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Biomedical subjects

L Brandt

Publications and source records attributed to L Brandt.

At least 253 records · Page 14Linked to original sources
PubMed1982

Chromosomal, morphological and clinical correlations in blastic crisis of chronic myeloid leukaemia: a study of 69 cases.

The karyotypic pattern in 69 patients with Ph1-positive chronic myeloid leukaemia (CML) was investigated during the blastic phase (BC) and correlated with survival and certain parameters of potential prognostic significance, including blast morphology, basophilia and thrombocytopenia. There was no difference in median survival in BC between patients with and without aberrations in addition to the Ph1. Nor were there any differences in this respect among patients with the specific aberrations +Ph1, +8, iso(17q), or other abnormalities. There was no correlation between the incidence of thrombocytopenia and any particular karyotypic change. However, the incidence of basophilia was a characteristic feature for patients with an iso(17q). The survival time in BC was considerably longer in patients with a lymphoid morphology of the blastic cells compared to the myeloid varieties, and within the myeloid varieties the survival in BC was longer in patients with granular differentiated blasts than in those with granular atypical blast cells. No obvious correlation was apparent between blast morphology and karyotypic pattern. However, a pattern was discernible regarding survival and certain chromosomal changes within some morphologic groups: in patients with granular differentiated and lymphoid morphology, the median survival in BC was considerably longer when the bone marrow cells had a Ph1 as the sle abnormality compared to patients who had additional aberrations.

Acute Disease↗
PubMed1982

Intracranial myeloid metaplasia in myelofibrosis.

In a man aged 62 years with a 14-year-history of polycythaemia vera progressing into a myelofibrotic stage symptoms and signs of an intracranial tumour with increased intracranial pressure developed. CT scan as well as angiography of the right internal carotid artery revealed richly vascularized masses within the meninges. The patient died in endocarditis and progressive heart failure and at autopsy the intracranial masses were shown to be due to meningeal myeloid metaplasia. The literature is reviewed and it appears that myeloid metaplasia within the central nervous system might be more common than has been hitherto anticipated. A CT scan is to be recommended in myelofibrosis whenever symptoms and signs suggesting intracranial disease are present.

Brain Diseases↗
PubMed1982

Early management of aneurysmal subarachnoid hemorrhage.

The Lund Clinic serves a population of 1.46 million inhabitants. During the calendar year 1981, 72 patients presented with a ruptured supratentorial aneurysm, diagnosed either at angiography or at autopsy. Upon admission, 60% of the patients were in good condition and 40% were in poor condition. Eighty-three per cent were admitted within 72 hours after the subarachnoid hemorrhage (SAH). In the total series, 50% made a good recovery; the overall management morbidity was 19% and the management mortality was 31%. Thirty-one patients in Grades I-III underwent early operation (43% of the total series), with a favorable outcome in 74% and 7% mortality. Of the 35 patients who were admitted early and in good condition, 71% made a good recovery, and the management mortality was 9%. These figures may be compared to the 51% favorable outcome and 27% mortality reported from the Cooperative Aneurysm Study with late operation. In the early operation cases, the incidence of significant arterial narrowing at postoperative angiography performed on Day 9 +/- 2 after SAH was 30% and the incidence of permanent neurological deficits of delayed onset was 10%. Two of the early operation patients developed permanent symptomatic hydrocephalus.

Adult↗
PubMed1982

[Cuff pressure changes due to diffusion of nitrous oxide. A contribution to the question of the in vivo-diffusion--area of the cuff].

The mechanisms of nitrous oxide-diffusion through the endotracheal tube-cuff wall are still unknown in detail. In 30 patients we observed the pressure in low and high pressure-cuffs during operations with extracorporeal circulation (ECC). Under the chosen circumstances we found in low pressure-cuffs an increase of the initial pressure of 15.15 mm Hg up to 74,7 mm Hg until the beginning of ECC. During the ECC cuff pressure decreased to 32.25 mm Hg and was dependent on the body-temperature of the patients. After ECC the cuff pressure increased again up to 79.05 mm Hg until the operation was finished. The pressure changes in high pressure-cuffs were similar at different pressure-levels. These results show that in vivo the whole cuff-wall is diffusion-area for nitrous oxide. The main part of gas diffusion occurs through the contact area of the cuff with the tracheal wall.

Anesthesia↗
PubMed1981

Chromosome pattern, occupation, and clinical features in patients with acute nonlymphocytic leukemia.

