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Biomedical subjects

E Hjelms

Publications and source records attributed to E Hjelms.

At least 55 records · Page 3Linked to original sources
PubMed1982

Myocardial protection during aortic valve replacement.

Peri-operative myocardial damage during aortic valve replacement is evaluated by analysis of S-GOT and LDH in the early postoperative phase. Combining the mortality figures and enzyme changes postoperatively, it is demonstrated that the peri-operative myocardial damage is significantly lower in the group operated on under cold cardioplegia a.m. Bretschneider, than in the group operated on under normothermia or moderate hypothermia and induced ventricular fibrillation.

Aortic Valve↗
PubMed1982

Results of pulmonary resection in cases of unilateral bronchiectasis.

Follow-up studies of 22 patients treated surgically for unilateral bronchiectasis showed that all patients were improved postoperatively following an average observation time of 9 years, 50% being completely free of respiratory symptoms. In all patients the number of days of recurrent illness had declined significantly after surgery. As mortality and morbidity rates in this kind of surgery are not negligible, a most careful pre-operative selection of patients suffering from bronchiectasis is indicated.

Adolescent↗
PubMed1982

Aberrant left pulmonary artery. Review of surgical results and report of a successfully treated case.

Aberrant left pulmonary artery is a rare anomaly which can cause severe respiratory distress by compressing the distal trachea. The most reliable diagnostic measures are barium swallow, which in most cases shows an anterior indentation of the oesophagus, and a pulmonary arteriogram to provide a conclusive diagnosis. Tomography of the trachea and the main bronchi should be performed, in order to detect possible additional malformations in the airways. In severely symptomatic cases, surgical correction should be done before a life-threatening situation has developed. The correction is best performed through a left thoracotomy, with transposition of the left pulmonary artery and end-to-side anastomosis to the main pulmonary artery. The postoperative course may be difficult, and the patient may require respirator support for two to three weeks. Early surgical revision must be considered if symptoms persist, if additional stenosis is demonstrated, or if malformations such as complete tracheal rings are observed in the area of compression at the time of the vascular correction.

Barium Sulfate↗
PubMed1981

Histological evaluation of transannular autografts of pericardium placed in the right ventricular outflow tract of dogs.

Autografts of pericardium were inserted as patches into incisions across the annulus of the pulmonary valve in 12 adult dogs and 12 pups. In order to accommodate for possible effects of pulmonary hypertension which pertains in many clinical circumstances, constricting teflon bands were placed around the main pulmonary artery in half of the animals. Samples of tissue from the patches were examined by light and scanning electron microscopy from 6 to 14 mth later. The eventual thickness of the insertion site of the patches was found to become 2-14 times greater than the initial autograft due to apposition of layers of collagenous tissue on the endocardial and epicardial surfaces of the autografts. Three pups showed small, angiographically undetected central aneurysms in their patches but the tissue in their base was 5 or more times thicker than control pericardium. Cartilaginous metaplasia was evident at the margins of 57% of the patches, necrotic remnants of parts of the autograft were evident in 38% and foci of dystrophic calcification in 24% of them. Whereas smooth muscle cells sometimes extended into the repair tissue (19%), elastic fibres were not present in the patches. Thus pericardial autografts in the right ventricular outflow tract seem unlikely to develop clinically significant abnormalities.

Animals↗
PubMed1981

Study of autologous pericardial patch-grafts in the right ventricular outflow tracts in growing and adult dogs.

The effects of growth and hemodynamic load on autologous pericardial grafts in the right ventricular outflow tract were studied in adult dogs (nine) and pups (12); ten of the 21 also had bands around the main pulmonary artery. All grafts functioned without radiographic evidence of abnormality for up to 14 months. At necropsy small central aneurysms were found in patches in three pups. Fibrous organization extending from the margins and adventitial aspect considerably thickened each patch. Cartilaginous metaplasia was evident in the ingrowing host tissue in many animals (57%). Small foci of necrotic pericardium and dystrophic calcification were evident in half of the grafts in pups but not in those in adult dogs. Patches in animals with normal pressures showed a reduction (p < 0.05) in the axis which lay in the direction of blood flow but no increase in the transverse axis. Only those patches subjected to elevated pressures in adult dogs showed an increase in patch size. These findings indicate that autologous pericardium is a suitable material for use in the surgical enlargement of the right ventricular outflow tract.

Age Factors↗
PubMed1979

Experimental evaluation of aortic homograft valves mounted on flexible support frames and comparison with glutaraldehyde-treated porcine valves.

The durability of the aortic homograft valve, when mounted in a rigid support frame, has been limited in some cases by aortic wall detachment from the frame in the commissure buttress area. To investigate the effects of frame flexibility, a stent was designed which was suitable for canine aortic valves of selected sizes. Of the two materials tested, acetal copolymer was found to be superior to polypropylene, as stents made from the latter material were permanently deformed as a result of polymer creep under the action of a cyclic load. Observations of a commercially available glutaraldehyde-treated heterograft mounted on a polypropylene frame indicated that stent flexibility was less important than had been suggested in earlier reports. It is considered that the glutaraldehyde preservation and the method of mounting this valve in the frame are major factors in prolonging the life of the implant.

Acetals↗
PubMed1977

Uncontrollable hemorrhage and tissue adhesive.

A case is reported of uncontrollable hemorrhage from suture lines in a patient having undergone coronary surgery. Ultimately the bleeding was brought under control by the use of isobutyl-cyanoacrylate. A piece of fascia was affixed to the suture line. Tissue adhesive is a valuable tool in difficult hemostatic situations, and should be available where major surgery is performed.

Adult↗
PubMed1975

Uptake of 67Ga in malignant lesions of the lung and lymphatic tissue.

Thirty-nine patients were given 67Ga intravenously before thoracotomy because of suspected lung cancer. Specimens of relevant tissue were removed and counted in a well-counter. The uptake of 67Ga in bronchogenic epidermoid and anaplastic tumours was greater than the uptake in normal lung tissue, while the uptake in adenocarcinomas seemed to be equal to that in normal tissue. Two out of seven benign lesions showed greater uptake than normal tissue. Thus 67Ga seems to be of limited value in the differentiation of malignant from benign lesions of the lung. The uptake in lymphatic tissue showed a great variation which did not indicate whether metastases were present or not. For this reason 67Ga seems to be of no use for demonstration of metastases in regional lymph nodes from cancer of the lung.

Adenocarcinoma↗