Search PubMed⌕ Search

Biomedical subjects

R Jelnes

Publications and source records attributed to R Jelnes.

53 records · Page 3Linked to original sources
PubMed1986

Iliofemoral bypass surgery for lower limb ischaemia. A follow-up of 62 patients.

This study evaluates iliofemoral bypass reconstruction in limb-salvage, graft patency, and appearance of contralateral symptoms. The study included 62 consecutive iliofemoral bypass reconstructions during 1980-82. The indication for surgery was disabling intermittent claudication in 19% of the patients and severe ischaemia in 81%. At follow-up 42 patients were examined, 16 were dead and 4 were lost to follow-up. The primary mortality was 5%. At 3 years postoperatively the survival rate was 78%, ipsilateral limb-salvage 88%, graft patency 83%, and patency of the contralateral iliofemoral segment 92%. During the follow-up period reconstructive vascular surgery on the contralateral aortoiliac segment was performed in only 3 patients. The results of the iliofemoral bypass reconstruction in this study were comparable to the results of aortic bifurcation grafts, and the patency of the contralateral iliofemoral segment was higher than might have been expected. The iliofemoral bypass reconstruction seems to be useful for patients with unilateral affection of the iliofemoral segment, for limb-salvage concerning patients in poor general condition, and for patients who have had a contralateral amputation.

Adult↗
PubMed1985

Trochanteric fractures treated by the McLaughlin nail and plate.

In this study 624 trochanteric and subtrochanteric femoral fractures have been assessed retrospectively with regard to stability of the fracture, reduction, internal fixation, healing and weight bearing. It is seen that stable fractures pose no serious problems. In the group of unstable fractures, varus displacement and perforation by the nail of the head of the femur occurred because of lack of stability of the McLaughlin apparatus. Results of a device with a fixed angle and a sliding screw nail are compared.

Aged↗
PubMed1985

Determination of the tissue-to-blood partition coefficient for 131iodo-antipyrine in human subcutaneous adipose tissue.

131Iodo-antipyrine (131I-AP) is commonly used for blood flow measurements in adipose tissue. These estimations have been based on the assumption of the tissue-to-blood partition coefficient being 1 ml g-1. No exact determination of the tissue-to-blood partition coefficient for 131I-AP in adipose tissue has been carried out. In the present study a partition coefficient of 1.12 +/- 0.06 (mean +/- S.D.) for 131I-AP in adipose tissue has been determined based on the partition coefficient for 131I-AP between lipid-saline (1.24 ml g-1), red blood cells-plasma (0.64 ml g-1), protein-saline (0.19 ml g-1) and plasma-saline (0.84 ml ml-1).

Adipose Tissue↗
PubMed1985

The double isotope technique for in vivo determination of the tissue-to-blood partition coefficient for xenon in human subcutaneous adipose tissue--an evaluation.

Local subcutaneous 133xenon (133Xe) elimination was registered in the human forefoot in 34 patients. The tissue/blood partition coefficient for Xe was estimated individually by simultaneous registration of 133Xe and [131I]antipyrine ([131I]AP) washout from the same local depot. When measured in this way, an average partition coefficient for Xe was found to be 4.3 +/- 1.23 ml g-1. This value is significantly lower than the partition coefficient found in a previous in vitro study in which a Xe partition coefficient of 7.5 +/- 1.57 ml g-1 was found. Thus, if the local blood flow is calculated using the partition coefficient found by the double isotope technique, significantly lower values are obtained than if the in vitro determined coefficient is used. This difference is explained mainly by local dilution when injecting xenon subcutaneously. In short-term studies, utilization of the double isotope technique reduces the coefficient of variation on average flow determinations, thus an improvement in accuracy of local blood flow estimation can be obtained compared to the method in which an average partition coefficient is used. For long-term studies a partition coefficient of 7.5 ml g-1 seems valid.

Adipose Tissue↗
PubMed1985

Arterial embolism of the legs. A follow-up study of 252 patients.

This retrospective study of 279 embolectomies in 252 patients shows a mortality of 27%, and an amputation rate of 15% within the first month after the embolectomy. The mortality as well as the rate of amputations decreased through the first year. After this period the mortality was comparable to that of a normal population and the rate of amputation was negligible. The mortality rate as well as the number of amputations increased with increasing time-lag of the embolectomy. In addition, the rate of amputation increased with preexisting intermittent claudication. There was no significant difference in amputation rate between limbs with and without palpable pulsations in the groin on admission, but 8 out of 103 limbs without groin pulsations had successful major vascular reconstruction performed after failing embolectomy in contrast to none in the group where pulsations were present. In 28 patients the embolectomy was followed by impairment of renal function and 14 of these died. It is concluded that embolectomy must be performed as early as possible, vascular reconstruction must be considered if the embolectomy fails to revascularize the limb, preventive measures should be taken against renal failure, i.e. the myonephropathic-metabolic syndrome.

Acute Kidney Injury↗
PubMed1984

Nocturnal foot blood flow in patients with arterial insufficiency.

Twenty-four hour continuous recording of xenon (133Xe) wash-out from the forefoot was performed on patients with normal circulations (n = 10) and on patients with different degrees of arterial insufficiency (n = 36). During day hours the calculated subcutaneous blood flow in the forefoot was on average the same in patients with normal circulations and in patients with different degrees of arterial insufficiency (mean: 2.0 +/- 0.8 ml min-1 100 g-1). During sleep the blood flow nearly doubled in patients with normal circulations; no systematic change was seen in patients with intermittent claudication. In patients with severe ischaemia, i.e. having rest pain, the blood flow decreased by approximately 50%. The changes in local blood flow may be due to changes in local sympathetic tone and to changes in local perfusion pressure.

