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Biomedical subjects

B Husum

Publications and source records attributed to B Husum.

At least 55 records · Page 3Linked to original sources
PubMed1984

Perivascular axillary block IV: blockade following 40, 50 or 60 ml of mepivacaine 1% with adrenaline.

Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. The patients were randomly allocated to receive either 40, 50 or 60 ml of 1% mepivacaine with adrenaline 1:200,000. Blood concentrations of mepivacaine were measured up to 90 min after injection in seven, eight and ten of the patients from the three groups. Sensory and motor blockade was evaluated 20, 30 and 40 min after injection. All groups showed the same temporal development of the blockade, i.e. improval of the blockade during the period from 20 to 40 min after injection, but no difference was found in the sensory or motor blockade between the three groups. However, a further analysis of the incomplete blockades showed a better quality of the sensory blockade in the groups given 50 and 60 ml than in the group given 40 ml. None of the 90 patients showed any signs of systemic toxic reactions. The mean peak values of blood concentrations were 0.5-1.0 microgram/ml higher in the groups given 50 ml and 60 ml than in the group given 40 ml. On the basis of the present and two previous investigations on the dose response in perivascular axillary blockade, a dose of 50 ml 1% mepivacaine with adrenaline or another equivalent drug with vasoconstrictor is recommended.

Adult↗
PubMed1984

Acute epiglottitis in adults. A management protocol based on a 17-year material.

During a 17-year period 75 adult patients were treated for acute epiglottis. Twenty of the patients had respiratory symptoms and in 13 patients an artificial airway was established by means of nasotracheal intubation or tracheotomy. One patient died of suffocation and one other patient had severe incapacitating brain damage because of cardiac arrest in combination with respiratory obstruction. All the other patients were discharged from the hospital without any sequelae. On the basis of our 17-year material and the literature, a protocol for the handling of patients with suspected acute epiglottitis is presented.

Acute Disease↗
PubMed1984

Perivascular axillary block V: blockade following 60 ml of mepivacaine 1% injected as a bolus or as 30 + 30 ml with a 20-min interval.

Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. Blood concentrations of mepivacaine were measured up to 90 min after injection of local anaesthetic. Sensory and motor blockade were evaluated 20, 30 and 40 min after injection. Forty minutes after the last injection of local anaesthetic, there was no difference between the blockades of the two groups, except for the sensory blockade of the lower lateral cutaneous nerve of the arm, in which the frequency of analgesia was 90% after bolus injection and 63% after fractional injections. There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.

Adult↗
PubMed1984

Generalized anxiety or depression measured by the Hamilton Anxiety Scale and the Melancholia Scale in patients before and after cardiac surgery.

We have examined the applicability of the Hamilton Anxiety Scale (HAS) and our Melancholia Scale (MES) on a group of patients suffering from cardiac disease. They were assessed before surgery and again 1, 3, and 6 months after the operation. The results showed that the median for this group of patients even preoperatively was below the cut-off scores for both rating scales with a monotonous fall in score on the follow-ups. Item analysis showed that it was the psychic or cognitive symptoms of the HAS rather than the somatic symptoms of anxiety that explained the score variation. On the MES it was symptoms like depressed mood, psychic anxiety, pains, emotional and intellectual retardation rather than symptoms of guilt, motor retardation or suicidal impulses that were present. From both scales a total of 10 items emerged which were considered to measure generalized anxiety (Generalized Anxiety Scale). When the patients were classified into groups by a global assessment according to their ability to verbalize preoperative anxiety it was found that patients who were less able to verbalize had the lowest rating scale score. It was argued that preoperative anxiety is an introspective perception of fluctuating somatic manifestations of anxiety, whereas the rating scale procedure focuses on the persistent or cognitive part of anxiety which mostly is retrospectively perceived.

Adult↗
PubMed1984

ATP release from pig muscles during exercise measured by the firefly luminescence technique.

