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Biomedical subjects

A Lunderquist

Publications and source records attributed to A Lunderquist.

At least 37 records · Page 2Linked to original sources
PubMed1989

Radiologic diagnosis of neuroendocrine tumors.

The radiologic work-up of a patient with a pancreatic endocrine tumor should follow a strict course. Ultrasonography as the first procedure should be followed by angiography, if possible. Negative ultrasonography should be followed by computed tomography (CT), which, whether positive or negative, is supplemented by angiography. Negative CT and angiography is followed by transhepatic venous sampling. In patients with suspected liver metastases from intestinal and pancreatic endocrine tumors, angiography may reveal more metastases than CT and ultrasonography.

Angiography↗
PubMed1989

Evaluation of temporary liver dearterialization and embolization in patients with metastatic carcinoid tumour.

Patients with serotonin-containing metastatic midgut carcinoid tumours were treated with temporary liver dearterialization (19 patients) or liver embolization (8 patients). After 3, 6 and 12 months the effects of treatment were registered in changes in serotonin in platelet-poor plasma and blood, in urinary 5-HIAA, in tumour extent in the liver and in symptomatic relief. Seventeen patients, who underwent the dearterialization procedure survived the operation, while 2 patients who had a concomitant small bowel resection died of complications. Tumour response was obtained in 8 patients after 6 months and in 9 patients after 12. Stable disease was noted in 5 patients after 6 months and 3 patients after 12 months. Progressive disease was seen in 4 patients. All 19 patients except one exhibited the carcinoid syndrome prior to operation and 11 patients were free from symptoms for at least 12 months postoperatively. The gelatine foam powder liver embolization was performed uneventfully in all 8 patients. Tumour response was obtained in 3 patients at both 3 and 12 months. Stable disease was noted in 5 patients at 3 months and 4 patients at 12 months. Before embolization the patients suffered from the carcinoid syndrome and the treatment resulted in the immediate disappearance of the syndrome in 5 patients. After 12 months one patient was still free from obvious carcinoid symptoms. In one patient the disease aggravated in spite of treatment and he died 5 months after embolization. Thus, temporary liver dearterialization and liver embolization in midgut carcinoid patients resulted in tumour regression and symptomatic relief in 9 out of 19 patients and 3 out of 8 patients respectively. The complication rate was low.

Adult↗
PubMed1988

Tumour calcification following repeated hepatic de-arterialization in patients: a preliminary communication.

A novel method of repeated hepatic de-arterialization is presented. A vascular occluder is placed around the hepatic artery and connected to an injection port. The hepatic artery can thereafter be occluded repeatedly. Patients with irresectable liver metastases from colorectal cancers were treated with occlusions of the hepatic artery for 1 h twice daily, in combination with intraperitoneal cyclic administration of 5-fluorouracil. The first three patients treated are presented. They all exhibited massive tumour calcifications in the liver reflecting tumour necrosis and resorption. This therapeutic principle must undergo further clinical trials.

Adult↗
PubMed1986

Unresectable and locally recurrent rectal cancer treated with radiotherapy or bilateral internal iliac artery infusion of 5-fluorouracil.

Seventy-nine patients with histopathologically verified unresectable or locally recurrent rectal cancer were nonrandomly allocated to radiotherapy or regional intra-arterial infusion of 5-Fluorouracil (5-FU). Fifteen patients with unresectable and 32 with locally recurrent rectal cancer were subjected to radiotherapy. The absorbed dose was 30 Gy in patients with an unresectable tumor and 45 Gy in patients with locally recurrent rectal cancer. Six patients with unresectable and 26 with locally recurrent rectal cancer received bilateral internal iliac artery infusion of 5-FU in a median dose of 7.5 g. There was no difference in survival between the two methods of treatment. Resection of an initially unresectable tumor could be performed in 5 of 21 patients (4 after radiotherapy and 1 after chemotherapy). All except eight patients had pelvic or perineal pain before treatment. Forty of 43 (93%) patients reported pain relief after radiotherapy and 21 of 28 (75%) after infusion therapy. Ten nonresponders were subjected to alternative treatment (three to intra-arterial infusion and seven to radiotherapy). Five of these ten patients reported complete pain relief and five partial pain relief. After radiotherapy, no significant side effects or complications were observed. The infusion chemotherapy was the cause of death in one patient. In summary, similar palliation was achieved with bilateral iliac artery 5-FU-infusion and radiotherapy. Owing to the complications registered with infusion therapy, radiotherapy must be considered the treatment of choice for these patients. Patients who do not respond to radiotherapy or suffer recurrence of pelvic and perineal pain may receive further palliation from intra-arterial infusion.

