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Biomedical subjects

C H Soderberg

Publications and source records attributed to C H Soderberg.

15 recordsLinked to original sources
PubMed1994

Factors affecting prognosis and management of carcinoma of the colon and rectum in patients more than eighty years of age.

BACKGROUND: The safety and efficacy of operations for gastrointestinal diseases in very elderly patients has been a matter of debate in recent years. STUDY DESIGN: One hundred seventy-seven instances of carcinoma of the colon and rectum in patients more than 80 years of age who wee surgically treated between 1961 and 1987 were reviewed. They were compared with 623 similar instances in patients younger than 80 years of age who were treated during the same time period. RESULTS: Octogenarians and nonagenarians significantly more often displayed obstruction or perforation, elevated preoperative carcinoembryonic antigen, right-sided lesions, and solitary hepatic metastases, when present. Patients more than 80 years of age received adjuvant chemotherapy or radiotherapy less often. Carcinoma recurrence in very elderly patients implied a very poor prognosis, with only a 4 percent salvage rate. The actuarial five year survival rate was 32 percent for the older patients and 48 percent in the younger group (p < 0.05). There was no significant difference in operative mortality between the two groups. CONCLUSIONS: In general, age alone should not alter treatment strategy in patients with carcinoma of the colon and rectum.

Age Factors↗
PubMed1991

Mammographic localization and biopsy of nonpalpable breast lesions. A 5-year study.

A malignancy rate of 24% was achieved as a result of needle localizations and biopsies of 548 nonpalpable mammographically detected breast lesions in 507 consecutive patients during a 5-year period. Malignancy was present in 74 (23.8%) of 311 irregular soft-tissue densities, in 40 (19.6%) of 204 cases with clustered microcalcifications, and in 33 cases (54.5%) when both features were present. Same-day admission and discharge were achieved in 491 patients and local anesthesia supplemented with intravenous sedation was used in 73 (74%) of the 98 patients (in 1989) by the end of the study period. Nonpalpable cancers were categorized pathologically as stage 0 in 25 patients (20.8%), stage I in 67 patients (55.8%), stage IIA in 24 patients (20.0%), and stage IIB in four patients (3.3%). The malignancy rate rose sharply from the fourth to the fifth decade.

Biopsy, Needle↗
PubMed1991

Effect of perigraft seroma fluid on fibroblast proliferation in vitro.

Different theories have been postulated in the last 10 years in an attempt to explain the pathogenetic mechanisms involved in perigraft seroma formation. This paper reports our experience with in vitro analysis of the cellular composition and the effect of perigraft seroma fluid on fibroblast proliferative activity. Our results indicate that the cellular component of the fluid was almost exclusively represented by polymorphonuclear leukocytes. Perigraft seroma fluid was stimulatory on fibroblast growth, while plasma samples from the patient and normal controls were inhibitory. These findings suggest that a perigraft seroma may represent a complex phenomenon which cannot be explained exclusively in terms of fibroblast stimulation or inhibition. This pattern displays a close similarity to experimental observations in the early phases of wound healing. Perigraft seroma formation could be mediated by an intense and persistent chemotactic stimulus on leukocytes, which does not allow normal progression of wound healing through fibroblast growth and collagen deposition.

Blood Vessel Prosthesis↗
PubMed1983

Hyperthermic adjuvant perfusion chemotherapy for Stage I malignant melanoma of the extremity with literature review.

Thirty-nine patients with clinical Stage I malignant melanoma of the extremities were treated with hyperthermic perfusion chemotherapy using melphalan followed by excision or wide re-excision of the area and regional lymph node dissection. Four patients with positive lymph nodes, on histologic examination, were considered pathologic Stage II. Seventy-two patients with clinical Stage I extremity melanomas, who were treated by conventional surgical methods, served as concurrent controls, and were comparable in the distribution of their various pretreatment characteristics. The actuarial survivals for clinical Stage I perfusion patients calculated by the life-table method at 5, 10, and 15 years were 91%, 86%, and 77%, respectively, and disease-free survivals were 85%, 80%, and 80%, respectively. These figures were significantly better than controls. A Breslow depth of invasion of greater than 1.5 mm showed a significant difference in both clinical and pathologic Stage I disease as compared with the controls. Similarly, perfused patients aged less than or equal to 50 years survived significantly better than controls in both clinical and pathologic Stage I disease. The literature has been reviewed.