ATP measurements were performed on perfusates from muscles in anaesthetized pigs in vivo. Samples were obtained every 5 min by perfusion of a double-walled, fenestrated cannula inserted in the muscle. Five pigs served as controls and in 6 animals the adductor muscles of the thigh were electrically stimulated to contract each second for a period of 30 min. ATP was measured by the firefly bioluminescence technique. Immediately after insertion of the cannula ATP was high in the perfusate probably due to the physical damage to the cells and capillaries. After 50 min ATP reached a rather low level. Compared to controls, ATP in centrifuged, cell-free perfusate was unchanged during 30 min of muscle activity and for 60 min thereafter. In cell-containing samples ATP was slightly increased during the muscle activity period, probably due to damage from the cannula. It was concluded that, by this method, no indication was found of an association of muscular activity and release of ATP into the extracellular space.

Adenosine Triphosphate↗
PubMed1983

Electroconvulsive therapy and intracranial aneurysm. Prevention of blood pressure elevation in a normotensive patient by hydralazine and propranolol.

A 42-year-old normotensive woman developed a severe mental depression 6 months after an operation for intracranial aneurysm. The use of electroconvulsive therapy (ECT) was judged to be of vital importance. By concurrent administration of intravenous hydralazine and propranolol before induction of anaesthesia the normally occurring ECT-induced blood pressure elevation was completely prevented, and the patient received a series of ten ECTs without complications.

Adult↗
PubMed1983

Sister chromatid exchanges and structural chromosome aberrations in lymphocytes in operating room personnel.

Information on possible chromosomal damage in humans after long-term exposure to trace concentrations of waste anaesthetic gases is scarce. We examined peripheral lymphocytes in operating room personnel for both chromosome aberrations and sister chromatid exchanges (SCE). Following a standardized procedure of cultivation and staining, 30 cells from each person were scored for SCE and 100 cells from each person were examined for chromosome aberrations. A total of 45 persons were examined, representing anaesthetists (n = 15), operating room nurses assisting the surgeon (n = 10), nurses circulating in the operating room (n = 8) and healthy, unexposed controls (n = 12). The median duration of working in the operating room was 102 months, 66 months and 66 months, respectively. Time-weighted concentration levels of 2.5-4.3 p.p.m. of halothane and 25-400 p.p.m. of nitrous oxide were measured in the breathing zones of the anaesthetists during mask anaesthesia. Examination of SCE and chromosome aberrations yielded corresponding qualitative results. With both tests, no statistically significant difference was observed between the four groups of persons. It was concluded that by examination of both SCE and chromosome aberrations in peripheral lymphocytes in operating room personnel, no indication was found of a mutagenic effect of long-term exposure to trace concentrations of waste anaesthetic gases.

Anesthesiology↗
PubMed1983

Acute epiglottitis. A management protocol based on a 15-year material.

During a 15-year period 141 patients were treated for acute epiglottitis. 70 of the patients needed an artificial airway which was established by means of nasotracheal intubation. The mean intubation time was 41 h. All patients except 1, who suffocated before a free airway could be established, were discharged from the hospital without any serious sequelae. A follow-up study revealed no serious physical or psychological damage caused by the intubation treatment. On the basis of our 15-year material and the literature a protocol for the handling of patients suspected for acute epiglottitis is presented.

Acute Disease↗
PubMed1983

Intramyocardial temperature following various cooling procedures.

In 12 dogs on cardiopulmonary bypass, the intramyocardial temperatures in the anterior and the posterior wall of the left ventricle and in the septum were measured with microthermoelectrodes when different cooling procedures were used during 60 min of anoxic cardiac arrest. External cooling with 4 degrees C glucose (5.5%) solution dripping into the pericardial sac did not lower the temperature in the septum or in the posterior wall. Packing the heart in slushed ice after injection of the same glucose solution into the coronary tree reduced the septum and posterior wall temperature to around 30 degrees C. This cooling procedure, in combination with general moderate hypothermia, lowered the temperature to about 20 degrees C in these parts of the heart. Only when combined with general hypothermia did local cooling achieve low temperatures in all regions of the myocardium.

Animals↗
PubMed1983

Myocardial preservation during anoxic arrest. Chemical cardioplegia.

Two types of cardioplegic solution--the potassium arrest and the Bretschneider solution, both at 4 degrees C--were compared with regard to protective effect against ischemic damage during 60 min of anoxic cardiac arrest in the dog heart. Both solutions provided equally good protection, which was superior to that given by hypothermia alone.

