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Biomedical subjects

A Linder

Publications and source records attributed to A Linder.

At least 55 records · Page 3Linked to original sources
PubMed1993

Palmar thermometry for intraoperative success control of thoracic sympathectomy.

In a pilot study involving six patients, palmar thermometry was used as a non-invasive method for intraoperative success control during thoracic sympathectomy. Using commercially available thermo-elements and amplifier modules, a marked increase in temperature could be registered in five patients after the severance of their rami communicants grisei for the hand. This effect was associated with the long-term success of therapy for hyperhidrosis in all five patients. This initial experience demonstrates that palmar thermometry is sensitive enough to measure surgical success intraoperatively. The limit of the thoracic sympathectomy in the cranial direction is indicated intraoperatively and Horner's syndrome is avoided with certainty.

Body Temperature↗
PubMed1993

Selective video-assisted thoracoscopic sympathectomy.

Video-assisted and thermometrically controlled thoracoscopic sympathectomy demonstrates new ways in the treatment of upper-limb hyperhidrosis. An anatomical portrayal of the sympathetic chain is possible as a result of the improved visualization and magnification of the operative area provided by the video-optic technique. The difference in temperature, registered by means of a thermometric sensor in the palm of the hand, indicates that the sympathetic nerves responsible for the hyperhidrotic segments have been severed. The number of postoperative Horner's syndromes will be reduced significantly with this method. Until now, we have successfully treated six thermometrically controlled patients. No recurrences have arisen during an 18 months observation period. Neither intraoperative nor postoperative complications were recorded. One patient complained of increased compensatory sweating of the trunk. Thermometrically controlled thoracoscopic sympathectomy is expected to improve the various forms of treatment available for sympathetic reflex dystrophies in the future.

Body Temperature↗
PubMed1993

Immunocompetent cells in human nasal polyps and normal mucosa.

The distribution of T- and B-lymphocytes, HLA-DR-expressing cells, and macrophages was determined using monoclonal antibodies in frozen biopsy sections of nasal polyps from 12 patients, and of nasal mucosa from five disease-free controls. The relative proportion and spatial distribution of different lymphoid cells was similar with regards to both nasal polyps and normal mucosa. Numerous scattered T lymphocytes (Leu4-positive) and HLA-DR-expressing macrophage/dendritic-like cells were shown and tended to accumulate in the subepithelial areas. Aggregates of T lymphocytes and HLA-DR-positive cells were also found close to deeper glands. In the submucosal clusters, the Leu3a-positive ("helper/inducer") cells were more common than the Leu2a-positive ("suppressor/cytotoxic") cells. Furthermore, a number of epithelial, non-lymphoid cells were found to express the HLA-DR antigen, which suggests an active role for the epithelium in the immunological response of the normal mucosa as well as that of the nasal polyp.

Adult↗
PubMed1992

Na,K-ATPase in crystalline form investigated by scanning force microscopy.

Na,K-ATPase has been isolated in purified membrane fragments from kidney tissue and crystallized by phospholipase treatment to obtain two-dimensional, membrane-bound protein crystals. Scanning force microscopy has been used to identify and analyze the topography of the membrane fragments. Specific patterns in accordance with electron microscopic images have been found. In biological material under physiological conditions the scanning force is a crucial parameter for the resulting image at high resolution.

Animals↗
PubMed1992

Vocal fold lateralization using carbon dioxide laser and fibrin glue.

Lateralization of one or both vocal folds is a generally accepted surgical principle for the relief of the airway obstruction caused by bilateral vocal fold paralysis. A modified, entirely endoscopic method of lateralization has been developed, employing a carbon dioxide laser to reduce the bulk of the fold, and fibrin glue to maintain the lateral position. The results of 18 operations on 15 patients, including six who had unsatisfactory results after previous surgery, were analyzed and compared retrospectively with the results from 22 patients operated on before the introduction of the method. The patient's ability to perform everyday activities improved in 12 cases, which paralleled the results of the previous, more cumbersome methods. The incidence of re-operation was comparable, given the shorter follow-up after the more recent method.

Adult↗
PubMed1991

[Conservative surgical techniques in the area of lung surgery].

An important condition for careful operations in lung surgery are modern anesthesia procedures like one-lung ventilation and high-frequency jet ventilation. The aim of careful procedures is the preservation of normal lung tissue. Most commonly broncho- and angioplastic resections are performed to avoid a pneumonectomy without loss of radicality. Minimally invasive endoscopic surgical techniques combined with laser application complete the spectrum of careful procedures in thoracic surgery, e.g., for resection of lung cysts or for thoracic sympathectomy.

