Biomedical subjects
Publications and source records attributed to S Brynitz.
Paratesticular sarcomas are rare, especially the malignant mesenchymoma. To our knowledge only four cases of paratesticular malignant mesenchymoma have been described previously. All were localized to the spermatic cord. We present a case of malignant mesenchymoma in the scrotum free of the spermatic cord.
The literature concerning embolization of the renal artery in patients with renal cell carcinoma is reviewed. Based on this review it is concluded that the method is useful in this patient group as it will facilitate the surgical procedure if nephrectomy is performed afterwards. Used as a palliative method, embolization reduces haematuria. It was not possible to draw conclusions concerning survival rates or eventual immuno-stimulating effects of embolization.
A case of two calculi found in the same urethral diverticulum in a 41-year-old woman with recurrent urinary tract infections is reported. The diagnostic procedures are discussed.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Severe perianal skin inflammation in six patients, following continent reservoir operation and ileoanal anastomosis, resistant to ordinary therapy, was treated with cholestyramine ointment twice a day. Cure was achieved within ten days.
The clinical efficiency and patient acceptability of peroral colonic lavage with a 3 liters balanced electrolyte solution (BES), when performed either at the hospital on the day of colonoscopy or during the preceding evening in the patient's home, was evaluated in 62 consecutive outpatients. No significant difference was found between adequacy of bowel preparation, when the lavage was performed in the patient's home or at the hospital. The bowel preparation was found to be satisfactory in 61% and 77% of the patients. The percentage of sufficient preparation was 60% of the patients, who were not able to drink 3 litres of BES within the 2-hours period. This study demonstrated that colonic lavage with BES could be performed equally well at home the day before colonoscopy as at the hospital on the day of colonoscopy. The relatively low rate of sufficient preparation was related to the fixed and small volume of BES ingested. To improve the adequacy of bowel preparation a graded intake of BES is suggested.
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A case of hematemesis caused by jejunal gastric intussusception diagnosed by gastroscopy is presented. The acute form of gastric intussusception is a rare condition after gastric surgery, but it is important to be aware of the remote possibility because of a tremendously high mortality, if treatment is delayed more than 48 hours. The gastroscopic evaluation of the acute type may be extremely difficult, especially after gastric resection, the survey being very poor.
A report is presented of 93 patients referred for specialist management of thoracic injuries in the 5-year period 1973-1978. Penetrating trauma to the thorax had been sustained by 18 patients and blunt trauma by 75. Falls and traffic accidents were the most common causes (32 and 35 cases). Rib fractures were the most frequent lesions, and 10 of these 67 patients had flail chest. Hemothorax and/or pneumothorax were found in four-fifths of the patients. The diaphragm was torn in five cases. Three had lesions of the heart and/or pericardium and one patient had a tracheal lesion. Closed pleural drainage was the most commonly used treatment. Thoracotomy was performed in 10 of the 93 patients. The mortality rate in the series (10%) agreed with findings from other, similar studies.
Pain is a major problem associated with thoracotomy. Intraoperative cryolysis of the intercostal nerves around the incision can essentially reduce the postoperative analgesic requirement and diminish the impairment of ventilatory capacity. To obtain maximum effect, it is recommended that the sites of drainage should also be treated with cryolysis.
Within a department specialized in surgical gastroenterology 11 perforations of the large bowel occurred over a 10 year period as complication of diagnosis and treatment of polyps by colonoscopy. The incidence by diagnostic colonoscopy was 0.6% (95% confidence interval 0.2-1.3%) and by polypectomy 0.7% (95% confidence interval 0.2-1.8%). Nine of the perforations were located in the sigmoid colon; one occurred retroperitonally in the descending colon. The lesions were from 1-8 cm long and were located in normal bowelsegments. The most important cause of perforation was forceful introduction of the scope and the use of electrocoagulation. The patients were treated by laparotomy and antibiotics. In six cases the operation was initiated within one hour after the perforation had occurred, the remaining 5 were operated on when they developed symptoms 1/2-3 days after the colonoscopy. One patient, a 84-year-old man, died of acute myocardial infarction 4 weeks after the operation.
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A screening method for detecting the dissemination of malignant tumours to the bifurcal lymph nodes is described. The procedure was performed in 300 patients. Malignancies were found in 255 cases, 216 of which were bronchogenic cancers. The transcarinal mediastinal needle biopsy (TMNB) was positive in 25% of all cases with malignant diseases, but in patients with anaplastic tumours a positive TMNB was found in 40%. No complications occurred, the method could be applied to out-patients, and if positive, mediastinoscopy could be avoided.
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.
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