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Biomedical subjects

H Fodstad

Publications and source records attributed to H Fodstad.

At least 37 records · Page 2Linked to original sources
PubMed1993

Intractable singultus: a diagnostic and therapeutic challenge.

Hiccup or singultus is a repeated involuntary, spasmodic contraction of the diaphragm accompanied by a sudden closure of the glottis mediated by sensory branches of the phrenic and vagus nerves as well as dorsal sympathetic afferents. The principle efferent limb and diaphragmatic spasms are mediated by motor fibers of the phrenic nerve. Hiccup has been classified as a respiratory reflex and the central connection probably consists an interaction among the brainstem respiratory centers, phrenic nerve nuclei, medullary reticular formation and the hypothalamus. Chronic intractable hiccup may be due to brainstem seizures, and baclofen may be the long-awaited remedy for intractable hiccup as demonstrated in three illustrative cases.

Afferent Pathways↗
PubMed1992

Self-reported prevalence of disability after subarachnoid haemorrhage, with special emphasis on return to leisure and work.

The prevalences of motor and language impairments and of disabilities in activities of daily living (ADL), leisure and work were investigated in a consecutive series (n = 296) of long-term survivors of subarachnoid haemorrhage (SAH). Motor and language impairments were present in 17 and 20%, respectively. The majority reported independence in self-care (91%) and instrumental (80%) ADL, but among the self-care independent, 23% reported need of personal assistance. Leisure disability occurred in 48% and vocational disability in 40%. Hence, disabilities are more common after SAH than is indicated by occurrences of motor and language impairments. It is concluded that the discrepancy between the prevalences of impairments and of disabilities may be to a great extent caused by coping difficulties in relation to socio-demographic and geographic circumstances. The findings indicate a need for rehabilitative follow-up for virtually all SAH-patients.

Activities of Daily Living↗
PubMed1992

Functional recovery after near complete traumatic deficit of the cervical cord lasting more than 24 h.

Two young men presented with a complete cervical cord deficit associated with bilateral C4-C5 dislocation and 11 mm encroachment (sagittal narrowing) of the spinal canal in one case and near complete cervical cord deficit due to a crush fracture of the C7 vertebral body with 9 mm axial compression and 50% antero-posterior encroachment of the canal in the other case. There was no improvement within the first 24 h. Both patients left the hospital walking after open surgical realignment and complete cord decompression.

Adult↗
PubMed1991

History of stroke.

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Cerebrovascular Disorders↗
PubMed1991

History of Clarke's stereotactic instrument.

The first original stereotactic instrument was designed by the turn of this century by the British surgeon, anatomist, and physiologist Robert Henry Clarke. In 1905 James Swift, in London, constructed the first machine, 'Clarke's stereoscopic instrument employed for excitation and electrolysis'. It was first used in 1906 by Clarke and Victor Horsley to create minute electrolytic lesions in the CNS of animals. The stereotactic apparatus was patented by Clarke in 1914 and cost 300 pounds. Two further instruments were made by Goodwin and Velacott in London and brought to the United States to be used for animal research. The principal of these machines constitutes the basis of modern stereoguides for human use designed after World War II. Clarke's original instrument was last used by Dr Barrington, a genitourinary surgeon in London in the early 1950s. It then disappeared but parts were detected by Dr Hitchcock in 1960 and the complete machine by Dr Merrington in 1970. It can now be found at the museum of University College Hospital in London.

History, 19th Century↗
PubMed1991

Diabolic hiccups.

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History, Ancient↗
PubMed1990

[Diaphragm pacing by electric stimulation of the phrenic nerves].

Artificial ventilation by electric stimulation of the phrenic nerves has become clinically significant within the past 20 years and, in the world as a whole, approximately 700 patients have been treated with implanted diaphragmatic pacemakers. The two first patients in whom diaphragmatic pacemakers were implanted in Denmark, had sustained accidental fractures of the second cervical vertebra with subsequent high cervical spinal cord lesions with not only tetraplegia but also respiratory arrest. In both patients, diaphragmatic pacemakers were implanted bilaterally and these were employed for 12-14 hours daily while ventilation with a respirator was employed at night. The main indications for diaphragmatic pacing are paralysis of respiration following high cervical spinal traumata and the chronic central hypoventilation syndrome (sleep apnoea of Undine's curse). Diaphragmatic pacing may improve the mode of ventilation and the quality of life for patients with tetraplegia and respiratory insufficiency. On account of the potential technical problems, the risk of complications and the limited number of patients in whom this operation is suitable, implantation of diaphragmatic pacemakers should be concentrated in a few centres and probably only one in Denmark.

Adolescent↗
PubMed1990

Advances in the management of victims struck by ruptured intracranial aneurysms.

