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K Højgaard

Publications and source records attributed to K Højgaard.

At least 19 recordsLinked to original sources
PubMed2002

Long term follow-up of superficial invasive bladder carcinoma with or without concomitant epithelial atypia--recurrence and progression.

OBJECTIVE: To examine the significance of concomitant epithelial atypia on late recurrence and progression by long-term follow-up of superficial invasive bladder tumours (stage T1). MATERIAL AND METHODS: Seventy consecutive, unselected patients with newly diagnosed transurethral resection (TURB)-treated stage T1 bladder tumour, and at least 1 year progression-free survival. Preselected site biopsies (PSB) were obtained prospectively to evaluate the significance of concomitant urothelial atypia. Followed for up to 17.6 years. RESULTS: The cumulative probability of recurrence (overall) was 85%, and for new stage T1 tumour 70% after 10 years. Forty per cent of those who survived 5 years without recurrence, were readmitted with often invasive recurrence later. Positive PSB significantly (p < 0.0001) predicted new T1 tumour. Progression (T2+ or metastases) occurred in 27 cases (39%) after the first year. The cumulative probability was 60% (15 years), with a mean progression-free interval of 64 months. Positive PSB, size >3 cm and early recurrence were significant predictive factors in multivariate analysis. CONCLUSION: T1-tumours are at high risk for late invasive recurrence and progression, especially if associated with urothelial atypia elsewhere in the bladder.

Adult↗
PubMed1998

Long-term survival of patients with bladder tumours: the significance of risk factors.

OBJECTIVE: To evaluate the significance of known risk factors, accessible by simple endoscopic and histological/cytological examination, on the clinical course and long-term survival of patients with superficial urinary bladder tumours. PATIENTS AND METHODS: The study included 584 consecutive unselected patients, primarily admitted between 1976 and 1984 for newly diagnosed bladder tumour, which was superficial (Ta, T1, Tis) in 362. The patients were followed routinely in a control programme; causes of death were obtained by autopsy (44%), from hospital files (33%) or from death certificates (8%), the remaining patients being alive at the end of the study, up to 20 years after initial diagnosis. Known risk factors, e.g. tumour size, histological grade, multiplicity and positive urine cytology, and dysplasia as assessed by random or pre-selected site biopsies, were evaluated as predetermining factors for new occurrences and survival. RESULTS: Invasion of the lamina propria was the most significant prognostic factor detected in the multivariate analysis. While 14% of patients with Ta tumours had died from cancer after 15 years, 63% of the T1 tumours were eventually fatal, reaching the mortality of those with T2 disease. Other independent significant factors were tumour size and, to a lesser extent, histological grade. Multiplicity and concomitant epithelial changes, as assayed by voided urine cytology and pre-selected site biopsies, were relevant prognostic factors for Ta but not for T1 tumours. CONCLUSION: In the therapy and surveillance of superficial urinary bladder tumours, the presence of lamina propria invasion is very important.

Adult↗
PubMed1995

Prognostic significance of DNA content in bladder cancer based on flow cytometric analysis of 249 transitional cell carcinomas.

The prognostic significance of DNA index (DI), S-phase fraction, and heterogeneity determined by flow cytometric DNA analysis was assessed in a prospective study of 249 newly diagnosed transitional cell carcinomas of the bladder. The median observation time was 4.8 years. A total of 456 subpopulations were detected. The S-phases could be estimated in 299 subpopulations. A DI > 1.25 or an S-phase above 9.7% were strongly correlated to invasiveness. One hundred and ten patients were treated with transurethral resection (TUR). Relapse-free survival could not be predicted by the DNA-derived parameters. Univariate analysis of survival showed prognostic significance of diploidy (0.98 < DI < or = 1.02, P = 0.02), hypotetraploidy (1.50 < DI < or = 1.96, P = 0.002), and S-phase size (P = 0.008). Multivariate analysis pointed to the T-classification (RR = 1.64) and hypotetraploidy (RR = 1.57) as prognostic parameters for survival of TUR-treated patients. One hundred and thirty-nine patients received radiotherapy (RT). A significantly better response was found for tumors with a subpopulation with a hypertetraploid DNA content (DI > 2.04, P = 0.05), and a significantly worse response for subpopulations with a maximum S-phase > 24.5% (P = 0.04). T-classification and histological grade had no predictive value. A logistic regression analysis indicated an estimated probability of response to RT of 77% for tumors with a DI > 2.04 and an S-phase < 24.5%, whereas tumors with a DI < 2.04 and an S-phase > 24.5% had only a 28% probability of response. The poor response to RT, predicted by an S-phase > 24.5%, translated into a poor survival, whereas the better treatment response found for patients with a DI > 2.04 did not result in a longer survival. Multivariate analysis pointed to S-phase (RR = 1.70), T-classification (RR = 1.60), and grade (RR = 0.65) as independent prognostic parameters for survival of RT-treated patients.

