Search PubMed⌕ Search

Biomedical subjects

S Hellsten

Publications and source records attributed to S Hellsten.

At least 55 records · Page 3Linked to original sources

Therapy of bladder carcinoma. Long-term results of a retrospective study of 214 cases.

Two hundred and fourteen bladder carcinomas were evaluated retrospectively after reclassification of histological specimens according to UICC. Follow-up time was 7 years or longer. Large size but not multiplicity of the primary tumour indicated a poor prognosis. Local infiltration, even if superficial and restricted to the lamina propria, worsened prognosis as well as high grade of the tumour. Late deaths in the present series were generally explained by a progression in stage in patients with high grade tumours at initial assessment. Therefore a close longterm follow-up should be performed in these patients.

Adult↗

Unrecognized renal cell carcinoma. Clinical and diagnostic aspects.

In a series of 16294 autopsies 350 cases of renal cell carcinoma were found. Of these tumours 235, i.e. two thirds, were unrecognized during lifetime. Metastatic spread was revealed in 56 patients (24%) with unrecognized renal cell carcinoma and was the main cause of death of 49 patients (21%). In 67 patients (33%) a second malignant tumour was observed causing the death of 47 patients (20%). Most patients died with rather than from the renal malignancy. The symptomatology as to the renal malignancy was generally poor. Haematuria, palpable mass, polycythemia and fever of unknown origin were less common findings in the present series as compared with fatigue, loss of weight and symptoms from metastatic sites.

Adenocarcinoma↗

Unrecognized renal cell carcinoma. Clinical and pathological aspects.

In an autopsy series comprising 235 clinically unrecognized renal cell carcinoma metastatic spread was revealed in 24%. The number of metastasizing tumours increased significantly with the size of the primary tumour. Local aggressiveness of the primary tumour was more common for large tumours but was much more closely correlated to metastatic spread than to size. Tumours ingrowth in the renal vein was significantly commoner in metastasizing tumours as compared to non-metastasizing tumours. The study confirmed that an analysis as to local aggressiveness was prognostically valuable and might be useful to define the group of patients that may benefit from adjuvant therapy such as radiation therapy, chemotherapy or immunotherapy.

Adenocarcinoma↗

Renal revascularization after intrarenal implantation of the splenic artery with a distal arteriovenous fistula.

Renal revascularization by splenic artery implantation was performed in 5 dogs using a temporary arteriovenous fistula in the distal end of the implanted artery for the purpose of increasing the blood flow and counteracting the thrombus formation in the artery. Following creation of renal artery stenosis, the revascularization process was evaluated by serial consecutive splenic arteriographies and by estimation of blood flow through the implanted arteries. The experimental animals survived occlusion of the ipsilateral renal artery and contralateral nephrectomy with maintenance of a reasonably good renal function. The present study also indicates a facilitation of a vascularization from the implanted artery when the initial thrombus formation within the artery was prevented by creation of such a fistula.

Angiography↗

Carcinoma in situ of the renal pelvis after cystectomy. A case report including comments concerning diagnostic procedures and surgical treatment.

Carcinoma in situ of the renal pelvis in a patient with an ileal conduit is reported. By fiberendoscopy, using gastrointestinal instruments, both ureters were catheterized. Cytological investigation of urine from each kidney revealed that malignant cells were exfoliated from the left side exclusively. The correct diagnosis of a carcinoma in situ of the left renal pelvis was confirmed by a histological examination of the operative specimen.

Aged↗

Intracavitary Epodyl for multiple non-invasive, highly differentiated bladder tumours.

Multiple, recurrent cancer of the bladder grade I-II (WHO), stage T1 (UICC) was treated with regular intravesical instillation of ethoglucid (Epodyl) in 39 patients. In ten of them cystitis necessitated withdrawal of the treatment. The therapeutic schedule could be followed in 29 cases, with eradication of the tumours in 27. Nine patients who continued the treatment on a prophylactic basis were still recurrence-free after 18-60 (mean 37) months. Myelosuppression did not occur, but cystitis was a serious problem that frequently jeopardized therapy.

Aged↗

Angiographic work-up in a patient with late vaginal metastasis from a renal carcinoma.

