Biomedical subjects
Publications and source records attributed to B Fåhraeus.
We describe the technique of microsurgical penile replantation and a case followed up after two years. The patient was a young man with decompensated schizophrenia who emasculated himself with a kitchen knife. A particularly good functional result was achieved including restoration of sensation in the penile shaft and in the glans, and return of erectile capacity.
Ventral and dorsal midline wide-mouthed diverticula and Cowper's perforate syringoceles were diagnosed in 12 men with symptoms such as post-voiding dribbling, dysuria, urethral discomfort and haematuria. In all cases the diagnosis was made during urethroscopy and most patients were treated at the same time with transurethral incision of the diverticular wall, thereby marsupializing the diverticulum into the urethra. Diverticula of the male anterior urethra are more common than has been hitherto assumed. In patients with longstanding and/or recurring urethral symptoms and post-voiding dribbling urethroscopy should be included in the investigation.
We investigated retrospectively 91 patients with prostatic carcinoma diagnosed cytologically between 1978 and 1979. Of the patients 57 had no metastases (M0) at presentation. The majority of the patients without metastases had well or moderately well differentiated carcinoma. Of 18 patients with poorly differentiated carcinoma 17 had metastases at presentation. The patients without metastases were left untreated, while those with metastases received active antitumor treatment. Local progression and/or development of metastases during surveillance occurred in 24 patients (42 per cent) and antitumor treatment was initiated. Mean observation time in the group untreated throughout observation was 47 months. Mean interval to progression in the patients treated subsequently was 31 months. In the surveillance group no difference in mean interval to progression, frequency of local progression, development of metastases or death rate of prostatic carcinoma was found when the patients with initially well and moderately well differentiated carcinoma were compared. Therefore, in our study initial cytological grade failed to predict a difference in progression in patients with well and moderately well differentiated prostatic carcinoma. Since almost all patients with poorly differentiated carcinoma had metastases at presentation a poor differentiation seems to predict a worse prognosis compared to well and moderately well differentiated tumors.
Morphological studies of the parathyroid glands from adult Mongolian gerbils in which hypercalcaemia had been induced by thyroidectomy and calcium injections for 2-19 days were carried out. The potassium pyro-antimonate technique and subsequent X-ray analysis of the precipitates were used for ultrastructural localization of cations. Ultrastructurally, most (suppressed) chief cells exhibited a dense cytoplasm, medium-sized or large mitochondria, glycogen particles, inconspicuous endoplasmic reticulum and Golgi complex, calcium-containing precipitates mainly in mitochondria and nuclei, and sometimes also lysosomal bodies and accumulations of secretory granules which occasionally seemed to be discharged into cytoplasmic vacuoles. A few parenchymal cells showed a low cytoplasmic density, few organelles, and structurally altered mitochondria, occasionally with associated smooth-surfaced vacuoles. These cells possessed calcium-containing precipitates in mitochondria, smooth-surfaced vacuoles, and also diffusely in the cytosol. It is concluded, that, in the main part of the parenchymal cells, the hypercalcaemia had resulted in a suppression primarily of the synthetic and later also of the secretory activity, and that the calcium-containing precipitation is different in the chief cell variants.
Ultrastructural examinations were performed in three groups of pigs; one sham-operated control group, one group subjected to thyroidectomy, and another group injected with parathormone after thyroidectomy (TX + PTH). Attention was mainly paid to the localization and structural details of the calcium deposits which were found in the TX + PTH group 78 and 150 hours after the first PTH injection. Calcium deposits were found in the epithelial cells and lumina of the tubular system, especially in the proximal convoluted tubules. It is suggested that calcium first is deposited in mitochondria and cytoplasmic vacuoles and that larger calcific bodies, occasionally with concentric lamellation, are formed by coalescence of small calcific particles, and that the calcium deposits induce degenerative changes in the tubular epithelium which may lead to discharge of calcific material into the lumina.
Various congenital malformations of the testis and the seminal pathways are illustrated by 10 cases. Though these malformations are often free from symptoms, an increasing number of them are now being discovered in connection with investigations of male infertility. In cases of azoospermia where testicular biopsies show complete spermatogenesis, surgical exploration is indicated. Some of these malformations may then be treated by surgery, with fairly good prospects of restored fertility.
Light-microscopic examinations were performed in three groups of pigs; one sham-operated control group, one group subjected to thyroidectomy (TX), and one group injected with parat-hormone (PTH) after thyroidectomy (TK + PTH). The kidneys of the sham-operated animals were normal, whereas slight to moderate dilatation of some tubules was seen in the TX group. The most prominent changes in the TX + PTH group were calcium deposition, tubular dilatation and degeneration, inflammation, and hyperaemia. In addition there were hyaline casts, PAS-positive globules and mitotic figures in the tubules. It is suggested that the calcium deposition caused by the PTH administration plays a major role in the development of degeneration in the tubular epithelium, and that these structural lesions are of importance in the development of reduced renal function.
The parathyroid glands of adult Mongolian gerbils were studied under an operation microscope, as well as with the aid of conventional light microscopy, and transmission and scanning electron microscopy. The mean serum level of calcium was 5.1 mEq/1 and that of phosphorus was 4.8 mg/100 ml. The animals possessed two small parathyroid glands, usually situated anteriorly and slightly laterally to the superior thyroid poles. The glands had a rich vascular supply and were composed of sheets of chief cells, which varied in electron density and content of organelles. No water-clear, oxyphil, or intraglandular fat cells were found. Some mitochondria exhibited electron lucent areas, and separation and bulbous projections of the membranes. The cell membranes were straight or tortuous and possessed microvilli, occasionally with central filamentous structures. The intercellular spaces were usually narrow. It is supposed that the variants of chief cells are interchangeable and that the differences in their morphological appearance are related to differences in functional state.
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