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Biomedical subjects

S Bertelsen

Publications and source records attributed to S Bertelsen.

At least 19 recordsLinked to original sources
PubMed1992

Pulmonary hamartoma.

Eighty-nine cases of pulmonary hamartoma were studied. There were 51 men and 38 women, with a mean age of 57.5 years (range 14 to 76 years). A histologic diagnosis from examination of the resection specimens was obtained in all patients who had operations. Moreover, transthoracic needle aspiration biopsies were performed in 40 patients, with a diagnostic result in 34 (85%). The hamartomas were equally distributed in the pulmonary lobes; mean transverse diameter at the time of diagnosis was 21.7 +/- 16.2 mm. Tumor size was independent of the anatomic localization, but it correlated with the age of the patients (p less than 0.01). Tumor growth was recorded in 15 of 31 patients who had follow-up (45%); mean expansion in transverse diameter was 3.2 +/- 2.6 mm per year during an average observation time of 4.1 years (range 1 to 20 years). Pulmonary symptoms were present in 35 patients (39%). Seventy-five patients underwent operations as follows: enucleation (54), resection (11), lobectomy (5), pneumonectomy (4), and bronchoscopic removal (1). Since most pulmonary hamartomas are nonexpanding or slowly growing neoplasms, it is concluded that operation is necessary only when expansion is recorded in young or middle-aged patients and in patients with pulmonary symptoms.

Adolescent↗
PubMed1990

Computed tomography and the TNM classification of lung cancer.

Computed tomography (CT) of the thorax and upper abdomen was prospectively evaluated in 84 patients with potentially operable lung cancer. Invasion into the thoracic wall and the mediastinal structures was not accurately demonstrated by CT. For metastatic mediastinal lymph nodes, the sensitivity and specificity of CT were, respectively, 86% and 61% and the positive and negative predictive indices 49% and 91%. For T1, T2 and T3 tumours the negative indices were 100%, 96% and 71%. Positive predictive index did not differ between squamous cell carcinoma and adenocarcinoma. Adrenal metastases were CT-suspected in 17 cases and liver metastases in eight, but were verified by ultrasonography in only one and four cases. CT should be used in preoperative investigation of lung cancer, irrespective of stage. Demonstration of thoracic-wall or mediastinal invasion need not exclude tumour resection. Preoperative mediastinoscopy is indicated if CT shows nodal metastases or if there are signs of tumour invasion, but not in CT-negative T1 or T2 tumour. Abdominal metastases indicated by CT should be investigated with CT-guided needle biopsy.

Abdominal Neoplasms↗
PubMed1990

Primary hemangiopericytoma of the lung. Case report.

Hemangiopericytoma is a rare tumor, arising from pericytes. Its outcome is difficult to foretell, as the usual criteria for malignancy are unreliable in this neoplasm. Three cases of primary pulmonary hemangiopericytoma are presented and the pathologic and clinical aspects are briefly reviewed. All three patients were surgically treated, and two are still alive after 7 and 18 years without sign of recurrence or metastasis. The third patient, although still alive, has had three recurrences within 22 months and vertebral metastasis.

Female↗
PubMed1989

Bacteraemia following orotracheal intubation and oesophageal balloon dilatation.

Asymptomatic bacteraemia following balloon dilatation was assessed in 20 adults with oesophageal stricture. Asymptomatic bacteraemia occurred in 12 of 19 patients. The source of the bacteraemia appeared to be the patients' oropharyngeal flora. The bacteraemia was not of clinical importance in our patients, but might lead to endocarditis in predisposed individuals.

Aged↗
PubMed1988

Transhiatal esophagectomy without thoracotomy.

Twenty patients with cancer of the esophagus and/or cardia underwent transmediastinal esophagectomy by blunt dissection without thoracotomy. Resection and reconstruction with gastroesophageal anastomosis was performed in a single stage in 13 cases. The tumor was nonresectable in seven cases, and instead a substernal bypass was performed. The technical maneuvers are described, and the results and possible advantages and disadvantages of the transhiatal method are discussed.

Adenocarcinoma↗
PubMed1988

Boerhaave's syndrome: spontaneous rupture of the oesophagus.

A review of nine patients with spontaneous rupture of the oesophagus is presented. All patients had mediastinal or pleural air or fluid on x-ray, but a diagnostic error was made in five of them leading to postponed treatment and a fatal outcome from mediastinitis. Of the remaining four patients two recovered and left hospital while another two died of vascular and respiratory complications. Clinical signs and treatment are discussed and early diagnosis emphasized in order to reduce the high mortality.

