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L Hjelt

Publications and source records attributed to L Hjelt.

At least 19 recordsLinked to original sources

Colonoscopy in the diagnosis of antibiotic-associated colitis. A prospective study.

Colonoscopic findings among 16 patients with histologically proved antibiotic-associated pseudomembranous colitis (PMC) were analyzed. The characteristic endoscopic changes of PMC with pseudomembranes were observed in only 5 (31%) out of 16 patients by sigmoidoscopy but in 11 (85%) out of 13 patients in whom colonoscopy was also performed. The findings suggest the importance of colonoscopy in the early diagnosis of PMC and indicate that the typical endoscopic changes of PMC are limited to the colon above the rectosigmoid area in most patients with antibiotic-associated colitis. It is emphasized that colonoscopy should be performed at least in clinically suspected PMC cases, in which the early diagnosis of PMC might be missed if sigmoidoscopy alone is performed.

Adult

Intestinal metaplasia with colonic-type sulphomucins in the gastric mucosa; its association with gastric carcinoma.

The occurrence of intestinal metaplasia with colonic-type sulphomucins: (abbreviated: s-IM or s-positive IM) in the gastric mucosa was studied in 125 patients with gastric carcinoma (GCA), 62 patients with pernicious anemia (PA), 301 and 183 first-degree relatives of GCA and PA patients, 406 outpatients and in 358 controls matched from a large population sample. The sulphomucins (s-mucins) were demonstrated histochemically in endoscopic biopsy specimens by using high iron diamine and Alcian blue (pH 1) methods. The prevalence of s-IM, especially the strongly s-positive IM, was significantly higher in GCA patients than in other series or controls of the same age group. Further, s-IM was significantly more common in PA patients and its prevalence higher in GCA relatives and outpatients than in other series or controls. The occurrence of s-IM was also age-dependent and dependent on the extent of IM. It was suggested that the occurrence of s-IM can be used as a sign of lesions that are more closely associated with GCA than IM is in general.

Adult

Grading of human renal adenocarcinoma.

One hundred and thirty-eight adenocarcinomas of human kidney were assessed histologically with special reference to the tumor malignancy as indicated by the 5-year survival of the patients. Four different grading systems were used; the classification based on the histologic type of tumor growth, the grading of malignancy according to Arner et al., the grading based on the nuclear structure of carcinoma cells and finally a combined grading system based on the nuclear structure and the demarcation of the tumor from the surround tissue. The histologic type of growth was observed to be an inappropriate basis for grading of renal carcinoma. The grading system of Arner et al. was an appropriate method of malignancy grading despite its somewhat low reproducibility. The grading system based on the nuclear structure of the tumor cells was an accurate measure of the intrinsic malignancy of renal carcinoma and gave an excellent correlation between tumor grade and the 5-year survival rate of the patients. The combined grading system was an equally accurate method in estimating the 5-year prognosis of ranal carcinomas and indicated that the poor demarcation of the tumor from the surroundings in an unfavorable prognostic sign.

Adenocarcinoma

Ultrastructural characteristics of human renal cell carcinoma in relation to the light microscopic grading.

Twenty-two consecutive cases of renal adenocarcinoma were graded histologically according to the nuclear structure of the tumor cells. The ultrastructural characteristics of these tumors were then evaluated and the findings were compared with the results of the nuclear grading. No ultrastructural characteristic was found which would have been specific for either Grade I, II, III or IV carcinomas. There was no ultrastructural features that could have been used as a basis for malignancy grading. The results show that electron microscopy has nothing to add to the nuclear grading system of renal adenocarcinoma and the value of this grading system is to be emphasized.

Adenocarcinoma

Calcification in cervical arteries in life and at autopsy.

In the clinical part of the study routine neck PA radiographs taken with the mouth open were compared with soft tissue films with the mouth closed for detection of calcification in the carotid arteries. Only 5.5% of 90 hospitalized patients showed foci of calcification in routine films. But foci of calcification were seen in 22% of the soft tissue radiographs of the whole series. In the autopsy part of the study large foci of calcification were found at the carotid bifurcations in 12 out of 20 cadavers by radiography. In an additional five cases contact radiographs also showed smaller foci of calcification. The vascular endothelium over the calcification was often ulcerated. The significance of the large arterial foci of calcification demonstrated in the neck radiographs as a sign of atherosclerosis and as a source of cerebral thromboembolism is discussed.

Adult

Hereditary nephronophthisis with a life span of three decades. Light and electron microscopical, immunohistochemical, clinical and family studies.

Familial nephronophthisis was diagnosed in a son and two daughters of a mother who herself died in uraemia at the age of 29 years. The son died at 33 years, two daughters are alive at 30 and 33 years. Our cases suggest a dominant autosomal type of inheritance because the mother married twice; the affected son was from the first marriage and the affected daughters from the second marriage. There was no known consanguinity between the parents. The pathogenesis of the disease can be explained by a slowly progressive process that leads to complete or partial obstruction of the tubules in the corticomedullary area, and also, therefore, to cystic dilatations. Histological evidence for this is provided by the proliferation of fibroblasts around the collecting ducts and other tubules, prominent thickening of the tubular basement membrane, and fibroblasts and collagen fibrils in or inside the thickened basement membranes. An ultrastructural description of affected kidneys is given.

Adult

[Thymoma].

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Adolescent