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Biomedical subjects

M Perko

Publications and source records attributed to M Perko.

At least 19 recordsLinked to original sources
PubMed1992

Middle cerebral artery flow velocity and blood flow during exercise and muscle ischemia in humans.

Changes in middle cerebral artery flow velocity (Vmean), measured by transcranial Doppler ultrasound, were used to determine whether increases in mean arterial pressure (MAP) or brain activation enhance cerebral perfusion during exercise. We also evaluated the role of "central command," mechanoreceptors, and/or muscle "metaboreceptors" on cerebral perfusion. Ten healthy subjects performed two levels of dynamic exercise corresponding to a heart rate of 110 (range 89-134) and 148 (129-170) beats/min, respectively, and exhaustive one-legged static knee extension. Measurements were continued during 2-2.5 min of muscle ischemia. MAP increased similarly during static [114 (102-133) mmHg] and heavy dynamic exercise [121 (104-136) mmHg] and increased during muscle ischemia after dynamic exercise. During heavy dynamic exercise, Vmean increased 24% (10-47%; P less than 0.01) over approximately 3 min despite constant arterial carbon dioxide tension. In contrast, static exercise with a higher rate of perceived exertion [18 (13-20) vs. 15 (12-18) units; P less than 0.01] was associated with no significant change in Vmean. Muscle ischemia after exercise was not associated with an elevation in Vmean, and it did not provoke an increase in Vmean after static exercise. Changes in Vmean during exercise were similar to those recorded with the initial slope index of the 133Xe clearance method. The data show that middle cerebral artery mean flow velocity reflects changes in cerebral perfusion during exercise. Furthermore, they support the hypothesis that cerebral perfusion during exercise reflects an increase in brain activation that is independent of MAP, central command, and muscle metaboreceptors but is likely to depend on influence of mechanoreceptors.

Adult↗
PubMed1991

[Surgery of ruptured abdominal aortic aneurysm. Are the results compatible with the effort?].

During 1979-1988 218 patients were operated on for ruptured abdominal aortic aneurysm. On admission 110 patients (50%) were in shock. Patients with a systolic blood pressure less than 100 mmHg, anuria on admission, peroperative bleeding of more than five litres and aged more than 70 years had an increased mortality. The intraoperative mortality was 15% and the postoperative mortality 21%. The perioperative mortality decreased from 45% in 1979 to 32% in 1988. The most frequent complications were renal failure and respiratory insufficiency, both were associated with a mortality of more than 50%. The five year survival was 48%. This study has revealed that patients with ruptured abdominal aortic aneurysm have an acceptable prognosis. The investigation emphasizes the importance of early diagnosis and elective operation to avoid rupture.

Aged↗
PubMed1990

[Hemodynamic assessment of cerebrovascular circulation using transcranial Doppler ultrasound in patients with carotid stenosis].

Transcranial Doppler-ultrasound (TCD) is a new non-invasive technique which renders continuous monitoring of the rate of flow in the major intracerebral arteries possible. The method appears, therefore, to be attractive for perioperative monitoring of patients submitted to operation on account of carotid stenosis. Seventeen patients were included in this preliminary investigation. These patients were submitted for thromboarterectomy of the internal carotid artery. Preoperatively the average flow rate (Vmean) in the ipsilateral medial cerebral artery measured at rest was 54 cm/second (range 34-94) as compared with 57 cm/second (range 32-86) in the contralateral medial cerebral artery. During occlusion, Vmean in the ipsilateral medial cerebral artery decreased momentarily, on an average 35% (p less than 0.001), and returned to the preoperative level after reopening of the internal carotid artery. Corresponding but no significant changes were observed in the pulsatile index. The preliminary experience suggests that TCD is scarcely useful as a diagnostic method in individual cases but that it is well suited for continuous monitoring of changes in cerebral circulating during surgery on the internal cerebral artery. Further assessment of the technique is necessary before the method can be employed routinely, mainly on account of the great interindividual scatter.

