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Biomedical subjects

S Holm

Publications and source records attributed to S Holm.

At least 199 records · Page 11Linked to original sources
PubMed1989

[2 cases of severe Streptococcus group A infection].

During recent years there have been several cases of death due to severe infection caused by GAS. Here we report two cases treated at our hospital, one of a patient presenting with preshock (case 1), the other of a patient with septic shock (case 2), in both of whom the concentrations of various coagulation factors and platelet counts were low. Other clinical findings common to both cases were scarlet coloured maculopapular exanthema, relative bradycardia, excessive tendency to develop oedema, and impaired function both in the lungs, kidneys and brain; and both patients were devoid of antibodies against the most predominant toxins (B and C) of the GAS strains isolated. Initial treatment comprised extensive administration of fluids, antibiotics, antithrombin, and low dose hydrocortisone. Plasma exchange by continuous centrifugation (CS 3000 Travenol Baxter) was given twice in case 1 and five times in case 2. In case 2, besides human immunoglobulin with a high anti-GAS (toxins A, B and C) antibody content given at admission, the patient received respiratory support, infusion of inotropic drugs and CAVH. Both patients recovered. The risk of death is high in cases of progressive multiple organ failure during the course of septic shock; and where conventional treatment combinations fail to remedy the condition, adjuvant treatment components may prove successful.

Adult↗
PubMed1989

[Danish physicians' attitude to capital punishment. A questionnaire study].

The attitudes of the Danish medical profession to capital punishment and participation in the procedure of capital punishment were illustrated by means of a questionnaire investigation. A total of 1,011 questionnaires were sent to a representative section of Danish doctors. Out of the 591 who replied, 474 considered that capital punishment is not an acceptable form of punishment while 76 considered that capital punishment is acceptable. Twenty doctors were willing to participate actively in executions although medical participation of this type has been condemned both by the Nordic Medical Associations and also by the World Medical Association.

Attitude of Health Personnel↗
PubMed1989

Effects of experimental graded compression on blood flow in spinal nerve roots. A vital microscopic study on the porcine cauda equina.

Compression injuries of spinal nerve roots are very common. However, the basic pathophysiology of these conditions is not fully understood. In this study a model is presented for experimental graded compression of the nerve roots of the pig cauda equina, including a technique for vital microscopic studies on the microcirculation flow of the intrinsic vessels of the nerve roots during compression. With this model critical pressure levels for compression-induced occlusion of the arterioles, capillaries, and venules of the intrinsic vasculature of the nerve roots were determined. The study showed that the average minimum pressure in the inflated balloon required to stop the flow in the arterioles was 127 mm Hg (SD = 18, n = 11), in the capillaries 40 mm Hg (SD = 6, n = 12), and in the venules 30 mm Hg (SD = 10, n = 12). The average mean arterial pressure (MAP) was 150 mm Hg (SD = 14, n = 12). There was a statistically significant correlation (p greater than 0.001) between the MAP and the pressure required to stop the flow in the arterioles (r = 0.83, n = 14), but no correlation between MAP and capillary (r = 0.09 NS, n = 20) or venular (r = -0.28 NS, n = 34) occlusion pressure. After the nerve roots had been compressed at 50 or 200 mm Hg for 10 min or 2 h, the recirculation started immediately. There was a hyperemia during the first 10 min, with a dilatation of the vessels, particularly the venules. In nerve roots exposed to compression for 2 h at either 50 or 200 mm Hg, an intraneural edema developed.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Continuous conjunctival oxygen tension (PcjO2) monitoring for assessment of cerebral oxygenation and metabolism during carotid artery surgery.

The clinical value of noninvasive continuous monitoring of conjunctival oxygen tension for assessment of cerebral perfusion during carotid endarterectomy performed under general anaesthesia has been evaluated. The patients (n = 17; mean age 62.5 +/- 1.7 years) were monitored as follows: conjunctival oxygen tension (PcjO2); internal jugular venous oxygen tension at the skull base level (PcijvO2); arterial blood pressure; arterial and internal jugular venous blood gases; acid-base data and lactate, pyruvate levels; end-tidal CO2 concentration. The mean preanaesthetic PcjO2 level of 4.86 +/- 0.40 kPa was significantly lower than PaO2(PcjO2)/PaO2 ratio of 0.48). Following anaesthesia, a larger PcjO2-PaO2 gradient (ratio 0.32) was seen in spite of the hyperoxic situation (FiO2 = 0.40) due to vasoconstriction induced by slight hypocapnia (reduction of PaCO2 from 5.13 +/- 0.08 to 4.64 +/- 0.10 kPa). The carotid artery crossclamping resulted in a rapid and pronounced decrease of PcjO2, while PcijvO2 remained unchanged. No relationship between PcjO2 and stump pressure was found, while a significant correlation (P less than 0.02) between PcjO2 and lactate in effluent venous blood from the brain was demonstrable. It is concluded that PcjO2 monitoring seems a clinically useful trend indicator of cerebral perfusion in the individual patient. Due to large interindividual variations in basal PcjO2 readings and in PcjO2 changes during carotid artery clamping, however, transconjunctival oxygen tension monitoring does not seem to allow early and accurate recognition of impending cerebral ischaemia during carotid endarterectomy, and its routine use therefore seems of limited value.

