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Biomedical subjects

T Aberg

Publications and source records attributed to T Aberg.

At least 91 records · Page 5Linked to original sources
PubMed1982

Release of adenylate kinase into cerebrospinal fluid during open-heart surgery and its relation to postoperative intellectual function.

In 33 of 36 patients having open-heart surgery, the levels of adenylate kinase in cerebrospinal fluid (CSF-AK) were raised. No such increase was seen in 8 patients who had had lung operations without cardiopulmonary bypass. A significant increase in CSF-AK was recorded in 18 patients whose CSF was examined both preoperatively and postoperatively, and this increase was correlated with change in an index of intellectual function. Since there was no evidence of damage to the blood-brain barrier, these findings point to a causal relation between brain-cell injury during cardiopulmonary bypass and release of AK into CSF. Measurement of CSF-AK may therefore prove useful in research to improve the quality of open-heart surgery.

Adenylate Kinase↗
PubMed1981

The choice of operation for bronchial carcinoids.

In a review of the literature, 1,392 patients with bronchial carcinoids were found. Of these, there were 313 patients for whom individual data with regard to type of operation, follow-up period, and outcome were given. Actuarial curves for proportions of patients who had not died of the disease or who had not undergone reoperation for residual disease were constructed for each type of operation. The prognosis up to 20 years after surgical treatment for bronchial carcinoids is excellent. For 15 to 20 years postoperatively, the prognosis after a lobectomy is excellent and after a pneumonectomy, slightly worse. The prognosis after a lung parenchyma-saving operation (wedge or segmental resection and bronchoplastic procedures) is similar to that after a lobectomy up to 7 years postoperatively. After that, the proportion of disease-free patients declines precipitously. At 20 years the difference in comparison with a lobectomy is statistically significant for both wedge or segmental resections and bronchoplastic procedures. Parenchyma-saving operations cannot therefore be said to be radical. A policy for decision-making at the operating table is formulated.

Actuarial Analysis↗
PubMed1981

Repair of cardiac defects with absorbable material.

Partial resection of the right atrium was performed in 5 young pigs. The defect was covered with a patch graft of absorbable material (polyglactin 910). Ten weeks postoperatively the mesh was completely replaced by a newly formed tissue with a smooth inner surface. Light microscopy showed regeneration of fibro-elastic tissue and the luminal surface was covered with endothelial-like cells indistinguishable from normal endocardium.

Animals↗
PubMed1980

The effect of metastasectomy: fact or fiction?

Metastasectomy in the treatment of solitary metastases has been recommended almost unanimously. The basis for this recommendation has been that 5-year survival after metastasectomy is around 30%, which is just as good as after operation for bronchial carcinoma. It has been assumed, implied, or claimed that the 5-year survival without operation is nil. Control material is, however, lacking. Seventy surgically treated patients were compared with a small, historical control group of 12 patients. There was no difference in 5-year survival. Because of these findings and after a study of the literature, we postulate that patients with lung metastases fulfilling the criteria for operation constitute a selected group with a favorable natural history. Five-year survival, therefore, is an insufficient way of describing the effect of metastasectomy. However, patients with 10-year survival are rare in the literature. In some patients with a favorable tumor-host relationship or with possibilities for effective chemotherapy, cure or prolongation of life has been achieved. Such patients should undergo operation. Randomized studies are needed in all groups for which we do not have sufficiently strong evidence that metastasectomy contributes to the longevity of the patient.

Adult↗
PubMed1980

Quality of survival in patients with surgically treated bronchial carcinoma.

Quality of survival was studied in 69 surgically treated bronchial carcinoma patients (25% of a total 273 patients in an unselected epidemiological sample). The Carlens vitagram index was used. The quality of survival in patients cured by pulmonary resection was excellent. It was poor in patients who underwent resection and subsequently died, and especially in patients who had non-resectional thoracotomies. The patients who were operated on and later died did not have a better quality of survival than non-surgically treated patients in the same stage. Thus pulmonary resection has no palliative effect in bronchial carcinoma patients who are not cured. The possible benefit of "removing the tumour burden" in patients treated with operation alone can, therefore, be dismissed. The only aim of the operation at present must be to cure.

Bronchial Neoplasms↗
PubMed1980

Argyrophil carcinoid tumors of the lung. Incidence, clinical study, and follow-up of 46 patients.

