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Biomedical subjects

E Bruun

Publications and source records attributed to E Bruun.

At least 19 recordsLinked to original sources
PubMed1992

[Partial spleen resection using a stapler].

At emergency laparotomy after a fall bleeding from injuries to the upper pole and from lacerations involving the hilum of the spleen were found in a 2 1/2-year-old girl. Partial splenectomy using a linear stapler allowed preservation of the lower pole with intact vessels. Observed peroperatively for 10 minutes, the splenic remnant retrained a macroscopically normal appearance. Blood transfusion was avoided and drainage postoperatively comprised no more than 25 ml serosanguineous fluid. Provided intact splenic capsule can be used for the line of resection, partial splenectomy using a linear stapler seems to be a safe method.

Accidental Falls↗
PubMed1992

The prognostic value of histological grading and mean nuclear volume in human prostatic cancer.

Fifty-eight consecutive patients diagnosed with prostatic cancer at transurethral resection in the period 1979-1983 were classified using histological grade according to Shelley, and using an unbiased estimate of mean nuclear volume. We find that both histological grade and mean nuclear volume appear to be significantly associated with survival. In eight of nine patients still alive after 89-130 months mean nuclear volume at diagnosis was in normal range and the histological grade showed a highly differentiated cancer in eight of the nine cases. These findings suggest highly differentiated cancer and normal range of mean nuclear volume may be important for long-term survival. In patients with advanced disease requiring endocrine treatment both histological grading and mean nuclear volume estimates failed to show any prognostic properties with regards to time to progression and time of survival. In patients not subjected to endocrine treatment histologic grade, but not mean nuclear volume, was found to be significantly associated with survival. Subtle changes in disease progression may be diagnosed early by repeated biopsies due to the accuracy and high reproducibility of mean nuclear volume measurements; however, a single estimate of mean nuclear volume has not been shown to offer advantage over histological grade with respect to prognostic properties.

Aged↗
PubMed1991

DNA distributions in maldescended testes: hyperdiploid aneuploidy without evidence of germ cell neoplasia.

Fine-needle aspiration biopsies and surgical biopsies were obtained from maldescended testes of 149 consecutive men. The aspirates were subjected to quantitative DNA flow cytometry and the surgical biopsy to histological evaluation. From more than 80% of the gonads, sufficient material was obtained for both examinations. A significant hyperdiploid cell population with a mean DNA index of 1.23 (range 1.17-1.31) was found in six gonads. Hyperdiploid aneuploidy was found in gonads without, as well as with, complete spermatogenesis. In none of the six cases did the surgical biopsy show evidence of early testicular neoplasia by morphology or by immunohistochemical methods with antibodies against carcinoma in situ. This indicates that aneuploidies in maldescended testes do not necessarily indicate malignancy. It may be speculated that hyperdiploid aneuploidy is related to the development of preneoplastic lesions.

Adult↗
PubMed1989

Prevalence of carcinoma in situ and other histopathological abnormalities in testes of men with a history of cryptorchidism.

The incidence of invasive testicular cancer is increased in men with a history of cryptorchidism. Previous studies based on relatively small series indicated that the risk of carcinoma in situ of the testis also is increased in these men. In our study 500 consecutive men 20 to 30 years old, who were previously admitted to a department of surgery with the diagnosis of testicular maldescent, were asked to participate in a screening for carcinoma in situ of the testis. Of the men 300 consented to testicular biopsy. The biopsies were evaluated by light microscopy for carcinoma in situ and other histopathological abnormalities. Carcinoma in situ was diagnosed in 5 patients (1.7%, 95% confidence limits 0.5 to 3.9%). However, the true risk of carcinoma in situ might be higher, since 2 men who had been treated for testicular cancer before they were offered biopsy were excluded from the study. Advanced spermatogenesis, including the spermatid stage in all tubules, was found in biopsy specimens from only 37% of the men. In 80% of these specimens even the number of late spermatids was decreased. Thus, our study, based on a large number of testicular biopsies from an unselected group of men with testicular maldescent, provided further evidence that these men have an increased risk for carcinoma in situ of the testis. Our data combined with the results of other Scandinavian studies indicate that the true prevalence of carcinoma in situ in men with a history of cryptorchidism is approximately 2 to 3%. Additionally, we confirmed that spermatogenic function is severely impaired in maldescended gonads. Invasive testicular cancer can be prevented if the neoplasm is detected at the stage of carcinoma in situ. In our opinion the magnitude of prevalence of carcinoma in situ found in men with a history of cryptorchidism justifies that these men should be offered testicular biopsy when they reach adulthood.