Chromosome banding pattern of bone marrow cells, cell morphology according to the FAB classification, and clinical finding were compared in two groups of adult patients with acute nonlymphocytic leukemia (ANLL): 52 patients occupationally exposed to chemical solvents, insecticides, or petrol products, and 110 patients with no history of occupational exposure to potential mutagenic/carcinogenic agents. Striking differences were found between the two groups: (1) Clonal chromosomal aberrations were present in 75% of exposed patients compared with only 32% in the nonexposed group. (2) Of the patients exposed to solvents and insecticides 92% had abnormal chromosomes, whereas only 29% of patients exposed to petrol products showed abnormalities; in the total material 10/13 exposed patients with normal chromosomes were exposed to petrol products. (3) The relationship between chromosomal abnormality and exposure was evident in both females and males. However, only 29% of women with an abnormal karyotype were exposed, whereas 70% of males with an abnormal karyotype were exposed. (4) The incidence of certain characteristic karyotypic abnormalities, i.e., -5/5q-, 7/7q-, +8, +21, t(8;21), and t(9;22), were decidedly more common in exposed than in nonexposed patients. At least one of these changes were present in 92% of exposed patients with aberrations, whereas in the nonexposed group the incidence was only 60%. (5) The monocytic varieties of ANLL (M4 + M5) were more common in the nonexposed patients, whereas erythroleukemia (M6) was more common in the exposed group. The predominance of abnormal karyotypes in the exposed compared to the nonexposed patients was similar in leukemia types M1 + M2 and in M4 + M5. (6) There was no difference in survival time between the two groups and the same correlation was obvious in both exposed and nonexposed patients: patients who had only abnormal metaphases had poorer prognosis than those with normal bone marrow metaphases only (6 vs 1.5 months). This correlation was obvious in patients classified as acute myeloid leukemia (AML) as well as in the monocytic varieties of ANLL.

Acute Disease↗
PubMed1981

Effects of extracellular calcium and of calcium antagonists on the contractile responses of isolated human pial and mesenteric arteries.

In isolated human pial arteries (diameter 0.4-0.5 mm), contractions were produced by potassium, noradrenaline, serotonin, and prostaglandin F2 alpha. For comparison, experiments were also performed on human mesenteric arteries. Threshold concentration for potassium-induced contraction in pial arteries was about 10 mM; in mesenteric arteries it was 3-5 mM higher. In pial arteries the calcium antagonists nifedipine and nimodipine caused an almost complete relaxation of contractions induced by potassium at drug concentrations relaxing prostaglandin F2 alpha-contracted vessels to only about 60%. Both nifedipine and nimodipine effectively inhibited contraction elicited by noradrenaline and serotonin in pial arteries. Nifedipine had a higher potency for relaxing cerebral than mesenteric arteries contracted by potassium (p less than 0.001). No such difference was demonstrated for nimodipine. In pial arteries pretreated in a calcium-free medium for 30 min, potassium depolarisation elicited contractions reaching a maximum amplitude of about 40% of that evoked in normal Krebs solution. Both nifedipine and nimodipine effectively inhibited contractions induced by calcium in pial arteries pretreated in a calcium-free medium and depolarised by potassium. The results suggest that potassium, amines, and prostaglandin F2 alpha activate isolated pial and mesenteric arteries by different calcium-dependent mechanisms and confirm the potent relaxant effects of nifedipine and nimodipine in these vessels.

Calcium↗
PubMed1981

Supradiaphragmatic presentation of non-Hodgkin's lymphoma in men occupationally exposed to organic solvents.

Using a standardized interview schedule, occupational exposure to organic solvents was investigated in 61 consecutive male patients with the diagnosis of non-Hodgkin's lymphoma. When exposure was defined as handling of organic solvents every working day for at least one year, 23 patients were exposed and 38 non-exposed. Of 15 patients with clinical stage I-II above the diaphragm, 12 (80%) were occupationally exposed to organic solvents. Only 1 (11%) of 9 patients with clinical stage I-II disease located below the diaphragm was exposed. Thirty-seven patients had clinical stage III-IV disease at the time of diagnosis and 10 (27%) of these were exposed. The predominance of exposed patients in the group with stage I-II disease above the diaphragm is significant and the results indicate a relation between exposure to organic solvents and supradiaphragmatic presentation of non-Hodgkin's lymphoma. No correlation was found between exposure and the morphology of the lymphomas.

Adult↗
PubMed1981

Metabolic activity of lymphoma cells and clinical course in non-Hodgkin lymphoma (NHL).

