectal cancer with fecal occult blood test.

To evaluate acceptability of and compliance with the Hemoccult-II guaiac test in screening for occult fecal blood, a representative sample of 685 persons 40-74 years old received slides and invitation without previous notice. Sixty-seven per cent accepted. Eight persons (1.7%) had a positive test. Two had rectal cancer, and two had adenomas. Acceptability decreased significantly with age in women but not in men. Eighty-seven per cent agreed to repeated screenings with intervals of 1-2 years. The acceptability was favorable compared with other studies and suggests 70-74 years as the upper limit for screening. Acceptability may even be increased by further information to the population. Written reminders were effective, but telephone calls were not. Compliance was high, since only 20 persons needed further instructions, and the proportion of false-positive tests suggested that dietary instructions had been followed. The high acceptability favors the planning of a major randomized trial of the possible effect of screening on mortality from colorectal cancer.

Adenoma↗
PubMed1983

Follow-up after colorectal polypectomy. I. A comparison of the effectiveness of repeated examinations of the colon every 6 and 24 months after removal of stalked polyps.

To investigate the effect of follow-up study after colorectal polypectomy, 156 patients with symptomatic stalked adenomas with light to severe dysplasia were allocated at random to colorectal examination every 6 (A) and 24 (B) months after colonoscopic polypectomy. No high-risk group could be identified. Twenty-one of the 23 new polyps were located above the rectum, but 15 could have been removed during examination with the flexible sigmoidoscope. The risk of new adenomas was similar at all 6-month examinations, during the first 4 years of the study. A small carcinoma (Dukes A) was found at 24 months in group B. A fatal colonic perforation was seen in group A after seven previous colonoscopies without complications. The new polyps caused no symptoms other than minimal bleeding in some of the patients, and because increasing the rate of colonoscopies increases risk of complications, it was considered justified to prolong the intervals to 24 and 48 months, at random.

Adenoma↗
PubMed1983

Follow-up after colorectal polypectomy. II. Repeated examinations of the colon every 6 months after removal of sessile adenomas and adenomas with the highest degrees of dysplasia.

Fifty-five patients with colorectal sessile adenomas and adenomas with the severest dysplasia were followed up every 6 months with colonoscopy and/or double-contrast enema during 4 years, after a clean colon had been obtained, by repeated colonoscopy within 3 months after piecemeal polypectomy. The repetition at 3 months resulted in detection of two cancers. An overlooked cancer was detected at 1 year, and another cancer was diagnosed between examinations. Risk of new adenomas (19 patients) was related to original size, number, and glandular structure of the polyps. Twelve of the 19 patients had new polyps above the rectum. The 336 colonoscopies were complicated by 3 laparotomies, made necessary by perforation and bleeding. The results suggest that intervals between examinations of patients with the present type of adenomas may be prolonged, and patients are now allocated at random to colorectal follow-up examination every 6 and 12 months.

Adenoma↗