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L Frich

Publications and source records attributed to L Frich.

6 recordsLinked to original sources

Hepatic radiofrequency ablation using perfusion electrodes in a pig model: effect of the Pringle manoeuvre.

AIM: To assess the influence of the Pringle manoeuvre on volume and geometry of coagulations close to the portal vein using an impedance-controlled radiofrequency ablation system with perfusion electrodes. METHODS: Twelve pigs were randomly assigned to a control group (n = 6) and a group where the Pringle manoeuvre was applied during ablation (n = 6). One coagulation was made in each animal close to the portal vein. All animals were sacrificed 4 days after ablation, and the livers were removed for gross and histopathologic analysis. RESULTS: Effective coagulation volume in the Pringle group (10.8 +/- 5.0 cm(3)) was significantly increased (p = 0.03) compared to the control group (4.1 +/- 4.1 cm(3)). The efficacy ratio, defined as the effective coagulation volume divided by the coagulation volume, was not significantly different in the Pringle group (0.47 +/- 0.27) compared to the control group (0.33 +/- 0.22). The geometrical centre of the effective coagulation volume did not correspond to the position of the ablation electrode. Thermal damage of the gallbladder was found in three animals, all belonging to the Pringle group. CONCLUSIONS: The Pringle manoeuvre was associated with increased effective coagulation volume, but did not significantly influence the predictability of coagulation volume or geometry.

Animals↗

[Cryoablation--a treatment option for inoperable liver tumors?].

BACKGROUND: Most patients with primary and secondary liver tumours are inoperable by conventional surgery. This has prompted the development of different techniques of local destruction of liver tumours, i.e. cryosurgical ablation radiofrequency, laser, and microwave ablation. MATERIAL AND METHODS: On the basis of relevant literature and our own experience we describe the principles of local destruction by cryoablation of colorectal metastases. RESULTS: Indications for ablation are mainly colorectal metastases and hepatocellular carcinoma. Mechanisms for tumour destruction include intra- and extracellular ice crystal formation, cellular membrane rupture, cellular dehydration and ischaemic damage. Ablation is regularly monitored by ultrasonography, which is suboptimal because of inadequate visualisation of the iceball. Long-term outcome of local destruction of liver tumours is not documented and randomized trials are not ethically acceptable. This complicates analyses of patient outcomes. INTERPRETATION: Local ablation of liver tumours is experimental therapy and should only be performed as a part of prospective trials.

Carcinoma, Hepatocellular↗

Familial occurrence of nonmedullary thyroid cancer: a population-based study of 5673 first-degree relatives of thyroid cancer patients from Norway.

The purpose of this study was to estimate the occurrence of familial nonmedullary thyroid cancer (FNMTC) in a large population-based study. Of the 5274 cases of thyroid cancer on record in the Norwegian Cancer Registry between 1960 and 1995, a total of 1025 patients could be identified with verified thyroid cancer, a unique personal identification number, and a link to at least one parent. For patients with nonmedullary carcinoma, 5457 first-degree relatives in 970 families were found, compared with 216 first-degree relatives in 37 families for the medullary cancers. A standardized incidence ratio (SIR) was calculated among the relatives based on rates from the Cancer Registry of Norway. A significantly increased risk of thyroid cancer was found among the 5457 relatives of nonmedullary index cases, both for males [SIR, 5.2; confidence interval (CI), 2.1-10.7; 7 cases] and females (SIR, 4.9; CI, 3.0-7.7; 19 cases). All of these 26 thyroid cancer cases were of the nonmedullary type. Furthermore, an increased risk was found among 4282 relatives of papillary index cases, for both males (SIR, 5.8; CI, 2.1-12.6; 6 cases) and females (SIR, 4.0; CI, 2.1-7.1; 12 cases). The 36 familial papillary thyroid cancer patients had an average age at diagnosis of 43 years. Genetic influence is probably only modest for the familial nonmedullary cases and clearly weaker than for the classic familial type of medullary thyroid cancer.

Adolescent↗

[Increased incidence of thyroid cancer among Norwegian women married to fishermen].

The relationship between thyroid cancer in women and the occupation of their spouses was examined in a retrospective cohort study. Of the 2.9 million women registered in the Central Population Registry of Norway by the end of 1991, 1.2 million had a spouse registered with an occupation in one or more of the censuses of 1960, 1970 or 1980. These women were included in the study. Based on the first digit of their husbands' five-digit Nordic occupational code, the women were assigned to ten broad categories. A standardised incidence ratio (SIR) and 95% confidence interval were calculated for each occupational category. The women were further subdivided and analysed in 71 groups defined by the first two digits of their husband's occupational code. Among the women included in the study, a total of 2,409 cases of thyroid cancer were reported to the Cancer Registry of Norway during the period 1960-92. A significantly elevated risk of thyroid cancer was found only among women whose spouses belonged to the occupational category Agriculture, forestry or fishery (n = 208,279), with a SIR of 1.13. In the subgroup Fishing, whaling and sealing work (n = 40,839), the risk was even higher with a standardised incidence ratio of 1.91. Our data support the proposed relationship between increased risk of thyroid cancer and mode of living, more specifically dietary fish or other seafood.

Adult↗

[When a physician makes a mistake].

Inevitably, doctors make mistakes in the normal course of providing care. Making a mistake often causes distress for the doctor involved, but it can also be an important source of knowledge and self-reflection. This article discusses central aspects with respect to mistakes and medical malpractice. The doctor's relationship to ethics and legislation is discussed, and an overview of the administrative action taken by the Norwegian health authorities is presented. The organisations and offices a physician may come into contact with when involved in a patient's complaint are briefly presented. "Meldesentralen" was formed in 1993 by the Norwegian Directorate of Health for the purpose of collecting reports on accidents in medical practice. We argue that the accidents reported to "Meldesentralen" do not reflect the true situation on this issue. We introduce a model for a systematic approach towards a colleague who has made a mistake or who is suspected of having made one.

Ethics, Medical↗

Increased risk of thyroid cancer among Norwegian women married to fishery workers--a retrospective cohort study.

The relationship between thyroid cancer in women and the occupation of their spouses was examined in a retrospective cohort study, with special reference to fishery. Of the 2.9 million women registered in the Central Population Registry of Norway on 31 December 1991, 1.2 million women had a spouse registered with an occupation in one or more of the censuses in 1960, 1970 or 1980. The women were assigned to ten broad categories based on the first digit of their husbands five-digit Nordic occupational classification code NYK, and a standardized incidence ratio (SIR) was calculated for each occupational category. The women were further subdivided and analysed in 71 groups defined by the first two digits of the NYK code. Among the women included in the study, a total of 2409 cases of thyroid cancer were reported to the cancer registry of Norway during 1960-92. A significantly elevated risk of thyroid cancer was found only among women whose spouses belonged to the occupational category 'agriculture, forestry or fishery' (n = 208 279), with a SIR of 1.13. In the group associated with 'fishing, whaling and sealing work' (n = 40 839), the risk was further increased (SIR 1.91, CI 1.65-2.21). An increased risk was also detected in the group associated with 'ship officers and pilots work' (n = 29 133) (SIR 1.35, CI 1.07-1.67). When allocating the women to southern and northern cohorts determined by their county of birth, a difference in risk was clearly present in all 10 occupational categories, with figures being 50-60% higher in the north. However, there was practically no difference in incidence between northern and southern cohorts among women associated with fishery work. Thus, the results obtained from this study indicate that being a fisherman's wife is associated with elevated risk of thyroid cancer, and our data support the suggested role of seafood as an aetiological factor.

Animals↗