Adult↗
PubMed1991

[3-year experiences with surgical treatment of epilepsy at the Hvidovre hospital].

The results of a retrospective survey of 48 patients submitted to neurosurgery for medically intractable epilepsy are presented. Twenty-eight patients were treated with selective amygdalohippocampectomy, one with temporal lobe resection, 12 with anterior callosotomy and seven with a total callosotomy. Of the amygdalohippocampectomized patients and the one with temporal lobe resection (n = 29), 52% were seizure free, 17% experienced rare seizures, 7% had a worthwhile improvement while 24% observed no worthwhile improvement (follow-up time 6 to 36 months). Of the callosotomized patients, 11% were free from generalized seizures, 69% had a significant seizure reduction and 18% experienced no worthwhile improvement. The observed neurological complications were: one patient had hemianopia, one had superior quadrant anopia, four developed unilateral anosmia and one complete anosmia. The callosotomized patients, with two exceptions, were all mentally and physically handicapped. In the callosotomy group, two patients died, one from a intracerebral hematoma three months after the operation and another patient seven months postoperatively from unknown causes.

Adult↗
PubMed1990

Diagnostic value of an abnormal smear in non-pregnant women. Evaluation of positive smear from the surface of the portio obtained by the cottonswab method or by the dry wooden Ayre spatula and the relevance of positive smear from the endocervix and/or from the surface of the portio.

During a 3-4 year period, 324 women with a positive smear were registered consecutively and prospectively and divided into two groups according to the design of the investigation. In one group the smear was taken with an Ayre spatula and in the other group with a cotton swab. The purpose of this investigation has been to make a comparison between the endocervical smear and the smear taken from the surface of the portio and at the same time between the samples taken with a dry wooden Ayre spatula and with a cotton swab. No differences were found. The cytological findings have been registered and correlated both with the histological findings by colposcopically directed punch-biopsies and endocervical curettings and with the final histological diagnosis obtained by punch-biopsy, conization or hysterectomy.

Adolescent↗
PubMed1988

Urothelial atypia and survival rate of 500 unselected patients with primary transitional-cell tumour of the urinary bladder.

In a consecutive series of 500 unselected patients with primary urinary bladder tumours the influence of urothelial atypia on the 5 years survival-rate was examined. All tumours were transitional-cell tumours categorized according to the T-classification. Mucosal biopsies from 7 pre-selected sites were taken at the initial cystoscopy in 391 patients (78%) to identify urothelial atypia. The over-all cumulative 5 years survival-rate was 48%. Submucosal and muscle invasion had major influence on survival, whereas tumour grade was less important. Patients with urothelial atypia fared significantly worse than those with normal bladder mucosa (5 years survival 42% versus 62%). This difference in survival-rate became apparent first after two years of observation. Grade II atypia in the bladder mucosa and grade III (carcinoma in situ) had equal significance assessed by the survival-rates.

Adult↗
PubMed1987

Vigabatrin: no microvacuoles in a human brain.

Vigabatrin (gamma-vinyl-GABA) has been shown to be an effective antiepileptic drug. However, clinical investigations have been hampered by the finding of intramyelin edema (microvacuoles) in rats and dogs. In an autopsy study of a 38-year-old woman with astrocytoma, treated with vigabatrin 80 mg/kg body weight per day for over 6 months and 125 mg/kg body weight per day for the last 2 months as add-on therapy because of drug-resistant epilepsy, we did not find any microvacuoles in the brain. So far microvacuoles have never been observed in primates, warranting continued investigations of this promising antiepileptic drug.