Animals↗
PubMed1983

Myocardial preservation during anoxic arrest. Premedication with propranolol, verapamil or methylprednisolone.

Anoxic cardiac arrest was studied for one hour in five groups of dogs. Groups I-III were given methylprednisolone (30 mg/kg b.w.) before aortic cross-clamping. Normothermia was used with electrically induced ventricular fibrillation in group I, and without such fibrillation in group II, while group III was studied in local hypothermia. Propranolol (10 micrograms/kg) was given to group IV and verapamil (0.2 mg/kg) to group V before the anoxic arrest in local hypothermia. Judged from the ability of the heart to take over the circulation after anoxic arrest, local cooling preceded by propranolol or verapamil gave working performance comparable with the pre-arrest values. In the cooled, steroid-pretreated hearts the work capacity was depressed to the same degree as in locally cooled hearts without steroid premedication. Methylprednisolone prevented ischemic contracture during normothermic arrest with induced fibrillation, but not in the absence of such fibrillation. As adjuvant to local cooling, pretreatment with metabolism-reducing drugs is favorable for cardiac performance after arrest. Steroid premedication should be considered when normothermic arrest with electrically induced ventricular fibrillation is planned.

Animals↗
PubMed1982

Nitroglycerin for ergotism. Experimental studies in vitro and in migraine patients and treatment of an overt case.

Ergotamine was used to induce arterial contraction in vitro (measurement of isometric tension in segments from 3 human temporal arteries) and in vivo (peripheral systolic blood pressure measured by strain gauge plethysmography in 5 migrainous patients). In both these models of ergotism, the directly acting vasodilator nitroglycerine (NTG) effectively relieved the ergotamine-induced arterial contractions. A case of ergotism treated successfully with NTG infusion is reported. The diagnosis was based on history and measurement of peripheral systolic blood pressure by strain gauge plethysmography. The latter technique was also used to monitor the response to treatment for 20 h. Blood levels of ergotamine during ergotism were in the therapeutic range. Possible explanations for this finding are discussed.

Adult↗
PubMed1982

Normal sister-chromatid exchanges in oral contraceptive users.

Sister-chromatid exchanges in peripheral lymphocytes were examined in 115 healthy women, aged 15-43 years. 63 women were on no medication at all, and 52 women used oral contraceptives. 30 metaphases from each culture were scored for SCE. In accord with previous studies, cigarette smoking increased SCE. The use of oral contraceptives had no influence on SCE on non-smoking and in cigarette-smoking women. Thus the results did not indicate any potential mutagenic effect of oral contraceptives.

Adolescent↗
PubMed1982

Myocardial preservation during anoxic arrest. Experimental model ventricular fibrillation.

An experimental model with anaesthetized healthy mongrel dogs on extracorporeal circulation is described. Anaesthesia and cardiopulmonary bypass are the same as used in clinical practice. Various methods of myocardial preservation were investigated and their protective effect was judged by cardiac performance after termination of 60 min of anoxic arrest. In this study, the first part of an experimental series, electrically-induced fibrillation during 60 min of normothermic and local hypothermic anoxic arrest was investigated. In group I, the hearts were fibrillated immediately after cross-clamping. In group II, which served as controls, the hearts were allowed to fibrillate spontaneously after aortic cross-clamping. All the hearts in group I went into an ischaemic contracture, whereas those in group II showed a 50% recovery, but with a strongly reduced cardiac performance after termination of anoxic arrest and cardiopulmonary bypass. Measurements of myocardial surface pH demonstrated a rapidly developed acidosis during the period of anoxic arrest. The most impressive finding by light microscopy was pronounced myocardial oedema. External cooling by 4 degrees C glucose 5.5% continuously flushed into the pericardial sac in combination with electrically-induced fibrillation proved to be ineffective as a protective method. None of the eight dogs in this group survived. External cooling combined with intraventricular injection of 4 degrees C glucose 5.5% seemed to protect the hearts against ischaemic damage, insofar that all six hearts in this group were able to take over the circulation after declamping. The working capacity was, however, impaired and a relatively long period of mechanical support and stimulation with inotropic drugs was necessary.

Animals↗