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Biomedical subjects

M Akerman

Publications and source records attributed to M Akerman.

At least 145 records · Page 8Linked to original sources
PubMed1979

Intraoperative fine needle aspiration cytology in pancreatic lesions.

The notes of 129 patients investigated by intraoperative fine needle aspiration biopsy between 1973 and 1977 have been reviewed. Eighty-four of the patients were operated on and punctured at the Department of Surgery, Lund, and 45 at different county hospitals belonging to the region. All aspirates were stained and evaluated at the Department of Cytodiagnostics, Lund. Sixty-four of the 75 patients with pancreatic cancer were correctly diagnosed and in another three patients the cytological diagnosis was "suspicion of cancer." Including these latter cases the sensitivity of the method was 91% in pancreatic cancer. In four out of five patients with endocrine tumors the cytological report was correct i.e., "endocrine tumor." In none of 22 patients with chronic pancreatitis or pancreatic cysts the diagnosis was falsely positive. Twenty-seven patients who during the operation were suspected of having a pancreatic lesion were at follow-up (mean 2.8 years) found not to have any significant pancreatic disease. Among these patients no falsely positive reports were given. In nine of the 129 patients (7%) the aspirates even at re-checking were found to be nonrepresentative or the aspiration unsuccessful. Six of these were performed at county hospitals. In 24 patients with pancreatic cancer total pancreatectomy was performed. In the remaining 105 patients no complications which could be related to the puncture were detected.

Biopsy, Needle↗
PubMed1979

Undifferentiated giant and spindle cell carcinoma of the thyroid. Report on two combined treatment modalities.

Undifferentiated giant and spindle cell carcinoma of the thyroid is a rapidly fatal disease. Most patients die from local tumour progression and with distant metastases. A combination of debulking surgery, irradiation and combination chemotherapy is reported. An improvement of the local results of treatment was observed. A combination of irradiation and chemotherapy resulted in local control in only one of 8 patients. Therefore, debulking surgery was added in the next 5 patients and a local control was achieved in 4.

Aged↗
PubMed1979

The effect of short-term high-dose treatment with methenamine hippurate of urinary infection in geriatric patients with indwelling catheters. I. The preparation and morphology of a quantified urine sediment.

A quantified sediment of the urine from patients with indwelling catheters was prepared by fixation of 0.1 ml urine in 0.9 ml 2% glutaraldehyde immediately after sampling. Slide preparations were then made from 0.2 ml of the glutaraldehyde suspensions by means of a cytocentrifuge. Bacteria and epithelial cells were properly contrasted by the May-Grünwald-Giemsa stain but haematoxylin-eosin and the Papanicolaou stain were superior as regards leukocyte morphology. It is suggested that glutaraldehyde-cytocentrifuge preparations of the urine cytology may be useful in the evaluation of urinary infection and in the evaluation of the therapy of urinary infection.

Aged↗
PubMed1978

Percutaneous cytodiagnosis of carcinoma of the pancreas and bile duct.

Fifty-one percutaneous fine-needle aspiration biopsies guided by selective angiography and 57 by percutaneous transhepatic cholangiography (PTC) were performed in 88 patients. Fifty-two of the patients had a tumor localized to the pancreas and 19 a tumor of the extrahepatic biliary tract. In 17 patients the suspicion of neoplasia was possible to rule out. In 60% of the patients with pancreatic carcinoma and in 53% of the patients with biliary duct carcinoma correct cytological diagnosis was obtained. No false positive results were found. The diagnostic reliability was the same under guidance of angiography as PTC. The experience of the examiner markedly influenced the accuracy of the method. Exact correlation between the cytologic and histologic reports was found in cases where representative material was obtained at the aspiration. None of the 108 punctions was followed by complications. Since the method is harmless and has a high success rate especially in experienced hands it is an important adjunct to the management of pancreatic and bile duct lesions.

Angiography↗
PubMed1978

Clinico-pathological correlations in the Kiel classification of non-Hodgkin's lymphomata in children.

