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Biomedical subjects

S Larsson

Publications and source records attributed to S Larsson.

At least 253 records · Page 14Linked to original sources
PubMed1988

Do pleural plaques produce symptoms? A brief report.

The occurrence of symptoms due to pleural plaques was studied by means of a questionnaire administered to asbestos-exposed workers participating in a health-screening program. One hundred thirty subjects who were found to have pleural plaques were compared with 1,103 control subjects who had no plaques and showed no changes on x-ray examination. No difference in occurrence of thoracic pain was found between the two groups. Dyspnea was more common among patients with pleural plaques, who also tended to have lower lung function values. There was a good correlation between reported dyspnea and lung function. The increased number of complaints of dyspnea among patients with pleural plaques could not be explained by differences in age or in smoking habits. It is suggested that dyspnea in patients with pleural plaques is caused by sub-roentgenologic fibrosis.

Age Factors↗
PubMed1988

Unicompartmental knee arthroplasty. A prospective consecutive series followed for six to 11 years.

A consecutive prospective series of 102 knees (90 patients) had unicompartmental knee arthroplasty (St. Georg "sledge") between 1973 and 1979 for gonarthrosis, Stages 2-4. Total clinical and roentgenographical evaluation was undertaken after 5-11 years (mean, 8.1 years) and included all 75 surviving patients. Fully comparable results were encountered in the 15 patients who died during the observation period. There were no early revisions but five late revisions; two due to loosening, one late infection, one instability, and one intractable pain. Complete loosening occurred in four patients (4%). Functional score (Hospital for Special Surgery method) averaged 77 points (preoperative, 43) with no tendency of deterioration with time. Loss of initially achieved alignment was generally associated with bone resorption around the tibial component. Minor arthrotic changes of the non-operated compartment occurred in 4% of the cases.

Aged↗
PubMed1987

Emergency treatment of rupture of the proximal anastomosis of an infected thoracoabdominal aortic graft with bleeding into a postpneumonectomy empyema cavity.

The thoracic part of a huge thoracoabdominal aortic aneurysm was resected. A prosthetic graft was implanted between the descending aorta and the iliac arteries. The celiac, superior mesenteric, and the renal arteries were connected to the aortic prosthesis with two bifurcation grafts. A life-threatening hemorrhage into an empyema cavity occurred postoperatively. An emergency two-stage procedure was employed involving: (1) exclusion of the infected intrathoracic segment and exclusion of an infected sutured aortic stump; (2) subsequent removal of necrotic and infected tissue, including the excluded segment of the aorta and the graft in a second operation. The patient recovered and is now well and works full-time. Angiography 3 years after the operation shows that all anastomoses are patent. A scheme of management of these rare cases is proposed.

Adult↗
PubMed1987

Management of postinfarction ventricular septal rupture.

Thirty-five patients were operated on for ventricular septal rupture after acute myocardial infarction (AMI). The overall operative mortality rate was 46%. Hemodynamic and clinical stability was achieved in 14 patients preoperatively. They were operated on after 4 weeks or more. Late development of cardiac failure was the main cause of an operative mortality rate of 21%. From a surgical point of view there are no reasons to delay the operation of these patients for more than 4-8 weeks. The operative mortality rate among 21 patients in cardiogenic shock was 62%. The present study shows, however, that it was possible to save lives by emergency operation of patients who otherwise would have died of cardiogenic shock. The time-interval from diagnosis to surgical treatment, and the preoperative condition of the patients appeared to be important prognostic factors. The location of the myocardial infarction did not significantly influence the prognosis in this series. The 19 long-term survivors returned to normal life, although 8 of them had a small residual shunt. More than half of the patients, who were examined, had multivessel disease. The operative mortality rate for those patients without concomitant coronary artery bypass grafting (CABG) was 80%. Technical failures and some new surgical principles are presented. The indications for IAPB and coronary angiography are discussed as well as the optimum time for surgical repair. The clinical course varies greatly and calls for a differentiated approach to treatment. A plan for surgical management of these patients is suggested.

Aged↗
PubMed1987

Conservative surgery for mitral valve prolapse with regurgitation: clinical follow-up and noninvasive assessment.