Adult↗
PubMed1987

Urothelial atypia concomitant with primary bladder tumour. Incidence in a consecutive series of 500 unselected patients.

A consecutive series of 500 primary bladder tumours from a single clinic is presented, with distribution of the tumours according to T category and histologic type and grade. Mucosal biopsies were obtained from pre-selected sites at initial cystoscopy or initial transurethral resection of the tumour in 396 cases. In 54% of the patients with grade III tumour there was concomitant urothelial atypia, either carcinoma in situ (urothelial atypia grade III, 30%) or urothelial atypia grade II (24%). In 30% of the patients with invasive grade II bladder tumour and in 14% of those with noninvasive grade II tumour there was concomitant urothelial atypia, mostly grade II. Since concomitant urothelial atypia predicts new tumour growth after successful transurethral surgery or radiotherapy, mucosal biopsies should be performed at preselected sites during initial cystoscopy or transurethral tumour resection in order to identify high-risk patients.

Adenocarcinoma↗
PubMed1986

Endoscann cell sampling for cytological assessment of endometrial pathology.

Cytological samples of the endometrium obtained by Endoscann were compared with histological preparations from conventional curettage of the uterine cavity (D & C) in 275 women. Indications of D & C were irregular menstrual bleeding, postmenopausal bleeding, or suspected ovarian or cervical neoplasia in women of 50 years or more. The women were consecutively enrolled in the study and had an average age of 60.2 years (range 50-87). The cytological investigation detected all 16 cases of endometrial cancer but none of 6 cases of atypical hyperplasia. Insertion of the Endoscann cell sampler was easily performed in 87% of the patients in whom cervical dilatation was unnecessary. The cytological technique had 11 cases of insufficient material (4%). By D & C, sufficient material for histological evaluation could not be obtained in 32 cases (12%). The predictive value of a positive test with respect to endometrial carcinoma was 0.38, the corresponding sensitivity was 1.00, and the specificity 0.90. A positive cytology should lead to immediate further investigation.

Adult↗
PubMed1985

Urothelial dysplasia concomitant with bladder tumours: a determinant for future new occurrences in patients treated by full-course radiotherapy.

Concomitant urothelial dysplasia has been shown to predict new tumour occurrences after successful transurethral surgery of primary invasive bladder tumours. Of 114 patients with invasive bladder tumours treated by radiotherapy alone, 32 patients had complete primary tumour response and mucosal biopsies taken at preselected sites during initial cystoscopy. 10 of these patients had concomitant carcinoma-in-situ; in 7 new invasive tumours occurred 9-24 months after completion of radiotherapy. 4 of 9 patients with concomitant dysplasia grade-II also showed new invasive tumour growth. No new tumours developed in 13 patients without concomitant urothelial dysplasia who were followed for 9-75 months. Thus, the presence of concomitant carcinoma-in-situ in patients treated by radiotherapy predicts new invasive tumour growth, whereas its absence favours a very good prognosis. Patients with carcinoma-in-situ concomitant with invasive bladder tumours are not suitable for full-course radiotherapy as the only treatment.

Carcinoma in Situ↗
PubMed1983

Urothelial dysplasia concomitant with bladder tumours as a determinant factor for future new occurrences.

Of 53 patients with primary bladder tumours of categories T1 or T2 about 50% had concomitant urothelial dysplasia, either carcinoma-insitu or less dedifferentiated dysplasia graded as grade II. In a follow-up study of these patients treated with transurethral resection alone, it was found that new occurrences had developed in 87% of patients with concomitant urothelial dysplasia, compared with 26% of those without dysplasia. Most new occurrences developed within 6 months of initial tumour resection. A new invasive tumour developed in all patients with concomitant carcinoma-in-situ, emphasising the serious prognostic significance of that entity. Thus, urothelial dysplasia concomitant with a bladder tumour is an important determinant factor for future new occurrences.

