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Biomedical subjects

O Geiran

Publications and source records attributed to O Geiran.

106 records · Page 6Linked to original sources
PubMed1983

Dynamics of the interventricular septum and free ventricular walls during selective left ventricular volume loading in dogs.

A previous study suggests that a change in the position of the interventricular septum played an important role in regulating cardiac performance during selective right ventricular volume loading. In the present study the cardiac response to selective left ventricular volume loading induced by a shunt between the subclavian artery and the left atrium was examined in anesthetized open-chest dogs. Opening the shunt increased left and reduced right ventricular stroke volume, particularly after blood volume expansion. The end-diastolic transseptal pressure difference increased. Myocardial segment length in the septum and free walls of both ventricles and the distances between the septum and the free walls were measured by an ultrasonic technique. Comparisons at similar left ventricular stroke volume with the shunt open and closed showed that the Frank-Starling mechanisms of the free wall of the left ventricle and the septum were stimulated less with the shunt open. At similar right ventricular stroke volume the end-diastolic dimension of the right ventricular free wall was larger with the shunt open. The distance decreased across the right ventricle and increased across the left ventricle when the shunt was open. We conclude that a change in the position of the septum improves left and reduces right ventricular performance during selective left ventricular volume loading.

Animals↗
PubMed1982

Dynamics of the interventricular septum and free ventricular walls during blood volume expansion and selective right ventricular volume loading in dogs.

To examine whether the right ventricle responds differently to blood volume expansion and selective right ventricular volume loading, segment lengths in the interventricular septum and the free walls of both ventricles and right ventricular septal-to-free-wall-distance were measured by an ultrasonic technique in open-chest dogs. Blood volume expansion increased segment lengths at all recording sites in proportion to stroke volume. Selective right ventricular volume loading induced by opening a shunt between the pulmonary artery and the superior vena cava increased right ventricular stroke volume by 40-80%; end-diastolic segment length and myocardial shortening increased in the septum and free wall of the right ventricle whereas left ventricular stroke volume and segment length decreased. Comparison of data obtained before and after opening of the shunt indicated that changes in myocardial dynamics of the right ventricle and septum accounted for approximately 30% of the increase in right ventricular stroke volume. However, both end-diastolic dimension and systolic shortening of the right ventricular septal-to-free-wall distance were larger during right ventricular volume loading than during blood volume expansion. Thus, most of the increase in stroke volume during selective right ventricular volume loading is caused by a change in the configuration of the right ventricle.

Animals↗
PubMed1981

HBsAG transmission from a cardiac surgeon incubating hepatitis B resulting in chronic antigenemia in four patients.

A cardiac surgeon experienced an uneventful course of acute hepatitis B. HBsAg was transmitted to 11 persons: 5 of 72 patients operated on during his incubation of hepatitis B, three relatives of the infected patients, one laboratory technician, and two of the surgeon's family members. Two years later, 4 of the 5 operated patients are still infectious, whereas the 7 non-operated persons have cleared their antigenemia. This study demonstrates the significant risk of hepatitis B transmission from a cardiac surgeon incubating the disease. Furthermore, it indicates that patients who have been infected during open heart surgery and cardiopulmonary bypass run a particular risk of becoming chronic HBs antigen carriers.

Adult↗
PubMed1981

Thoracic injuries.

Establishment of adequate ventilation takes the absolute precedence over all other therapeutic measures. Chest trauma has, therefore, the highest priority in a patient with multiple injuries. Bleeding may also be a decisive component. Emergency treatment aims at reestablishing normal physiological functions. Concurrently, diagnostic measures are taken to assess the underlying pathoanatomical changes. Treatment of chest injuries is a team effort of surgical and anaesthetic staff.

Bronchi↗
PubMed1979

Nonoperative internal drainage of obstructive common bile ducts.

A new nonoperative method for internal drainage of common bile duct obstructions by endoscopic retrograde cannulation of the papilla of Vater is described. After introduction of a tube in the common bile duct, a substantial decrease in serum activity of bilirubin, alkaline phosphatase, and gamma-glutamyl transferase was found. In addition, a rapid improvement of the clinical condition could be observed. No serious complications occurred. It is concluded that internal drainage of common bile duct obstructions might be of great value in the preoperative treatment of patients with common bile duct obstructions.

Aged↗
PubMed1975

Spontaneous pneumothorax.

Patients with spontaneous pneumothorax, who were treated in this department during the period 1950-59, were reviewed in 1963. Since the treatment of this group of patients has changed radically towards a greater surgical activity in the form of suction drainage and thoracotomy, the patients from the next decade, comprising 229 episodes in 202 patients, have now been reviewed to evaluate the results of this attitude. The conclusion from the earlier review, that recidivating pneumothorax should be operated upon, is further supported, and in quite a few patients (9%) thoracotomy had to be performed to control the first attack. Pleural rubbing, as an additional procedure to resection of bullae, seems as safe as partial pleurectomy in prevention of relapse. There were few serious operative complications. A rather protracted suction drainage has been practised in this series. One consequence of the experiences from the present review is that this time has been shortened.

Adolescent↗
PubMedDate not supplied

Left ventricular aneurysm and severe cardiac dysfunction: heart transplantation or aneurysm surgery?

We analyzed data from 26 patients with left ventricular aneurysm and severe congestive heart failure to evaluate our selection criteria for aneurysm surgery and heart transplantation. The operative results for patients who underwent aneurysm resection (group A, n = 14) were compared with those of patients who were accepted for heart transplantation (group B, n = 12). All patients were monitored and reinvestigated after surgery. Functional status and left ventricular angiographic and hemodynamic findings were significantly worse in group B than in group A, but with great overlap between the groups. The presence of mitral insufficiency or right ventricular dysfunction (or both), however, was important in our selection for transplantation. Two patients died after aneurysm surgery, whereas one died before heart transplantation. Functional status (p less than 0.004) and left ventricular ejection fraction (p less than 0.05) improved after aneurysm resection, whereas hemodynamic values remained unchanged. Symptoms were relieved (p less than 0.001), and, except for cardiac index, hemodynamic values were normalized in group B. We conclude that the combination of a left ventricular ejection fraction of less than 25%, mitral insufficiency, and right ventricular dysfunction favors heart transplantation in patients with left ventricular aneurysm and end-stage heart disease. The lack of donor organs and acceptable results of aneurysmectomy, however, justify conventional surgery even in high-risk patients.

Adult↗
PubMedDate not supplied

Single lung transplantation as treatment for end-stage pulmonary sarcoidosis: recurrence of sarcoidosis in two different lung allografts in one patient.

Three patients have undergone single lung transplantation in our hospital because of respiratory failure as a result of sarcoidosis. Two patients survived the postoperative period. Obliterative bronchiolitis developed in one of these patients, and recurrence of sarcoidosis in the transplanted lung necessitated contralateral single lung transplantation. Nine months later the first transplant became necrotic and infected and had to be removed. The postoperative course was uncomplicated. However, transbronchial biopsy specimens 10 months after retransplantation show sarcoid changes also in the second transplant, but without any signs of cellular rejection.

Bronchiolitis Obliterans↗