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Biomedical subjects

C M Eneroth

Publications and source records attributed to C M Eneroth.

At least 19 recordsLinked to original sources
PubMed1993

[The oto-rhino-laryngology clinic at Lund--yesterday, today, and tomorrow].

Oto-rhino-laryngology became a separate unit of the University Hospital in Lund in 1904 and has since then had only four heads: F.V. Törne, G. Dohlman, Hj. Koch och C.-M. eneroth. During each time period of these chairmen, great changes in the pattern of diseases and medical development have taken place. These periods are separately described, the first three of them emphasizing on the achievements of each chairman. The author is not, however, discussing his own life and activities during the fourth period. Instead, he describes the lines of research that started and developed during his leadership. Finally, some views on the future of the Department are presented.

Academic Medical Centers↗
PubMed1991

Early postoperative basal serum GH level and the GH response to TRH in relation to the long-term outcome of surgical treatment for acromegaly: a report on 39 patients.

During a 10-year period 39 patients with acromegaly, aged 23-73 years, underwent selective adenomectomy via a trans-sphenoidal or transfrontal (one case) approach. Six to 12 months after the operation, the serum level of growth hormone (GH) was reduced to less than 5 micrograms l-1 in 28 patients (74%) in at least two of three random samples and/or suppressed to less than 3 micrograms l-1 during an oral glucose load, thus fulfilling the commonly used criteria for a successful operation. In 10 patients these criteria for adequate GH reduction were not fulfilled, but their median S-GH level was reduced from 38 to 11 micrograms l-1 (P less than 0.01) after the operation. Surgery was successful in 11 of 13 (85%) patients with a microadenoma (less than 10 mm in diameter), in 10 of 14 (71%) patients with an adenoma of diameter greater than 10 mm but still enclosed in the sella, and in seven of 11 (64%) patients with locally invasive tumours. Impaired pituitary function was observed in 23% of the patients after surgery, independent of tumour size. In one patient the postoperative period was complicated by a lethal intracranial infection. During follow-up for 1-10 years, four patients relapsed, after 1, 1.5, 6 and 9 years, respectively. Patients for whom surgery appeared to have been ineffective at the evaluation 6-12 months postoperatively, or who later relapsed were identified by early (within 7 d) postoperative serum GH with a sensitivity of 90%. The accuracy for identification of a satisfactory outcome of surgery was 85%, and the predictive value was 90%. The corresponding values for the GH response to TRH measured 6-12 months postoperatively were 47, 40 and 54%, respectively. It is concluded that the basal level of serum GH measured 1-7 d postoperatively has higher sensitivity and specificity than the GH response to TRH 6-12 months postoperatively for evaluation of the effect of surgery on GH overproduction, and that it has a higher predictive power with regard to the long-term outcome of surgery for acromegaly.

Acromegaly↗
PubMed1980

Management of parotid gland neoplasms.

This clinical review presents a survey of the different types of epithelial neoplasms in the parotid gland. The incidence, histopathological classification, grade of malignancy, and staging system are discussed. Diagnostic procedures are reviewed and a scheme for treatment is proposed for the different types of epithelial parotid neoplasms.

Adenocarcinoma↗
PubMed1979

Intra-arterial chemotherapy of malignant head and neck tumours with superselective angiographic technique.

A technique is described for repeated superselective angiographic infusion of anticancer drugs into advanced malignant tumours of the head and neck region. The technique allows for a high concentration of the drug in the tumour and, furthermore, it is possible to ensure that the infused anticancer drug adequately reaches the tumour. Mitomycin C was given to 15 patients with advanced malignant tumours of the head and neck region. In 16 patients a partial remission was seen, and in another 5 patients a subjective improvement was reported. No complications were observed.

Adult↗
PubMed1978

Selective intra-arterial cytotostatic injections in malignant head and neck tumors.

Regional intra-arterial drug administration has been advocated in order to reduce the risks of systemic complications in conjunction with systemic tumor chemotherapy. We have been using superselective angiographic techniques to administer the antitumor drug mitomycin C directly into the feeding arteries of the tumor in 15 patients with advanced malignant head and neck tumors. No complications were observed. In five patients the tumor decreased significantly in size, in four patients, tumor cell necrosis was found. A marked decrease in pain was reported by nine of the 15 patients.

Adult↗
PubMed1978

Angiolithiasis in the parotid gland.