Biopsy↗
PubMed1983

Prognostic factors in local surgical treatment of invasive bladder cancer, with special reference to the presence of urothelial dysplasia.

Thirty-three patients with bladder cancer of categories pT1 or pT2 were treated by transurethral resection alone. At the initial diagnosis random preselected site mucosal biopsies were obtained to demonstrate the presence or absence of concomitant urothelial dysplasia. A statistically significant (P less than 0.01) relationship was found between the presence or absence of concomitant urothelial dysplasia and the development of new occurrence or the absence of recurrence at cystoscopic follow-up. Four of six patients with concomitant carcinoma in situ developed invasive bladder cancer within 6 months demonstrating the serious prognostic significance of this entity. Thus, the presence or absence of concomitant urothelial dysplasia at the initial diagnosis of invasive bladder cancer seems to be an important prognostic factor for future new occurrences.

Adult↗
PubMed1983

Brain CT-scanning and neurological examination in small cell bronchogenic carcinoma.

A brain CT-scan and a neurological examination were performed on forty-nine consecutive patients with small cell bronchogenic carcinoma before the start of chemotherapy and every three months thereafter. Contrast-enhancement was used in 90% of the CT-scans. Ninety percent of the neurologic examinations were performed by the same neurologist. No prophylactic cranial irradiation was given, and cranial irradiation was withheld if a CT-scan indicated metastases, unless the patient was symptomatic. Thirty-five patients are evaluable including 34 with a brain autopsy. CNS-metastases were found in 18 patients. Two of them had not been examined within three months of autopsy and are excluded from the calculations of diagnostic accuracy. Of the remaining 16 patients 10 had a correct diagnosis of cerebral metastases made by CT-scan, while the neurologist made 11 correct diagnoses of CNS-metastases. Seventeen patients did not have CNS-metastases including one patient alive and free of disease. Fifteen and 11 were judged to be free of metastases by the CT-scan and the neurologist, respectively. Two patients with negative autopsies had positive CT-scans turning negative at subsequent examinations. Two had positive CT-scans which became negative and at autopsy CNS-metastases were located at different sites from those initially indicated by CT. The positive predictive value of CT-scan was 71%, while the negative predictive value was 71%. In conclusion, routine CT-scan and neurological examination are equally sensitive but have low yields when there is no clinical suspicion of CNS-metastases. The predictive value of CT-scanning could possibly be higher with the newer generations of equipment.

Aged↗
PubMed1982

Superficial eosinophilic squamous epithelial cells in vaginal smears from postmenopausal women.

19 500 vaginal smears from women aged 20-90 years were examined from August 1976 to November 1979. 3 000 were from women more than 55 years of age. 146 of these had smears with an increased proportion of superficial eosinophilic squamous epithelial cells (SESEC). The smears were divided into four groups, A-D with 0-25%, 25-50%, 50-75% and 75-100% of SESEC of the examined squamous epithelial cells. 39% of the 146 with increased proportions of SESEC were either undergoing treatment with estrogenic hormones, or else the possibility of estrogenic influence could not be ruled out. In group D the possibility of an estrogenic influence was more pronounced, here found to be 67%. In 32% of the 146 cases we believe that these cells were possibly the result of changed anatomical conditions in the cervix/vagina. Such an explanation seems most frequently probable in groups A and B. In 5% of the 146 cases the cells appeared changed, as can be seen in trichomoniasis. In 21% the discovery of the cells could not be explained. Finally, no explanation could be found for 5% in group D.

Age Factors↗
PubMed1980

Dentition on Umm an-Nar (Trucial Oman), 2500 B.C.

Teeth and jaws excavated from three burial cairns on the island of Umm an-Nar outside Abu Dhabi were examined. Dating: 2500 B.C. The number of individuals buried was estimated from the dentitions. In spite of the bad condition of the sparse material an attempt was made to give an impression of non-metric and metric traits of the teeth. The teeth showed Caucasoid but no Mongoloid traits. They were small, worn at an early age, with abundant calculus, multiple fractures but no carious lesions. The percentages of agenesis of third molars in the three graves were equal. Alveoloclasia appeared frequently. The population would seem to be hunters and fishermen rather than agriculturists.

Adolescent↗