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Biomedical subjects

G Semb

Publications and source records attributed to G Semb.

At least 37 records · Page 2Linked to original sources
PubMed1991

A study of facial growth in patients with bilateral cleft lip and palate treated by the Oslo CLP Team.

Lateral and frontal cephalometric analysis of a mixed longitudinal survey of 90 individuals with complete bilateral clefts of the lip and palate from the Oslo Growth Archive is described. All subjects were treated and followed-up by the Olso CLP Team according to strictly defined protocols for treatment and documentation. Craniofacial form in this sample is generally similar to that reported for Caucasian subjects treated for this condition elsewhere.

Adolescent↗
PubMed1991

Simonart's band and facial growth in unilateral clefts of the lip and palate.

A cephalometric analysis was carried out to see if the presence of a Simonart's band at birth was associated with a detectable difference in subsequent craniofacial form. Mixed longitudinal data from 5 through 18 years of age was analyzed for 257 individuals with complete UCLP included in the Oslo CLP Growth Archive, 80 with a Simonart's band and 177 without. No major differences were detected between individuals with or without Simonart's band, though the presence of a Simonart's band was associated with a larger cranial base angle and a slightly more favorable maxillomandibular relationship. The findings are discussed in relation to embryogenesis, primary surgery, and secondary surgery. It is recommended that cephalometric studies of UCLP involving group comparisons should avoid major imbalance with respect to the proportion of individuals with a Simonart's band at birth.

Adolescent↗
PubMed1991

Strategies for the advancement of surgical methods in cleft lip and palate.

This paper examines the clinical research methodologies used for the evaluation of cleft lip and palate therapies. A survey of clinical reports in the Cleft Palate Journal between 1964 and 1988 revealed that almost all used retrospective methods (96%). The authors examine the merits and biases associated with retrospective evaluation of therapies and compared these to prospective randomized clinical trials. The strengths and weaknesses of clinical trials are discussed in relation to the long-term evaluation of primary surgery in cleft patients. For these to be successful, further work is needed to investigate questions such as sample size, possible predictors of long-term outcome, and improved methods of presurgical assessment. The authors conclude that if the uncertainties associated with the choice of primary cleft surgery are to be resolved, the challenge of multicenter prospective clinical trials must be faced by the various disciplines involved in cleft palate clinical research.

Cleft Lip↗
PubMed1991

Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. I. Maxillary development.

Lateral skull radiographs of 85 patients with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes were compared at three different ages regarding maxillary development. Regimes that included primary bone grafting to the alveolus at six months of age resulted in inhibited anterior maxillary growth and reduced maxillary inclination. Regimes that included secondary bone grafting after eruption of the incisors but before the eruption of the canines, resulted in better maxillary development, but were not as good as regimes that omitted bone grafting altogether.

Adolescent↗
PubMed1991

Craniofacial and occlusal characteristics in unilateral cleft lip and palate patients from four Scandinavian centres.

Craniofacial morphology and dental occlusion were studied at early school age in 15 consecutive patients with unilateral cleft lip and palate from each of four Scandinavian cleft centres. Treatment differed mainly in the techniques of palatal repair. Push-back closure of the palate particularly impaired maxillary development, which resulted in an increased incidence of crossbite and reduced intercanine distance when compared with patients who had been operated on by the von Langenbeck method or in whom the anterior palate had not yet been closed.

Cephalometry↗
PubMed1990

[Blood transfusion in heart surgery].

We have studied the effect of blood-saving measures in open heart surgery. Such measures were introduced in 1987. All fluids administered on the day of operation and on the first postoperative day were registered in all cardiac patients operated during one month in 1986, 1987, 1988. In 1986 the patients were exposed to a median of 21 donors while in 1988 they were exposed to a median of 2 donors. The reduction in transfusions was achieved by substituting plasma by polygeline, by giving thrombocytes only when there was a low thrombocyte count and by accepting a hemoglobin value of 9 g/100 ml before transfusion of erythrocytes. In 1988 most postoperatively drained blood was retransfused using a Sorensen retransfusion set. The reduction in transfusions has reduced the cost of each open heart operation by NOK 11,662.

Blood Donors↗
PubMed1990

Risk factors for morbidity and mortality in mitral valve replacement.

Risk factors of operative mortality and long term survival were identified in 219 patients who underwent mitral valve replacement (MVR) using Bjørk-Shiley mechanical prostheses. Early mortality was 7.3%. The accumulated follow-up time was 1134 patient-years, and the 5-year survival for the total cohort was 78 +/- 3%. Independent prognostic factors of early mortality were poor NYHA class, which carried a relative risk (RR) of 3.2, and ischaemic aetiology, with a RR of 2.2. Ischaemic aetiology was the sole predictor of heart pump failure requiring intra-aortic balloon pump support (RR = 2.7). Independent risk factors of total mortality (early and late) were male sex (RR = 2.3), NYHA class III-IV (RR = 2.4), presence of mitral regurgitation (RR = 3.2) and relative heart volume (RR = 1.6 for a 800 ml/m2 size compared to a heart of 550 ml/m2). Our results underline the importance of patient-related factors in MVR, and indicate that care is needed in comparing the quality of MVR from different institutions with respect to mortality and morbidity. The results of MVR are palliative rather than curative except in female patients with NYHA class II function and mitral stenosis, in whom cure was attained.

Adolescent↗
PubMed1990

Effects of nimodipine on cerebral blood flow and neuropsychological outcome after cardiac surgery.