Adult↗
PubMed1986

Pre-operative infusion cholangiography compared to routine operative cholangiography at elective cholecystectomy.

Routine operative cholangiography (group 1) was compared with pre-operative intravenous infusion cholangiography and selective operative cholangiography (group 2) in 200 patients subjected to elective cholecystectomy. All patients were examined with pre-operative intravenous infusion cholangiography. In group 1 patients, this examination was not made available to the surgeon and not used in any way except for a later analysis. Thirteen patients had to be excluded for different reasons. In group 1, normal operative cholangiograms were obtained in 82/94 cases. Choledocholithotomy was performed in 7/12 cases, choledochotomy in 2/12 and no exploration in 3/12 cases. In group 2, pathological or inconclusive infusion cholangiograms were demonstrated in 17/91 cases. Choledocholithotomy was performed in 11/17 cases. One of 17 patients was subjected to choledochotomy only. In 5/17 patients, no exploration was carried out because of normal operative cholangiography. No residual or retained stone/s have been revealed during a follow-up period of 1 year. The general clinical outcome in the two groups of patients was similar. Significantly shorter operative time was an important advantage of the strategy in group 2 patients.

Adolescent↗
PubMed1985

The pancreas.

A review has been made of the angiographic findings of different benign and malignant pancreatic lesions. The limited need for angiography as a diagnostic procedure is emphasized with guidelines to its indications when such other diagnostic modalities as US and CT are available. The technique, indications and results of pancreatic venography and venous sampling for hormone assay are discussed.

Adenocarcinoma↗
PubMed1984

Embolization of the liver in the management of metastatic carcinoid tumors.

Eight patients with metastatic carcinoid tumors and the carcinoid syndrome were treated with gelatin foam embolization of the hepatic arterial tree. The aims were to reduce the tumor mass in the liver and to eliminate the carcinoid syndrome. The effects of the treatment were judged from arteriograms, CT scans, and the levels of serotonin in blood and 5-HIAA in urine, as well as from the clinical symptoms. The mean follow-up time was 12.5 months. In all patients the liver tumor mass was reduced after embolization, and this reduction persisted for at least 6 months in seven patients. After treatment, reduced serotonin levels in blood were measured in four patients and reduced 5-HIAA levels in urine in seven patients. In five patients the carcinoid syndrome disappeared after embolization, but after 6 months two of these five patients had regained symptoms. Adverse reactions were minor consisting of a slight fever, reversibly increased serum levels of liver enzymes, and abdominal pain. In our experience, the hepatic embolization is a simple and safe method of giving relief from the carcinoid syndrome.

Aged↗
PubMed1984

Umbilical and paraumbilical veins in ligamentum teres. Their significance as collaterals in portal hypertension.

Twenty-two postmortem specimens of the liver (18 normal livers, three with liver metastases, and one with liver cirrhosis) with attached ligamenta teres were investigated using silicone rubber injection technique. In all cases, the paraumbilical veins were demonstrated. They were usually divided into 2 groups, one on the right and one on the left side of the ligamentum teres, and they terminated in a variable manner into small peripheral portal vein branches in the liver parenchyma. A patent segment of the umbilical vein was found in 7 of the 22 cases. Connections between the umbilical vein and paraumbilical veins were supposed to represent one of the collateral channels in portal hypertension.

Adult↗
PubMed1984

Portal blood supply of liver metastases.

Using Microfil technique, hepatic arteries and portal veins were injected in four human cadaver livers with metastases of different origin. Specimens were dissected under stereomicroscope and vessels supplying the tumor nodules were traced. In all cases, tumor vessels could be filled from the portal side; in three, the supplying portal branches were rather wide. The findings were correlated with histologic sections.