To evaluate the result of mitral valve repair in pure regurgitation due to mitral valve prolapse with or without chordal rupture, 11 patients were followed noninvasively for 2.0 to 3.5 years and clinically for at least 5 years in a prospective study. The patients were operated upon before ominous signs of left ventricular dysfunction appeared, all patients being in functional class III, with an ejection fraction of at least 0.50 and mean velocity of circumferential fibre shortening above 1.0. There was no operative mortality. No thrombo-embolic episodes occurred during follow-up. Ten of the 11 patients were alive 5 years postoperatively. One patient died 9 months after the initial repair shortly after reoperation for mitral and tricuspid regurgitation. The other patients all showed definite clinical improvement. Confirming the experience of others, the two patients with ruptured chordae to the anterior mitral leaflet and the only patient with a thick anterior mitral leaflet all had moderate mitral regurgitation postoperatively. Complete repair of mitral valve prolapse is feasible and gives a good functional result of long duration. The results of this study support early mitral repair when complete restoration of ventricular size and function is still possible.

Echocardiography↗
PubMed1987

Social class and sickness absences. A comparative study of four ways to measure social class.

Four different class measures (social groups, a socioeconomic classification, a measure by Erik Olin Wright, and a structural class concept) were applied on a gross material of 3,252 persons registered by sickness insurance authorities. The measures were compared by description of absence days, average durations, sickness rates, and sex. No significant differences were found. By associating measures and absence days, differences were found only for doctor certified days, where the structural class concept diverged. Two conclusions are drawn: When dependent variables are of ideological character, practical considerations may decide choice of class measure. In other cases, caution is advised and further research needed.

Absenteeism↗
PubMed1987

Radioactive iodine and cesium in travellers to different parts of Europe after the Chernobyl accident.

Thyroid uptake of 131I was measured in 130 volunteers following the nuclear power plant accident at Chernobyl in April 1986. Ninety of these volunteers had been travelling in different parts of eastern Europe at the time of or immediately after the accident while 40 persons were permanently in Sweden. Also, 28 additional healthy volunteers, living in Sweden, were chosen for a long-term follow-up of the time-course of 134Cs and 137Cs whole body uptake. The highest levels of 131I were found in persons having visited Poland (mean value 3.27 kBq +/- 3.68 SD, extrapolated to April 27) while persons that had stayed in other parts of eastern or northern Europe showed significantly lower levels (p less than 0.01). The whole body burdens of cesium radionuclides were barely detectable immediately after the accident but increased gradually throughout the observed period. After five months nine farmers from a high fallout area in central Sweden had reached mean values of 4.20 kBq (+/- 3.34 SD) of 134Cs and 137Cs while six nonfarmers from the Stockholm area showed significantly lower levels, 0.64 kBq (+/- 0.24 SD, p less than 0.05). The radiation doses from the observed amounts of iodine and cesium isotopes reported in this study reflect only a marginal addition to the already existing dose from the natural environmental background radiation.

Accidents↗
PubMed1987

Surgical management of tracheal tumours.

The annual incidence of primary tracheal tumours in Sweden is less than 1 per million population. Five cases of malignant tracheal neoplasm treated with segmental resection and primary reconstruction are described. Exploration and mobilization of the trachea were performed via right thoracotomy. Suprahyoid laryngeal release was also done in two cases, using a cervicomediastinal approach. The length of resected segment in these cases was 6 and 7 cm. High-frequency positive-pressure ventilation was used in four of the five cases and greatly facilitated the operation. Recovery was uneventful. Adenoid cystic carcinoma was too extensive for extirpation in one case, but 4 months after radiotherapy a 7 cm tracheal segment with residual tumour was removed; 3 years later the patient is well. There was no stenosis or other late complication and no local recurrence in the long-term survivors. No vocal paralysis occurred. The two patients with laryngeal release had remarkably little and transitory dysphagia. Technical problems are discussed and conclusions are presented.

Adult↗
PubMed1987

Concomitant lung cancer and surgical heart disease.

Concomitance of pulmonary carcinoma and heart disease poses problems of management. We encountered this disease combination in 6 of 2,139 patients operated on with extracorporeal circulation during a 5-year period. Our policy has been to correct the heart disease first. The tumour was subsequently operated on in five of the six patients, but the sixth was subjected only to excisional biopsy of malignant tumour nodules during the heart operation. There was no operative mortality. Three patients died in the follow-up period. A treatment strategy is suggested, based on our experience and on a review of the literature.

Female↗
PubMed1987

Incorporation of nonviable bone grafts. Autoclaved autogeneic and frozen allogeneic bone grafts compared in the rabbit.