Aged↗
PubMed1990

[Femoro-popliteal bypass surgery in Denmark 1983-1987].

In a retrospective study of femoro-popliteal bypass surgery in Denmark during the period 1983 to 1987, a total of 1,532 operations were performed. Approximately 2/3 of the patients were operated upon for limb salvage, the remainder for severe disabling claudication. The perioperative lethality was below two per cent in all departments. Early occlusion rate was found to be between 21 and 11 per cent, leading to major amputation in about half of the patients.

Arteriosclerosis↗
PubMed1990

[Early and late results after surgery of abdominal aortic aneurysm].

From 1983-1987, 388 patients were operated upon for abdominal aortic aneurysm. Elective operation was performed on 171 patients (44%) with a mortality of 2.9%. Emergency operation was done in 277 patients of whom 132 (34%) had ruptured aneurysms. The mortality for ruptured aneurysms was 36% and 21% for patients operated on as emergencies without signs of rupture of the aneurysm. The five year survival rate was 75% after elective operation, 60% after emergency operation and 40% after operation for ruptured aneurysm. The high mortality after emergency operation for abdominal aortic aneurysm confirms the importance of early diagnosis and elective operation before rupture occurs.

Aorta, Abdominal↗
PubMed1990

Renal failure after operation for abdominal aortic aneurysm.

Among 656 patients undergoing surgery for abdominal aortic aneurysm, 81 patients (12%) developed postoperative renal failure. Before operation hypotension and shock occurred in 88% of the patients with ruptured aneurysm, whereas none of the patients operated electively were hypotensive. Dialysis was performed in 32 patients, while the remaining 49 patients were managed without dialysis. Within 30 days after the operation 47 patients (58%) had died. There was no difference in mortality between patients in dialysis and patients managed without dialysis. Thirteen patients died during follow-up. In six cases the death was caused by renal failure only or in combination with failure of other organs. Analysis of the cumulative survival shows that, if the patients survive the postoperative period, their life expectancy is comparable to that of patients without renal complications.

Acute Kidney Injury↗
PubMed1989

Adenylate degradation products release from the human myocardium during open heart surgery.

Purine degradation products were determined in the human heart coronary sinus effluent collected from patients undergoing cardiac surgery, during infusion of a cardioplegic solution. At the onset of cardiopulmonary bypass the mean concentrations of adenosine, inosine and hypoxanthine were 0.1, 0.5 and 0.3 mumol/l, respectively. Ischemic arrest leads to a progressive increase of the respective levels to 1.4 17.8 and 9.6 mumol/l after 60-80 min of ischemia. Xanthine concentration was undetectable (less than 0.2 mumol/l) throughout. A substantial urate release (20 mumol/l) was observed which decreased with the duration of ischemia. Xanthine oxidoreductase activity in human myocardium was found to be below the detection limit (0.1 mU/g wet weight). Thus, urate release represented wash out of urate which had accumulated in the tissue.

Adenosine↗
PubMed1989

Speech results of the Zürich approach in the treatment of unilateral cleft lip and palate.

The purpose of this study was to describe perceptually the speech articulation, voice quality, and velopharyngeal competency of subjects with complete unilateral cleft lip and palate treated by the Zürich approach. The mean age of the 37 subjects was 10.5 years. Although only one subject had had secondary palatal management, no subject was rated as exhibiting a severe articulation or nasality problem. Subjects were rated as exhibiting adequate to marginal velopharyngeal competency 94.5 percent of the time, and the incidence of compensatory articulation errors was low. In comparison with other studies that evaluated the two-stage palatal repair, the Zürich approach appears to give the better results. The type of initial soft palate repair is probably the significant factor which contributes to the better speech of these subjects.

Adolescent↗
PubMed1987

[Dominantly inherited lower lip fistulas and facial clefts (Van der Woude syndrome). A study of 52 cases].