Angiolithiasis in salivary glands is a very rare finding, and the knowledge of the morphology and histogenesis of these stone formations is therefore limited. Six small angioliths from the left parotid gland of a 19-year-old girl were examined histologically, microradiographically and diffractometrically. The angiolithiasis developed from a regressed hemangioma which had been observed since the patient was 3--4 years old. The angioliths, which were encapsulated, exhibited in some areas diffuse laminations with shells of alternatingly high and low mineral content. In other areas, however, the sturcture of the stones was rather homogeneous. The central part of all angioliths was highly mineralized. All the examined specimens exhibited a mineral pattern of pure apatite. Due to presence of erythrocytes as well as of fibroblasts in the matrix of the examined noduli, the diagnosis of angiolithiasis was established.

Adolescent↗
PubMed1978

Ultrastructure of salivary calculi.

Twenty-one submandibular salivary calculi from 19 patients were examined with the light and electron microscope. Adjacent to the peripheral parts of the calculi metaplastic squamous epithelium or connective tissue was seen in close contact to the mineralized matrix. Disintegrated cellular substances from these tissue components were in some cases found to condense in a peripherally located zone of the salivary calculi. The morphology of the examined salivary calculi varied extensively not only within each calculus but also from one calculus to another. High and low incidence of crystals gave rise to the lamellated pattern. In some cases the crystals were so abundant as to five a dense homogeneous appearance. In the central parts of the calculi spheroid bodies of very low electron density with a size ranging from 1 to 100micrometer were found in an amorphous matrix. The origin of these structures is discussed. In the peripheral parts of some calculi osmiophilic spherical bodies with an electron microscopical appearance similar to lipid granules as well as bacteria of cocci or coliform type were found. Degenerated bacteria might in some cases contribute in forming part of the peripheral organic matrix.

Humans↗
PubMed1978

Antibiotic concentrations in saliva of purulent parotitis.

In patients with unilateral acute purulent parotitis treated with penicillin and doxycycline the antibiotic concentration was determined in plasma and saliva from both the healthy and the affected parotid gland. The results show that the penicillin concentrations in purulent saliva of the diseased gland is considerably higher than in non-purulent saliva of the healthy parotid gland. There was no such marked difference in concentrations of doxycycline. The possible mechanisms behind these observations are discussed as are the conclusions that can be drawn concerning treatment of acute purulent and chronic recurrent parotitis.

Acute Disease↗
PubMed1977

The relation of lipids to the mineral components in salivary calculi.

Using lipid histochemical and microradiographic methods, the distribution of lipids and the inorganic component in different areas of salivary calculi was investigated. Two main groups of lipids were found, i.e. hydrophilic phospholipids and hydrophobic lipids. The hydrophilic phospholipids were shown to be composed mainly of phosphosphingosides and of the hydrophobic lipids cholesterol was demonstrated. Phosphosphingosides were localized in more or less lamellar zones as also in large homogeneous areas. In some cases the calculi were surrounded by a structureless non-mineralized zone exhibiting a strongly positive reaction for phosphosphingosides. Cholesterol was found in isolated band-formed areas. Phosphosphingosides and cholesterol were especially prevalent in areas showing a low or slight degree of mineralization. In areas showing a high degree of mineralization the corresponding lipids gave a weak or absent histochemical reaction. After EDTA-decalcification, however, an increase in the concentration of lipid was noticed in high mineralized areas, indicating a masking process. The influence of various factors on the presence and distribution of different lipids was discussed.

Autoradiography↗
PubMed1977

Preoperative facial paralysis in malignant parotid tumours.

Preoperative paralysis of the facial nerve was found in 145 of 1,029 patients with malignant parotid tumours (14%) treated at nine university clinics in Scandinavia. The incidence of facial paralysis varied between the different clinics. A parellelism between the incidence of the facial paralysis and the impairment of the prognosis of the different tumour types is shown. The presence of preoperative facial nerve paralysis in malignant parotid tumours implies a very poor prognosis but the situation is not as hopeless as has been suggested and therefore one must rely on very radical surgery.

Adenoma↗
PubMed1976

[Clinical aspects of salivary gland tumors].

This paper reports on epithelial tumours arising primarily in the major and minor salivary glands. The purpose of this presentation is to summarize our experience of salivary gland tumours on the basis of a material comprising of approximately 3000 salivary gland tumours as well as a review of the literature to date. The tumours are classified according to the classification recommended by WHO 1972. The incidence, location, symptomatology, grade of malignancy and treatment of the different tumour types in this classification are reviewed. Diagnostic procedures are discussed and a scheme for surgical treatment and radiotherapy of the different types of salivary gland tumours is proposed.

Adenocarcinoma↗
PubMed1975

Malignant melanoma of the oral cavity.

