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Biomedical subjects

M Fagerlund

Publications and source records attributed to M Fagerlund.

46 records · Page 3Linked to original sources
PubMed1980

Staging laparotomy for Hodgkin's disease.

Splenectomy was performed in patients with Hodgkin's disease in a prospective study at the University Hospital of Umeå 1973-1978. Fifty-nine subjects were included and the laparotomy was made as a part of the pre-treatment investigation. The result of the surgical exploration was compared to other investigations, e.g., lymphangiography or cavography. The operation morbidity was 5% (3/59). The clinical stage was changed in 15/58 (26%). Fourteen upstaged and one downstaged. The macroscopical evaluation was poorly correlated to the histological involvement. It is concluded that if the staging procedure is performed by specialized surgeons the morbidity is low. No adverse effects have yet been observed after splenectomy. The staging laparotomy and splenectomy is considered superior to nonsurgical staging procedures from both treatment and cost benefit point of view.

Adolescent↗
PubMed1975

Extragonadal endodermal sinus tumours. Report of a case.

A case is described of endodermal sinus tumour originating in the sacro-coccygeal region in a man 20 years of age. Of the hitherto presented cases of endodermal sinus tumour of a gonadal origin, 24 out of 42 patients have died. Of 21 patients in whom the disease was of an extragonadal origin, 18 have died. Thus, the prognosis seems to be less favourable in patients with extragonadal tumours. The best prognosis has been reported in boys with endodermal sinus tumours of a testicular origin operated before the age of 2 years.

Abdominal Neoplasms↗
PubMedDate not supplied

Clinical features and prognosis in young adults with infratentorial infarcts.

BACKGROUND AND PURPOSE: Many comprehensive descriptions of the clinical spectrum of infratentorial infarcts in elderly patients and with a retrospective design have been published. The aim of this study was to describe the clinical characteristics and prognosis in young patients with isolated infratentorial infarcts. METHODS: In a prospective series of 105 patients aged 18-44 years with cerebral infarction 24 had a brainstem or cerebellar infarction. The patient selection was validated in a population-based epidemiological survey. The patients were assessed acutely and at 4 and 12 months after onset. Extensive evaluation included CT and MRI scans, angiography, ultrasonic duplex scanning, transesophageal echocardiography and a chemistry panel including hematologic testing. The modified Rankin scale and NIH stroke scale were used for assessment of disability and neurological dysfunction. RESULTS: Eighteen patients had a cerebellar infarct (posterior inferior cerebellar artery territory in 9 patients, superior cerebellar artery in 6, anterior inferior cerebellar artery in 2, nonterritorial in 1). Two patients had lateral medullary infarcts and 2 isolated pontine infarcts. In 2 patients MRI was normal despite repeated investigations. Hearing loss and tinnitus were the only explicit symptoms for superior cerebellar artery infarcts, but it was otherwise impossible to classify each case to a vascular territory according to clinical characteristics. The age-specific incidence of isolated cerebellar infarction was 1.8/100,000/year. The presumed causes were arterial dissection in 8 patients, idiopathic in 7, cardioembolic in 5, oral contraceptive use in 3 and protein S deficiency in 1 patient. One patient died during the acute phase and another developed a locked-in syndrome. At follow-up, 1 patient had a transitory ischemic attack and 1 a silent cerebral infarction. Twenty-two patients had a favorable outcome according to the modified Rankin scale (grade 0-2) and the NIH scale. CONCLUSIONS: Cerebellar infarctions are frequent among young stroke patients in northern Sweden. Arterial dissection is the prevailing stroke mechanism in infratentorial infarcts. The prognosis is favorable regarding motor impairment but cognitive deficits may prevent return to work.

Adolescent↗
PubMedDate not supplied

Clinical and histopathological features of a large parapharyngeal neurilemmoma located at the base of the tongue.

Neurilemmomas of the tongue have only been sporadically reported in the literature. Vague symptoms and limited knowledge of this kind of tumor may result in long delays before diagnosis and treatment. The rarity of the lesion in this area is the main reason why we report this case of neurilemmoma. After observation of a mass in the tongue, magnetic resonance imaging showed a large tumor with central necrosis localized to the base of the tongue. Needle electromyography disclosed no nerve lesion. Fine-needle aspiration cytology was negative, whereas biopsy revealed a neurilemmoma. The tumor was surgically removed, and histopathology, including immunohistochemistry, of the resected specimen disclosed the typical neurilemmoma. The postoperative course was uneventful.

Adult↗
PubMedDate not supplied

Thigh musculature in relation to chronic anterior cruciate ligament tear: muscle size, morphology, and mechanical output before reconstruction.

Eighteen male patients who had untreated chronic ACL rupture were studied in order to evaluate thigh muscle size, morphology, and isokinetic performance of the quadriceps muscle. Computed tomography disclosed a 5.1% mean atrophy of the quadriceps (P less than 0.05), 2.1% slight hypertrophy of the hamstrings (P less than 0.05), and also nonsignificant changes of all other muscle areas of the injured thigh. Muscle morphology (m. vastus lateralis) was normal in 11 biopsy specimens, whereas minor abnormalities (irregular shape or hypotrophy) could be seen in the rest. Isokinetic mechanical output of the knee extensors was 71% to 87% of that of the noninjured limb (P less than 0.01), and the mechanical output corrected for differences in quadriceps cross-sectional area was significantly lower in the injured than the uninjured limb. As there were no significant correlations between isokinetic performance and muscle size or qualitative morphology or morphometric data, the strength decrease cannot be explained by muscle atrophy or structural changes per se. We conclude that nonoptimal activation of the muscles during voluntary contractions is probably the most important causative mechanism of the strength decrease found in patients who have chronic symptomatic ACL tear.

Adult↗
PubMedDate not supplied

Intermittent cerebrospinal liquorrhea. Cerebral computed tomography in the non-drop period.

Eight patients with posttraumatic intermittent rhinoliquorrhea were examined in the dry non-drop period, seven of them with CT metrizamide cisternography. The evidence of fracture of the skull base in combination with protruding soft tissues into the sinuses, a local deformity of basal sulci, and pooling of contrast medium in a dural pouch or herniated soft tissue plug will localize the site of leakage. There is no need for special maneuvers such as raising the intracranial pressure in order to initiate flow of the cerebrospinal fluid. Criteria for localizing the leakage are discussed.

Adolescent↗
PubMedDate not supplied

Computed tomography of the cerebellopontine cistern in normal and acoustic tumor patients.

Air computed tomography of the cerebellopontine cistern was performed in 15 consecutive patients. The series comprised 7 patients with a normal cistern and 8 patients with tumor, including one with bilateral tumors. Two tumors were of small size (less than 10 mm i diameter), 3 were medium sized (10-20 mm in diameter), and 4 were large (greater than 20 mm in diameter). In the normal group, the jugular foramen nerve bundle (the 9th, 10th and 11th nerves), the trigeminal nerve, or the brain stem margin were clearly defined by air. In the tumor group, the possible extension of the tumor to these structures could be defined. Differentiation between a compression or attachment of the trigeminal nerve to the tumor was not always possible. The importance of using reconstruction views is stressed.

Adolescent↗