Cerebral stroke treated in a general medical department.
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Adult↗
Biomedical subjects
S Holm
Publications and source records attributed to S Holm.
Influence of noradrenaline and temperature on the isolated perfused rat heart.
Myocardial protection during open heart surgery is achieved by general cooling and cold cardioplegia. However sympathetic activation during the operation causes raised circulating catecholamine levels that might negatively influence the myocardial metabolism. Moreover, local liberation of catecholamines, in "poorly perfused' regions of the myocardium in patients with ischemic heart disease, might occur. In respect of these problems, we studied the influence of noradrenaline at different temperatures on the isolated perfused rat heart. The temperatures chosen were: 10, 20, 32, 37 and 39 degrees C. The results show clearcut adverse effect of noradrenaline at 32 degrees and higher, on metabolism and hemodynamic performance. At lower temperatures there still seem to be an adverse effect of noradrenaline although not statistically significant. The results of this study indicates the importance of presurgical myocardial protection especially of badly perfused myocardial areas. Such protection could be accomplished by beta-blockade and/or loading of the myocardium with glycogen by glucose-insulin-potassium infusion.
Animals↗
Elective cholecystectomy with intraperitoneal drain. A bacteriological evaluation.
The occurrence of bacteria in 108 patients operated on with elective cholecystectomy was investigated in specimens from preoperative skin, gallbladder bile, drain wound secretion and drainage fluid. Growth of bacteria in gallbladder bile was found in 13% and in drainage fluid in 46% of the patients. The occurrence of bacteria in drainage fluid was not correlated with the operative time or the experience of the surgeon. The presence of pathogenic bacteria in the drainage fluid in our investigation was related to increased amounts of drainage fluid and to increased incidence of infectious complications (manifest or suspected intra-abdominal abscess and wound infection). Growth of bacteria analogous to those found in drainage fluid was observed in gallbladder bile (5% of the patients), in preoperative skin culture (12%) and in drain wound secretion (14%). Most of the bacteria in the drainage fluid seemed to come from an exogenic source. However, in 35% of the patients with bacteria in the gallbladder bile analogous bacteria were demonstrated in the drainage fluid. Since an increased occurrence of bacteria in gallbladder bile has been found in patients with acute cholecystitis and in patients more than 60 years of age the use of intraperitoneal drain from a bacteriological point of view could thus be limited to these groups of patients.
Bacteria↗
Cerebral blood-flow tomography: xenon-133 compared with isopropyl-amphetamine-iodine-123: concise communication.
Tomographic maps of local cerebral blood flow (CBF) were obtained with xenon-133 and with isopropyl-amphetamine-iodine-123 (IMP) in 11 subjects: one normal, two tumor cases, and eight cerebrovascular cases. A highly sensitive four-face, rapidly rotating, single-photon emission tomograph was used. The Xe-133 flow maps are essentially based on the average Xe-133 concentration over the initial 2 min during and after an inhalation of the inert gas lasting 1 min. These maps agreed very well with the early IMP maps obtained over the initial 10 min following an i.v. bolus injection. The subsequent IMP tomograms showed a slight decrease in contrast amounting to appr. five percentage points in the CBF ratio between diseased and contralateral areas. It is concluded that Xe-133 is more practical: low cost, available on a 7-day basis, easily repeatable, quantifiable without the need for arterial sampling, and with low radiation exposure to patient and personnel. On the other hand, IMP gives an image of slightly higher resolution. It also introduces a new class of iodinated brain-seeking compounds allowing, perhaps, imaging of other functions more important than mere blood flow.
Amphetamines↗
Cerebral blood flow tomography by SPECT (single photon emission computerized tomography): Xenon-133 compared to isopropyl-amphetamine-iodine-123.
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Adult↗
The incidence of bacteria in gallbladder bile at acute and elective cholecystectomy.
