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Biomedical subjects

M Kaste

Publications and source records attributed to M Kaste.

At least 181 records · Page 10Linked to original sources
PubMed1978

Subarachnoid haemorrhage: long-term follow-up results of late surgical versus conservative treatment.

During 1964-9, 178 patients with subarachnoid haemorrhage from a single intracranial arterial aneurysm were allocated at random to receive operative or conservative treatment at an average of seven weeks after bleeding. During the follow-up fatal rebleeding episodes occurred in six of the 86 patients treated surgically and 16 of the 92 treated conservatively. This difference was significant. Fatal rebleeding occurred on average 40 months after the first episode. Deaths from all causes occurred in 17 of the 86 patients treated surgically and 22 of the 92 treated conservatively. Life-table analysis of the chances of surviving 1, 5, and 11 years gave probabilities of 95 and 91%, 87 and 86%, and 76 and 75% in the two treatment groups respectively. Of the 139 patients alive after a mean follow-up of nine years, 130 (94%) were fully independent in their daily lives, and only 43 (31%) were unable to work. The method of treatment did not affect the quality of survival.The results show that fatal rebleeding may occur even many years after the first episode. Nevertheless, if the patient is in good condition seven weeks after a haemorrhage from a single intracranial arterial aneurysm the outcome is good irrespective of whether operation is performed at this late stage.

Adult↗
PubMed1978

Elevation of high-density lipoprotein in epileptic patients treated with phenytoin.

Previous observations have shown that serum alpha (high-density) lipoprotein (HDL) cholesterol is increased by some agents which also act as liver microsomal inducers. Against this background we measured the serum HDL and other lipoprotein and apolipoprotein A levels in 28 epileptic patients who received phenytoin as the only medication. In comparison with healthy controls of similar age and sex, the phenytoin users had significantly higher HDL cholesterol (p less than 0.001) and apolipoprotein A-I (p less than 0.01) levels. Highest values of both parameters were found in patients whose serum phenytoin concentration was within the therapeutic range. HDL cholesterol levels were above the control mean +2 S.D. in 43% of the phenytoin users. Hypertriglyceridemia was more common among male phenytoin users than in control males (33 vs. 16%). It is suggested that phenytoin increases the secretion of nascent HDL particles (and probably also that of VLDL) by the liver and that this could be associated with the induction of hepatic microsomes. Since HDL is inversely reversely related to risk of coronary heart disease, the observed increase of this lipoprotein may be an example of a beneficial side-effect of a drug.

Adult↗
PubMed1978

Heart type creatine kinase isoenzyme (CK MB) in acute cerebral disorders.

Heart type creatine kinase isoenzyme (CK MB) was detected in the serum in 23 out of 53 patients (43%) with acute cerebrovascular, traumatic, or infectious brain damage. Electrocardiogram disclosed abnormalities suggestive of acute myocardial injury in 15 of these 23 patients. Eleven of them also showed increased LD1 activity. Subendocardial haemorrhage was detected in 3 out of 8 necropsied patients with serum CK MB activity. Among those 30 patients in whom no CK MB activity was found electrocardiographic abnormalities suggestive of acute myocardial injury were observed in 2 and increased LD1 was seen in 4 cases. The mortality was higher if either CK MB isoenzyme or electrocardiographic abnormalities suggestive of acute myocardial injury were present, compared with the patients lacking these signs (P less than 0.01). Present findings suggest that acute brain damage may secondarily cause myocardial damage more often than has been believed before. Results also indicate that a combination of acute brain damage and acute myocardial injury often indicated a poor prognosis.

Acute Disease↗
PubMed1977

Brain-type creatine kinase isoenzyme. Occurrence in serum in acute cerebral disorders.

Acute brain damage-cerebrovascular or cardiovascular, traumatic or infectious-released brain-type isoenzyme of creatine kinase (BB-CK) into the circulation within a few hours in 16 of 62 patients (26%). Occurrence of BB-CK was transient in the serum. BB-CK activity was found in the peripheral blood in 13 of 23 patients with diffuse brain damage compared to three of 39 patients with a local cerebrovascular accident (P less than .0005). The mortality of patients having BB-CK in their serum was 63% compared to 39% of those without BB-CK activity in their serum (P less than .05).

Adult↗
PubMed1976

Combined dexamethasone and low-molecular-weight dextran in acute brain infarction: double-blind study.

Intramuscular dexamethasone combined with intravenous low-molecular-weight dextran (dextran 40) was compared with placebo in 40 patients with acute ischaemic cerebral infarction. A double-blind procedure was used. Dexamethasone was given for up to 14 days and dextran 40 for up to three days after the infarction. A weighted scoring system was used to evaluate neurological state and mobility. There were no differences in mortality or in improvement of the neurological or mobility scores between the two groups.

Clinical Trials as Topic↗
PubMed1975

Brain creatine kinase in blood after acute brain injury.

Severe cold injury of the brain increased significantly both total creatine kinase and the corresponding brain isoenzyme (CKBB) activity in confluens sinuum samples. CKBB could be detected also in peripheral blood a few hours after severe brain injury in eight of 12 patients. Finding of CKBB in human plasma may prove a useful indicator of severe brain injury.

Animals↗
PubMed1972

[Brain edema].

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Animals↗