Congenital lip pits may occur alone or in combination with oral clefts. They characteristically present as symmetric pits close to the vermilion border of the lower lip, about 0.5 cm off the midline, and are usually connected with heterotopic salivary glands; occasionally, salivation may occur. Congenital lip pits are associated with clefts of the upper lip and/or the palate in about half of the cases. Hypodontia may also be observed. Lip pits with or without clefts are found in a few dominantly inherited syndromes, in most cases involving the autosomal dominant Van der Woude syndrome. 52 carriers of the Van der Woude gene are described. In 8 cases the syndrome occurred as a fresh mutation and the other 44 cases occurred in 5 families. Penetrance was complete and expression very variable. Sex distribution was 1:1. For genetic counselling purposes it can be concluded that all carriers of the Van der Woude gene can be identified. Every symptom (pits, micro-pits, cleft, submucous clefts, uvula bifida) may represent the only manifestation of the gene. The recurrence risks for offspring of gene carriers is 50%, but the risk of severe forms of cleft is much lower.

Adult↗
PubMed1987

Shape and function of the unilateral cleft nose in adolescents following modified Millard lip repair.

24 patients with unilateral clefts operated on (at age of 6 months) according to the Millard (1964) procedure were examined at an average age of 10.1 years. Nasal shape and function were evaluated. No change of nasal shape was found during the observation period. The results were superior to those attained by the author with the Tennison-Trauner (1952, 1957) procedure in 6 cases. 13 of the Millard (1964) cases are not expected to need secondary nasal correction at a later date.

Adolescent↗
PubMed1987

Early orthopaedic stabilization of the praemaxilla in complete bilateral cleft lip and palate in combination with the Celesnik lip repair.

Co-ordination of maxillary orthopaedics with two-stage lip surgery according to the Celesnik principle for complete BCLP is described, and the results of the procedure are analyzed at the 10 to 15 year age level. Taking advantage of the effects of growth within the first 6 to 8 months of the patient's life, orthopaedics and concomitant surgery achieve a considerable degree of alignment and stabilization of the praemaxilla within the alveolar arch without reverting to any active orthopaedic retrusion. Around age 10 the praemaxilla has assumed a normal sagittal position relative to the anterior cranial base. Due to relatively short and retropositioned mandibles all cases in the sample investigated display rather receding 'Class II type' profiles in early adolescence.

Cephalometry↗
PubMed1986

The history of treatment of cleft lip and palate.

The history of surgery of cleft lip and palates reaches as far backwards as the prechristian era to 390 B.C. when for the first time a cleft lip was closed successfully in China. Although Egyptian and Greek medicines developed to a remarkable degree, no descriptions of cleft operations have survived. In the middle ages operations on cleft lip have been several times described. A successful operation on a cleft palate did however not occur until 1816. This can be explained by the fact that cleft palates were thought to be secondary to syphilis, but also because without anaesthetic this operation was extremely painful and difficult. Graefe in 1816 [20a] and Roux in 1819 [49] published the first satisfactory results. After the introduction of chloroform cleft surgery made remarkable progress. The development of cleft surgery has been chronologically described and finally the present state of affairs is discussed.

Child↗
PubMed1986

[Oral teratoma (epignathus), a rare congenital abnormality].

We report on 2 newborn girls with congenital oropharyngeal teratoma (Epignathus). In both children the tumour was totally resected on the first days of life. The histopathological investigation shows tissue from all three germ layers. 11 and 19 months after excision there is no evidence of recurrence. Frequency, prognosis and therapy of oral teratomas are discussed.

Female↗
PubMed1979

[Glossodynia].

Burning sensations on the tongue have several causes which may be found in only 50% cases. It is hardly possible to establish a differentiation into symptomatic and essential forms because transition from one into the other are of moving nature. Known causes may be divided into general and local ones. In cases of unknown origin it was found that they belonged to female patients mainly, during menopause and in cases of cancerophobia.

Female↗