| 1. |
- Andersson, Roland, et al.
(författare)
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Implantation Metastases from Gastrointestinal Cancer after Percutaneous Puncture or Biliary Drainage
- 1996
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Ingår i: European Journal of Surgery. - 1102-4151. ; 162:7, s. 551-554
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evaluation of incidence and outcome of implantation metastases after percutaneous fine-needle biopsy or biliary drainage. Design: Retrospective study. Setting: University hospital, Sweden. Subjects: Eight patients with implantation metastases from gastrointestinal cancers after percutaneous fine-needle biopsy (n = 7) or biliary drainage (n = 1). Main outcome measures: Incidence of implantation metastases, treatment and influence on outcome and survival. Results: In two out of three patients who had had otherwise radical operations, the implantation metastases meant that the operations were palliative rather than curative. Patients who had had palliative resections of the implantation metastases developed major local complications. One patient is alive with no signs of disease after 106 months, while one is alive with disease 30 months after the diagnosis of the implantation metastases. The remaining patients have died after 6 to 23 months. Conclusion: The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seems to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis.
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| 2. |
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| 3. |
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| 4. |
- Annertz, Mårten, et al.
(författare)
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Ländryggsröntgen ger falsk säkerhet och ringa nytta för patienten : MRT och DT ger bättre och billigare resultat
- 2017
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Ingår i: Läkartidningen. - 0023-7205. ; 114:46, s. 1962-1962
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In 2016 140 000 lumbar spine radiographies were performed in Sweden (14 000 per million inhabitants) to a cost of about 85 million SEK (≈8.5 million Euro) and a negligible value for the patients with low back pain. In the work-up of low back pain, when imaging is indicated, lumbar spine radiography should be replaced by limited magnetic resonance imaging including a whole lower body coronal STIR sequence or computed tomography with radiation dose adapted to indication and patient age. Indication for imaging should be restricted to 1) low back pain with more than 3-4 weeks duration in combination with at least one »red flag«, 2) radicular pain without improvement on conservative treatment, or 3) low back pain with more than 8 weeks duration in combination with »yellow flags«.
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| 5. |
- Ansari, David, et al.
(författare)
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Pancreatic cancer and thromboembolic disease, 150 years after Trousseau.
- 2015
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Ingår i: HepatoBiliary surgery and nutrition. - 2304-3881. ; 4:5, s. 325-335
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Forskningsöversikt (refereegranskat)abstract
- The connection between pancreatic cancer and venous thrombosis has been discussed for almost 150 years. The exact pathophysiological mechanisms are still partly understood, but it is known that pancreatic cancer induces a prothrombotic and hypercoagulable state and genetic events involved in neoplastic transformation (e.g., KRAS, c-MET, p53), procoagulant factors [e.g., tissue factor (TF), platelet factor 4 (PF4), plasminogen activator inhibitor type 1 (PAI-1)], mucin production (e.g., through activation of P- and L-selectin) and pro-inflammatory factors [e.g., cytokines, cyclooxygenase-2 (COX-2)] may be implicated. Also pancreatitis, both acute and chronic, is associated with increased risk of venous thrombosis, but in this circumstance a direct inflammatory process may be more important. This article discusses the incidence, treatment and outcome of venous thromboembolism (VTE) complicating pancreatic disease, with special emphasis on new knowledge obtained during the last fifteen years.
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| 6. |
- Fan, Bo-Guang, et al.
(författare)
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Total parenteral nutrition influences both endocrine and exocrine function of rat pancreas
- 1997
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Ingår i: Pancreas. - 0885-3177. ; 15:2, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the effect of total parenteral nutrition (TPN) on the endocrine and exocine function of the pancreas. Endocrine function was investigated using an intravenous glucose tolerance test (IGTT) in rats with TPN for 7 or 14 days. Exocrine function was evaluated by measuring amylase secretion from isolated acini as well as pancreatic weight, water content, protein, and enzymes after 7 days of TPN. When the TPN rats were compared with the controls, the glucose tolerance curve after an IGTT was unchanged, the basal plasma insulin levels were slightly lower and the insulin secretory response to intravenous glucose was markedly impaired. No differences could be seen between the insulin response after 7 days and that after 14 days of TPN. The weight of pancreas, the total content and concentration of pancreatic protein, and the total amylase content of the pancreas were lower, whereas the total content of both chymotrypsin and trypsin was higher. The concentration of DNA remained intact, whereas the total DNA content decreased. The levels of lipolytic enzymes, except for carboxylesterlipase, were unaffected. After TPN treatment, the insulin secretory response to glucose is impaired, the exocrine pancreas is hypoplastic and the storage pattern of pancreatic exocrine enzymes is altered.