Thirty-five patients undergoing cardiac surgery requiring cardiopulmonary bypass (CPB) were allocated randomly in a prospective double-blind study to receive either nimodipine 0.5 micrograms kg-1 min-1 or placebo. Cerebral blood flow (CBF) was measured during and immediately after CPB. Neuropsychological tests were performed 6 months after surgery to determine any relationship between ischaemic damage and CBF and administration of nimodipine. There were no differences in CBF between the nimodipine (n = 18) and placebo groups (n = 17). Significant changes in neuropsychological tests were found in six patients tested 6 months after surgery but there were no conclusive signs of ischaemic damage. The nimodipine-treated group performed better in tests of verbal fluency and visual retention, suggesting that some memory functions were preserved better in this group.

Brain↗
PubMed1990

Pharyngeal flap and facial growth.

The present study addressed two questions. Does the skeletal pattern of children with cleft lip and palate who require a pharyngeal flap differ from children with similar clefts who do not? Following a pharyngeal flap does the pattern of facial development change? Skeletal form prior to pharyngeal flap was compared using cephalograms in 52 subjects with unilateral cleft lip and palate (UCLP) who subsequently received a superiorly based pharyngeal flap and 52 UCLP controls matched for sex and age. The flap group had slightly smaller maxillary length and anterior face heights and greater mandibular protrusion (p less than 0.5) before the pharyngeal flaps were done. Preoperative and five year (minimum) postoperative records were analyzed for 29 early pharyngeal flap cases and 29 matched controls. Subsequent growth demonstrated some assimilation of the flap group with the controls, but repeated measures analysis of variance failed to identify any important differences in growth after pharyngeal flap, suggesting that the superiorly based pharyngeal flap carries no systematic risk of interference with facial growth.

Adolescent↗
PubMed1989

[Peroperative autotransfusion in aortic surgery].

Intraoperative autotransfusion of blood by means of a Solcotrans retransfusion bag was used during abdominal aortic surgery in a series of 25 patients. The need for transfusion of blood products, erythrocytes and plasma, decreased from 8.5 units to 4.5, as compared with 26 patients operated during the same period the preceding year (p less than 0.01). Hemoglobin was not lower at any point per- or postoperatively when autotransfusion was used. In contrast to one out of 26 patients operated without autotransfusion (p less than 0.05), seven of 25 patients whose operations involved autotransfusion did not need any donor transfusions. Exposure to potentially contagious donor products may be further decreased by using polygeline (Haemmaccel), and in some cases heat-treated albumin, in stead of plasma. While the mean number of donor transfusions remained relatively high with autotransfusion, the median number of erythrocyte donor transfusions was 0 units preoperatively and one unit postoperatively. An average of 684 ml of blood was retransfused. This corresponds to less than two units of blood. The main decrease in the number of transfusions was due to more careful surgical technique, the use of impregnated vascular grafts, and a changed attitude towards transfusions.

Aged↗
PubMed1989

Experimental transplantation of teeth to simulated maxillary alveolar clefts.

A total of 14 teeth were transplanted to simulated alveolar clefts in 5 monkeys. Autogenous cancellous bone was grafted to the cleft together with the tooth in ten instances. Healing processes were observed 216 or 271 days postoperatively. Another group of four teeth were transplanted in the cleft areas 133 days after bone grafting. These teeth were observed for 138 days before sacrifice. Radiological and histological findings support previous reports on adverse effects to dental tissues when placed in direct contact with fresh transplanted bone. Root resorption and ankylosis occurred to a large extent. Establishment of a normal periodontal membrane could, however, be observed when the tooth was transplanted to an area grafted 4 months previously. An interval before tooth transplantation allowing the cancellous graft to organize and bone to remodel seems to be indicated.

Alveolar Process↗
PubMed1989

Surgical treatment of left ventricular aneurysm. Analysis of risk factors, morbidity and mortality in 205 cases.

Left ventricular aneurysm was surgically treated in 205 patients during the decade 1975-1984. The patients had had one to five myocardial infarctions, the latest days to years (mean 32 months) preoperatively and 92% were in NYHA functional class III or IV. The main indications for surgery were angina (47%), congestive heart failure (38%) and arrhythmia (15%). The 176 anterior, 23 posterior and six combined aneurysms were treated with resection (130 cases) or plication (75). The early mortality was 5%. Univariate analysis identified arrhythmia, concomitant valve replacement and need for intra-aortic balloon pumping (IABP) as significant risk factors, and multivariate analysis revealed the indication for surgery and need for IABP as the only independent predictors of total mortality. The survival rates 5 and 10 years postoperatively were respectively, 74% and 60%. At follow-up after 1/2-10 years, almost 90% of the surviving patients had improved functional status. Left ventricular aneurysm thus can be surgically treated with low mortality rate and good functional result.

Adult↗
PubMed1988

[Lung abscess].

Explore the source record for details and available documents.

Adolescent↗
PubMed1988

Effect of alveolar bone grafting on maxillary growth in unilateral cleft lip and palate patients.

This cephalometric study reports the extent to which maxillary growth may be impaired by grafting of alveolar bone during the period of mixed dentition. The analysis is confined to subjects with unilateral cleft lip and palate (UCLP). The craniofacial dimensions of a group of 28 children who underwent grafting before the age of 12 years were compared by t-test to those of a nongrafted group (N = 30) at 9 and 16 years of age. In addition, two multiple-regression analyses were performed, the second on a group of 70 subjects with UCLP who received a bone graft between the ages of 8 and 15 years. The principal finding was that bone grafting, even when performed on those as young as 8 or 9 years, had no adverse effect on anteroposterior or vertical maxillary growth. This may be attributable to postponement of grafting until most anteroposterior and transverse growth of the anterior maxilla had ceased and to the grafted tissue's ability to participate in the vertical development of the alveolar process.

Adolescent↗