Adult↗
PubMed1989

Flow dynamics of the crocodilian heart.

We report for the first time the flow events corresponding to the pressure patterns in the left and right aorta (LAo and RAo) during the cardiac cycle in the caiman (Caiman crocodylus ssp). These experiments show a complex LAo flow pattern; an initial small anterograde flow in the early systole is reversed to a backflow at midsystole. At the end of systole there is again a small anterograde flow. This second flow pulse corresponds to a pressure peak ("foramen spike") in the LAo pressure trace. The observed pattern is compatible with the view that the foramen Panizzae is obstructed by the medial cusp of the RAo valve during part of the systole. LAo pressure remains normally above right ventricular pressure throughout the cardiac cycle and there is thus no contribution to LAo flow from the right ventricle. The net flow in the LAo normally equals the flow through the foramen Panizzae and is very small compared with the systemic flow in the RAo.

Alligators and Crocodiles↗
PubMed1989

Edema formation in spinal nerve roots induced by experimental, graded compression. An experimental study on the pig cauda equina with special reference to differences in effects between rapid and slow onset of compression.

Edema formation in spinal nerve roots of the pig cauda equina was studied following experimental compression at various pressure levels, durations, and rates of onset, using a fluorescence microscopic technique. The time-pressure thresholds for the occurrence of edema in the nerve roots were: following rapid onset of compression (0.05-0.1 seconds), 2 minutes at both 50 mm Hg and 200 mm Hg, and following slow onset of compression (the pressure was slowly increased during 15-20 seconds), 2 hours at 50 mm Hg and 2 minutes at 200 mm Hg. Generally, the edema formation was more pronounced after rapid than after slow onset of compression. The data in this study also indicate that intraneural edema might be more easily formed in nerve roots than in peripheral nerves after compression injury.

Animals↗
PubMed1989

Blood-flow and metabolic response in a contracting canine masticatory muscle.

The mechanical and metabolic characteristics of the canine masseter muscle of seven adult dogs, aged 3 years, weighing 45-55 kg, were evaluated by electrically provoked contractions. The masseter muscle was exposed by careful surgery and stimulated by two silver electrodes placed in the anterior and posterior aspects of the muscle. The bite force was measured with a force transducer. Glycogen, glucose-contents together with lactate, pyruvate, creatine phosphate, NADH and NAD were analysed fluorimetrically. Intra-muscular oxygen tension was continuously recorded by a flexible silver electrode. Blood-flow was measured by the 133Xenon clearance technique. Biopsies were taken at rest and after stimulation. The registered bite force revealed an initial peak, representing maximal force production and thereafter a rapid decline in power output. During the following stimulation events the bite force curve showed decrease in amplitude concerning maximal force as well as duration of bite force production. The blood-flow and oxygen tension were significantly reduced at the end of stimulation. However, after recovery these parameters were normalised to initial values. The glycogen and glucose were depleted after stimulation. The lactate concentration increased about three to four times. The observed changes in NAD and NADH indicate a hypoxic situation in the muscle cells. The oxygen deficit in conjunction with the intramuscular blood-flow impairment and the metabolite variations reflect the energy and redox state in the muscle and may contribute to the decline in bite force production.

Animals↗
PubMed1988

Gross anatomy of the craniomandibular joint and masticatory muscles of the dog.

The craniomandibular joint (CMJ) and masticatory muscles in 15 dogs (Canis familiaris) were dissected. The major structures were fossa, disc and condyle surrounded by a thin fibrous capsule. The horizontally orientated temporal fossa had a pronounced tubercle anteriorly. Posteriorly, a retroarticular process curved backwards. This fossa and process closely surrounded the condyle. The disc was thin. The cylindrically-shaped condyle was elongated in the medio-lateral direction, situated at right angles to the sagittal plane. The lateral pterygoid muscle was poorly developed; the temporalis was by far the largest masticatory muscle. These findings support the assumption that the movements of the canine mandible are mainly hinge-like. Furthermore, the canine CMJ differs in many respects from the corresponding anatomical structures in the domestic pig, as well as in man.

Animals↗
PubMed1988

The peaceable pluralistic society and the question of persons.

In his recent book The Foundation of Bioethics, H. Tristam Engelhardt Jr. advances the idea of a peaceable pluralist moral society based on principles of autonomy, beneficience, and ownership. This paper tries to show that unless there is one and only one rationally sustainable definition of "a person", then the peaceable society cannot remain peaceable, but will be stirred up by groups with different and equally rational definitions. The paper further tries to show that Engelhardt's own definition of "persons in the strict sense" is an unsatisfactory solution to the problem, and the same is true for any of the possible compromises.

Beginning of Human Life↗
PubMed1988

Factors influencing the biological inactivation of high protein bound beta-lactam antibiotics in vitro.