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| 7. |
- Gorunova, Ludmila, et al.
(författare)
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Extensive cytogenetic heterogeneity in a benign retroperitoneal schwannoma
- 2001
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Ingår i: Cancer Genetics and Cytogenetics. - 0165-4608. ; 127:2, s. 148-154
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Tidskriftsartikel (refereegranskat)abstract
- A benign retroperitoneal schwannoma from a patient without prior exposure to radiotherapy or chemotherapy was analyzed by chromosome banding after short-term culture. An extensive intratumor heterogeneity in the form of 29 karyotypically related as well as unrelated clones was found. The aberrant clones were diploid or near-diploid and displayed both numerical and structural changes. All chromosomes, except 11, 16, and 20, were affected. Numerical changes included trisomies X, 7, 9, 17, and 18, and monosomies 13 and 18. No clonal loss of chromosome 22, the most characteristic abnormality in schwannomas of other locations, was, however, detected. The structural aberrations resulted in a total of 58 chromosomal breakpoints, with chromosomes 18, 1, and 15 participating in rearrangements most frequently, followed by chromosomes 14, 2, and 22. A striking finding was the clonal involvement of 18p11 in eight rearrangements affecting different chromosomes, suggesting alteration of telomeric function. The molecular mechanisms underlying the observed massive polyclonality in the schwannoma, particularly the presence of cytogenetically unrelated clones, are unknown and probably heterogeneous.
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| 8. |
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| 9. |
- Lindskog, Bengt I., et al.
(författare)
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Medicinsk terminologi
- 2004
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Bok (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Maisonneuve, P, et al.
(författare)
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Cigarette smoking accelerates progression of alcoholic chronic pancreatitis
- 2005
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Ingår i: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 54:4, s. 510-514
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Tidskriftsartikel (refereegranskat)abstract
- Background: Smoking is a recognised risk factor for pancreatic cancer and has been associated with chronic pancreatitis and also with type II diabetes. Aims: The aim of this study was to investigate the effect of tobacco on the age of diagnosis of pancreatitis and progression of disease, as measured by the appearance of calcification and diabetes. Patients: We used data from a retrospective cohort of 934 patients with chronic alcoholic pancreatitis where information on smoking was available, who were diagnosed and followed in clinical centres in five countries. Methods: We compared age at diagnosis of pancreatitis in smokers versus non-smokers, and used the Cox proportional hazards model to evaluate the effects of tobacco on the development of calcification and diabetes, after adjustment for age, sex, centre, and alcohol consumption. Results: The diagnosis of pancreatitis was made, on average, 4.7 years earlier in smokers than in nonsmokers (p=0.001). Tobacco smoking increased significantly the risk of pancreatic calcifications ( hazard ratio (HR) 4.9 (95% confidence interval (CI) 2.3-10.5) for smokers v non-smokers) and to a lesser extent the risk of diabetes (HR 2.3 (95% CI 1.2-4.2)) during the course of pancreatitis. Conclusions: In this study, tobacco smoking was associated with earlier diagnosis of chronic alcoholic pancreatitis and with the appearance of calcifications and diabetes, independent of alcohol consumption.
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| 11. |
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| 12. |
- Wallengren, Nils-Olof, et al.
(författare)
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Rectal carcinoma: double-contrast MR imaging for preoperative staging
- 2000
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Ingår i: Radiology. - 1527-1315. ; 215:1, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To evaluate and compare the imaging findings and staging of rectal carcinoma by using conventional magnetic resonance (MR) imaging, MR imaging with an enema of superparamagnetic ferristene-based contrast material, and MR imaging with an enema of ferristene solution plus intravenous injection of gadodiamide. MATERIALS AND METHODS: Twenty-nine patients (17 women, 12 men; age range, 39-91 years) referred with a diagnosis of rectal carcinoma were examined. Analysis of the rectal wall and staging of the tumor were performed. In all patients, the MR imaging findings were correlated with the histopathologic findings. RESULTS: The contrast material enema caused distention of the rectum and an intraluminal signal void, whereas the gadodiamide injection caused enhancement of the mucosa on T1-weighted images. This enhancement enabled evaluation of the normal rectal wall and differentiation of the mucosa, tunica muscularis, and perirectal space, which was not possible on the nonenhanced images. Double-contrast (ferristene solution plus gadodiamide) MR imaging was superior to imaging with only ferristene-based contrast material and had a sensitivity of 100%, specificity of 70%, and accuracy of 90% in distinguishing tumor stages worse than Dukes A. CONCLUSION: Double contrast material-enhanced MR imaging enables accurate rectal carcinoma staging, which is not possible at nonenhanced imaging.
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