Biomedical subjects
Publications and source records attributed to J Oland.
During a 12-year period, 10 men and 5 women ranging in age from 22-76 (mean 53 years), were treated for liposarcoma. In 7 the tumor was located in the retroperitoneum, in 5 in the lower extremity and in 1 each, in the back, shoulder and groin. The best results were given by wide excision of the tumor followed by chemo or radiotherapy.
The only acceptable definitive diagnosis of a soft tissue mass is histologic or cytologic examination. In recent years, fine-needle aspiration cytology is used in more and more centers for diagnosis of soft tissue masses. We studied 196 aspiration cytologies performed on soft tissue lesions. Out of these, in 48 cases a definitive surgical procedure or open biopsy for histology and further evaluation were performed. There were 25 sarcomas and 23 benign tumors. There was one false negative cytologic result in this group; no false positive cytologies were detected. It seems that cytodiagnosis of soft tissue masses performed by an experienced pathologist is the method of choice, permitting a good diagnostic evaluation, with almost none of the traumatic and oncologic disadvantages of the other methods of biopsy.
Fine needle aspiration cytology has been increasingly used in recent years to diagnose pancreatic lesions. During a 6 year period, we performed 33 aspiration cytologies of the pancreas. Twenty-one were performed during exploratory laparotomy, seven under the guidance of computed tomography and five guided by ultrasonography. In seven cases inflammatory lesions were found, while 26 cases were of malignant tumors. Out of these patients, 10 underwent additional tissue biopsy. The correlation between cytology and histology was 100%. We suggest that fine needle cytology of pancreatic and other intraabdominal lesions can be considered an accurate diagnostic procedure.
The location of the pancreatic tail in the lienorenal ligament and its relationship to the splenic hilus were studied in 32 computed tomography (CT) scannings and in 37 autopsy specimens. We found several anatomical variations in both study groups: the pancreatic tail did not penetrate the lienorenal ligament in 24% of the autopsy specimens and in 37.5% of the CT group. The tail was adjacent to the splenic hilus in 29.7% of the autopsies and in 25% of the CT group. We classified the anatomical variations into 4 categories, three of which could be well demonstrated on CT with satisfactory correlation to the anatomical findings of the autopsy specimens.
Fifty-four patients over the age of 40, with direct inguinal hernias were studied. Thirty-two of them underwent operation with the anterior rectus sheath flap, and 22 patients in whom the hernias were repaired by the method described by Bassini served as the control group. We could not demonstrate any significant difference between the two groups in regard to length of hospital stay, complications, and recurrence rate. There was only one recurrence in the rectus flap group. Anterior rectus sheath repair proved to be easy to perform and comfortable for the patient.
A case of localized, perforated diverticulitis of the transverse colon in a 45-year-old woman is presented. Preoperatively, this rare disease is indistinguishable from other acute surgical conditions, and often is mistaken for carcinoma at laparotomy. This report increases awareness of this unusual condition, and emphasizes the clinical, diagnostic, and therapeutic implications. Case reports described in the literature are reviewed.
Four members of the same family operated on for acute retrocaecal appendicitis are reported. It is suggested that they provide further support for the hypothesis that an hereditary factor might be involved in the pathogenesis of acute appendicitis.
A 5-month-old infant presented with severe dyspnea and dysphagia resulting from a right-sided cervical mass. At 5 months of age, a large aberrant thymus was excised, resulting in the disappearance of all symptoms. Pathological examination showed normal thymus tissue. Since the preoperative chest X-ray film showed a normal thymic shadow and the T-lymphocyte functions were normal, we conclude that this was not an ectopic gland but an undescended thymic implant.
The theory that insufficiency of the spermatic cord layers could be the etiological factor in the development of varicocele is reviewed critically. A prospective study of 40 patients operated upon for a left indirect inguinal hernia was done. The spermatic cord layers were excised as a routine part of the operation but combined manual and Doppler examinations revealed no postoperative reflux into the pampiniform plexus. We conclude that the spermatic cord layers probably do not have a major role in the pathogenesis of varicocele.
Small-bowel obstruction in an old woman was the result of a twisted Meckel's diverticulum containing a large neoplasm. As neoplasms comprise only 1.2-1.4% of the complications of the diverticulum, and generally bleed or cause intussusception, we believe that the condition described is not common.
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