Vaginal metastasis from a renal cell carcinoma appeared 23 years after the primary surgery in a 64-year-old female. At angiographic work-up local recurrence in the renal fossa and liver metastasis were demonstrated. These findings indicated radiation treatment instead of radical surgery of the vaginal metastasis, which primarily was though to be solitary. Angiography and/or computorized tomography (CT) of the retroperitoneal space and the liver should be performed in patients with late and presumed solitary metastasis from a renal cell carcinoma before radical surgery of the metastasis is attempted.

Adenocarcinoma↗

Percutaneous pyelolithotomy. Case report and technical comments.

A case of nonoperative renal stone extraction through a nephrostomy tract is described. The stone was removed with the aid of a newly constructed device. The advantage of this device over a Dormia stone basket is that it has a steerable tip, which facilitates trapping of the stone in the basket.

Aged↗

Retrocaval ureter.

A case of retrocaval ureter is reported taking especially the diagnostic procedure and the therapeutic alternatives into account.

Humans↗

Lesions of the dorsal renal artery in surgery for renal pelvic calculus. A potential cause of renovascular hypertension.

2 cases of lesions of the dorsal renal artery in surgery for renal pelvic calculus are described. In 1 of the cases hypertension developed. Anatomic factors and previous operations predispose to this complication. An arterial complication should be suspected when hypertension develops postoperatively. The blood pressure of patients with known renal vascular complications should be checked repeatedly for several months postoperatively. The diagnosis is radiological, renal angiography being the definite procedure although a reduction of kidney size observed at urography may indicate the vascular lesion.

Adult↗

Renal revascularization by splenic artery implantation in the dog.

36 mongrels were subjected to splenic artery implantation into the left kidney. A stenosis of the left renal artery was created in 33 of the dogs. The revascularization process from the implanted artery was studied by angiography in vivo and ex vivo, by histological examination and by blood flow measurements. After creation of the stenosis and eventual occlusion of the left renal artery, newly formed intrarenal vessels could be demonstrated next to the implanted artery. These vessels formed communications between the splenic and intrarenal arteries. The experimental animals survived contralateral nephrectomy and ligature of the ipsilateral renal artery with a slight or moderate elevation of the serum creatinine level, provided that a slowly progressing stenosis of the renal artery was created.

Angiography↗

Percutaneous nephrostomy. Aspects on applications and technique.

Percutaneous nephrostomy was performed in 32 patients: in 8 patients for permanent and in 24 for temporary drainage. The most common indication was obstruction of the distal ureter due to malignancy. Puncture of the renal pelvis was performed with the aid of fluoroscopy and/or ultrasound. Change to larger catheters was achieved using the Seldinger technique. Complications in the form of bleeding occurred in 5 patients and were in conjunction with repuncture after the initial catheter had slipped out, or occured in connection with change to larger catheters. With the routine use of ultrasound and specially designed catheters the method should be an effective alternative to operative nephrostomy also in the nonemergency patient.

Adult↗

Renal revascularization after splenic artery implantation into the kidney. Consecutive serial angiographic study in the dog.

29 mongrels were subjected to splenic artery implantation into the left kidney. Consecutive angiographies showed that this procedure regularly was followed by an initial thrombus formation in the implanted artery and an early recanalization of this thrombus. After creation of stenosis and eventually occlusion of the left renal artery, newly formed intrarenal vessels could be demonstrated next to the implanted artery. These vessels formed communications between the splenic and intrarenal arteries. At angiography of the implanted splenic artery the constrast medium was seen to pass over to the newly formed vessels and to intrarenal arteries followed by contrast medium opacification of the renal parenchyma and the renal vein and excretion to the pelvis and ureter. The experimental animals survived contralateral nephrectomy and ligature of the ipsilateral renal artery provided that a slowly progressing stenosis of this artery was created.

Animals↗

Hydro- and hemodynamic effects of catheterization of vessels. IV. Catheterization in the dog.

In four dogs the hemodynamic effects of renal artery catheterization has been analysed. Aortic and renal arterial blood pressure and renal blood flow were determined and injection of contrast medium made before during, and after the catheterization maneuver, using catheters with different outer diameters. No effect on the blood pressure or the mean renal blood flow was found until catheters were used with the outer diameter close to the inner diameter of the renal artery.

Animals↗