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Biomedical subjects

B Gunterberg

Publications and source records attributed to B Gunterberg.

13 recordsLinked to original sources
PubMed1990

Light and electron microscopic examination of fine-needle aspirates in the preoperative diagnosis of cartilaginous tumors.

Twenty-eight patients with chondrogenic tumours--2 chondroblastomas, 4 chondromas, 18 chondrosarcomas, 1 clear-cell chondrosarcoma, and 3 mesenchymal chondrosarcomas--underwent fine-needle aspiration biopsy (FNAB) in the preoperative investigation. The cytologic features in smears were compared with the histopathologic findings in the surgical specimens; in 14 cases they were also compared with the light and electron microscopic findings in resin-embedded fine-needle aspirates. The smears of the vast majority of the classical chondrosarcomas presented features that made possible the FNAB diagnosis of a chondrogenic tumor to be made. In the case of the low-grade chondrosarcomas in particular, which were poorly or moderately cellular in smears and showed chondroblastic cells often in lacunary structures of hyaline matrix, consideration of the clinical presentation, size, location, and roentgenographic appearance was essential for the diagnosis of chondrosarcoma. On the other hand, the high-grade chondrosarcomas presented cytologic features that clearly indicated their malignancy and they usually had a myxoid matrix. The possible differential diagnoses that may arise from the FNAB diagnosis of cartilaginous tumors are discussed. The resin-embedding technique for the light and electron microscopic examination of FNABs, along with the histochemical analysis for the demonstration of sulphated glucosaminoglycans and the immunocytochemistry applied to smears, was found to be of value in the definite diagnosis, especially in the distinction of chondrogenic tumors from chordoma and metastatic mucous-producing carcinoma.

Adolescent↗
PubMed1979

Angiography in myeloma (plasmacytoma). A correlated angiographic and histologic study.

Angiography was performed in ten cases of myeloma (plasmacytoma), of which nine were solitary on admission. All lesions were hypervascular bone tumors with extension of neoplastic growth into adjacent soft tissue. Contrast uptake of the tumors occurred regularly and usually was non-homogeneous. In nearly all cases irregular tumor vessels and early venous drainage was evident with arteriovenous shunting in three. Pathologic-anatomic correlation demonstrated 'tumor vessels' to be newly formed vascular spaces lacking the normal constituents of vessel walls. The contrast uptake presumably was caused by passage of contrast into the newly formed, slit-like capillary vascular spaces. Angiography usually permitted separation of myeloma from benign, hypervascular bone lesions. The procedure proved to be of particular value in indicating definite malignancy, since myeloma was considered initially as the probable diagnosis in only one of the series. It was not possible, however, to differentiate myeloma from other malignant tumors by plain radiography or angiography. Irreversible renal failure occurred in one patient after angiography.

Adult↗
PubMed1979

Resurfacing arthroplasty of the hip. Biomechanical, morphological, and clinical aspects based on the results of a preliminary clinical study.

As an alternative in total hip replacement the so called resurfacing arthroplasty of the hip is gaining wider acceptance. The procedure can be said to be a modernisation of the original Smith-Pedersen operation and is suggested in young people with degenerative hip disease, congenital hip dysplasia or Perthes' disease. The advantages are that the femoral head and neck are retained and thus no femoral stem prosthesis is necessary. The greatest disadvantage is that in case of socket loosening a secondary operation might not remain as successful as could the initial operation with a socket which is not as large as those recommended for the resurfacing procedure. In this presentation a preliminary report of a one-year material is presented together with a presentation of advantages, disadvantages, and the biomechanical appraisal of resurfacing of the hip. Fifteen patients with 17 hips have been operated and followed-up and by using the Merle d'Aubigné evaluation there was an improvement of some 3--4 points in pain, walking, and total motion. Patient opinion indicated 80% satisfaction. The management of two serious complications is also described.

Adult↗
PubMed1978

High amputation of the sacrum for extirpation of tumors. Principles and technique.

A detailed description is given of the principles and surgical technique for extensive resection of the sacrum, including an adjacent part of each ilium, for radical removal of tumor. Two levels of sacral amputation are discussed: between S1 and S2 (through the canals of the S1 nerves) and through S1 (above the canals of the S1 nerves), with or without inclusion of the rectum in the specimen. The former level permits the preservation of the S1 nerves; the latter does not. Important pathoanatomic facts are discussed. The effects of these operations on the urogenital and anorectal function and on the stability of the pelvic girdle are briefly reviewed. Five illustrative cases are reported with comments on the results.

Anal Canal↗
PubMed1978

Intraosseous lipoma. A report of two cases.

Intraosseous lipoma seems to be a rare condition as only some 20 cases have been reported so far. A further two cases are described the lesions being in the calcaneus and in the tibia. Radiographically the lesions appeared osteolytic and well delineated, containing calcified areas. The microscopic features were those of mature adipose tissue. Curettage and packing with autogenous bone grafts is recommended, if the lesion causes pain or a correct diagnosis cannot otherwise be obtained.

Adult↗
PubMed1978

Fixation of pelvic fractures and dislocations. An experimental study on the loading of pelvic fractures and sacro-iliac dislocations after external compression fixation.