By microcalorimetry the metabolic activity of malignant cells from 2l patients with non-Hodgkin lymphoma was monitored. Heat production, a measure of the metabolic activity of cells, showed positive correlation with the clinical course of the disease. The heat produced by tumor cells from patients with progressive disease was 5.5 pW/cell, while that from patients responding to treatment was 3.l pW/cell. The difference between the 2 groups is significant (P less than 0.05). A higher heat production was obtained in tumor cells from 7 out of 10 patients who were unresponsive to the therapy when compared with cells from 11 patients who had become asymptomatic as a result of the same therapy. Also heat production from blood lymphocytes was found to be higher (P less than 0.005) in the group of patients with progressive disease as compared to the group of patients who responded to therapy. The present results indicate an association between high heat production in lymphoma cells and blood lymphocytes and a poor prognosis.

Aged↗
PubMed1981

Cerebrovascular effects of ammonia in vitro.

The effect of ammonia (ammonium salts) upon human and rabbit cerebral arteries was studied in vitro. Ammonia (NH3/NH4+) caused relaxation of cerebrovascular smooth muscle which was transient and occurred irrespective of how the vessels were preconstricted (potassium-Krebs solution, noradrenaline, serotonin, prostaglandin F2 alpha). The effect was independent of ammonia-induced extracellular changes in pH. It is concluded that ammonia may contribute to the vasodilatation and increase in cerebral blood flow which occurs under certain pathophysiological conditions.

Ammonia↗
PubMed1981

Vasoconstrictive effects of human post-hemorrhagic cerebrospinal fluid on cat pial arterioles in situ.

Cat cortical arterioles were exposed in vivo to cerebrospinal fluid (CSF) from four patients with subarachnoid hemorrhage (SAH) due to a ruptured intracranial aneurysm. Pial arteriolar caliber was measured by the television image-splitting technique. There was a consistent vasoconstrictive response to CSF. This effect could be ascribed neither to the pH of the CSF nor to the potassium concentration. The vasoconstriction, which was more pronounced with decreasing arteriolar caliber, could be resolved by the perivascular application of nifedipine.

Adult↗
PubMed1981

Results of early operations for ruptured aneurysms.

In a consecutive series of 219 patients with a ruptured aneurysm of the anterior part of the circle of Willis, 119 patients (54%) made a good recovery and 67 (31%) died. Of 53 patients who did not have surgery, six (11%) made a good recovery and 37 (70%) died. Urgent surgery with evacuation of an associated significant intracerebral hematoma was performed in 30 patients; nine (30%) made a good recovery and 15 (50%) died. Delayed surgery was performed in 55 patients of whom 42 (76%) made a good recovery and two (4%) died. Early intracranial operation (within 48 to 60 hours after subarachnoid hemorrhage (SAH)) was performed in 81 patients who were in Grades I to III prior to surgery. Sixty patients (74%) made a good recovery, and eight died within a month. Five patients were severely disabled and died 2 to 8 months after SAH and surgery. In 17 patients, although the immediate postoperative course was uneventful, evidence of cerebral ischemia developed 4 to 13 days after the bleed and resulted in death in eight patients. A poor outcome was correlated with a history of elevated blood pressure before SAH. Seven patients, of whom six were women of child-bearing age, demonstrated pronounced vasospasm on postoperative angiography; nevertheless, they remained well and free from ischemic symptoms after surgery. Early operation combined with removal of subarachnoid clots and rinsing the basal cisterns does not eliminate the risk of delayed ischemic dysfunction. Such early surgery, however, improves overall outcome by preventing recurrent bleeding, and may also reduce the frequency of hydrocephalus.

Adolescent↗
PubMed1981

Vasoconstrictor activity in cerebrospinal fluid from patients subjected to early surgery for ruptured intracranial aneurysms.

Vasoconstrictor activity was examined in serial samples of cerebrospinal fluid (CSF) obtained from 10 patients undergoing aneurysm clipping within 48 hours after subarachnoid hemorrhage (SAH). There was no close relationship between vasoconstrictor activity in postoperative CSF samples and the patient's clinical condition or angiographic vasospasm. The identity of the vasoconstrictor substance(s) in CSF was not established, but serotonin, histamine, norepinephrine, epinephrine, acetylcholine, or angiotensin II were eliminated as prime vasoconstrictor agents inducing cerebral vasospasm. Differences in the temporal profile of the responses of isolated tissues to CSF from patients with early and late surgery suggested that differing substances were involved in the production of spasm. A correlation between CSF potassium concentrations and vasoactive substances was found, but potassium could not account for vasoconstrictor activity of CSF. A log:linear correlation between total vasoconstrictor activity and total CSF collected could not be explained. Also, because of possible differences in the identity of vasoactive substances in CSF in this study compared to earlier studies, clinical comparisons based on apparent differences in pharmacological potency of CSF were not warranted. Nevertheless, removal of subarachnoid blood by cisternal rinsing seemed to be a useful surgical adjunct.

Adult↗