Adult↗
PubMed1989

Stereological estimation of mean nuclear volume in prostatic cancer, the reproducibility and the possible value of estimations on repeated biopsies in the course of disease.

The reproducibility of stereological estimates of mean nuclear volume by using the principle of volume estimation of particles of arbitrary shape is investigated together with the possible prognostic value of the estimates in the course of advanced prostatic cancer. Repeated transurethral resection of the prostate was performed 14-93 months after the first resection in 14 of 85 consecutive patients in whom prostatic cancer was newly diagnosed in the period 1979-1983. Twelve of these fourteen patients needed endocrine treatment because of progression of the metastatic disease. The reproducibility of the estimations was excellent as the variation of the method was less than 1% when the estimation of the mean nuclear volume was repeated at random on the same specimens after a time-interval of 2 months. The progression of the disease was evidenced by a significant histological upgrading and by a highly significant increase of the mean nuclear volume from the first to the second transurethral resection of the prostate.

Aged↗
PubMed1988

Intravesical therapy of noninvasive bladder tumors (stage Ta) with doxorubicin: initial treatment results and the long-term course.

A total of 64 consecutive patients with noninvasive bladder tumors (stage Ta) between 1977 and 1983 underwent treatment with intravesical instillation of doxorubicin. The total response rate was 85 per cent and 57 per cent of the patients had a complete response after 16 weekly instillations. Half of the patients with a complete response had recurrences within 12 to 16 months. Ten per cent of all patients had an invasive tumor during the observation period. We conclude that doxorubicin can render some patients with noninvasive bladder tumors (stage Ta) free of disease but there currently is nothing to indicate that the same results could not be obtained by transurethral resection.

Administration, Intravesical↗
PubMed1988

Dihydrotestosterone measured in core biopsies from prostatic tissues.

Dihydrotestosterone (DHT) levels were measured and related to the content of DNA in 10- to 15-mg tissue samples obtained by punch biopsies from the prostatic gland. The aim of the study was to provide an opportunity to detect the variation of dihydrotestosterone (DHT) in prostatic tissue on endocrine manipulations in phase III studies of metastatic prostatic cancer. DHT was assayed in ranges of 27.9 to 102.9 pg/ml or when related to DNA from 0.57 to 4.00 pg/micrograms DNA by modifying a commercial testosterone/dihydrotestosterone kit. Preliminary clinical results from nine patients with prostatic cancer and eight with benign hyperplasia showed a significantly lower DHT/DNA ratio in prostatic cancer. The predictive value of the histological grading was improved by estimates of the weighted mean nuclear volume. The trend that mean nuclear volume of prostatic cancer exceeded the mean nuclear volume of hyperplasia was clear, and a significantly larger nuclear variation was demonstrated in the malignant specimens. Neither the DHT/DNA ratio nor the mean nuclear volume appears to be sufficient to guide the handling of individual patients, but the described methods enable us by repeated measurements to follow the course of disease and response to treatment.

Aged↗
PubMed1988

Stereological estimates of nuclear volume correlated with clinical stage and progression of prostatic cancer: clinical aspects.

Fifty-one transurethral prostatectomies were reviewed regarding the possible prognostic value of stereological estimation of cell nuclear volume in prostatic cancer. Patients with manifest cancer had a larger nuclear volume than those with incidental cancer, even though the two groups were matched concerning age and histological grade of the cancer. The nuclear volume was larger in patients with incidental cancer than in those with prostatic hyperplasia. Stereological estimation of nuclear volume may be a useful objective supplement to other prognostic parameters in prostatic cancer.

Aged↗
PubMed1987

"TUR syndrome" after transurethral resection of the prostate using suprapubic drainage.

