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Biomedical subjects

A V Persson

Publications and source records attributed to A V Persson.

At least 55 records · Page 3Linked to original sources
PubMed1980

Femoral-to-femoral bypass graft.

Femoral-to-femoral bypass reconstructions were first described by Vetto in 1962. It is a low-stress, low-risk procedure with excellent long-term results. Its use need not be confined to high-risk patients with tissue necrosis; it can be offered to moderate-risk patients with unilateral disease and incapacitating claudication. Studies in the noninvasive vascular laboratory assist in the preoperative selection of patients as they determine if the iliac artery on the asymptomatic side is capable of acting as an inflow vessel. Noninvasive evaluation and monitoring at regular intervals after operation allow for early detection and correction of new disease.

Arterial Occlusive Diseases↗
PubMed1980

The surgical management of carotid artery disease.

A reduction in the incidence of strokes among the general population requires recognition and effective management of those who are at greatest risk for stroke. Surgical management of carotid artery disease is a valuable therapeutic approach, and is probably more effective than medical management in preventing strokes in certain patients. Not every patient is a candidate for surgery, and the surgeon must carefully weight the risks of angiography and surgery versus the risks of a stroke. Those patients at greatest surgical risk are those with significant coronary artery disease and those who are neurologically unstable. Carotid endarterectomy should only be considered if an experienced angiographer and surgeon who routinely perform this procedure with good results are available. Older patients scheduled for major surgery should be evaluated for carotid artery disease regardless of the presence of a bruit, particularly if they show evidence of atherosclerosis alsewhere. Noninvasive carotid studies are very valuable in assessing patients. With proper selection, carotid endarterectomy can decrease the incidence of the devastating stroke.

Acute Disease↗
PubMed1980

Fibrinolytic therapy.

Fibrinolytic therapy is a useful addition to the armamentarium of most clinicians. Patients with fibrin-based intraluminal clots are seen by almost all physicians. With proper patient selection and careful physician adherence to dosage schedule and monitoring, the incidence of significant complications with fibrinolytic agents is about the same as with heparin therapy. Heparin stops the thrombotic process, whereas fibrinolytic therapy not only stops the thrombotic process, but often reestablishes a normal, hemodynamic state. Patients who undergo fibrinolytic therapy are spared long-term problems like amputation and the postphlebitic syndrome.

Arterial Occlusive Diseases↗
PubMed1978

A new chromogenic substrate for angiotensin-converting enzyme.

The compound para-nitrobenzyloxycarbonylglycyl-(S-4-nitrobenzo-2-oxa- 1,3-diazole)-L-cysteinylglycine [NO2ZGly(S-NBD)CysGly] with an absorption maximum at 423 nm is readily hydrolyzed by angiotensin-converting enzyme (EC 3.4.15.1. peptidlyldipeptide hydrolase) to yield the S-benzfurazan derivative of cysteinylglycine. An internal S-->N shift occurs immediately to yield the N-benzfurazan derivative which in turn reacts with the sulfhydryl reagent 4,4'-dithiodipyridine to produce the mixed disulfide with an intense absorption at 461 nm. The maximum difference in molar absorptivity of 13,000 M-1 cm-1 occurs at 470 nm.

Chromogenic Compounds↗
PubMed1978

A fluorogenic substrate for angiotensin-converting enzyme in plasma.

A simple, sensitive, and reproducible assay for angiotensin-converting enzyme is described. It is based on the hydrolysis of the minimally fluorescent substrate p-nitrobenzyloxycarbonylglycyl-L-tryptophylglycine to the products p-nitrobenzyloxycarbonylglycine and the highly fluorescent L-tryptophylglycine. The L-tryptophylglycine was analyzed by fluorometry (lambda excitation = 285 nm; lambda emission = 350 nm). The mean value for human plasma (serum) is 16.5 nmol of substrate hydrolyzed per minute per milliter of plasma under the described assay conditions.

Dipeptides↗
PubMed1976

Acute arterial occlusions.

Aside from a ruptured aneurysm or an acute myocardial infarction, acute arterial occlusion is one of the most pressing of the nontraumatic situations facing the physician. Administration of sodium bicarbonate, papaverine, and heparin will often provide the extra few hours needed to get the patient into the hands of a vascular surgeon for surgical removal of the occlusion. Occasionally, one finds a candidate for the use of streptokinase. Regardless of the mode of therapy chosen, post-treatment angiograms are very important, for they often elucidate atherosclerotic lesions amenable to elective reconstructive surgery.