Humans↗
PubMed1989

Bilobectomy in a 90-year-old patient.

A 90-year-old patient was admitted to our clinic after two weeks of dangerously increasing hemoptysis. Bronchoscopy showed the segment bronchi of the right lower lobe to be subtotally occluded by a tumour. A biopsy was not taken because of simultaneous bleeding. After weighing the risks, surgery was decided on despite the advanced age of the patient. The centralized position of the tumour necessitated a bilobectomy. Histology showed a small-cell bronchial carcinoma T2N1M0. After initial secretion retention and mild transitional syndrome, the postoperative course was uncomplicated. Four weeks after surgery, the patient could be transferred to his local hospital where he was discharged home after a further two months. There was no reappearance of hemoptysis. At the last check-up, one year postoperatively, there was no tumour recurrence. The patient lives alone in his flat as prior to surgery. This case shows that, in individual patients, larger pulmonary resections are also possible and justified in the tenth decade of life.

Aged↗
PubMed1989

Mucociliary clearance following tracheal resection and end-to-end anastomosis.

Mucociliary clearance is an important cleaning system of the bronchial tree. The complex transport system reacts sensitively to medicinal stimuli and inhaled substances. A disturbance causes secretion retention which encourages the development of acute and chronic pulmonary diseases. It is not yet known in which way sectional resection of the central airway effects mucociliary clearance. A large number of the surgical failures are attributable to septic complications in the area of the anastomosis. In order to study the transportation process over the anastomosis, ten dogs underwent a tracheal resection with end-to-end anastomosis, and the mucociliary activity was recorded using a bronchoscopic video-technical method. Recommencement of mucous transport was observed on the third, and transport over the anastomosis from the sixth to tenth, postoperative days. The mucociliary clearance had completely recovered on the twenty-first day in the majority of dogs. Histological examination of the anastomoses nine months postoperatively showed a flat substitute epithelium without cilia-bearing cells in all dogs. This contrasts with the quick restitution of the transport function. In case of undamaged respiratory mucosa, a good adaptation of the resection margins suffices for the mucous film to slide over the anastomosis.

Anastomosis, Surgical↗
PubMed1989

[Functional aspects of pleural empyema and pleural induration].

Decortication for pleural empyema with or without residual cavities was performed in 161 patients. Indications were sanitation of infection sites and improvement of respiratory function. A total of 73.3% of the patients had a non-specific and 22.4% a tuberculous empyema. Postoperative complications included 8.7% wound infections and 1.2% recurring empyema. Operative mortality was 0.6%. To estimate pulmonary function, the preoperative values of blood gas analysis and vital capacity were assessed in 75 patients and compared with those obtained after one year. A relatively slight improvement was seen only in those patients who had a preoperative reduction of vital capacity amounting to more than 40%. An indication for decortication solely to improve pulmonary function is rare. As a rule decortication is indicated for the simultaneous removal of septic foci and functional improvement.

Adult↗
PubMed1988

Symptom scores as measures of the severity of rhinitis.

Methodological aspects of subjective symptom ratings were investigated in 103 symptomatic rhinitis patients. The patient's own overall rating registered on a visual analogue scale was compared with a summed symptom score calculated from ratings of sneezing, rhinorrhea and congestion. A significant correlation, but not complete correspondence, was found in patients with untreated rhinitis during the birch pollen season and after challenges with birch pollen or histamine. Comparisons between the overall rating and scores for individual symptoms gave lower degrees of correlation or non-significant correlations. When twenty-five patients were treated with an intranasal corticosteroid during the pollen season, both the overall rating and the summed symptom score decreased significantly. The changes in the two ratings for each patient showed a moderate correlation. The patients' ratings of rhinorrhea correlated with an approximate measure of the volume of secretion after pollen challenge but not during the pollen season or after histamine challenge. It is recommended on the basis of these findings that, for measuring the severity of rhinitis, scores indicating the course of individual symptoms should not be combined into a summed score, but that the patient's overall rating of the condition should be used. Scores for individual symptoms can be used to draw more detailed conclusions about nasal pathophysiological features and about qualitative disimilarities between different modes of therapy.

Adrenal Cortex Hormones↗
PubMed1988

Variations in histamine concentration in nasal secretion in patients with allergic rhinitis.

