Biomedical subjects
Publications and source records attributed to K Borup.
We here describe a patient where a process in the ureter initially suspected to be potentially malignant turned out to be a fibroepithelial polyp, diagnosed and treated endoscopically. The kidney function and the excretory urogram three years after the treatment were normal.
In a large proportion of enuretics, the enuresis episodes are accompanied by high urine output at night. At this study we provoked a high urine output in normal non-enuretic children in order to investigate whether volume provocation per se could cause enuresis. In six of ten children it was possible to provoke nine enuresis-like episodes. The enuresis volumes were small with no relation to functional bladder capacity. It is concluded, that increased urine output at night may produce enuresis-like episodes even in normal children.
True hermaphroditism was found in a phenotypically normal boy admitted to the urology department with the diagnosis of right undescended testis. The tissue expected to be cryptorchid proved to constitute an ovary, uterus and salpinx. Normal left testicular tissue was found at biopsy. The patient's genotype was 46 XX.
A retrospective investigation was undertaken concerning 552 patients who were submitted to appendectomy on account of suspected acute appendicitis during the period January 1 1983-December 31 1987. The diagnostic certainty was found to be 69%. A total of 14.3% (79/552) developed postoperative complications, including 20 patients in whom normal appendices were removed. Some of the complications were possibly attributable to the cause of the symptoms of acute appendicitis but this was not possible to determine by review of the case records. No differences were found in the frequencies of complications in whom normal appendices were removed as compared with those in whom inflamed appendices were removed. The frequency of perforation was 17.2% (95/552) which is in agreement with the findings in previous investigations. It may thus be concluded that the incidence of complications associated with removal of a normal appendix is no greater than after removal of an inflamed appendix. Removal of a normal appendix is, however, not a harmless procedure. The incidence of "negative appendectomy" must be reduced by meticulous observation and repeated reassessment of the patient and employment of other diagnostic aids e.g. ultrasonic scanning or laparoscopy in order to confirm or refute the diagnosis prior to possible operation.
The course of delivery and fetal outcome in 149 women with forecoming normal pregnancy and a prepregnancy body mass index (BMI) less than 20.0 were compared to a similar group of women with BMI between 20.0 and 24.9 after matching for age and parity. None of the women was undernourished. Suspected intrauterine asphyxia was significantly more common in primipara with BMI below 18.0 than in their controls (6/12 vs. 1/12), and there was a trend towards fewer babies weighing at least 4,000 g in the women with low BMI. No other significant differences related to BMI were found. It is concluded, that constitutional low weight for height is not a predictor of complications during delivery, and no special observation of this group is recommended.
Malignant transformation occurs in about 2% only of ovarian dermoid cysts. The clinical and histopathological findings in a rare case of primary ovarian malignant melanoma of amelanotic type are presented.
The diagnosis periappendicitis is well known. The causes to periappendicitis are manifold. In the literature, we have not yet found a case, where periappendicitis developed because amnion fluid passed to the peritoneum during an elective section. We present a case, where a patient, 5 days after an elective section, developed the symptoms of appendicitis. The pathologic diagnosis is periappendicitis, presumably developed because of the amnion fluid.
The incidence of cutaneous malignant melanoma is increasing. The behaviour of the spread is unpredictable. The case report of a woman with cutaneous malignant melanoma which spread to the ovaries is presented.
A patient who had been sterilised laparoscopically four years previously was admitted with torsion of the left salpinx from the site of electrocoagulation and outwards. Tubal torsion is thus a possible late complication of laparoscopic sterilisation.
The course of deliveries in 134 obese women in whom the pregnancies had been normal were compared with a matched control group of women with normal weights. More of the obese women had second stages of labour lasting for more than one hour. Apart from this no differences were observed in the frequencies of complications, the nature of the complications or the number of interventions during delivery. The frequencies of infants weighing more than 4,000 g were identical in both groups but were high compared with other investigations. In the group of obese mothers, significantly more infants were found to have Apgar scores of 7 or less after one minute. An association was found between a long second stage and low Apgar score in five out of 12 infants in the obese group. Two out of three infants with shoulder dystocia, all born to obese mothers, had low Apgar scores. It is emphasized that in obese parturient women, particular care should be employed to ensure optimal conditions in the active phase and during the actual delivery. Stimulation with syntocin and episiotomy are recommended on liberal indications. Apart from this, there does not appear to be any need for increased observation of obese parturient women, provided that pregnancy has been normal.
The authors report a case of isolated torsion of the Fallopian tube in a thirteen years old girl. Only because of laparoscopy, the diagnosis was determined. Torsion of the fallopian tube as a differential diagnosis to acute abdomen is discussed.
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The Authors illustrate a case of torsion of the Fallopian tube in a young girl not yet sexually active. Even though this pathology is very rare in childhood and early puberty, torsion of the fallopian tube should be considered as a possible differential diagnosis in intermittent abdominal pain.