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Biomedical subjects

M Lie

Publications and source records attributed to M Lie.

At least 37 records · Page 2Linked to original sources
PubMed1993

Surgical revascularization in the treatment of ventricular tachycardia and fibrillation exposed by exercise-induced ischaemia.

The role of myocardial revascularization in the treatment of malignant ventricular arrhythmias is not well defined. Our hypothesis was that in patients with ventricular tachycardia or fibrillation exposed by exercise-induced ischaemia, the acute transient ischaemia plays a principal causal role, and that in these patients surgical myocardial revascularization alone might be an effective treatment. Among 1100 consecutive patients undergoing isolated coronary artery bypass surgery (CABG) 30 patients (2.7%) characterized by ventricular tachycardia or fibrillation at the symptom-limited exercise tests prior to revascularization were studied prospectively. All patients had exercise-induced angina pectoris or ischaemic ST-segment depression preceding at least one of the arrhythmic events. In addition, eight of these 30 patients had experienced syncope during out-of-hospital exertional activities. After surgical revascularization, the 28 patients surviving to hospital discharge were followed for 1.6 to 86 months (mean 29 +/- 29 months) as outpatients and underwent between one to eight exercise tests (mean 2.6 +/- 1.9). One of these patients died suddenly of unknown causes at 14 months, another from cancer at 53 months. Twenty-six patients experienced a total of 34 episodes of ventricular tachycardia before revascularization. Two of these patients, both having residual ischaemia, had arrhythmia recurrences during follow-up; odds ratio (OR) 84.5, 95% confidence interval (CI) 18.7-381.9; P = < 0.010. Exercise-induced ventricular fibrillation occurred in eight patients pre-operatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Iodixanol in abdominal digital subtraction angiography. A randomized, double-blind, parallel trial with iodixanol and iohexol.

The safety, tolerability and efficacy of iodixanol 270 mg I/ml were compared to those of iohexol 300 mg I/ml in a double-blind, randomized, parallel abdominal intra-arterial DSA phase III trial. Fifty-nine patients were included in the trial; 39 patients received iodixanol and 20 received iohexol. The mean volume of iodixanol administered was 235.8 ml (0.93 g I/kg b.w.) while the mean volume of iohexol was 254.7 ml (1.10 g I/kg b.w.). No differences in diagnostic information and radiographic density were apparent in spite of the difference in the concentration of iodine. No serious adverse events occurred. Four patients (10%) in the iodixanol group and 2 (10%) in the iohexol group experienced adverse events. Eight percent of the injections of iodixanol promoted discomfort, compared to 12% of the injections of iohexol. An increase in S-urea and S-creatinine was seen with both agents the first day after injection, but appeared to be less pronounced with iodixanol than with iohexol. Other serum tests revealed no changes of clinical importance. Both iodixanol and iohexol were found to be effective, safe and well tolerated contrast media for abdominal intra-arterial DSA.

Abdomen↗
PubMed1990

[Improved treatment of abdominal aortic aneurysms. Progress over 17 years].

During the period 1970-86, 155 men and 24 women were operated on for abdominal aortic aneurysms at the University Hospital in Tromsø. Elective operations were performed in 76 patients with an operative mortality of 5 (7%), impending rupture in 49, of whom 14 died (29%) and ruptured aneurysms in 54 patients, of whom 33 (61%) died. There has been a substantial increase in the number of patients per year admitted with abdominal aneurysms, from an average of 4.5 during the years 1970-76 inclusive, to over 20 during the years 1984-86. Operative and early postoperative mortality have been reduced and there has been no death following elective operations during the last three years of the reported period. Mortality was 8% for impending rupture and 45% for ruptured aneurysms. Electively abdominal aortic aneurysms can be operated safely even in patients over the age of 80. Ruptured aneurysms, however, still carry a high operative mortality in patients over the age of 70.

Age Factors↗
PubMed1990

Coronary trapping of a complement activation product (C3a des-Arg) during myocardial reperfusion in open-heart surgery.

Accumulation of complement factors has been found to occur in the myocardium after infarction. We studied the possibility that the complement activation product C3a des-Arg is trapped within the coronary circulation during reperfusion of the ischemic myocardium. In 11 patients undergoing routine coronary artery bypass grafting, arterial blood was sampled before, during and after cardiopulmonary bypass. Blood was drawn from the coronary sinus concomitantly with arterial blood sampling 5 and 30 min after release of the aortic cross-clamp (n = 10). From a preoperative value of 92 +/- 13 ng/ml, C3a des-Arg rose during CPB to a maximum of 1816 +/- 393 at the end of CPB. Following reperfusion for 5 min, C3a des-Arg was 1284 +/- 232 ng/ml in arterial and 1106 +/- 100 in coronary sinus blood, a significant difference (p less than 0.05). The amount of C3a des-Arg trapped in the heart at 5-min reperfusion showed positive correlation with its arterial concentration (p less than 0.05). No significant difference was found after 30 min of reperfusion. Complement activation products trapped in the heart in the early reperfusion period may play a pathogenetic role in myocardial ischemia-reperfusion injury.

