Biomedical subjects

L Samuelsson

Publications and source records attributed to L Samuelsson.

78 records · Page 5Linked to original sources

PubMedDate not supplied

Computed tomography of malignant ovarian disease.

One hundred and five patients with proven malignant ovarian disease were examined with one or more abdomino-pelvic CT scans in order to evaluate clinically suspected recurrence, complete clinical remission, or the effect of therapy. The findings obtained at CT were compared with follow-up examinations including surgery in 85 patients within 3 months. CT was accurate in the evaluation of therapeutic response, but if negative not reliable enough to replace a laparotomy of patients with possible recurrence or in clinical remission.

Female↗

PubMedDate not supplied

The percentage of migration as indicator of femoral head position.

In childhood subluxation of one or both hips may develop rather insidiously. For lack of generally accepted objective methods of assessment, ambiguous interpretations of findings in serial examinations are common. Many subluxations are overlooked during the early stages. In order to overcome such disadvantages, determination of the percentage of migration seems to be a reasonably easy and reliable technique facilitating evaluation of impending dislocation. This investigation was carried out in order to establish norms applicable to patients in the pediatric age interval. The 98th percentile of migration increases with age from 16 per cent in patients less than 4 years of age to 24 per cent in patients greater than or equal to 12 years. Higher figures represent subluxation. If the migration exceeds 80 per cent a manifest luxation is present. A difference in migration between the two hips larger than 12 per cent indicates abnormality calling for clinical and radiologic follow-up.

Adolescent↗

PubMedDate not supplied

MR imaging of syringohydromyelia and Chiari malformations in myelomeningocele patients with scoliosis.

The brain and spinal cord were examined with MR imaging in 30 myelomeningocele patients 3-32 years old to study the prevalence of syringohydromyelia and Chiari malformations and to correlate these conditions with developmental scoliosis and spontaneously arrested hydrocephalus. Twelve patients had neurologic deficits above the level of the myelomeningocele and 10 had spontaneously arrested hydrocephalus. MR visualized syringohydromyelia in four patients with widened or focally bulging spinal cords and in eight patients with atrophic spinal cords. All patients had Chiari malformations, 28 of type II and two of type I. Syringohydromyelia was not correlated with type of scoliosis, result of ventriculoperitoneal shunting procedures, radiologic level of the myelomeningocele, or extent of the Chiari malformation. The two patients with the most rapid progression of thoracic scoliosis had the most extensive syringohydromyelia and radiologically low lumbar levels. Neurologic deterioration due to syringohydromyelia and Chiari malformations is probably more common in myelomeningocele than has been recognized previously and may cause developmental scoliosis, loss of ambulation, impaired extremity function, and progressive cranial nerve paralysis.

Adolescent↗

PubMedDate not supplied

The effect of continuous lumbar epidural infusion of ropivacaine (0.1%, 0.2%, and 0.3%) and 0.25% bupivacaine on sensory and motor block in volunteers: a double-blind study.

BACKGROUND AND OBJECTIVES: In animal studies, ropivacaine has shown more pronounced sensory block than motor block, which makes it an interesting drug for postoperative pain relief. The aim of this study was to investigate the dose response of sensory and motor block during continuous epidural infusion of 0.1, 0.2, or 0.3% ropivacaine in volunteers in a double-blind manner. Bupivacaine 0.25% and isotonic saline were used as reference and control, respectively. METHODS: Each treatment group consisted of eight healthy men. After a bolus dose of 10 mL at the L2-L3 interspace, the solution in question was infused at 10 mL/h for 21 hours. Sensory block was evaluated by the pinprick, light touch, and Thermotest methods. Motor block was measured by the Bromage scale, by average rectified electromyography in abdominal muscles, and by mechanical measurement of isometric muscle force in the lower extremities. Mobilization of the subjects was attempted throughout the investigation. RESULTS: The number of blocked dermatomes (evaluated by pinprick) with 0.1% ropivacaine was significantly smaller than with the other test solutions (P = .002-.0008). Motor block was minimal with 0.1% ropivacaine, so that all subjects could be mobilized; it was moderate with 0.2 and 0.3% ropivacaine and most intense with 0.25% bupivacaine. The regression phase was significantly shorter with all three concentrations of ropivacaine than with bupivacaine (P < .01). CONCLUSIONS: Ropivacaine 0.1% produced limited analgesia and minimal motor block, so that ambulation was possible throughout the investigation. With 0.2 and 0.3% ropivacaine, analgesia was more extensive, and motor block was considered moderate. Ropivacaine 0.2% should be evaluated for future postoperative pain treatment.

Adult↗

PubMedDate not supplied

Evaluation of epidural sensory block by thermal stimulation, laser stimulation, and recording of somatosensory evoked potentials.

BACKGROUND AND OBJECTIVES: The existence of differential sensory block during epidural analgesia has been confirmed by some authors and disputed by others. This study attempts to elucidate this issue by using quantitative methods for evaluation of sensory block. METHODS: A single epidural injection of 20 mL 0.5% bupivacaine with epinephrine was administered at the L1-T12 level in 11 male volunteers. Sensory block was evaluated by two qualitative (pinprick and light touch) and two quantitative methods (thermal stimulation with Thermotest [Somedic, Stockholm, Sweden] and argon laser stimulation). For measurement of motor block in the lower extremities and in the rectus abdominis muscle, quantitative methods were used. Sensory block was also assessed by somatosensory evoked potentials recorded during electrical and laser stimulation at the most cranial analgesic dermatome (loss of sharpness in pinprick perception) and the anesthetic dermatome L2 (loss of light touch perception). RESULTS: The zone of anesthesia was smaller than the zone of any other investigated variable. The cranial spread of analgesia and motor block was lower than that of laser-assessed block. Partial block of laser perception and thermal perception lasted longer than analgesia and motor block. No consistent segmental or temporal differences were found between the Thermotest and laser methods. During epidural block, prolongation of latencies and reduction in amplitudes of somatosensory evoked potentials produced at the most cranial analgesic dermatome did not differ significantly from those produced at the anesthetic dermatome. CONCLUSIONS: No differential block of small nerve fibers was found during epidural analgesia by Thermotest and argon laser stimulation. Recording of somatosensory evoked potentials did not demonstrate significant difference between responses from the sites with most superficial and with most intense sensory block.

Adult↗

PubMedDate not supplied

Scoliosis and trunk asymmetry in upper limb transverse dysmelia.

The incidence of scoliosis and trunk asymmetry were studied in 60 patients with upper limb dysmelia of the transverse type. The evaluations were based on radiographic measurements of the spine and scoliometer readings of the angle of trunk rotation (ATR), which were correlated with the side and level of the limb deficiency and also with leg length-inequality (LLI). Nineteen patients (31%) had a scoliosis between 10 and 19 degrees, whereas the curves were between 5 and 10 degrees in another 30 patients and the remainder had no measurable curve. The scoliosis seemed at least partly to be of postural origin as LLI significantly correlated with the direction of the curves, but there was no correlation between the Cobb angles and the magnitude of LLI. The scoliometer readings did not correlate with the scoliosis or LLI. Our findings indicate that most patients with upper limb transverse amputations do not develop a significant scoliosis. A scoliometer screen has a low positive predictive rate for scoliosis and the diagnosis of scoliosis requires a radiograph of the spine.

Adolescent↗