PubMed Health⌕ Search

Biomedical subjects

Jon Arne Søreide

Publications and source records attributed to Jon Arne Søreide.

6 recordsLinked to original sources
PubMed2006

Bile duct cyst as precursor to biliary tract cancer.

BACKGROUND: Bile duct cysts (BDC) are rare, of uncertain origin, and occur most often in young females of Asian descent. Increasingly, BDCs are reported in the Western population, often with coexistent biliary tract cancer. METHODS: The PubMed and Medline literature databases were searched for pertinent publications regarding the clinical association and molecular biological development of cancerogenesis in BDC. Reports from the last two decades were emphasized. RESULTS: Cancer is found in 10-30% of adults with BDC. The cancer-risk is low in childhood (<1% in the first decade), and shows a clear increase with age. Cholangiocarcinoma is the most common malignancy in BDC, and represents a 20- to 30-fold risk compared to the general population. The mean age of malignancy in BDC is 32 years (about two decades earlier than in the general population). Type I and type IV cysts show a higher cancer incidence, even after cyst excision. Pathological findings strongly suggest a hyperplasia-dysplasia-carcinoma sequence in carcinogenesis of pancreatico-biliary maljunction (PBM). Reflux of pancreatic enzymes, amylase, bile stasis, and an increased intraductal concentration of bile acids contribute to proliferative activity of bile acids in BDC. While microsatellite instability, k-ras mutations, expression of COX-2 and bcl-2, and increased telomerase activity seem to occur early; involvement of cyclin D1, beta-catenin, DPC-4/Smad4 and p53 appear later in carcinogenesis. CONCLUSION: Increased molecular knowledge substantiates the clinically related cancer-risk in BDC. Surgery remains the golden standard for treatment, relieves patients from associated complications, and interrupts the cancerous potential in BDC.

Bile Duct Diseases↗
PubMed2006

Benign peritoneal cystic mesothelioma.

BACKGROUND: Benign peritoneal cystic mesothelioma (BPCM) is a rare tumor of unknown origin, most frequently encountered in women of reproductive age. Etiology is unknown; definitions and terminology are confusing, and preoperative diagnosis is difficult. Several differential diagnoses must be considered. METHODS: Based on our own clinical experience and a review of the relevant literature, we address clinical challenges and controversies of importance. RESULTS: Current literature on BPCM is mostly based on small case reports. Complete surgical resection is recommended if possible. Nevertheless, recurrent disease is not uncommon. Clinical positive effects of various adjuvant medical treatments remain to be shown. CONCLUSIONS: Lack of consistent definitions, various treatment approaches, and mostly short follow-up times make it difficult to draw any firm conclusions from published reports. The natural history of this rare disease is less than well clarified. When possible, in an individual patient, surgical resection with curative intent seems to be the treatment of choice.

Aged↗
PubMed2005

[A 90-year-old woman with acute abdomen].

Bowel strangulation is defined as mechanical obstruction associated with compromised blood circulation of the bowel wall. Delayed diagnosis and treatment are the main causes of the high mortality. A 90-year-old woman was admitted to our hospital with acute abdominal pain. Plain abdominal x-ray studies were inconclusive. However, bowel strangulation was suggested by computer tomography and the diagnosis was confirmed under the laparotomy. In the case of bowel strangulation, abdominal CT is a fast, reliable and useful diagnostic tool when imaging is considered necessary before a laparotomy.

Abdomen, Acute↗
PubMed2005

[Thyroid surgery in Rogaland].

BACKGROUND: Thyroid surgery is performed at both hospitals in Rogaland county. In this retrospective study we compare clinical features, including preoperative diagnostics, type of surgery, and recorded postoperative complications. MATERIALS AND METHODS: Between 1994 and 1998, 380 patients (89% women) underwent thyroid surgery. Data were retrieved from hospital records and surgical notes. Non-parametric methods were employed for statistical analysis. RESULTS: The annual operative incidence per 100,000 inhabitants was 20.5; there was no significant difference between the two hospitals. Median age was 45 years (range 14-85). Two thirds of the procedures were done at Rogaland Central Hospital (SiR). At Haugesund Hospital (HS) 31% of the 120 patients were operated in the department of ear-nose-throat diseases. Ultrasound of the thyroid gland was requested more often at HS, whereas thyroid scintigraphy was more frequently done at SiR. Fine needle aspiration cytology was performed on 80% of the patients, including non-representative samples in 13% at HS and 8% at SiR, respectively. Hemithyroidectomy was the most frequently performed operation. The operative mortality was zero. Postoperative complications were few: permanent hypoparathyroidism was encountered in two (0.5%) patients and unilateral permanent vocal cord paralysis in five (1.1%) patients. INTERPRETATION: Our results are in accordance with national and international standards. Observed differences in preoperative diagnostics are most likely explained by different traditions among general practitioners and different access to imaging modalities. Implementation of updated guidelines for referral and work up of this group of patients are warranted.

Adolescent↗
PubMed2002

[Hurler's syndrome--early clinical suspicion].

BACKGROUND: Hurler's syndrome is a rare congenital metabolic disorder and is inevitably lethal when untreated. The presenting symptoms are usually vague, resembling those found in otherwise healthy children. MATERIAL AND METHODS: We present a patient with Hurler's syndrome and discuss the unspecific clinical signs and symptoms seen in these patients based on a review of relevant literature. RESULTS: A two-months-old infant boy was operated for a rightsided inguinal hernia. The anaesthesiologist had difficulty intubating the patient. During the following months the patient had a severe allergic reaction to vaccination, chronic rhinitis with recurrent upper airway infections, and diarrhoea and vomiting. Eventually, failure to gain weight, and psychomotoric delay led to a thorough clinical investigation. Extensive X-ray diagnostics and analysis of urine and serum concluded with Hurler's syndrome. INTERPRETATION: Clinical vigilance is needed in the diagnosis of Hurler's syndrome. Early symptoms, such as rhinitis and hernia, are vague and unspecific. Radiological features, such as broad costae or gibbus, are helpful in obtaining the diagnosis. Decreased level of alpha-L-iduronidase in serum confirms the diagnosis of Hurler's syndrome. Patients tend to be treated symptomatically before the eventual diagnosis of this syndrome.

Diagnosis, Differential↗