Unpredictable inactivation of antimicrobial agents may cause erratic results in pharmacokinetic studies. In this study we followed the inactivation of the high protein bound beta-lactams flucloxacillin, dicloxacillin and ceftriaxone in vitro. The antibiotics were added to pools of human and rabbit sera, ultrafiltrates of these pools, rabbit interstitial fluid, phosphate buffered saline (PBS), rabbit albumin in PBS and sodium dodecyl sulphate (SDS) treated preparations of human sera. Ceftriaxone was relatively stable but different serum pools varied significantly in their flucloxacillin and dicloxacillin inactivating capacity. The dominating inactivation took place within five minutes after the addition of antibiotics to serum. The inactivating factor was heat stable at 56 degrees C, 0.5 h, of relatively high molecular weight, and not related to albumin. The inactivating capacity could be diminished by SDS-treatment of serum suggesting a lipoprotein nature.

Animals↗
PubMed1988

Somatomedin C immunoreactivity in the Achilles tendon varies in a dynamic manner with the mechanical load.

Distribution of the trophic peptide somatomedin C (Sm-C; insulin-like growth factor I; IGF-I) immunoreactivity was mapped in normal Achilles and tibialis anterior tendons. The spindle-shaped tendon fibroblasts showed faint perinuclear staining. Fibroblasts in the paratenon mostly had a more intense IGF-I immunoreactivity, i.e. faint to moderate. When analysing either tendon in detail, areas with more intense IGF-I immunoreactivity could be recognized and seemed to correlate with areas of high mechanical stress. Increased mechanical load induced over 3 days elevated IGF-I immunoreactivity throughout the cytoplasm of tendon fibroblasts. Peak intensity was reached in 7 days, and thereafter the IGF-I immunoreactivity seemed to decrease irrespective of persistent high mechanical load. Training the animals on a treadmill for from 20 up to 60 min per day for 5 days induced after 3-5 days increased IGF-I immunoreactivity throughout the cytoplasm of the tendon and paratenon fibroblasts. Sudden curtailment of loading the Achilles tendon resulted in a marked reduction of the IGF-I immunoreactivity in most fibroblasts within 3 days. After a week only a small number of tendon fibroblasts showed any IGF-I immunoreactivity. The IGF-I immunoreactivity of tendon fibroblasts thus correlates to mechanical loading of the tendon. It is proposed that IGF-I may have a trophic influence on tendon and paratenon cells by autocrine and/or paracrine mechanisms.

Achilles Tendon↗
PubMed1988

New Danish law: human life begins at conception.

A new law has been passed by the Danish Parliament, establishing an ethical council. The law has caused considerable debate in Denmark, particularly because it states that 'the work of the council shall build on the basis that human life takes its beginning at the time of conception'.

Advisory Committees↗
PubMed1988

Cerebral blood flow during delirium tremens and related clinical states studied with xenon-133 inhalation tomography.

The regional cerebral blood flow of 12 patients with severe alcohol withdrawal reactions (delirium tremens or impending delirium tremens) was measured during the acute state before treatment and after recovery. Greater cerebral blood flow was significantly correlated with visual hallucinations and agitation during the acute withdrawal reaction. The results suggest that delirium tremens and related clinical states represent a type of acute brain syndrome mainly characterized by CNS hyperexcitability.

Adult↗
PubMed1988

Nutrition of the intervertebral disc: acute effects of cigarette smoking. An experimental animal study.

We have in the present experimental study investigated the influence of cigarette smoking on some nutritional parameters of the porcine intervertebral disc. The results from the acute smoking tests show a significant reduction in solute transport. Diffusion of sulphate, oxygen and methyl glucose was reduced by 30-40 per cent. This effect was obtained after exposure to smoke for 20-30 minutes. A smoking period of three hours reduced the transport efficiency to about 50 per cent. The effect of smoking decreased when the exposure ceased. The concentration gradients were close to normal after 2 hours "recovery". These findings suggest that cigarette smoking not only significantly affects the circulatory system outside the intervertebral disc, where the most pronounced effect is the reduction in solute exchange capacity, but also significantly deteriorates the cellular uptake rate and metabolite production within the disc.

Animals↗
PubMed1987

Hydrocarbon exposure from handling jet fuel at some Swedish aircraft units.

The exposure to vapors from jet fuel under different work conditions was examined in three aircraft squadrons. Exposure measurements were made by charcoal sampling in the breathing zones of 23 randomly selected employees belonging to three different personnel groups. Each person was followed during two consecutive days by long-time sampling and, furthermore, by 15-minute sampling during work operations with possible high exposure. The charcoal tubes were eluted with carbon disulfide, and the hydrocarbons were analyzed with gas chromatography. The geometric mean of both the long- and the short-time exposure was only 1-2% of the corresponding occupational exposure limits. The highest long-time exposure observed was about 25% of the occupational exposure limit, while the highest short-time exposure was about 130% of the corresponding limit. Thus the present long-term exposure to solvent vapor in Swedish aircraft units is low, but infrequent short-time exposure above the present limit may occur in some work operations.

Air Pollutants, Occupational↗