Adult↗
PubMed1987

Electron microscopy of biopsies from bronchogenic neoplasms.

Bronchial biopsies were investigated by light microscopy (LM) and electron microscopy (EM) with the aim to evaluate if EM could contribute to the LM tumour type diagnosis. Fourty-three pairs of biopsies were comparable. A histogenetic typing, especially of light microscopically undifferentiated and unclassifiable carcinomas, was possible by EM. However, when considering the therapeutical possibilities, at present time, LM tumour classification must be regarded as fully sufficient.

Biopsy↗
PubMed1987

Combined modality therapy for oesophageal squamous cell carcinoma.

In a prospective study 110 patients with histologically confirmed oesophageal squamous cell carcinoma received radiation therapy combined with bleomycin or a retinoid. Surgery was initially intended in 34 patients and was later on undertaken in 25 of them after irradiation; in 12 patients the operation was regarded as radical and in 4 of these no remaining tumour was found at operation. The survival rate was significantly higher in the operated than in the non-operated patients which entirely depended on the radically operated ones. Survivals up to more than 71 months were observed and the best results were apparently obtained in patients who became tumour-free after preoperative therapy. It is concluded, that the combined treatment was curative only in a few cases and that future studies should be focused on more intensive preoperative treatment and more critical selection of patients for surgery.

Adult↗
PubMed1987

Innominate artery rupture. A fatal complication of tracheostomy.

Tracheo-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. The case histories of three patients with tracheo-innominate artery fistula are presented, and one is a longterm survivor. The haemorrhage can be controlled by hyperinflation of the cuff of the tracheostomy tube or by direct digital compression of the artery. The damaged segment of the eroded artery should be resected and the ends oversewn. Measures to prevent this complication are described.

Adult↗
PubMed1985

Bronchial carcinoid tumours. A clinicopathologic study of 82 cases.

A clinical and "blind" histologic review of 82 cases of bronchial carcinoid tumour is presented. The malignant potential of the tumours was only partly predictable from their histologic appearance. Histologically 65 of the tumours were typical benign carcinoids. Regional metastases were found at operation in two of these patients. Fatal carcinoid syndrome with regional and distant metastases appeared in two patients about 1 and 3 years postoperatively. One of the patients with regional metastases at operation is clinically free from carcinoid 12 years later. Malignancy was histologically suspected in 17 cases, in ten of which regional metastases were found at operation. Three of these ten patients are alive 6 to 16 years postoperatively, but two without regional metastases at operation died of local recurrence and distant metastases after 3 to 4 years. Carcinoid syndrome was not seen in these 17 patients. There was one peroperative death. Altogether ten patients (12%) died of recurrence. Among the cases judged at the "blind" histologic review to be suspectedly malignant, the corresponding figure was 50%. For typical carcinoids, conservative resection, including lymph-node metastases, is the treatment of choice. Wedge or sleeve resection with or without pulmonary resection were employed in ten cases. Suspectedly malignant carcinoid tumours may require more extensive surgery.

Adolescent↗
PubMed1985

Transcarinal mediastinal needle biopsy compared with mediastinoscopy.

A total of 183 patients with abnormalities on the chest roentgenogram were examined by bronchoscopy in conjunction with transcarinal mediastinal needle biopsy and mediastinoscopy to investigate the agreement between these methods regarding possible metastases. In 37 of the 159 patients with malignant pulmonary lesions, needle biopsy demonstrated metastases in the subcarinal lymph nodes. Mediastinoscopy had the same percentage of positive findings in the subcarinal nodes, but there was only agreement between the two methods in 20 cases. Transcarinal mediastinal needle biopsy as a supplement to conventional bronchoscopy is applicable in the outpatient evaluation of patients with malignant bronchial lesions as a screening for further examination. The method does not carry complications of any kind. Positive biopsy results, combined with other clinical findings, can at times spare the patient a mediastinoscopy. On the other hand, an adequately indicated needle biopsy which yields negative findings should always be followed by mediastinoscopy. In the planning of treatment for patients with malignant lesions of the lungs, it is of decisive importance to evaluate the dissemination of the tumor to the mediastinal structures, primarily to the subcarinal and the contralateral lymph nodes.

Adenocarcinoma↗