The rapid development of chemotherapy and radiotherapy during the last decade makes an increasing demand for a reliable classification of malignant non-Hodgkin's lymphomas. This is especially important in children since in this age group the lymphomas show a much worse prognosis than in adults. An attempt at a modern classification is offered by the so-called Kiel classification. 38 children with non-Hodgkin's lymphomas previously classified according to Rappaport were re-evaluated according to the Kiel system. Reclassification was technically feasible in 26 patients. There was good agreement on typing between the two independently working cytopathologists. 3 patients proved to be cases of histiocytic medullary reticulosis. Among the remaining patients, a much larger variety of histological subgroups was seen than in the one published paediatric series of Lennert. 17 patients had high-grade malignant lymphomas with lymphoblastic lymphomas predominating. Some clinical correlations not detectable with the Rappaport classification were found using the Kiel system. 6 patients were judged as having low-grade malignant lymphomas but in this group the survival was poorer than expected and 1 patient showed leukaemic transformation. The Kiel classification makes high demands for adequate surgical techniques and preparatory routines. It seems to represent a step forward in the classification of non-Hodgkin's lymphomas but much more experience is needed, especially in children, in order to evaluate its role as a guide to differentiated therapy.

Child↗
PubMed1976

[EEG effects of sodium nitroprusside and hemodynamic references].

A study was performed on baboons (Papio papio) of various hemodynamic and EEG effects of sodium nitroprussiate (SNP), substance with powerful vasodilator action. Three different procedures of drug injection were used: (1) in isolation, either in doses close to those used in clinical practice or in high doses; (2) after neuroleptanalgesia (NLA); (3) after causing vasospasm. With isolated SNP, effects on blood pressure were unstable; in certain cases hypotension could be maintained only with toxic doses. Hypotension was facilitated when NLA had been previously induced. At low doses the cerebral blood flow (CBF) was practically unmodified, whereas at toxic doses it first increased then decreased. In animals under NLA, the CBF drop was only moderate, suggesting persistence of adequate spasm, CBF was significantly improved through SNP. The EEG did not undergo sizeable change at low SNP doses given in isolation; toxic doses always induced alterations with peculiar morphology, but developing only tardily after SNP perfusion was begun. This lag may indicate that hypotensive and toxic SNP effects are dissociated. These alterations suggest that screening of the EEG is necessary during prolonged administration of SNP, e.g., in surgical procedures. Combining NLA and SNP (at low doses) causes EEG deceleration, but no great alteration of the rhythms, as observed during other types of controlled experimental hypotension. Hence, cerebral circulation may be relatively well protected during SNP hypotension.

Animals↗
PubMed1976

Aspiration cytology of salivary gland tumors: diagnostic experience from six years of routine laboratory work.

Fine-needle aspiration cytology has been used as a routine diagnostic instrument in patients with salivary gland lesions during 1966-1972. A retrospective analysis of the primary cytologic reports correlated with the revised final diagnoses in 461 patients where a pathologic report is available, shows exact agreement in 63 percent, good and not misleading agreement in a further 18 percent, while false reports were initially given in 8 percent, and unsatisfactory specimens were obtained in 11 percent of the patients. On revision of the false reports it is found that with the present experience acquired over several years these can be reduced to under 5 percent. This analysis has also given indications upon which types of specimens are likely to cause diagnostic difficulties.

Adenolymphoma↗
PubMed1976

Hepatic angiography in ulcerative colitis and Crohn's disease.

Liver angiography was performed in 13 patients with Crohn's disease and three with ulcerative colitis. Of these patients, 13 underwent liver biopsy, and findings were correlated with results of angiography and biochemical tests. Twelve liver biopsies were abnormal, primarily showing fatty infiltration and reactive hepatitis. Thirteen angiographies were abnormal, with widened and tortuous liver arteries being the most common finding. Liver function tests were within normal limits for all but three of the 16 patients, thus correlating poorly with findings of the other tests. These data show that angiography is useful in detecting hepatic abnormality, but evaluation with liver biopsy is necessary to determine the nature of the lesion.

Adolescent↗
PubMed1976

Biopsy of the nasopharynx as a staging procedure in Hodgkin's disease.

Biopsy of the nasopharynx was perfomred in 45 patients with Hodgkin's disease as part of the pretherapeutic staging. Seven of the 45 (16%) had microscopic abnormalities in the nasopharynx compatible with Hodgkin's disease. Such abnormalities occurred even in the absence of local ENT-symptoms or signs, and they could not be predicted from the microscopic type of lymph node biopsy, stage of disease or general presentation. A generous biopsy of the nasopharynx is recommended to be included in the staging procedures in Hodgkin's disease.