Aerobic and anaerobic bacterial cultivation was carried out on gallbladder bile collected from all patients operated on with cholecystectomy during a 10-month period. Acute cholecystectomy was performed on 34 patients because of acute cholecystitis. Elective cholecystectomy was performed on 177 patients because of non-acute gallbladder pathology. Bacteria were found in gallbladder bile in 16.4% of patients with non-acute cholecystopathy compared to 58.8% of patients with acute cholecystitis (p less than 0.001). An increased incidence of pathogenic bacteria was observed in the acute compared to the elective cholecystectomy material. The acute inflammatory process, its severity and the age of the patient seemed to be important factors which could be related to the increased occurrence of bacteria in the gallbladder bile. A higher incidence of postoperative morbidity and infectious complications was found in patients with pathogenic bacteria in gallbladder bile than in patients with no growth of bacteria or opportunistic bacteria in gallbladder bile.
Acute Disease↗
The penetration of flucloxacillin into cortical and cancellous bone during arthroplasty of the knee.
Antibiotic prophylaxis with 2 g flucloxacillin was given 2 h before operation in 23 adult patients undergoing knee replacement operations for rheumatoid arthritis or osteoarthrosis. The mean extracted concentration of flucloxacillin obtained at operation was 12.9 micrograms/ml (SD 5.25) in synovial fluid; 2.9 micrograms/g (SD 3.59) in synovium; 2.0 micrograms/g (SD 1.48) in cancellous bone and 1.3 micrograms/g (SD 1.25) in cortical bone. The minimum inhibiting concentration (MIC) value for flucloxacillin was usually 0.25 micrograms/g against Staphylococcus aureus. Therapeutically active concentrations were thus obtained. There were no adverse reactions from the antibiotic administration.
Adult↗
Cefadroxil in the treatment of acute otitis media in children.
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Acute Disease↗
Urine microscopy as screening method for bacteriuria.
Fresh urine samples from 90 ambulatory patients with urological disorders were examined for leucocytes by counting the number of WBC/mm3 and per high power field (HPF) in sediment. Bacteria could be cultured in 20 samples, 18 of which contained greater than 8 WBC/mm3. Two (3%) of the 63 samples with less than or equal to 8 WBC/mm3 contained bacteria. Bacteriuria was found in two (3%) of 65 samples containing 0--1 WBC/HPF. Microscopic examination of the sediment might be used for the screening of patients with a high frequency and urgency of micturition for bacteriuria. A normal number of urinary leucocytes (less than or equal to 8/mm3) indicates that no bacteria will be found in culture. Leucocyturia indicates a high probability of bacteriuria.
Adult↗
Renal function in familial amyloidosis with polyneuropathy.
The renal function is assumed to be normal in most patients with familial amyloidosis with polyneuropathy (FAP) type 1. In the present study of 24 patients with FAP type 1, estimation of the urinary concentrating capacity and 51Cr-EDTA clearance demonstrated that the glomerular clearance and the concentrating capacity were imparied in most patients. The concentrating capacity was significantly correlated with the clearance values. Urine electrophoresis indicated a glomerular cause for the proteinuria. It is suggested that the renal dysfunction should be attributed to deposition of amyloid substance in the glomeruli.
Adolescent↗
Carbohydrate metabolism and concentration profiles of solutes in the canine lumbar intervertebral disc.
Utilization of glucose and oxygen by the cells as well as concentration profiles of solutes were studied in the canine intervertebral disc. Cell metabolism in this avascular tissue, being predominantly anaerobic, was found to be dependent on oxygen tension (this being especially pronounced in the region of 0.13-0.4 kPa (1-3 mmHg). A high production rate of lactic acid was found in the nucleus pulposus, whereas towards the periphery of the annulus fibrosus this rate gradually decreased. In the centrally located areas of the disc tissue, far away from the blood circulation, the highest concentrations of lactic acid were found. For the normal disc the energy demands seem to be met as even small amounts of oxygen account for a large energy source, whereas the cellular requirements are balanced up predominantly by glucose. In regions with extremely low oxygen tensions large amounts of glucose are consumed, but an additional potential energy pool of glycogen seems to be available.
Animals↗
Plasma proteins and anti-kidney antibodies in renal carcinoma.
Occurrence of the nephrotic syndrome in association with renal carcinoma has been reported earlier. There is a risk of masking of carcinoma due to symptoms of nephrotic syndrome/glomerulonephritis. In this study the serum protein profile in patients with renal carcinoma was found to be similar to that of patients with glomerulonephritis. However, increased levels of complement factors C3 and C4 were found, indicating low or none complement consumption. Patients with metastasis had higher blood ESR, orosomucoid, CRP, C3 and C4 but lower Hb and albumin than patients without evidence of metastasis. Immunofluorescence examination of kidneys and sera indicated the occurrence of antibodies against glomerular structures, IgG antibodies were demonstrated in most patients, IgA and IgM in some.