The advances in management of victims struck by the rupture of an intracranial aneurysm is reviewed. In the 1970s the management outcome was still far from acceptable; many victims who had 'recovered' following a major aneurysmal subarachnoid haemorrhage (SAH) succumbed or became crippled as the result of repeat bleeds and/or delayed SAH-induced ischaemic deterioration ('cerebral vasospasm'). The era of prosperity for microneurosurgery, the introduction of the calcium channel blocker nimodipine and the accumulation of cases in centres with a team of dedicated aneurysm surgeons form the basis of a recent breakthrough in the previously gloomy management outcome. With microsurgical techniques elective surgery can now be performed in the acute stage thereby preventing disastrous reruptures which occur frequently in the early phase after the first bleed. The concomitant use of nimodipine minimizes delayed SAH-induced ischaemic deterioration. Today a management regime including early operation combined with nimodipine has led to grossly improved results. Nevertheless cognitive disturbances and psychosocial maladjustment are frequent sequelae following a major aneurysmal bleed. Hope for further improvements could depend on the development of techniques which may allow identification of intracranial aneurysms before they rupture and increased knowledge of the aetiology of such cerebral arterial wall lesions.

Aged↗
PubMed1990

Ondine's curse with Hirschsprung's disease.

Hirschsprung's disease can be associated with other congenital abnormalities, some of which are neural in origin. A rare association is with congenital failure of automatic control of respiration--central hypoventilation syndrome, sleep apnoea or Ondine's curse. Patients with this combination tend to have a short life expectancy. Diaphragmatic pacing by electrophrenic stimulation has proven useful in management of patients with central hypoventilation. Three children, two females and one male, with this combination are described. The male child, who had total intestinal aganglionosis, died at the age of one month despite an ileostomy and nocturnal mechanical ventilation. The two females had aganglionosis more typical of Hirschsprung's disease, one requiring colostomy. At the ages of 2 and 6 years, respectively, phrenic nerve stimulators were implanted. Both girls remain independent of nocturnal, mechanical ventilation two and three years after commencement of diaphragm pacing. In patients with Ondine's curse and Hirschsprung's disease in whom the aganglionosis can be effectively managed, diaphragm pacing may lead to independence from mechanical ventilation and prolongation of life of an acceptable quality.

Child↗
PubMed1990

Vilhelm Magnus--pioneer neurosurgeon.

In parallel with but completely independent from Harvey Cushing, Norway had its own giant in the establishment of the special field of neurological surgery. Vilhelm Magnus (1871-1929), born in the United States in Fillmore County, Minnesota, was Norway's pioneering neurosurgeon. Following graduation in Oslo, he started his clinical training in neurology and became an early member of the small group of neurologists of the time who were dissatisfied with the therapeutic nihilism generally accepted in relation to diseases of the nervous system. After working with Victor Horsley, whom he held in high esteem. Magnus devoted himself to surgically treatable lesions in the nervous system. During a quarter of a century he single-handedly established the special field of neurological surgery in Norway. Magnus was a far-seeing and brilliant surgeon with a broad intellectual mind, a startling diligence, and wide research activities. He published his first scientific paper in 1899 and his total contribution to the literature amounted to 70 papers. In 1901 he was able to demonstrate the importance of the corpus luteum in the first 3 weeks of pregnancy. As early as 1903 Magnus manifested his interest in the surgical treatment of brain tumors. In 1926 his surgical material comprised 216 patients, with an 8% operative mortality rate among 161 cases of supratentorial tumor versus 17% for 55 cases of infratentorial tumors, including 14 cases of acoustic tumor. Vilhelm Magnus, who visited Harvey Cushing in 1928, has hitherto not been given the attention he merits.

Female↗
PubMed1989

Pacing of the diaphragm to control breathing in patients with paralysis of central nervous system origin.

Thirty-five patients, 21 males and 14 females, aged 2-69 years (mean 25 years) with partial or total respiratory paralysis due to high cervical cord lesions, brain stem lesions, or central hypoventilation syndrome (sleep apnoea, 'Ondine's curse'), received phrenic nerve stimulators for pacing of the diaphragm. At a mean follow-up time of 46 months (range 2 months to 10 years) 15 patients are entirely independent of respirator and 8 quadriplegics ventilate with pacers at different daytime intervals and use mechanical ventilators during the night. Five patients have stopped pacing and 7 additional cases have died of causes unrelated to electrophrenic stimulation.

Adolescent↗
PubMed1988

Fundamental considerations in pacing of the diaphragm for chronic ventilatory insufficiency: a multi-center study.

Records were reviewed of 477 patients who had diaphragm pacemakers implanted for treatment of chronic hypoventilation. Three groups were established for comparison. (1) Center group: 165 patients operated on in six medical centers participating in a cooperative study; (2) Noncenter group, sufficient data available: 203 patients operated on by surgeons with experience limited to a few cases; (3) Nonstudy group, minimal data available: 109 patients operated on as in group 2; vital statistics only were contributed. The protocol for data gathering was comprised of 154 major variables. Basic data on age, sex, diagnosis and etiology were analyzed for homogenicity of data among the groups. A comprehensive analysis of the pacing methods, complication and results from the Center group yielded information on the early experience with diaphragm pacing important to its future application.

Diaphragm↗