Search PubMed⌕ Search

Biomedical subjects

K Johansen

Publications and source records attributed to K Johansen.

At least 163 records · Page 9Linked to original sources
PubMed1984

Abdominal aortic aneurysms.

Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness.

Aorta, Abdominal↗
PubMed1983

Mycotic aortic aneurysms. A reappraisal.

Mycotic aneurysms are uncommon but not rare lesions with potential for catastrophic hemorrhage or sepsis. They have been ascribed to bacterial endocarditis and, when present in the aorta, were termed "inevitably fatal" as recently as 1967. A 15-year review of the English-language literature on mycotic aneurysms showed that arterial trauma, concurrent sepsis, and depressed host immunity have become the cardinal "risk factors" in the development of these lesions. Conventional treatment of mycotic aortic aneurysms usually includes aortic ligation, aneurysmal excision, and extra-anatomic bypass grafting. Nevertheless, four of our patients with well-localized mycotic aortic aneurysms survived three to 54 months (mean, 40 months) after aortic excision and in situ prosthetic graft restoration of aortic continuity. This experience suggests that mycotic aortic aneurysms can be successfully treated, frequently by in situ grafting, if diagnosis and treatment are timely and aggressive.

Adult↗
PubMed1983

Enhanced survival in patients with variceal bleeding after elective portal decompression.

In a retrospective study of 49 patients who had bled from esophageal varices but who survived and did not require emergency portal decompression, 24 patients were discharged without surgical consultation and 25 underwent portal decompression using a small-stoma portacaval shunt. Shunted and nonshunted patients were similar both demographically and in clinical and chemical criteria for preoperative hepatocellular function. Among nonshunted patients, survival was 33 percent during a follow-up period of up to 39 months, whereas shunted patients had an 83 percent survival during a follow-up period of up to 43 months. This difference in survival was statistically significant (p = 0.03). Shunted patients showed a 10.5 percent incidence of hepatic encephalopathy. We conclude that survival after variceal hemorrhage may be significantly increased by a portacaval shunt procedure, especially if it is carried out semielectively in stable patients.

Actuarial Analysis↗
PubMed1983

Human insulin--medical progress?

Human insulin is now produced in commercial scale by semisynthesis from porcine insulin or by recombinant DNA techniques. Comparative studies in non-diabetic or diabetic subjects on the hypoglycaemic effect of human insulin after intravenous or subcutaneous administration do not indicate that human insulin has advantage over highly purified pork insulin. In two of the three studies in which plasma insulin levels were examined after subcutaneous injection the results suggest that absorption of biosynthetic human insulin may be more rapid than that of purified porcine insulin. The amount of insulin needed to maintain normoglycemia in subjects with insulin-dependent diabetes, studied with a glucose controlled insulin infusion system was generally the same with human and pork insulin. Studies concerning subcutaneous absorption of NPH insulin in patients with insulin-dependent diabetes are needed. Long-term studies on the tendency of human insulin to induce antibody production are still lacking. Scientifically, the production of human insulin by recombinant DNA methods is a great advance. It remains, however, to be shown that human insulin has any clinical advantages over porcine insulin.

Animals↗
PubMed1983

The effect of vitamin E on erythrocyte hemolysis and lipid peroxidation in newborn premature infants.

The biochemical effect of vitamin E supplementation to mothers with threatened premature delivery and to premature infants after birth has been studied. Although a weak correlation was found between maternal and cord blood vitamin E levels at birth, cord blood levels were not significantly higher in the infants from supplemented mothers than those from unsupplemented mothers. Furthermore, maternal vitamin E treatment did not prevent either erythrocyte hemolysis or lipid peroxide formation in the premature infants after birth. On the other hand, intramuscular vitamin E to infants after birth produced a marked biochemical effect, with both zero erythrocyte hemolysis and low lipid peroxide formation when serum vitamin E increased above 2 mg/100 ml. We conclude that intramuscular vitamin E immediately after birth is necessary to achieve a biochemical effect of vitamin E in the early neonatal period. (No cases of retrolental fibroplasia occurred in the present study.)

Erythrocytes↗
PubMed1983

Percutaneous transluminal angioplasty (PTA) as an adjunct in vascular trauma: case report.

An iliac stenosis causing a pressure gradient of 70 mm Hg proximal to repair of a traumatically divided superficial femoral artery was relieved by percutaneous transluminal balloon angioplasty (PTA). Though the magnitude of the accompanying crush injury led to massive muscle necrosis and ultimately necessitated mid-thigh amputation, the arterial repair remained patent.

Angioplasty, Balloon↗
PubMed1983

Hematuria after blunt trauma: when is pyelography useful?