Mucosal malignant melanomas of the oral cavity are rare and the present series comprising 23 patients is one of the largest ever published. The poor prognosis of these tumors appears from the fact that only two of the 23 patients could be presumed to have been treated sucessfully. The survival time of the 21 patients who died during the follow-up period was short in all but one patient, surviving 35 years after the first symptom of the tumor despite regional lymph node metastases in an early stage of the disease and repeated local recurrences. This indicates the importance of a regular lifelong follow-up and surgical activity concerning local recurrences and regional lymph node metastases. The poor prognosis may be explained by the patients' delay in seeking medical advice, which is stressed by the deep and massive infiltration of the extensive primary lesions as well as by the fact that metastases already were demonstrable in most patients at the first examination. A necessary condition for radical surgical therapy, and therefore an improvement in the very bad prognosis of oral malignant melanomas, is an earlier diagnosis than in the present series. As oral malignant melanomas almost exclusively appear in the palate and superior alveolar process, particular attention must be paid to lumps, ulcerations and pigmented spots occurring in this region.

Adult↗
PubMed1975

Morphology of salivary calculi. The distribution of the inorganic component.

Different hypotheses concerning the pathogenesis of salivary calculi have been postulated on the basis of their morphology. In the present study, microradiography of plane-polished ground sections of a number of salivary calculi has shown that the morphology of salivary calculi varies considerably. The commonly accepted concept that salivary calculi emanate from an inorganic nucleus, which then successively grows by the apposition of alternating shells of organic and inorganic substances, could not be established by this study, as the microradiographs show that the distribution of mineral elements varied extensively from one calculus to another. Thus, whereas some calculi exhibited a lamellar structure, others consisted largely of homogeneous, irregular layers of alternatively high and low mineral content. The lamellar structure also showed great variation, extending in some cases over the entire diameter of the calculus. Some calculi lacked the lamination in their peripheral parts whereas, in others, lamination occurred only in the most peripheral zone. The structure of the central portions also showed a varied configuration. The calculi were often built up around one or more mineralized nuclei, often centrally located, while in some cases a mineralized nucleus was lacking. This report discusses some of the significant factors in the great variation in morphological features and therefore also in the pathogenesis of salivary calculi.

Humans↗
PubMed1975

Crystalline structure of salivary calculi. A microradiographic and microdiffractometric study.

The crystalline substances localized in different areas of salivary calculi were identified by using microradiographic and X-ray microdiffractometric techniques. All 19 calculi analyzed had a general pattern of apatite which was recognizable both in the center and at varying distances from the core. In addition to apatite patterns, six of the calculi gave a diffraction pattern of whitlockite, which in all but one case was located in the central part of the calculi. The influence of various factors on the distribution of the crystalline substances of apatite and whitlockite within the calculi is discussed.

Apatites↗
PubMed1975

Antibiotic concentrations in maxillary sinus secretions and in the sinus mucosa.

In maxillary sinusitis, the blood circulation is supposed to be impaired in the oedematous sinus mucosa, and in such cases the transport of antibiotics into the maxillary sinus should be reduced. To prove the accuracy of this assumption a comparison has been made between the concentrations of penicillin and doxycycline (Vibramycin, Pfizer) in sinus mucosa and secretions and the serum concentrations in patients under treatment with these antibiotics. Measureable concentrations of penicillin (greater than 0.2 mug/ml) were reached in the secretions only if the serum concentration was high (greater than 4-5 mug/ml). In contrast, measurable concentrations of doxycycline were achieved in both mucosa and secretions in all patients treated with this antibiotic. This must depend on the fact that doxycycline, due to its optimal lipid solubility, was able to penetrate poorly vascularized tissue. In most cases, the concentrations of doxycycline far exceeded the minimum inhibitory concentrations of the isolated organisms, and in some cases the local concentrations were higher than those found in the serum. The clinical response to doxycycline was good and correlated well to the laboratory data.

Doxycycline↗
PubMed1975

Evaluation of the antibiotic effect of treatment of maxillary sinusitis.

As the effect of antibiotic treatment of maxillary sinusitis has been questioned, the elimination of bacteria from sinus secretions was studied during antibiotic treatment. Penicillin V, azidocillin, tetracycline or doxycycline was administered to 54 patients with maxillary sinusitis. Samples of sinus secretion were aspirated both before treatment and 2-3 days after the onset of treatment. When the antibiotic concentration was below the upper limit of MIC for sensitivity group 1, bacterial growth was present in practically all samples. When the antibiotic concentration equalled or was above this limit, there was no bacterial growth in about half of the samples. A prerequisite for antibiotic effect--elimination of bacteria--is that the antibiotic concentration is well above the MIC of the bacteria at the site of infection. The choice between bactericidal or bacteriostatic antibiotics appeared unimportant. Bacterial survival in the maxillary sinus despite a high antibiotic concentration in the sinus illustrates that MIC values determined in the laboratory do not always mirror the sensitivity of bacteria to antibiotics in vivo.

Anti-Bacterial Agents↗