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Biomedical subjects

L Forsberg

Publications and source records attributed to L Forsberg.

At least 19 recordsLinked to original sources
PubMed1992

Ultrasound, hepatic lymph nodes and primary biliary cirrhosis.

Thirty-five consecutive patients with primary biliary cirrhosis were examined using liver biopsy, laboratory tests and ultrasonography of the hepato-duodenal ligament to investigate the possible correlation between enlarged lymph nodes in the hepato-duodenal ligament and biochemical activity, histologic activity or stage and/or humoral immunoreactivity. We found a positive correlation between the size of the largest lymph node and laboratory values of cholestasis, hepatocellular damage and increased humoral immunoreactivity. On the other hand, we found a negative association between lymph node size and hepatocellular function. When twelve of the patients were reexamined after at least 10 months, in the majority of the patients changes in lymph node size were accompanied by similar changes in markers of cholestasis, hepatocellular damage and immunoreactivity. Prognostic index was also directly associated with lymph node size in most of these patients. No association between lymph node size and histologic stage was observed.

Adult↗
PubMed1991

Preoperative localization of enlarged parathyroid glands with ultrasonically guided fine needle aspiration for parathyroid hormone assay.

For preoperative localization of enlarged parathyroid glands, several imaging techniques have been used. In this study we demonstrate the feasibility of using ultrasonography with fine needle aspiration for parathyroid hormone assay as a preoperative localization procedure in 21 patients with primary hyperparathyroidism. A single adenoma was found in 18 patients while 3 patients had multiglandular disease. Ultrasonically guided fine needle biopsy was possible in 11 cases. In 8 of these aspirates, a high parathyroid hormone content was found. In all 8 cases the localization was confirmed at surgery. We conclude that the efficiency to preoperatively localize enlarged parathyroid glands is enhanced by fine needle aspiration.

Adult↗
PubMed1990

Percutaneous management of pyogenic hepatic abscesses.

Twelve patients (9 men, 3 women) with a mean age of 65 (54-78) years, with pyogenic hepatic abscesses were managed by percutaneous drainage between 1979 and 1987. Biliary origin was most common (4 patients), followed by hepatic abscesses as a late postoperative complication (seen in 3 patients) and hepatic abscesses occurring in association with acute appendicitis (2 patients). The origin was unknown in 3 patients. Diagnosis was reached by computed tomography or ultrasonography with a diagnostic delay of in mean 11 days. Seventeen abscesses were found among the 12 patients. The median abscess size (maximal diameter) was 7 (1-12) cm. Nine patients were treated with percutaneous drainage with an indwelling catheter within the abscess cavity for up to 3 weeks, while 3 patients were managed with percutaneous puncture and aspiration alone. The most commonly isolated organism from the drained hepatic abscess was E. coli. The course following percutaneous treatment was uneventful, without mortality and recurrence of the hepatic abscess during follow-up. One patient required surgical drainage of an additional hepatic abscess. Percutaneous drainage of hepatic abscesses, independent of origin, thus seems as a safe and reliable method, which should be considered as the treatment of choice if facilities and knowledge of percutaneous management are provided.

Aged↗
PubMed1990

Ultrasound examination of lymph nodes in the hepatoduodenal ligament.

Ninety patients, found to have lymph nodes in the hepato-duodenal ligament (HDL) on ultrasound examination were reviewed over a one-year period in order to define the diseases in which such nodes can be found. The patients were divided into four main groups: benign liver disease (n = 31), malignant disease (n = 26), disease of the gallbladder or the biliary tree (n = 14) and a group with various benign, most inflammatory diseases (n = 19). In 40% of the patients (36/90), the lymph nodes in the HDL were the only sign of disease on ultrasound examination, and the majority of those were in the benign group.

Adolescent↗
PubMed1990

One hundred impotent men.

One hundred men complaining of poor or absent erectile capacity were investigated with a multidisciplinary approach. Their median age was 47 years. Mainly organic causes of the erectile failure were found in 27 and mainly psychologic in 40 cases, while factors of both types contributed in 33 cases. Vascular disorder was present in 20 men, including (functional) vasoconstriction in eight. Among 24 men with serum testosterone below 15 nmol/l the incidence of arterial disease, alcoholism and partner-related problems was significantly higher than in those with higher testosterone levels. Most psychologic factors were in general intrapsychic (affecting only the patient himself), while a minority were dyadic (related to the partner).

Erectile Dysfunction↗
PubMed1990

Entrapped ovarian cyst. An unusual case of persistent abdominal pain.

Recurrent abdominal pain in the left fossa often mimicking attacks of subileus is described in a woman aged 48 with extensive adhesions caused by multiple surgical procedures. Repeated examinations with conventional abdominal radiography and barium meals were negative with regard to mechanical intestinal obstruction. A cystic lesion varying in size from 2 to 8 cm in diameter was seen adjacent to the left ovary on repeat US examinations and also on CT. Pain episodes were sometimes correlated to increasing size of the lesion which was finally thought to be either a peritoneal inclusion cyst (fluid trapped between pelvic adhesions) or, as was finally confirmed at surgery, a true ovarian cyst (corpus luteum cyst) similarly trapped.

Abdominal Pain↗
PubMed1990

Ultrasonography and Doppler Duplex compared with angiography in follow-up of mesocaval shunt patency.