Forty-nine patients with lung tumors initially diagnosed as carcinoids from their cellular appearance and arrangement were originally included in the study. The tumors of 46 of these patients showed an argyrophil reaction with the Grimelius silver stain. The three nonargyrophil tumors were reclassified as noncarcinoid tumors at further examination. The use of the argyrophil technique in characterization of the lung carcinoid tumors is discussed. The incidence of lung carcinoid tumors in the County of Uppsala was 0.7 patients per 100,000 inhabitants per year. Eleven patients with detected disease were symptom-free. The doctor's delay in 9 patients was 3 to 13.8 years. Yet, the prognosis was good, with 5-year survival in 91 percent, 10-year survival in 91 percent, and 15-year survival in 86 percent of the 46 surgically-treated patients. It is concluded that the surgical treatment should at least comprise a lobectomy.

Adolescent↗
PubMed1979

The need for surgery in an unselected bronchial carcinoma population.

An epidemiological study of bronchial carcinoma was carried out in the county of Uppsala, Sweden, during a five-year period. The number of cases found was 273. Of these, 25% were operated upon. The operation rate was six operations/100,000 inhibitants per year. Including additional patients with a false preoperative diagnosis of carcinoma, the operation rate was seven operations/100,000 inhabitants per yera. This figure is clearly subject to influence by the level of medical ambition. The expected five-year survival rate of the surgically treated carcinoma cases in 29%. Twenty-nine percent of the surgically treated patients and 45% of the expected survivors were detected by mass miniature chest X-ray during a general health survey. Fifty-five percent of the surgically treated patients and 75% of the expected survivors were discovered by chance. In no group comparisons with comparable non-surgically treated patients were the deceased surgically treated patients found to have a longer survival. Among the patients who were operated upon, a small tumor size, a peripheral location, clinico-anatomical stage 1 of the disease, and detection by chance were favorable prognostic indicators. Twenty-eight percent of the surgically treated patients were over 70 years of age. Their expected five-year survival rate is 21%. Active early diagnosis (increasing the need for surgery) and restriction of surgery only to those most likely to benefit from it (decreasing the need for surgery) may be expected to give maximum effectiveness in the surgical treatment in bronchial carcinoma.

Adult↗
PubMed1979

Surgical classification of abdominal aortic aneurysms.

A new surgical classification of abdominal aortic aneurysms is proposed. The classification is based upon the clinical features immediately prior to surgery and the findings during operation. Group I consists of elective cases without symptoms, group II elective cases with symptoms, group III suspected rupture, group IV rupture without clinical shock and group V rupture with clinical shock. The mortality in a material of 129 cases was 0 in group I and progressed to 74% in group V. The mortality distribution was confirmed by a collective review of the literature. The proposed classification sheds light upon the natural history of the disease, prognosis and indication for operation.

Aged↗
PubMed1977

Cerebral protection during open heart surgery. A comparison between a disk oxygenator and two bubble oxygenators.

A disk oxygenator (Björk-AGA HLM) with a moderate hemodilution prime and two bubble oygenators (Harvey H 800 and Galen Optiflo 42-201) with a clear fluid prime are compared in regard to their effect upon postoperative intellectual function as measured by psychometric tests. There was no difference between the two bubble oxygenators. There was a marked, statistically significant difference between the bubble oxygenators and the disk oxygenator, the disk oxygenator yields considerably worse results. The reason for this is obscure but probably lies in the different microembolic output. The literature, however is not consistent on this question. At the present time, only bubble oxygenators are used in our unit.

Brain Damage, Chronic↗
PubMed1977

Cerebral protection during open-heart surgery.

To reduce the incidence of cerebral damage after open-heart surgery measures were undertaken based on physiological principles and consideration of the possible injury caused by microemboli. Intellectual function was measured by psychometric tests before and after operation. The results were compared with those of an earlier series. There was a striking reduction in the incidence of neurolocial complications. There was also a considerable reduction in the degree of impairment of intellectual function previously shown to develop after open-heart surgery. However, there are still signs that cardiopulmonary bypass brings about subclinical cerebral injuriies. The measures taken and their rationale are discussed. Psychometric testing is a useful method for evaluating the quality of cardiopulmonary bypass as it allows a quantitative assessment of postoperative cerebral function.

Adult↗