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Biomedical subjects

G Semb

Publications and source records attributed to G Semb.

At least 73 records · Page 4Linked to original sources
PubMed1987

The Björk-Shiley 70 degree convexo-concave prosthesis strut fracture problem (present state of information).

Between June 1980 and June 1983 4028 Björk-Shiley 70 degree convexo-concave prosthetic heart valves were distributed and implanted in Australia, Canada, Europe and South Africa. As of March 1986, a total of 52 outlet strut fractures (1.29%; 70% CL: 1.1%-1.5%) have been reported from 29 implant institutions in 12 countries. The majority (82.7%) occurred in Europe. Intervals between implantation and fracture were 13 days to 45.3 months (mean: 18.4 months; 70% CL: 16.6 months-20.1 months). The mortality rate after strut fracture was 78.7% (70% CL: 72.5%-84.9%). Upon stratification of the fracture by valve sizes and types it becomes evident that 75% (70% CL: 68.8%-81.2%) of all fractures are related to the sizes 29 mm to 33 mm (which virtually represent the same valve size) and predominantly to mitral valves (p less than 0.01). The large valves again have been stratified into two subsets, namely those fabricated from flanges originally machined as Björk-Shiley 60 degree convexo-concave valves (group I) and later produced valves machined initially to 70 degree specifications (group II). In group I the fracture rate was 5.2% (70% CL: 4.2%-6.2%) versus 1.6% (70% CL: 1.1%-2.1%) in group II (p less than 0.01), which identifies the group I 29 mm-33 mm Björk-Shiley 70 degree convexo-concave valves as the highest risk group for strut fracture. The rates are based upon all available information as of March 16, 1986.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart Valve Prosthesis↗
PubMed1987

Temporal pattern of enzyme changes in cerebrospinal fluid in patients with neurologic complications after open heart surgery.

We serially measured creatine kinase (CK), lactate dehydrogenase, aspartate aminotransferase (AST) and lactate from the lumbar cerebrospinal fluid in 14 patients with neurologic complications after open heart surgery with cardiopulmonary bypass (CPB). These analyses revealed a correlation between worsening neurologic deficit and the peak CK (r = .87, p less than .001), AST (r = .75, p less than .01), and lactate (r = .93, p less than .001) levels. Lactate increased before enzymes did. In 12 patients without complications, only lactate was significantly (p less than .005) elevated; however, within this group, CK but not lactate could be used to differentiate patients who later developed subtle mental changes. Although CPB appeared to induce metabolic changes in the brain that could possibly disturb function, severe cerebral damage appeared to require additional global or focal anoxic-ischemic factors. Short hypothermia during bypass did not influence CK, but it was falsely elevated after prolonged hypothermic periods. The testing of these enzymes may be a reliable indicator of the degree of brain damage and the prognosis.

Aged↗
PubMed1987

Comparison of bubble release from various types of oxygenators. An in vivo investigation.

The present study compares the creation of free gas bubbles in five different bubble oxygenators and one membrane oxygenator, by use of Doppler ultrasound technique. The study was carried out on groups of male patients undergoing coronary artery bypass surgery. The results show that the bubble oxygenators produce a considerable amount of free gas bubbles, with variances based on type. The membrane oxygenator showed virtually no counts at all.

Coronary Artery Bypass↗
PubMed1987

The Goslon Yardstick: a new system of assessing dental arch relationships in children with unilateral clefts of the lip and palate.

The Goslon (Great Ormond Street, London and Oslo) Yardstick is a clinical tool that allows categorization of the dental relationships in the late mixed and or early permanent dentition stage into five discrete categories. Cases are allocated to these categories on a value judgment basis by reference to the anchor groups of the Goslon Yardstick. The categorization was sufficiently sensitive to distinguish the treatment results at different centers in this study. It is proposed that the Goslon Yardstick should facilitate cross-center studies.

Cleft Lip↗
PubMed1986

Secondary bone grafting and orthodontic treatment in patients with bilateral complete clefts of the lip and palate.

The results of secondary bone grafting and orthodontic treatment in 41 patients with bilateral complete clefts of the lip and palate are reported. Good bone formation was found in 98% of the cleft sites grafted before the eruption of the canines, and in 80% of the clefts grafted later. Closure of both cleft spaces by orthodontic means was achieved in 20 of the 21 patients in the first group, and in 14 of the 20 patients in the second group. The bone grafts failed in one cleft site in 4 patients, all of which were regrafted with satisfactory results. In 2 patients one of the canines was later affected by external root resorption, necessitating endodontic treatment. Both the failures and the root resorptions occurred in patients bone grafted at an older age than was considered optimal for bilateral clefts: 10 to 11 years. Seven patients needed a bridge prosthesis, 3 of these over one cleft space only. Even these patients benefited greatly from bone grafting.

Adolescent↗
PubMed1986

Elimination of the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment.