Cardiopulmonary Bypass↗
PubMed1990

Rupture of a splenic artery aneurysm into the pancreatic duct. Case report.

A 71-year-old woman was admitted to a local hospital with abdominal pain and repeated haematemeses and melaena. Plain X-ray of the abdomen showed a cystic mass with a calcified wall behind the stomach. No bleeding point in the stomach or duodenum was found at gastroscopy. Over a period of 28 days she had five episodes of gastrointestinal haemorrhage with no drop in blood pressure. She was transferred to the regional hospital 26 days after admission. Angiography showed a splenic artery aneurysm 5 x 10 cm, which at operation was found to have ruptured into the pancreatic duct. The aneurysm, the tail of the pancreas and the spleen were removed, and she made an uneventful recovery.

Aged↗
PubMed1988

Splenic arteriovenous fistula. Case report.

A case of splenic arteriovenous fistula is reported. Two types of this anomaly are known--the more common, true, arteriovenous fistula, and a fistula between the arterial system and the portal venous system. In the present case the second, very rare, type developed after a motorcar accident.

Accidents, Traffic↗
PubMed1987

Coronary bypass surgery in exercise-induced ventricular tachycardia.

Among 400 consecutive patients undergoing conventional isolated bypass surgery, 9 patients had clinical and electrocardiographic evidence of severe ischaemia during exercise and serious exercise-induced ventricular arrhythmias. Four patients had spontaneous exercise-induced arrhythmias and two had been resuscitated for out-of-hospital cardiac arrest. Postoperatively all patients were free of angina, off anti-anginal drugs with considerably increased exercise capacity and maximal heart rate during exercise. No spontaneous or exercise-induced arrhythmias have recurred during observation periods ranging from one to four and a half years. In this subset of patients ischaemia seems to be the crucial arrhythmia-inducing factor and bypass surgery alone may therefore be therapeutic. The reduction of ischaemic exercise-induced arrhythmias may be one way by which bypass surgery reduces mortality in larger patient series.

Aged↗
PubMed1983

Effect of prophylactic high-dose treatment with ampicillin and cloxacillin on bleeding time and bleeding in patients undergoing elective vascular surgery.

50 patients undergoing elective vascular surgery were randomized to prophylactic antibiotic treatment with ampicillin 2 g X 4 + cloxacillin 1 g X 4 for 4 d following the operation, or to a control group without antibiotics. All patients received heparin subcutaneously 5000 IU X 2, for 7 d. On days 1 and 4 after the operation, the median bleeding time was 1 1/2-2 min longer in the antibiotics group. 5 patients on antibiotics had a bleeding time prolongation beyond the normal range, but only 2 of these, who had additional haemostatic defects, had abnormal bleeding.

Adult↗
PubMed1978

On use of chromogenic substrates for studies of coagulation inhibitors.

Methodological problems encountered using chromogenic substrates on thrombin and Xa are discussed: (1) influence of substrate on inhibitor; (2) influence of heparin; (3) optimal concentrations; (4) specificity; (5) denatured enzymes, and (6) natural versus chromogenic substrates.

Antithrombins↗
PubMed1977

Effect of glycine and glucagon on glomerular filtration and renal metabolic rates.

A rise in glomerular filtration rate (GFR) during saline infusion increases outer medullary more than cortical metabolic rate. To determine whether other GFR-increasing agents have a similar effect, renal metabolic rates were estimated by the heat-production technique during infusion of glycine or glucagon. Glycine and glucagon increased GFR by 17 +/- 2 and 32 +/- 2%, renal blood flow (RBF) by 34 and 21%, and outer medullary metabolic rate by 42 +/- 3 and 59 +/- 4%, respectively. Cortical metabolic rate rose by 7 +/- 1% during glucagon, and it increased by 29 +/- 2% during glycine infusion, suggesting a stimulation unrelated to sodium reabsorption. To determine whether glucagon influenced renal metabolism independent of its GFR-increasing effects, vasodilation was achieved by ureteral or suprarenal aortic constriction. Glucagon was without effect on RBF, GFR, and metabolic rate, but infusion of acetylcholine still raised RBF. We conclude that glucagon increases GFR by dilating vascular segments participating in autoregulation, and that energy-requiring NaCl reabsorption in the outer medulla is increased secondary to increased delivery of NaCl.

Acetylcholine↗