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Biomedical subjects

K Lie

Publications and source records attributed to K Lie.

At least 19 recordsLinked to original sources
PubMed2001

[Surgery and sentinel node examination in early vulvar cancer].

BACKGROUND: Less than radical vulvectomy for primary vulvar cancer has been controversial. Less mutilating surgery without sacrificing benefits in prognosis is warranted. MATERIAL AND METHODS: Based on relevant literature and our own experience, we give a review of surgery and sentinel node examination in early vulvar cancer. RESULTS: Regional lymph node metastasis rarely occurs when tumour thickness is less than 1 mm. Smaller lesions (< 2 cm in diameter) should therefore be treated by wide excision only and without lymph node dissection. Other T1 lesions with deeper invasion should be radically excised with at least 2 cm margins and extend deep to the inferior fascia of the urogenital diaphragm. Complete inguinal-femoral lymphadenectomy should be performed in patients without groin metastases to avoid a small, but definite risk of recurrence, although the incidence of lymph node metastases for all clinical stage I patients is less than 10%. Lymphatic mapping with 99mTechnetium and patent blue technique is a potentially valuable intraoperative tool for assuring removal of the sentinel node most likely to have metastasis, defining the extent of the superficial inguinal lymphadenectomy and identifying uncommon anatomic variations. INTERPRETATION: Until reliable data on the benefits of selective lymphadenectomy using intraoperative lymphoscintigraphy are available, the procedure should only be performed in an approved research setting.

Female↗
PubMed2001

Meningococcal outer membrane vesicle vaccine given intranasally can induce immunological memory and booster responses without evidence of tolerance.

We have studied the ability of outer membrane vesicle (OMV) vaccines from Neisseria meningitidis serogroup B to induce vaccine-specific antibody and spleen cell proliferative responses in mice after being administered intranasally (i.n.) and/or subcutaneously (s.c.). A series of four weekly i.n. doses (25 microg) without adjuvant or a single s.c. dose (2.5 microg) with aluminum hydroxide was followed 2 months later by secondary i.n. or s.c. immunizations. After i.n. priming, both immunoglobulin G (IgG) antibody responses in serum, measured by enzyme-linked immunosorbent assay, and IgA antibodies in saliva and extracts of feces were significantly boosted by later i.n. immunizations. The IgG antibody responses in serum were also significantly augmented by secondary s.c. immunization after i.n. as well as s.c. priming. Sera from mice immunized i.n. reached the same level of bactericidal activity as after s.c. immunizations. The s.c. immunizations alone, however, had no effect on mucosal IgA antibody responses, but could prime for booster antibody responses in secretions to later i.n. immunizations. The i.n. immunizations also led to marked OMV-specific spleen cell proliferation in vitro. Both serum antibody responses and spleen cell proliferation were higher after i.n. priming and later s.c. immunizations than after s.c. immunizations alone. There was thus no evidence that i.n. priming had induced immunological tolerance within the B- or T-cell system. Our results indicate that a nonproliferating meningococcal OMV vaccine given i.n. can induce immunological memory and that it may be favorably combined with similar vaccines for injections.

Administration, Intranasal↗
PubMed1998

Two-year follow-up study to evaluate the reduction of left ventricular mass and diastolic function in mild to moderate diastolic hypertensive patients.

OBJECTIVE: To compare the effects of two antihypertensive agents, amlodipine and lisinopril, on left ventricular mass and diastolic filling in patients from primary care centers with mild to moderate diastolic hypertension. STUDY DESIGN: A second-year, open follow-up of a prospective, double-blind, randomized, parallel group, comparative study. METHODS: Male and female patients between 25 and 75 years-of-age with elevated diastolic blood pressure (four measurements > or = 95 mmHg from multiple measurements taken on three occasions and average diastolic blood pressure < 115 mmHg) were recruited from a population survey. After 4 weeks' placebo run-in, 71 patients were included of whom 60 finished the first study year and 51 finished the second study year. Patients were randomly assigned to receive doses of 5-10 mg amlodipine or 10-20 mg lisinopril, which were titrated on the basis of the effects on blood pressure. Primary endpoints were left ventricular mass index (LVMI) and early to atrial peak filling velocity. Office and ambulatory blood pressure were considered secondary endpoints. RESULTS: The decrease in blood pressure was equal for both treatment regimens in the first year. A statistically significant (P< 0.001) decrease in LVMI in both treatment groups was observed in the first year [-11.0 g/m2 (95% Cl -6.0 to -16.1) in the amlodipine group and -12.6 g/m2 (95% Cl -8.2 to -17.0) in the lisinopril group]. Early to atrial peak filling velocity did not change significantly within the treatment groups in the first year [+0.07 (95% CI -0.01 to +0.15) in the amlodipine group and +0.01 (95%9 Cl -0.06 to +0.08) in the lisinopril group. Blood pressure, LVMI and early to atrial peak filling velocity did not change in the second year of treatment. No significant differences in primary and secondary endpoints between treatment groups were found in the first or second year. CONCLUSION: The effects of amlodipine and lisinopril on left ventricular mass and early to atrial filling peak velocity after 2 years of treatment were similar and these effects were already observed after 1 year of treatment. Additional studies of longer duration (> or = 4 years) and with a larger sample size are recommended.

Adult↗
PubMed1997

The effects of topical nasal steroids on rat respiratory mucosa in vivo, with special reference to benzalkonium chloride.