A combined surgical/orthodontic procedure to eliminate the residual alveolar cleft by secondary bone grafting and subsequent orthodontic treatment is described. The operations have been carried out on 378 patients: 240 males and 138 females. Seventy-two patients had bilateral clefts, making a total of 450 grafted clefts. The optimal age for this secondary bone grafting has been found to be 9 to 11 years. In 292 of the cases, the canine had reached its final position in the arch, which allowed a four-group semiquantitative assessment of the newly obtained interdental septum on dental radiographs. The best results have been achieved in cases where the bone graft was carried out prior to the eruption of the canine. In this group, a normal (category I) interdental septal height was achieved in 64 percent and a slightly lower (category II) interdental septum in 32 percent. Interdental septa classified as type I and II are considered to be acceptable. The cleft space was closed in 90 percent of the cases. No significant difference between unilateral and bilateral cases was found. When the same procedure was carried out after eruption of the canine, the results were less favorable.

Adolescent↗
PubMed1985

Ventricular septal rupture diagnosed by simultaneous cross-sectional echocardiography and Doppler ultrasound.

Thirteen patients with intraventricular septal rupture in the course of acute myocardial infarction (AMI) have been examined with simultaneous cross-sectional echocardiography (CSE) and Doppler ultrasound. Visualization of the rupture was achieved in six patients by CSE alone. The simultaneous technique identified the rupture in all patients. Eight patients were operated upon; seven of them are still alive. We conclude that simultaneous CSE and Doppler ultrasound is a sensitive, rapid and safe technique for diagnosing ventricular septal rupture (VSR) after AMI.

Aged↗
PubMed1985

Effect of high-dose ampicillin and cloxacillin on bleeding time and bleeding in open-heart surgery.

To determine if platelet dysfunction caused by high doses of penicillin compounds is of practical importance in patients with additional haemostatic defects perioperatively, a study was made of patients undergoing open-heart surgery. They were randomly assigned to prophylactic treatment with ampicillin 8 g plus cloxacillin 4 g daily for three days, or with cephalothin 8 g daily for three days. Fifty patients in each group were evaluated. The median bleeding time preoperatively and on days 1 and 4 postoperatively did not differ between the groups. The bleeding time was prolonged beyond the normal range in eight patients of the ampicillin/cloxacillin group and in three of the cephalothin group (p less than 0.05). Prolonged bleeding time was not associated with lower platelet count or greater blood loss. The total blood loss and the amounts of transfused blood, platelets and cryoprecipitate were all greater in the ampicillin/cloxacillin group, but the difference was not statistically significant. Combined use of ampicillin and cloxacillin in open-heart surgery is associated with increased bleeding, but the increase is without practical importance.

Adolescent↗
PubMed1985

Demonstration of an alpha adrenoceptor-mediated inotropic effect of norepinephrine in human atria.

It has been claimed by other investigators that norepinephrine does not evoke a significant alpha adrenergic inotropic effect in human atria in contrast to epinephrine and phenylephrine, indicating a limitation of a possible functional role of the cardiac alpha adrenoceptors. We therefore characterized the inotropic effects of norepinephrine in isometrically contracting muscle strips from human atria obtained during open heart surgery. Both contraction and relaxation were studied by measuring developed tension and its first and second derivatives. Both the influence of propranolol and prazosin upon the inotropic responses to norepinephrine and the qualitative characteristics of the responses revealed that norepinephrine evoked both alpha and beta adrenergic inotropic effects. The alpha adrenergic response to norepinephrine was qualitatively different from the beta adrenergic effect and qualitatively similar to the alpha adrenergic effect of norepinephrine observed in other mammalian species. Although the alpha adrenergic effect was marked, the beta adrenergic effect was the dominating one as has also been found in other species. It is concluded that also in human atria norepinephrine evokes inotropic effects through both alpha and beta adrenoceptors.

Heart Atria↗
PubMed1982

Myocardial protection during aortocoronary bypass operations. Comparison of two different operative procedures: cold chemical cardioplegia versus intermittent cross-clamping of the aorta.

Myocardial injury was studied in 40 randomized coronary patients operated on electively with coronary bypass grafting using two different techniques, (A) cardioplegic arrest and continuous cross-clamping of aorta, and (B) ischaemic arrest and intermittent cross-clamping of aorta. The released quantity of the MB isoenzyme of creatine kinase was used as an indicator of myocardial injury. Of the whole group, 3 patients (8%) suffered a myocardial infarction as judged by ECG. The CK-MB release was not significantly different in the two groups. The total period of aortic cross-clamping was markedly longer in the cardioplegic group than in the intermittent clamping group. A significant correlation between the duration of aortic clamping and the amount of CK-MB release was found in the cardioplegic group. Our results indicate that the beneficial effects of cardioplegic arrest are outweighed by an unavoidable longer period of total aortic clamping as compared with the intermittent clamping technique.

Aorta↗
PubMed1982

Surgical treatment of severe angular kyphosis.

Five patients 10-21 years old were treated for severe angular kyphosis, ranging from 61 to 133 degrees, by a three-stage procedure: 1. distraction in a halo-pelvic apparatus, 2. anterior decompression and/or fusion and 3. posterior fusion with Harrington compression rods. An average correction of 68% and a good cosmetic result were obtained. A solid fusion was achieved in all patients. There were no neurological complications. A 12-year-old girl gained 20 cm in height and the spinal kyphosis was reduced from 133 to 27 degrees.

Adolescent↗