Chemotherapy, Cancer, Regional Perfusion↗
PubMed1980

Experience with the EEA stapling device.

The EEA stapling instrument was used to perform 48 anastomoses without operative mortality. One of the 29 colorectal anastomoses developed a leak. Two intraabdominal abscesses were noted, one after an intraperitoneal colocolostomy and one after a colorectal anastomosis. No leaks were demonstrated in the 12 esophageal anastomoses. Minor bleeding that occurred in one of the colorectal anastomoses ceased spontaneously without need for transfusion. One esophageal and one colorectal anastomosis became narrowed postoperatively, but both were corrected with dilatation without further problem. In two of the very low colorectal anastomoses, transient fecal soilage occurred for 4 to 5 months postoperatively. On the basis of our experience, we believe that the EEA instruments has a definite place in gastrointestinal surgery. Its greatest virtue is that it provides a means to perform the heretofore technically difficult and frequently insecure colorectal and esophageal anastomoses with greater facility and security.

Colon↗
PubMed1978

A combined treatment approach to management of hepatic metastasis.

Forty-eight patients with liver metastases were treated at Rhode ISland Hospital in a nonrandomized sequential manner between January 1972 and June 1977. Eight received 5 FUDR hepatic artery infusion, 14 hepatic irradiation, and 25 were planned for combined intra-arterial chemotherapy plus total hepatic irradiation. Those patients who successfully completed induction treatments had a median survival in the radiation only group of 140 days, in the intra-arterial chemotherapy group 270 days, and in the combined group 376 days. Hepatic radiation when combined with chemotherapy was well tolerated. Primary tumor site, disease duration, and degree of abnormality of liver function had no relationship to the response to treatment. The pretreatment performance level of the patient as determined by the Karnofsky Performance Index gave the best indication for potential response to combined therapy. Based on the results of this treatment and the reports of other series, it appears that the combination of intra-arterial 5 FUDR plus hepatic irradiation may offer prolonged and worthwhile palliation to appropriately chosen patients.

Bone Marrow↗
PubMed1978

Change in the management of adult groin hernia.

Three hundred fifty-seven groin hernia repairs were performed under local anesthesia using a long-lasting local anesthetic agent. An ilioinguinal, iliohypogastric, and twelfth intercostal nerve block was carried out initially, followed by regional infiltration of the agent, using a technic first described by Ponka [8] with several modifications. This technic can be employed suffessfully in the majority of groin hernia repairs. It requires careful attention to detail in the administration of preoperative sedation and analgesia and the use of sharp dissection only and greater gentleness in the handling of tissue. We have observed a significant reduction in postoperative discomfort and the virtual elimination of urinary retention, urinary sepsis, atelectasis, and phlebitis in these cases. All patients are fully ambulatory, without assistance immediately after surgery and the majority are discharged the same day or the following morning. This results in a marked reduction in the total cost of repairing a groin hernia.

Adolescent↗
PubMed1976

Catamenial pneumothorax.

Consistent clinical features of catamenial pneumothorax are its recurrent nature, repeated involvement of the right hemithorax, and a temporal relationship to the onset of menstruation. A personal case with endometrial implants and defects of the the diaphragm is presented. A review of the entire 41 cases reported in the literature reveals that the syndrome is more common than previously believed; there is a definite relationship with endometriosis; and the air allowing the pneumothorax does not appear to enter the chest by way of the genital tract, as originally postulated.

Adult↗