Biomedical subjects
Publications and source records attributed to F Lund.
Two case reports of late recurrence of upper urinary tract urothelial tumours 13 years after ipsilateral local resection and 19 years after contralateral nephroureterectomy are used in the discussion on when to perform local resection. In accordance with existing literature we propose local resection in case of low-grade upper urinary tract urothelial tumours.
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Digital pulse plethysmography (DPG) has proved a technically simple, noninvasive, sensitive and informative technique for studying the effects of nitroglycerin and other nitrates on peripheral arteries. The importance of performing nitrate evaluation by DPG mainly in elderly subjects is emphasized. On the basis of observations with DPG some indirect conclusions on the effect of nitrates on the coronary arteries are justified. A review, with recommendations based on own experience, is given of various recording techniques and principles of evaluating quantitatively the digital volume pulse contour, with special reference to the influence of nitrates on the position and appearance of dicrotism. DPG seems to be a convenient, noninvasive and helpful procedure in studies on the development of nitrate tolerance.
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110 adult patients with benign and malignant conditions subjected to an ileal conduit urinary diversion were followed from 1 to 8 years after the operation. 62 patients (59 with a malignant disease) died in the follow-up period. The patients were divided into 3 groups according to their primary diseases: (1) benign, (2) malignant without irradiation, and (3) malignant with irradiation. Early complication rates were 22% in group 1, 33% in group 2, and 29% in group 3. In addition, the complications were more serious in the group with malignant diseases. Late complication rates were 70% in group 1, 80% in group 2, and 54% in group 3, possibly due to a shorter time of observation in group 3. Renal function deteriorated in 18% of the patients but only 3% became uremic. When urinary diversion is inevitable we find this method acceptable, at least until the long-term results of newer methods are known.
The present work represents an attempt to develop a method for measuring relative blood flow in intestinal capillaries, by the use of sodium fluorescein (Na-F) as an indicator substance. The method is called fluorescein flowmetry (FF). A mathematical model was developed; blood flow was expressed as an index between the maximum fluorescence obtained during the first circulatory passage of Na-F and the rise time, defined as the time interval between 10 and 90% of the maximum fluorescence. The prerequisites for the mathematical model were tested in experiments in animals and man. The extraction of Na-F in the intestinal capillaries was found to be more than 99%. The ratio between the tissue clearance and uptake was found to be 0.0051, indicating no back flux. Experiments in man revealed that the rise time was proportional to the mean transit time and the mean transversal time of the bolus proper. The accuracy of FF was confirmed in man where the ratio between mucosal and serosal-muscular capillary blood flow was 2:1. From the results obtained, it appears that FF can be used as a method for measuring relative capillary blood flow in the intestine.
The intestinal capillary blood flow in hemorrhagic shock was studied in 32 rats by fluorescein flowmetry (FF). FF implies the measurement of relative intestinal capillary blood flow, expressed as an index. Exsanguination to 35 mmHg for 180 min resulted in a heterogeneous fluorescence pattern with 51% difference in blood flow index between the areas with most and those with least fluorescence, compared with 14% in the control group. Following retransfusion of the shed blood, the difference in blood flow index between areas with most and least fluorescence was 54%, suggesting that the heterogeneous blood flow was not improved by retransfusion. Heterogeneity of the capillary blood flow in the intestines seems to be a phenomenon of hemorrhagic shock and FF to be a suitable method for studying this condition.
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Fifty eight patients with idiopathic chronic anal fissure were included in a randomised prospective trial of lateral subcutaneous sphincterotomy versus simple anal dilatation carried out as outpatient procedures. Operations were performed under local anaesthesia and the patients reviewed 10-30 months later (median follow up time 18 months). Altogether 30 patients were treated by lateral subcutaneous sphincterotomy and 28 by anal dilatation. No serious complications were observed in either group. One recurrence was observed in the group treated by sphincterotomy, whereas eight occurred in the other group (p less than 0.05). Functional results with respect to impaired control of flatus and soiling of underwear were significantly better after sphincterotomy (p less than 0.002). It is concluded that lateral subcutaneous sphincterotomy is the treatment of choice for idiopathic chronic anal fissure resistant to conservative measures.
This report is an evaluation of the changes in bone scans in certain patients entered into the EORTC protocol 30762 and discusses the relevance of these expensive investigations.
A controlled study has been conducted to ascertain whether administration for 8 months of a vitamin A-acid analog, Tigason, could prevent recurrences of non-invasive bladder tumors. Eligible were 73 patients, 33 in the Tigason group, and 40 in the placebo group. The results indicate that Tigason, as used in this study, is ineffective as prophylaxis. Side effects to Tigason urged 17 patients to drop out from the study mostly due to symptoms from skin and mucous membranes. The discussion considers different reasons for the lack of effect and concludes that more tolerable vitamin A-acid analogs are needed if further studies of prevention of non-invasive bladder tumors are to be carried out.
Clinical use of O-(beta-hydroxyethyl)-rutosides (HR) has been mainly in chronic venous insufficiency, but to some extent also in arterial insufficiency. We investigated the effect of HR on the central circulation in a group of patients undergoing aortocoronary bypass surgery. Measurements were made during operation and on the first postoperative day, both before and after intravenous injection of 15 ml 10% HR (1.5 g). None of the obtained or calculated values for cardiac output, central blood pressures, coronary blood flow, heart rate, stroke volume and systemic, pulmonary and regional myocardial vascular resistance showed significant change following HR injection intraoperatively or postoperatively. We conclude that this intravenous dosage of HR has no adverse effect on central haemodynamics in patients with advanced coronary disease. This suggests that the drug can also be safely used in patients with peripheral arterial disease, as its beneficial effect on nutritional skin blood flow in these patients seems to be due to action on the microrheology of the blood and not to peripheral vasodilatation.
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The study of the Korteweg-deVries, nonlinear Schrödinger, Sine-Gordon, and Toda lattice equations is simply the study of constrained oscillators. This is likely to be true for any nonlinear wave equation associated with a second-order linear problem.
In a series of patients in whom the patello-femoral joint had been examined by arthroscopy, in conjunction with arthrotomy or both, previously obtained films were reviewed. A series of radiologic morphometric measurements with bearing on the shape of the patella and the patello-femoral joint was carried out and compared between patients who had normal patello-femoral joints, patients with chondromalacia grade II or III and patients with chondromalacia grade IV or arthrosis. No difference between the three groups in any of the variables was found. However, a shallow excavation in the subchondral bone was observed in the lateral view of the patella in most of those patients with proven chondromalacia patellae.