Aged↗
Oxygen tension alterations in the intervertebral disc as a response to changes in the arterial blood.
Measurements of oxygen tension in the canine lumbar intervertebral disc, by the use of a polarographic oxygen electrode, were performed. The oxygen tension in the arterial blood was changed by regulating the oxygen concentration in the inspired air. The alterations in oxygen tension in the nucleus pulposus, as a function of distance to the vertebral endplate were determined. The response times registered in the disc matrix were relatively short (within five min.), which implies an efficient solute transport from the vertebral blood pool underneath the hyaline cartilage into the avascular intervertebral disc.
Animals↗
Clinical experience with azlocillin in the treatment of urinary tract infections with Pseudomonas aeruginosa.
27 patients, aged 19-23 yr, with symptomatic urinary tract infection or epididymitis due to Pseudomonas aeruginosa were treated with azlocillin. All pseudomonas strains were sensitive to azlocillin. The microorganism was eradicated in 25/26 evaluable patients. 25/27 patients were clinically cured. Bacteriological relapse occurred in 11 patients. No serious drug reactions were noted.
Adult↗
Nutritional changes in the canine intervertebral disc after spinal fusion.
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Animals↗
Nutrition of the intervertebral disc: effect of fluid flow on solute transport.
Adult dogs were injected intravenously with 35S-sulphate, and moderately exercised for one to six hours to measure isotope concentrations and profiles throughout the intervertebral discs. The isotope profiles were also observed in control animals that had been under anesthesia between injections and death. In both sets of animals, the profiles were in agreement with those expected for isotope transport by diffusion. This agreement indicates that fluid "pumping" during movement has an insignificant effect on transport of nutrients into the disc. Small solutes, e.g., O2, glucose, and sulphate, are transported into the disc chiefly by diffusion. However, calculations show that because of their low diffusivities, "pumping" may increase the rate of transport of large solutes into the disc, as it does in articular cartilage.
Anesthesia↗
Energy metabolism in relation to oxygen partial pressure in human skeletal muscle during exercise.
1. The intramuscular oxygen partial pressure (pO2) in human gastrocnemius muscle was monitored during exercise and compared with metabolite concentrations reflecting the energy and the redox state in the tissue. Ten normal subjects and ten patients with peripheral vascular occlusive disease were investigated. 2. In normal subjects the pO2 at the end of exercise was related to the intensity of the exercise, expressed as effect (J/s) per contraction. 3. In both patients and normal subject the pO2 was related to the [ATP]/[ADP] ratio, the [lactate/[pyruvate] ratio and the phosphocreatine concentration in the muscle tissue at rest and during exercise. 4. At each pO2 value, a lower [lactate/[pyruvate] ratio was found in the muscle tissue of the patients compared with that of normal subjects. This was interpreted as a beneficial effect of the higher oxidative-enzyme capacity in the muscle of the patients. 5. The results show the importance of pO2 for the regulation of the energy and the redox state of the tissue. During exercise the changes induced in pO2 and thus the energy state will stimulate the respiratory rate. This might be an important link in triggering the oxidative-enzyme capacity in response to physical training as well as in peripheral vascular occlusive disease.
Energy Metabolism↗
Nutrition of the intervertebral disc: solute transport and metabolism.
The metabolism of the canine nucleus pulposus was investigated at different oxygen tensions. It was found that even at high oxygen tensions the metabolism is mainly anaerobic, only approximately 1.5% of the glucose being converted to carbon dioxide. The concentration dependence of oxygen consumption is limited to very low oxygen tensions. Values of oxygen consumption and lactic acid production were used to calculate the concentration profiles of these substances within the nucleus pulposus, using a diffusion theory. The predicted concentration profiles were compared with the experimental measurements of concentration at various positions in the disc. The good agreement in these values found in the nucleus confirms that the main mechanism of metabolite transport is diffusion, and the main route of nutrient supply into the nucleus is via the endplate.
Anaerobiosis↗