A trapezoid external compression fixation frame, assembled with the Hoffman instruments, was used for stabilizing experimental injuries to the pelvic skeleton of ten cadaver specimens. The resistance to loading in a position corresponding to upright standing was tested in 17 experiments and related to the calculated load in vivo. The results indicated that ipsilateral injuries, either presenting as dislocations of the sacro-iliac joint and symphysis or as unilateral fractures of the sacrum or ilium in combination with fractures of the pubic rami could be stabilized by the external compression frame well enough to permit weight-bearing in the upright standing position. Bilateral injuries to the pelvic skeleton, vertical or oblique, could not, however, be stabilized enough to resist more than a fraction of the normal load in the upright standing position.

Aged↗
PubMed1976

Anorectal function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves.

The anorectal function in 3 patients with bilateral and 4 patients with unilateral well-defined loss of sacral nerves after radical tumour excision was studied by clinical examination and by simultaneous registration of the following variables: volume and pressure in the rectum, pressure in the internal anal sphincter area and myoelectrical activity in the external anal sphincter. The patients with bilateral loss of sacral nerves had serious impairment of function. Constipation was their only safeguard against incontinence. The preservation of the first and second sacral nerves bilaterally was not sufficient for discrimination between different qualities of rectal contents passing the anal canal. The sensation of rectal distension was also impaired. The reflex pattern of the internal anal sphincter was, however, intact. The external anal sphincter displayed a weak spontaneous myoelectrical activity in the patients who had at least one second sacral nerve intact, and a weak increase of the activity could be induced voluntarily. The normal transient increase of myoelectrical discharge from the external anal sphincter in response to rectal distension could not, however, be elicited. In patients with total unilateral loss of the sacral nerves no significant impairment of anorectal function was noted. Total one-sided denervation implied deficient sensibility of the anal canal unilaterally, but no disturbance of sphincter function as judged from the reflex response of the internal and external anal sphincters to rectal distension.

Adult↗
PubMed1976

Sexual function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves.

The sexual function of nine patients with severance of sacral nerves bilaterally (five patients) or unilaterally (four patients), performed during operations for radical extirpation of tumors of the sacrum or its vicinity, was studied. Sexual histories were obtained and sensibility tests were performed. In four of the five male patients an attempt was made to collect electromyographic recordings from the external urethral and anal sphincters during ejaculation. Bilateral loss of S3 to S5 nerves in two women seemed not to affect their sexual function. Bilateral loss of S2 to S5 nerves in one man was compatible with gratifying sexual intercourse, the stimulation for erection being purely psychogenic, and "ejaculation" of a dripping nature. Unilateral loss of all sacral nerves did not impair previously normal sexual function, although the penises and vulvae of these patients were anesthetic on one side. The sensibility of the penis seemed to be subserved by the second sacral nerve. The myoelectric activity of the striated urethral and anal sphincters during ejaculation recorded in one patient with unilateral total loss of sacral nerves was normal bilaterally considering the duration of, and intervals between, the clonic contractions.

Adult↗
PubMed1976

Pelvic strength after major amputation of the sacrum. An exerimental study.

Major sacral resections up to the level of S 1 and even higher have been performed. This has raised the question of the degree to which such operations weaken the pelvic ring. Fifteen cadaver pelves, including the fifth lumbar vertebra, were loaded to failure, five unresected, five after resection of the sacrum between S 1 and S 2, and five after resection about 1 cm below the promontory. The weakening of the pelvic ring amounted to approximately 30 per cent with the former type of resection and 50 per cent with the latter. Taking into consideration the calculated normal load on L 5 in upright standing it seems safe from this study to allow patients to stand with full weight-bearing at an early stage postoperatively after submaximal resection of the sacrum.

Adult↗
PubMed1975

Neurourologic evaluation after resection of the sacrum.

Five patients with bilateral, and four patients with unilateral, well defined sacral nerve lesions after sacral resection for tumor were examined with a clinical evaluation, cystometry, and cystoscopy including a test of vesical and urethal sensibility with different stimuli. In patients with bilateral division of the sacral nerves below the S 2 level, no active detrusor contractions were registered, indicating that the second sacral segment alone cannot subserve the micturition reflex. In patients with unilateral division of sacral nerves 1 to 5 or 2 to 5, a normal micturition reflex was registered. There was a complete loss of bladder mucosal pain when sacral nerves 3 to 5 had been cut bilaterally, while the sensibility was normal when sacral nerves 4 to 5 had been cut bilaterally. In patients with unilateral division of all sacral nerves below L 5 or S 1, mucosal pain tested by means of electrcoagulation of the bladder and pin-pricking of the urethra could not be felt on the denervated side. Stretching of the detrusor wall with a ureteral catheter, however, could be felt on the denervated side, indicating that this sensation was not mediated in sacral nerves but probably in the hypogastric nerves. Thermesthesia of the mucosa was demonstrated on the intact side of the bladder but not on the denervated side when the patients with unilateral sacral nerve lesions were tested with jet streams of cold or hot saline against the bladder wall.

Adult↗