Biomedical subjects
Publications and source records attributed to J Friis.
An 18-year-old, previously healthy, woman was admitted to hospital because of haematemesis. Endoscopy showed large varices in the fundus of the stomach. Further investigations revealed segmental portal hypertension caused by situs inversus of the spleen. The case illustrates the importance of considering causes other than liver diseases in variceal bleeding.
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Forty-nine patients under the age of 65 years, who had a low anterior resection performed for cancer of the midrectum, were interviewed. Eight patients were sexually inactive before the operation and were excluded. Postoperatively thirty-five had normal sexual function. Two male patients developed transient erectile impotence while two female patients had given up active sexual life after the operation because of dyspareunia. Two patients, one male and one female had permanent impairment. It is concluded, that severe sexual dysfunction can be seen after low anterior resection for cancer, but no early conclusion about permanent sexual dysfunction should be drawn.
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We review the symptoms, diagnosis and treatment of extrarenal and renal angiomyolipomas. The pathological anatomy is described and it is maintained that renal localization of angiomyolipoma is by far the most common. A case is reported of an extrarenal angiomyolipoma that was revealed by exploratory laparotomy. Treatment is always surgical, since it is difficult to establish the differential diagnosis preoperatively. Angiomyolipoma is a benign tumor and malignant degeneration has not been observed. However, there is a tendency toward recurrence if the entire tumor is not removed.
Concanavalin-A-induced suppressor cell activity was investigated in 63 patients with a definite diagnosis of juvenile rheumatoid arthritis. Peripheral blood lymphoid cells from these patients did not have the same ability as cells from normal individuals to suppress the proliferative response of autologous cells, responding to phytohaemaglutinin, Candida albicans antigen, or allogeneic cells. No correlation was found between suppressor activity, disease activity, or number of joints involved. Nor was there any significant association between decreased suppressor cell activity and HLA-A, -B, -C, -D antigens, although there was a tendency towards association between decreased suppressor cell activity and HLA-B27.
Low anterior resection for carcinoma in the mid- and lower third of the rectum has been performed with autosuture technique, using the EEA autosuture stapling instrument in 38 patients, 26 with carcinoma, 10 with diverticulitis, and 2 with Crohn's disease. In 16 patients the anastomotic line was 4-6 cm above the anal verge, and in 22 patients 7-12 cm above the anal verge. Thirty-two patients (80%) had an uneventful postoperative course. Four patients had complications: one, with leakage from a very low-seated anastomosis, was treated with an abdominoperineal resection; 2 had temporary transversostomy performed due to minor anastomotic leakage; and 1 patient developed a fistula, which closed spontaneously. Two patients died, 1 from pulmonary embolism, 1 from cerebral thrombosis. The EEA stapling instrument seems safe, and approximately 42% of the patients in this material would formerly have been subjected to abdominoperineal resection and permanent colostomy.
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A case of Reiter's disease occurring in a girl aged 7 is reported. It commenced with diarrhoea precipitated by a salmonella infection. The patient has suffered from recurring arthritis accompanied by conjunctivitis, oral lesions and nail changes. The course was protracted, the patients having had two recurrences during a period of 6 1/2 years. The first of these lasted for more than one year, the second for a few months. The patient carries the histocompatibility antigen HLA B27 and a review of the literature would seem to establish that the correlation between Reiter's disease with childhood onset and this tissue antigen is as close as that reported in adults. It is stressed that the patient is now in complete remission and that no radiological changes have been demonstrated despite the protracted course. The patient shows no signs either of spondylitis or of sacro-iliitis.