Arterial Occlusive Diseases↗
PubMed1976

Management of asymptomatic carotid bruits.

Asymptomatic carotid bruits may originate in the internal carotid artery from atherosclerotic plaques which predispose to strokes in certain individuals over the age of 40. Certain recently developed noninvasive screening tests are helpful in determining the hemodynamic significance of these bruits, which ultimately require arteriography to determine precise diagnosis and significance. If hazardous lesions are demonstrated, carotid endarterectomy may be recommended for selected patients without multiple risk factors to prevent the occurrence of ischemic cerebral episodes.

Angiography↗
PubMed1976

Progression of popliteal aneurysmal disease following popliteal aneurysm resection with graft: a twenty year experience.

Multifocal occurrence of peripheral atherosclerotic aneurysm is well known. However, little attention has been directed to subsequent progressive aneurysmal development adjacent to sites of previously resected and grafted popliteal aneurysms. During a 20 year follow-up study of 79 patients with 115 popliteal aneurysms, we have observed the development of six atherosclerotic femoropopliteal aneurysms adjacent to the original aneurysm site in four patients, occurring 5 months to 10 years (average, 5 1/2 years) after the initial operation. Operative repaire was accomplished successfully of five of the six aneurysms; one popliteal aneurysm has not been operlateral popliteal aneurysm (46 percent). Fifty-seven patients (72 percent) presented with complications of the aneurysm, including 35 with thrombosis. As initial therapy, 69 grafting procedures were performed on 58 patients; nine extremities had sympathectomy only; four aneurysms were ligated or resected without grafting; and four extremities required amputation as the only procedure. Among patients with grafts, nine subsequent amputations were necessary in the early postoperative period, all occurring in patients presenting with thrombosed aneurysms. No patient who developed pedal pulses in the period immediately after operation required amputation. In addition, two patients developed aneurysmal degeneration in popliteal homografts. These data demonstrate the progressive nature of popliteal aneurysmal disease and emphasize the need for regular and life-long follow-up.

Adult↗
PubMed1975

Surgical management of abdominal aortic aneurysms: factors influencing mortality and morbidity--a 20-year experience.

Abdominal aortic aneurysmectomy is being performed with progressively lower operative mortality and morbidity. Three hundred thirty seven patients have had elective aneurysm repair since 1954. Factors affecting mortality and morbidity in the last 108 cases are analyzed. Seventy-four per cent of patients had pre-existing disease, either cardiac, pulmonary, renal, cerebrovascular, diabetes mellitus, or hypertension. Six patients died following operation, a mortality rate of 5.5%. One died of pulmonary and 5 of cardiac causes. No patient died of renal failure or required dialysis. A signficant feature of management is the regimen of fluid therapy using dextrose in lactated Ringer's solution during and after operation to minimize hypotensive and renal complications. No patient developed a wound infection, graft infection, wound dehiscence, stroke, or intestinal ischemia. Serious postoperative complications were largely cardiac or pulmonary. Despite recent liberalization of indications for operation, comparative figures show continued reduction in operative mortality from 17% during 1954-1961, or 7.4% during 1962-1967, to 5.5% in the 1968-1974 era. This declining mortality is related to earlier diagnosis using non-invasive methods (sonogram), simplified operative techniques, improvement in fluid management, innovations in cardiopulmonary therapy, and recognition and proper handling of unusual manifestations of aortic aneurysms.

Aged↗
PubMed1975

Management of post-traumatic pain syndromes (causalgia).

A number of post-traumatic pain syndromes may be grouped under the two headings: causalgia and mimocausalgia states. Our concern is the early recognition of patients whose complaints have a real organic basis but whose physical signs are not of sufficient degree to make this fact readily apparent. These patients are all too often mismanaged or neglected for sufficiently long periods of time to permit the underlying pathologic physiology to secure supremacy over normal function. Recognized and treated properly by means of sympathetic ablation, either medical or surgical, the vast majority can be relieved of their symptoms. The extremities can then be rehabilitated by appropriate measures.

Adolescent↗