The histamine concentration and content in nasal secretion and the volume of nasal secretion in nasal washing samples were measured under different conditions in 28 patients with allergic rhinitis sensitive to birch pollen. The mean histamine concentration was significantly lower after intranasal birch pollen challenge (2.08 micrograms/ml) than in prechallenge samples (6.96 micrograms/ml), and was also significantly lower in untreated patients during the birch pollen season (2.30 micrograms/ml) than off-season (7.18 micrograms/ml). The same relationship was found between the histamine content of the secretion samples obtained on these occasions. The mean secretion volume was greater after than before challenge, but not significantly higher during the season than off-season. A partial reversion of the changes in histamine concentration and content that occurred during the season was observed during intranasal corticosteroid therapy. The concentration and content of histamine in nasal secretion from symptomatic patients after intranasal histamine challenge did not differ significantly from those in asymptomatic subjects before challenge. It was concluded that although the histamine level in nasal secretion can be used as a marker of changes in the severity of allergic rhinitis, it is not ideal for this purpose.

Beclomethasone↗
PubMed1987

Eosinophil cationic protein and myeloperoxidase in nasal secretion as markers of inflammation in allergic rhinitis.

The inflammatory component of allergic rhinitis was studied by measuring the concentration and content of eosinophil cationic protein (ECP, specific for eosinophils) and myeloperoxidase (MPO, specific for neutrophils) in samples of nasal secretion from 20 pollen-allergic subjects. All secretion samples contained measurable concentrations of both proteins. The mean ECP concentrations on two occasions without pollen exposure were 950 and 1170 micrograms/l. The ECP concentration during the pollen season without any therapy (mean 1160 micrograms/l) did not differ significantly from the baseline values, but intranasal corticosteroid therapy resulted in a significant decrease (mean 530 micrograms/l). The concentration of MPO was about 10 times higher than that of ECP, but the changes in MPO were nonsignificant throughout the observation period. An inverse correlation was found between the threshold dose in histamine challenges and the ECP level expressed either as concentration or as content. Furthermore, the ECP concentration and content 1 day after a positive allergen challenge were both significantly correlated with the strength of the challenge reaction. Measurements of ECP in nasal secretions are useful for studying the presence and activity of eosinophils in the nasal mucosa, and may prove of value in clinical investigations on patients with allergic rhinitis.

Adolescent↗
PubMed1987

Histamine concentrations in nasal secretion and secretory activity in allergic rhinitis.

The prerequisites for using the assayed histamine concentration in nasal secretion as an objective measure of disease activity in allergic rhinitis were investigated. It was demonstrated that in histamine determination procedures the presence of quenching substances in the nasal secretion could lead to underestimation of the histamine concentration. This bias was eliminated in a modified spectrofluorometric assay. Only an insignificant fraction of the histamine in samples collected by nasal spray washing was bound to unfiltrable particles or cells. The mean histamine concentration in nasal secretions from 15 healthy subjects was 11.2 micrograms/ml and in a group of nine patients with allergic rhinitis out of season 3.36 micrograms/ml. The histamine concentration in the latter group decreased during the pollen season and after positive allergen challenge. It is suggested that this decrease is caused by the increase in volume of the secretion during the allergic response. The use of lithium as an exogenous marker permitted quantitation of the increase in the relative amount of nasal secretion recovered by washing in the symptomatic subjects.

Adult↗
PubMed1983

Augmentation cystoplasty in the treatment of neurogenic bladder dysfunction.

We report on the role of augmentation cystoplasty in the treatment of 18 patients with neurogenic bladder dysfunction and associated symptoms of severe urinary urgency, frequency and urinary incontinence. All patients failed to obtain any symptomatic improvement with a variety of treatments, including intermittent self-catheterization and pharmacologic manipulation. Preoperative evaluation helped segregate the patients into 3 groups: 1) those with extremely poor bladder wall compliance, 2) those with severe detrusor hyperreflexia and 3) those with a combined problem of poor bladder wall compliance and hyperreflexia. Bladder augmentation involved cecocystoplasty in 15 cases and ileocystoplasty in 3. In 5 patients an artificial urinary sphincter cuff was placed in an attempt to improve continence. Followup ranging from 12 to 120 months (mean 38 months) was available in 17 patients. An excellent surgical result was obtained in 82 per cent of the patients who became asymptomatic and continent after augmentation cystoplasty. Augmentation cystoplasty is a therapeutic modality that should be considered a viable treatment option in selected patients with neurogenic bladder dysfunction.

Adolescent↗