Adult↗
PubMed1984

Evaluation of a method for determination of the subcutaneous blood flow in the forefoot continuously over 24 h.

A method is presented which allows for continuous registration of forefoot blood flow over 24 h. Blood flow was estimated by the radioactive Xenon washout method and a portable CdTe detector system was used to measure the tracer disappearance rate. Since the semiconductor detector is placed very close to the tracer depot the washout rates registered are a mixture of rate constants due to tracer removal by blood flow and diffusion of the tracer depot away from the detector. Rate constants only due to diffusion were obtained over 24 h from amputated feet and similarly from normal feet with circulatory arrest in several 20 min periods during 24 h. The rate constants due to blood flow could thus be calculated by subtraction of the appropriate diffusion rate constants from the recorded rate constants. Blood flow in the forefoot during 24 h was measured in 10 experimental subjects with normal peripheral circulation. Blood flow during daytime did not differ between the first and second day. Blood flow during night-time was about twice that during daytime.

Conductometry↗
PubMed1984

Direct determination of the tissue-to-blood partition coefficient for Xenon in human subcutaneous adipose tissue.

The tissue-to-blood partition coefficient for Xenon (lambda Xe) in the subcutaneous tissue in the forefoot was determined by physical and chemical analysis. The difference between patients with normal circulation (n = 10) and serve ischaemia (n = 13) was insignificant; pooled mean: 7.42 +/- 1.57 ml x g-1. The lambda Xe in the forefoot was significantly lower than lambda Xe of the abdominal wall (lambda Xe - abd: 8.67 +/- 1.27 ml x g-1; P = 0.03). The influence of oedema on the local blood flow [in ml x (100 g x min)-1] and on the post-reconstructive hyperaemia (in ml x min-1) is discussed. It is concluded that local blood flow determinations, based on 133Xenon wash-out rates, in individual cases, are not possible. In subcutaneous tissue with low lipid contents, the ratio between the post- and preoperative wash-out rates tend to underestimate the post reconstructive hyperaemia. This is due to the volume increase of the subcutaneous tissue being larger than the decrease of the tissue-to-blood partition coefficient due to the oedema.

Adipose Tissue↗
PubMedDate not supplied

Nocturnal subcutaneous hyperaemia in the lower leg and foot of type 1 diabetic patients.

Nocturnal fluctuations in subcutaneous blood flow in the lower leg and foot were measured during sleep in Type 1 diabetic patients without autonomic neuropathy. Subcutaneous blood flow was measured, simultaneously, 100 mm above the malleolus on the medial aspect of the right lower leg and at the dorsum of the left foot in 10 diabetic patients, and on the right lower leg only in 10 normal human subjects over 12-20 h. The 133Xe wash-out technique, portable CdTe (Cl) detectors and a portable data storage unit were used. The tracer depots were applied by means of the epicutaneous, atraumatic labelling technique. In diabetic patients, subcutaneous blood flow increased 102 +/- 68% in the lower leg and 111 +/- 98% in the foot at 113 +/- 32 min and 107 +/- 37 min, after going to sleep. The hyperaemic phase lasted 128 +/- 43 min and 150 +/- 42 min, respectively. The hyperaemic response was not different from that in the control subjects (89 +/- 61%). There was no significant correlation between the absolute hyperaemia in the leg and that in the foot. In conclusion, Type 1 diabetic patients without autonomic neuropathy have normal nocturnal hyperaemia during sleep.

Adipose Tissue↗
PubMedDate not supplied

Primary aorto-enteric fistula: a practicable curable condition? Pathogenetic and clinical aspects.

Primary aorto-enteric fistulas is now being a rare occurrence because of an aggressive approach in terms of surgery of abdominal aortic aneurysms. Three cases is presented in an attempt to elucidate the ethiology, pathogenesis and diagnostic possibilities when dealing with primary aorto-enteric fistulas. The clinical presentation of the patients with primary aorto-enteric fistulas is inconstant, but a hightened index of suspicion should be present when a patient presents with gastrointestinal bleeding of obscure origin, abdominal or back pain and an abdominal mass. Endoscopy and diagnostic imaging may detect a fistula, but a high rate of false negative investigations are produced. The result of diagnostic workup is often laparotomy, which is the safest diagnostic method and may save the patients life.

Adult↗
PubMedDate not supplied

Arterial pressure measurements correlated to symptoms and signs of peripheral arterial disease.

The systolic pressure observed in 150 patients with peripheral arterial disease has been compared to their symptoms and signs. In patients with claudication the ankle mean pressure was 58 mmHg. In patients with rest pain it was 33 mmHg and in patients with chronic ulcerations it was 20 mmHg. In these 3 groups the mean ankle-foot pressure gradient was low (2-10 mmHg) were detected at the level of the iliaco-femoral and femora-popliteal segments. In the group of diabetic patients an high gradient was observed. Patients with peripheral arterial disease can be divided in four symptomatic groups but the angiographic and physiological patterns of patients with rest pain and ischemic ulcerations are similar and they are the best candidates to reconstructive arterial surgery.

Arterial Occlusive Diseases↗