Hepatic Artery↗
PubMed1984

Hepatic rupture secondary to pre-eclampsia--report of a case treated conservatively.

Hepatic rupture during pregnancy is related to toxaemia and is most often fatal. Epigastric pain and signs of intra-abdominal bleeding are the most common presenting symptoms. In previous reports liver surgery has been considered the method of choice in all patients. However, we have successfully treated a patient with bilateral hepatic rupture and intra-thoracic bleeding with termination of the pregnancy but otherwise conservative measures. The importance of early diagnosis, by ultrasonography and/or explorative laparotomy, and early termination of the pregnancy is stressed. Also, it is suggested that liver surgery should be individually tailored and that it is preferably avoided in some patients.

Adult↗
PubMed1984

Postmortem examination of the blood supply and vascular pattern of small liver metastases in man.

Thirteen human cadavers with liver metastases were examined. Microfil was injected into the portal vein and hepatic artery. The liver metastases were examined under dissecting microscope, and their vascular supply and patterns were registered. It was found that most metastases had both arterial and portal supply even if the arterial supply dominated. Extensive filling of tumor vessels was observed in both lobes in one liver in which the portal vein of one lobe and the hepatic artery of the other was injected (i.e., the same kind of metastases could be filled from either the hepatic artery or the portal vein). It is suggested that the findings could be of great importance in planning treatment of patients with liver metastases.

Adult↗
PubMed1984

Budd-Chiari syndrome. Report of a case, successfully treated with a meso-caval shunt.

A young woman with the Budd-Chiari syndrome is described. About 2 months after the onset of her illness, a mesocaval shunt with a 14-mm Gore-Tex prosthesis was performed. She recovered rapidly after the operation and returned to work 5 weeks postoperatively. Two years after the operation, hepatic veins were clearly visualized by ultrasound. The impact of early portosystemic shunting on prognosis in these cases is discussed and the value of modern ultrasonography is emphasized.

Adult↗
PubMed1983

Preoperative diagnosis and evaluation of hepatic tumor resectability.

In the interpretation of patients with primary and secondary tumors of the liver, different radiologic procedures play an important role. We discuss ultrasound, computerized tomography, and angiography; the advantages and drawbacks of these modalities; and how they should be used when surgery or infusion chemotherapy is planned.

Hepatic Artery↗
PubMed1983

Radiological diagnosis in proven intraabdominal abscess formation: a comparison between plain films of the abdomen, ultrasonography and computerized tomography.

Plain films of the abdomen, ultrasonography, and computed tomography were performed on 180 patients to rule out an intraabdominal abscess. The efficacy of the different modalities was reviewed in retrospect. Thirty-six of these 180 patients had a definite abscess formation. This was demonstrated in 65% of the plain film examinations, in 44% by ultrasonography, and in 94% by computerized tomography. Computed tomography seems efficient in ruling out abdominal abscess.

Abdomen↗
PubMed1983

Pharmacologic influence on esophageal varices: a preliminary report.

Selective catheterization of the left gastric vein was performed after percutaneous transhepatic portography (PTP) in patients with portal hypertension and esophageal varices. Following the hypothesis that drugs increasing the lower esophageal sphincter (LES) pressure may obstruct the variceal blood flow through the lower esophagus, the effect of different drugs (i.e., intravenous injection of vasopressin, pentagastrin, domperidone and somatostatin and subcutaneous injection of metacholine) on the variceal blood flow was examined. Vasopressin did not change the variceal blood flow; pentagastrin, with its known effect of increasing the LES pressure produced a total interruption of the flow in four of eight patients; domperidone, also known to increase the LES pressure obstructed the variceal blood flow in the only patient examined with this drug; somatostatin has no reported action on the LES but blocked the flow in one of two patients; and metacholine, reported to increase the LES pressure did not produce any change in the flow in the three patients examined. LES pressure was recorded before and during vasopressin infusion in seven patients with portal hypertension and esophageal varices. No reaction on the pressure was found. The patient number in the study is small and the results are nonuniform but still they suggest that drugs increasing the LES tonus might be useful to control variceal blood flow.

Adult↗