Fifty rats were treated with topical nasal steroids with and without the preservative benzalkonium chloride in their right nostril twice daily for 21 days, while the left nostrils were exposed to 0.9% NaCl. By cutting the noses serially in frontal sections, the structure of the mucosal lining of all parts of the nose could be investigated. Areas with squamous cell metaplasia were observed in all nostrils exposed to topical steroids containing benzalkonium chloride. Such alterations were not observed in any nasal cavities exposed to the topical nasal steroid without the preservative or to 0.9% NaCl. In conclusion, benzalkonium chloride appears to be potentially toxic to the mucosa in vivo.

Administration, Topical↗
PubMed1996

The cost-effectiveness of laparoscopic versus abdominal Burch procedures in women with urinary stress incontinence.

STUDY OBJECTIVE: To evaluate the cost-effectiveness of laparoscopic versus abdominal Burch procedures in women with urinary stress incontinence (USI). DESIGN: A historical cohort with a minimum follow-up of 1 year. SETTING: Two tertiary, university-affiliated referral centers. PATIENTS: Women with USI who had either a laparoscopic Burch (31 women) or an abdominal Burch procedure (31). They were matched for the type of procedure as well as any concurrent procedures. MEASUREMENTS AND MAIN RESULTS: The primary outcome was cure, defined as the absence of USI subjectively as described by the patient, and objectively as confirmed by urodynamic and stress tests. Cost data were extracted from hospital charts and office records. To calculate costs we assessed professional fees (physicians, nurses, nursing assistants), investigations (laboratory tests, radiology, urodynamics), drugs, capital equipment, disposable equipment, and length of stay. The cure rates were 97% and 90%, respectively. The mean duration of follow-up was 1.2 years (range 1-2.5 yrs) for a laparoscopic Burch and 2.7 years (range 1-9 yrs) for an abdominal Burch. Preliminary results showed a significant difference in cost effectiveness between the procedures. The average cost for a laparoscopic Burch was $2938.35 and for an abdominal Burch $5692.30. The higher costs for abdominal Burch were due to increased hospital stay. The cost-effectiveness ratios (cost/cure) were $3029.23 and $6324.78, respectively. Sensitivity analysis was performed to assess for robustness. CONCLUSIONS: The preliminary results show that a laparoscopic Burch is more cost-effective than the abdominal Burch in treating women with USI.

Adult↗
PubMed1994

The effect of decongestive nosedrops on human respiratory mucosa in vitro.

The aim of this study was to investigate the morphological effects of decongestive drops and sprays on human respiratory mucosa in vitro. Precultured fragments of adenoid tissue in a specially designed tissue culture system were exposed to decongestive preparations for 10 minutes once a day for 10 days. Tissue exposed to preparations preserved with benzalkonium chloride and tissue exposed to benzalkonium chloride alone underwent severe morphological alterations. Unpreserved decongestive substances did not have this effect. Benzalkonium chloride is a well-documented toxic substance in several respects. Supported by previous studies, it may seem unfortunate to use it as an additive in decongestive preparations.

Adenoids↗
PubMed1993

Comparison in the same patient of aberrant conduction and bundle branch reentry after dofetilide, a new selective class III antiarrhythmic agent.

Dofetilide may induce aberrant intraventricular conduction due to its Class III effect. This report describes an atrial fibrillation patient in whom intraventricular conduction was studied before and after dofetilide using multiple endocardial recordings. Dofetilide provoked aberrant conduction during atrial fibrillation, and aberrancy could be mimicked with programmed atrial stimulation after restoration of sinus rhythm. However, during right ventricular stimulation, isolated bundle branch reentrant beats were recorded after induction of critical retrograde conduction delays. This occurred in the setting of relatively large differences in refractoriness between the right bundle branch and the right ventricular myocardium. This favored distal retrograde bundle branch block during ventricular extrastimulation, in turn enhancing bundle branch reentry. This potential proarrhythmic mechanism deserves close attention in the further development of dofetilide and also of other new "pure" Class III agents.

Action Potentials↗
PubMed1993

Sequential bilateral bundle branch block during dofetilide, a new class III antiarrhythmic agent, in a patient with atrial fibrillation.

INTRODUCTION: The mechanism of wide QRS complex tachycardias during dofetilide infusion was studied in a patient with atrial fibrillation. METHODS AND RESULTS: Endocardial recordings from the intraventricular conduction system showed that dofetilide caused "classic" aberrant conduction (Ashman phenomenon, typical QRS morphology) at high prematurity ratios (preceding interval = 1.78 x coupling interval--290), thus mimicking ventricular ectopy. In addition, there was frequent sequential bilateral bundle branch block, caused by a significant difference in preceding bundle-to-bundle intervals (mean difference +/- 1 SD: 74 +/- 26 msec). CONCLUSION: The present findings may prove helpful in the clinical assessment of wide QRS complex rhythms after dofetilide and possibly other "pure" Class III antiarrhythmics.

Adult↗
PubMed1987

[Radiation burden in heart catheter studies--significance of measures for reducing scatter radiation].

During diagnostic and, more particularly, therapeutic intervention, such as transluminal coronary angioplasty, the operator may be exposed to a considerable degree of scatter radiation. In our study, we measured the level of radiation exposure of the head, unprotected knees and lower legs. A flexible lead screen, attached to the catheterization table (0.5 mm Pb) reduced scatter radiation of the lower legs by 95%. In addition, scatter radiation exposure of the head decreased by 54% by covering the patient with a rubber leaden blanket (0.25 mm Pb). Finally, the use of these supplementary yet simple measures did not hinder or interfere with the examination procedure in any way.

Cardiac Catheterization↗