Blood in the urine is common following blunt abdominal trauma. Most trauma centers routinely perform limited intravenous pyelography (IVP), usually with cystography, in such individuals presenting with any degree of hematuria in order to identify urinary tract injury. The observation that the yield of positive IVPs is small among such individuals, and the suspicion that a positive IVP rarely leads to a substantive change in outcome, resulted in the following retrospective study. We reviewed our Trauma Center's records for all patients undergoing IVP following blunt trauma in a 1-year period. Virtually all individuals had a cystogram performed. Positive studies were defined by various kidney, ureteral, bladder, or urethral abnormalities; bladder deviation by extrinsic pelvic hematoma was not counted as a positive finding. Among 156 patients undergoing IVP for hematuria in this period, 13 (8.3%) had an abnormal IVP or cystogram. Of these 13 patients ten (77%) had either gross or 4+ hematuria. Five patients (3%) required further diagnostic or therapeutic intervention. One patient (0.6%) required nephrectomy when exploration revealed renal artery thrombosis causing irreversible kidney ischemia. All five patients who required further evaluation or therapy presented with gross or 4+ hematuria. Had screening IVP been performed only in blunt trauma victims presenting with gross or 4+ hematuria, no patients with significant urinary tract injury would have been missed, and 119 (75%) of the patients in this series would have been spared the expenditure of time and money, and the radiation and dye exposure, resulting from their negative studies. Individuals in whom the possibility of renal injury is high following blunt trauma (flank pain or hematoma, low rib fractures) should undergo rapid limited IVP for diagnosis of significant genitourinary tract injury. Such evaluation should also be carried out in asymptomatic individuals who present with gross or 4+ hematuria. Microscopic hematuria alone, however, is a poor predictor of significant genitourinary tract damage. Our review suggests that asymptomatic victims of blunt trauma who have only small amounts of blood in the urine may safely be observed without routine emergency IVP.

Adolescent↗
PubMed1982

Possible association between DNA sequences flanking the insulin gene and atherosclerosis.

The proportion of subjects homozygous for DNA restriction fragments of a large size class (U alleles), in the polymorphic region flanking the 5' end of the insulin gene of chromosome 11, was higher in a group of non-insulin-dependent diabetic (NIDDM) patients than in normal controls. This finding confirms that the U allele is associated with at least one form of NIDDM. The U alleles were also found to be strongly associated with macroangiopathy in diabetic as well as in non-diabetic subjects. Thus, DNA sequences contained in the U alleles might be associated with the development of atherosclerosis in an as yet unknown way.

Alleles↗
PubMed1982

Excretion of methimazole in human milk.

It is universally stated that antithyroid drugs are concentrated in human milk and are thus contraindicated during breast-feeding. We recently showed, however, that propylthiouracil (PTU) was not concentrated in milk and a study has now been made of the excretion of another widely used antithyroid drug carbimazole (CMI) in human milk. Methimazole (MMI) in blood and milk from five lactating women was measured after oral administration of CMI 40 mg, which is rapidly and completely transformed to the active antithyroid compound MMI. One hour after CMI, the mean serum-MMI reached 253 microgram/I and the mean concentration of MMI in milk reached 182 microgram/I. MMI was found to be unionized and not to be protein bound in serum, and it occurred in milk in the same concentration as the serum; the mean milk/serum ratio was 0.98. The mean total amount of MMI excreted in milk over 8 h was 34 microgram (SEM +/- 5, n = 5), i.e. 0.14% of the dose administered.

Administration, Oral↗
PubMed1982

Aneurysms.

Explore the source record for details and available documents.

Aneurysm↗
PubMed1982

Temporary intraluminal shunts: resolution of a management dilemma in complex vascular injuries.

Complex vascular injuries of the extremities in which acute arterial insufficiency is combined with severe or prolonged shock, extended periods of ischemia, or associated fractures or soft-tissue injuries have unacceptably high limb loss rates, frequently because the allowable warm ischemia time for skeletal muscle is exceeded before adequate revascularization. In a 1-year period, ten patients with complex vascular injuries identified at our metropolitan trauma center underwent routine introduction of temporary plastic intravascular shunts at the site of vessel disruption, thus permitting immediate limb revascularization. This rapid reperfusion permitted appropriate attention to be directed toward skeletal fixation, soft-tissue debridement, and other procedures without the urgency usually associated with the presence of acute limb ischemia. Following various local and distant orthopedic or general surgical procedures, arterial and venous continuity were uneventfully re-established. This experience suggests that the routine use of plastic intraluminal shunts in complex vascular injuries of the extremities has the distinct potential of reducing the excess morbidity from prolonged acute arterial insufficiency noted in such injuries.

Adolescent↗