Biopsy↗
PubMed1976

Fine needle aspiration biopsy in the evaluation of tumor-like lesions of bone.

A consecutive series of bone lesions suspected to be tumors and examined by fine needle aspiration biopsy at the University Hospital Cytology Laboratory in Lund, Sweden, is reported. From 1966 to November 1974, 150 cases were examined. In 123, sufficient cellular material was obtained through aspiration by a needle with an outer diameter of 0.8 mm. The method is described. The reliability of cytology is compared with the results of the definite pathology after open biopsy or extirpation of the lesion. In the series of primary benign lesions 28 out of 39 were correctly diagnosed; among primary malignant 27 out of 38 were correct and among metastases 57 out of 73 were correctly diagnosed including those where insufficient cellular material was aspirated. In cases where sufficient material was achieved the reliability of the cytological diagnosis was around 90 per cent. There was one false positive and two false negative reports of malignancy. Fine needle aspiration biopsy with cytology is recommended as a standard step in orthopedic oncological examinations. It has at least the same degree of diagnostic reliability as other diagnostic methods, such as X-ray, for instance; however, it does not replace open biopsy and histology when mutilating surgery is in question.

Biopsy, Needle↗
PubMed1976

A new pattern of multiple endocrine adenomatosis: chemodectoma, bronchial carcinoid, GH-producing pituitary adenoma, and hyperplasia of the parathyroid glands, and antral and duodenal gastrin cells.

A female patient was found to have a chemodectoma, a GH-producing pituitary tumour and a bronchial carcinoid combined with hyperplasia of the parathyroids and of antral and duodenal gastrin cells. This combination of endocrine tumours and hyperplasias does not fit with the two multiple endocrine adenomatosis syndromes recognized at present. The case stresses the importance of scanning the patient for other endocrine tumours, once one has been diagnosed.

Adenoma↗
PubMed1976

Percutaneous biopsy of carcinoma of the pancreas guided by angiography.

Histologic verification of the angiographic diagnosis of carcinoma of the pancreas may be achieved by percutaneous, transperitoneal fine-needle aspiration biopsy. The method was used in conjunction with the angiographic procedure in 29 patients with tumors of varying size down to 3 centimeters in diameter. Positive diagnosis was obtained in 22. Complications were not encountered. Since the method is simple and harmless it is recommended whenever histologic verification is desired.

Angiography↗
PubMed1976

[Experimental study of the cerebrovascular effects of sodium nitroprusside in the baboon Papio papio. Its action on the experimental vasospasm].

Sodium nitroprusside (SNP) has been suggested as hypotensive agent in the surgery of cerebral aneurysms. As a preliminary step to neurosurgery, a study of its cerebro-vascular and EEG action had been carried out in 42 papio-papio baboons. On the unanaesthetized analgesic-free animal, doses below 20 mumg/kg/min. induce only a moderate decrease of mean arterial blood pressure (MABP), a slight rise of intracranial pressure (ICP) and a neat fall of cerebro-vascular resistance (CVR) without EEG modifications. Doses above 50 mumg/kg/min. induce a neat fall of MABP with a rise of cerebral blood flow (CBF), of ICP and signs of poisoning with metabolic acidosis and prolonged EEG disturbances. Beyond 90 mumg/kg/min. irreversible hypotension occured accompanied by metabolic acidosis and progressive abolition of cerebral electrogenesis. The hypotensive action of SNP is potentiated by neuroleptanalgesic drugs (phenoperidine and dehydrobenzoperidol). Using this combination marked hypotension was achieved with non toxic doses of SNP (6 to 10 mumg/kg/min.). During those hypotensions cerebral auto-regulation was maintained up to a MABP of 50 mmHg. Deeper brief hypotensions up to a MABP of 25 to 45 mmHg induce a 23% fall of CBF (p less than 0, 05) but without major EEG alterations. During experimental arterial spasms induced by injection of blood in the cisterna magna or serotonin infusion, SNP has a vasodilating action. It induces a significant rise of CBF (p less than 0, 01) for doses between 8 and 19 mumg/kg/min.

Acid-Base Equilibrium↗