Thirty-four patients with portal hypertension of various etiologies were operated upon with an interposition mesocaval Goretex graft. During a period of 6 years 84 angiographic and ultrasonographic (US) examinations (53 B-mode, and 31 Doppler Duplex) were performed, with few exceptions within 3 days. Angiography served as the 'gold standard'. Shunt patency was correctly interpreted as normal in B-mode US in 38 examinations. Shunt occlusion, definite or probable, was seen in 12 B-mode examinations, where angiography demonstrated occlusion in 6 and patency in the remaining 6 shunts. Shunt occlusion was not observed sonographically in one examination. US was technically inadequate on two occasions. Doppler Duplex showed shunt patency in all 31 examinations, which was correct according to angiography. Both B-mode US, in 6 out of 6 examinations, and Doppler Duplex, in 7 out of 9 examinations failed to reveal shunt stenosis. Five patients with abundant venous collaterals (in one case with aberrant vascular anatomy) were not possible to evaluate even after the introduction of Doppler Duplex, which otherwise facilitated the evaluation. We suggest that US including Doppler should be the primary modality for follow-up in patients with interposition mesocaval Goretex grafts.

Adolescent↗
PubMed1990

Diagnosis and percutaneous treatment of pyogenic hepatic abscesses.

Twelve patients with intrahepatic abscesses were examined with computed tomography and ultrasonography between 1979 and 1988. The median size of the lesions was 7 (1-12) cm. They were in 8 patients located only in the right liver lobe and in 3 in both liver lobes. On ultrasonography the echogenicity of the abscesses varied from hypo- to hyperechoic which is consistent with tumours. The final diagnosis of abscess was achieved by fine needle puncture and aspiration for bacterial culture. Nine patients were treated with percutaneous drainage. 3 of them with two catheters, and all received systemic antibiotic treatment. All patients survived the treatment.

Aged↗
PubMed1990

Percutaneous puncture and drainage of pancreatic pseudocysts. A retrospective study.

Experience with 19 consecutive patients who had 20 pancreatic pseudocysts treated by percutaneous puncture and/or drainage was reviewed. Ten pseudocysts (5 infected, 5 non-infected), underwent complete resolution after percutaneous treatment only and there was a considerable regression in 6 (5 infected, 1 non-infected), which means an overall cure rate of 80 per cent. Only one small pseudocyst remained unchanged. Complementary surgery was necessary in 3 cases. Fine needle evacuation was the method in 13 cases (11 cured) and catheter drainage in 7 (5 cured). We conclude that percutaneous drainage is a safe method for the treatment of pancreatic pseudocysts, that will cure the patient in most cases.

Adult↗
PubMed1989

[Acute cholecystitis. Percutaneous cholecystectomy guided by ultrasound as a therapeutic alternative for seriously ill patients].

Ultrasound guided percutaneous cholecystostomy was performed in nine episodes of acute cholecystitis in seven patients unsuitable for laparotomy owing to advancedage (mean 79 years) and the presence of other serious disease. No serious complications were observed (the importance of satisfactory local anaesthesia and minimal catheter manipulation is emphasized); and satisfactory pain relief was obtained almost instantaneously. The procedure would seem to be an acceptable alternative to cholecystectomy in cases of severe acute cholecystitis where laparotomy must be avoided.

Acute Disease↗
PubMed1989

Liver biopsy complications monitored by ultrasound.

Ultrasound (US) was performed in 96 patients (on 108 occasions) 2-4 h after diagnostic liver puncture with a modified Menghini needle. Serious complications (major haemorrhages: one intraparenchymal and one into the abdominal cavity) were seen in two patients, while seven presented with minor bleedings though without any registered clinical abnormality (slight pain in one). On 11 occasions (10 patients) slight to moderate pain was observed though in combination with a normal US. Findings on US and clinical observations showed poor correlation and the number of bleeding complications discovered by US examination seems to depend upon when the study is performed. US does not replace the clinical follow-up but may be helpful in the presence of adverse clinical reactions in order to establish the type of lesion: profuse parenchymal haemorrhage versus bleeding into the abdominal cavity. This information may be helpful in the choice between conservative and surgical therapy.

Adult↗
PubMed1989

Severe arterial insufficiency in impotence confirmed with an improved angiographic technique: the impact of smoking and some other etiologic factors.

Arteriography of the penile arteries in patients with pharmacologic erection has been performed by our group since 1983. Pathological Doppler findings and weak response to locally administered papaverine or alpha-blocking agents in these impotent men led to pharmacoangiography in 17 of 372 patients with erectile dysfunction; of these 372 patients 130 (35%) had subnormal penile blood flow according to Doppler ultrasonography. Only one had a proximal lesion (occlusion of the right common iliac artery) while the rest had distal lesions. Three patients were nonsmokers and the remaining 14 patients (82%) were smokers or had smoked previously. Only 2 of the 14 had other predisposing diseases.

Aged↗
PubMed1989

Etiologic aspects of impotence in diabetes.

An investigation of 37 diabetics with impotence (15) or erectile difficulties (22) is presented. On average two significant abnormalities per patient were found. Ranked in order of incidence, the causes were as follows: 1) Combination of neuropathy and psychosocial factors, 2) combination of neuropathy and vascular disease, 3) peripheral neuropathy only, 4) combination of hormonal imbalance and psychosocial factors, 5) combination of three or more defects, and 6) penile vascular disease or psychosocial problems only, or hormonal imbalance combined with peripheral neuropathy.

Diabetic Angiopathies↗