In 14 adult rabbits the middle third of the ulna was resected bilaterally followed by reimplantation of resected bone after autoclaving on one side and transplantation of allogeneic bone on the other. In 7 animals the bilateral implants were supplemented with allogeneic bone matrix. The reconstructions were studied in vivo by serial radiography, scintigraphy, and bone mineral determination. The animals were killed at 16 weeks, and the ulnar reconstructions further studied by high resolution radiography, 45Ca autoradiography, and histology. In both types of nonsupplemented reconstructions, new bone formation was poor; nonunion occurred in three out of seven autoclaved reimplants and in five out of seven allogeneic transplants. Supplemented with allogeneic bone matrix, both types of reconstructions exhibited abundant new bone formation and complete incorporation of all implants. Enhancement of new bone formation is probably more important than the type of nonviable bone graft chosen for reconstruction of large skeletal defects.

Animals↗
PubMed1987

Fixation of trochanteric hip fractures. A cadaver study of static and dynamic loading.

Human cadaveric femora were subjected to static and uniaxial dynamic load applied on the femoral head by a simulator. By two transducer-mounted aluminium rings attached to the bone, the static and the dynamic load causing an elastic deformation of 1 mm in the trochanteric region was assessed. A trochanteric fracture was then produced and stabilized by one of three fixation devices, after which the test was repeated. The unfractured femora had the most rigid appearance (static load, 25.9 KN/mm; dynamic load, 33.1 KN/mm). Of the fractured and stabilized specimens, the Jewett nail-plate gave the most rigid fixation (static load, 5.4 KN/mm; dynamic load, 11.5 KN/mm). The least rigid femora were those stabilized by the dynamic Nolok (static, 4.7 KN/mm; dynamic, 9.2 KN/mm) and Hansson (static, 3.2 KN/mm; dynamic 6.1 KN/mm) telescoping devices. Because of the viscoelastic properties of bone, the load applied in a hip simulator should be dynamic; otherwise, the ability of the device to withstand in vivo loading might be underestimated.

Biomechanical Phenomena↗
PubMed1987

Complications at extraction of the ASIF epiphysiodesis screws.

A retrospective study was performed of 30 consecutive patients operated on with ASIF epiphysiodesis for slipped capital femoral epiphysis. During extraction, complications were encountered in 13/23 patients. A total of 38 screws were removed. Thirteen screws broke and another three screws were embedded in bone, making extensive chiseling of cortical bone necessary before extraction was possible. Due to the frequent complications at extraction, the ASIF epiphysiodesis screw is not suitable for treatment of the slipped capital femoral epiphysis.

Adolescent↗
PubMed1987

Asbestos-associated lung effects in car mechanics.

In a study of the possible impact of asbestos exposure on car mechanics, 925 car mechanics and 109 referents (office workers in car-repair firms) were examined. They took part in a health screening in 1977-1981. The forced expiratory volumes in 1 s and the forced vital capacities of the car mechanics were close to the predicted values and did not differ from the findings of the referents. Pleural plaques were found in 41 of the mechanics but in none of the referents. Only minor changes were detected in the chest radiographs ie, 1/1 or less according to the ILO-U/C classification. It is concluded that asbestos exposure can generally cause pleural plaques in car mechanics but no substantial impairment of lung function.

Adult↗
PubMed1987

Radiographic appearance and lung function after non-malignant pleural effusion.

In order to study factors associated with changes in radiographic appearance and lung function after pleural effusion, we investigated 178 consecutive patients with non-malignant pleural effusion. At the initial examination etiology, smoking habits, asbestos exposure, ESR, blood eosinophils, size of effusion and other X-ray lesions were registered. At a 3-year follow-up, chest radiographs and lung function values were obtained and the association with the initially registered factors was evaluated. At follow-up, 20% of the patients had developed major additional X-ray lesions and/or significantly reduced lung function. Prognostically unfavourable factors were idiopathic etiology as compared to infectious, medium and large-size effusions and initial radiographs showing converging pleural linear structures and/or rounded atelectasis as compared to no or minor radiographic lesions. Converging pleural linear structures and rounded atelectasis were seen almost exclusively in association with idiopathic effusions. The obvious differences noted between patients with idiopathic and infectious effusions suggest that these effusions represent separate clinical entities.

Bacterial Infections↗