In a retrospective study of 522 consecutive patients who were subjected to transurethral resection of the prostate with suprapubic trocar technique, six patients were suspected of having transurethral prostatic resection syndrome. The majority of the transurethral resections were performed by surgical or urological trainees. Only two patients fulfilled the criterion for TUR syndrome caused by absorption of irrigating fluid and defined as an electrolyte dilution corresponding to a plasma sodium level below 120 mmol/l. In the present paper the symptomatology and treatment of TUR syndrome are outlined with reference to the literature. The trocar technique clearly has minimized the risk of TUR syndrome, which emphasizes the value of the method.

Aged↗
PubMed1987

Incidental versus manifest prostatic carcinoma.

The problem in managing incidental prostatic carcinoma is whether deferred treatment or active therapy should be preferred. Eighty-six consecutive patients with prostatic carcinoma diagnosed at TUR-P during 1979-83 were studied retrospectively. Seventeen of the patients (20%) had incidental prostatic carcinoma. Incidental carcinomas were significantly more well differentiated histologically than manifest carcinomas. The striking difference between incidental and manifest prostatic carcinomas appeared when the clinical course was considered. Only one patient with incidental carcinoma developed symptoms requiring endocrine therapy, against 31 patients with manifest carcinoma (p less than 0.01). It is therefore concluded that the distinction between manifest and incidental prostatic carcinoma is justified and that deferred treatment is sufficient in most patients presenting with incidental prostatic carcinoma at TUR-P.

Aged↗
PubMed1987

Ultrasound in detection of early neoplasia of the testis.

Testicular ultrasound scanning was performed in 192 men with a history of cryptorchidism. The ultrasonic tissue pattern was evaluated and each testis was accordingly given a score on a scale from 1 to 4, 1 representing the normal uniform pattern and 4 being a very irregular pattern. Testicular biopsy of the previously maldescended testicle(s) was carried out in 143 of the scanned men and from two contralateral testicles where the score 4 was given at the ultrasound examination. Two biopsies showed carcinoma-in-situ pattern. Both were found among testes with a very irregular echo pattern. This pattern was found in only 3.2% of all scanned testes.

Adolescent↗
PubMed1987

Testicular biopsy as an outpatient procedure in screening for carcinoma-in-situ: complications and the patient's acceptance.

Testicular biopsy has been performed as a simple outpatient procedure to facilitate screening purposes. The target population was men aged 20-30 years with previous cryptorchidism, and the aim of the study was to discover carcinoma-in-situ. When results from the first 209 consecutive males were assessed, very few and minor complications were encountered. Only three patients needed hospitalization for drainage of pus from the wound. The effects of the procedure as experienced by the patients were evaluated by a questionnaire. 72% of the patients found the method acceptable. The advantages were the patients' minimal absence from their jobs, and the low consumption of resources.

Adult↗
PubMed1987

A randomized trial of postoperative radiotherapy versus observation in stage II and III renal adenocarcinoma. A study by the Copenhagen Renal Cancer Study Group.

Between 1979 and 1984 the Copenhagen Renal Cancer Study Group randomized 72 patients nephrectomized for stages II and III renal adenocarcinoma in a prospective study of postoperative radiotherapy versus observation. Radiotherapy was 50 Gy in 20 fractions to the kidney bed, ipsi- and contralateral lymph nodes. 7/72 were excluded from further analysis because of major protocol violations. 33/65 were in stage II, 32/65 in stage III. Relapse was found in 31/65 = 48% during the follow-up period without any difference between the two groups. 12/27 = 44% had significant complications from stomach, duodenum or liver, median 5 mo., range 1-44 mo. after radiotherapy. In 5/27 = 19% did the postirradiatory complications contribute to the death of the patients. Patients with stage II tumours survived significantly better than those with stage III tumours (p less than 0.05), but no significant differences in survival could be demonstrated between patients randomized to postoperative radiotherapy or observation. It is concluded that postoperative radiotherapy as given in the present study is without any beneficial effect on relapse rate and survival. Moreover, the treatment is associated with an unacceptable complication rate.

Adult↗