Biomedical subjects
Publications and source records attributed to U Erikson.
The new Kifa catheter decreased the rte of complications related to the nature of the catheter, enabled the examination to be performed more safely and reduced the examination time compared with the Cook catheter. The Kifa catheter for the right coronary artery could also be used for a subsequent left ventriculography.
The measurement of the total heart volume should be performed with the patient in the supine position. Using a reproducible technique a slight increase of the heart volume related to the body weight was found with increasing age.
In 28 cardioangiographies and 24 peripheral angiographies the dimer ioxaglate (Hexabrix) and conventional monomeric contrast media were compared. The general effects of the media on the patients were the same, while the frequencies of pain, sensations of heat and involuntary movements were significantly lower with Hexabrix.
The videodensitometric method was applied for the determination of regional renal blood flow and filtration fraction using 2 contrast agents, where Thorotrast represented an intravascular indicator and Angiografin will be distributed in the intravascular and interstitial space and, in addition being freely filtrable in the glomeruli. The contrast density was continuously monitored from the light intensity on a TV-screen, where the region to be analyzed could be outlined by a light pen. The passage time of Angiografin analyzed from the videodensitometric curve was compared to that of 125I-labelled Angiografin as analyzed in the venous effluent. The two methods yielded almost identical values. Knowing the volume of distribution of the agents, the regional blood flow could be calculated and was found to be the same for the two contrast agents used. The curves for Thorotrast showed a rapid passage with a rapid declination towards the base-line. For Angiografin the curves ended in an almost horizontal plateau reflecting the fraction of the Angiografin filtered and remaining into the tubular system. The height of the plateau was then used for the determination of the filtration fraction. The figure obtained was compared to that obtained by conventional clearance techniques, and was found to yield similar values. It is concluded that the videodensitometric method allows for evaluation of the functional characteristics of the kidney in addition to the anatomical information given by the conventional angiography performed in parallel to the videodensitometric measurements.
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A method, already in clinical use, of determining the total volume of the heart in patients in the supine position was evaluated. The reproducibility in the measurement of individual diameters and distances was good. A minor difference was noted between the results of 2 different examiners. A discrepancy in the total heart volume of 30 ml or more between 2 determinations was statistically significant, which may be a guide in the assessment of volume determinations in clinical practice.
In animal experiments contrast medium and physiologic saline were found to be equivalent as indicator substances in thermodilution. The ejection fraction is determined with approximately the same accuracy with thermodilution as with videodensitometry. The cardiac output, on the other hand, is smaller when determined with videodensitometry than with thermodilution. The results indicate that thermodilution gives too high values.
An acceptable method and equations for predicting the total heart volume from correlations to physiologic variables in young and middle-aged healthy persons are presented. Body weight gives more predictive information than body surface area. The use of the total hemoglobin mass and measures of physical work capacity as variables in addition to body weight will only increase the accuracy of the prediction relatively slightly.
Of 121 patients surviving a by-pass operation 114 have been folowed up hitherto. At first follow-up - usually one year after operation - the angina pectoris was relieved in 87% of the patients and in 85% at least one vein by-pass was patent. A high correlation was found between subjective result and graft patency. Advanced arterial changes at preoperative coronary angiography did not prevent good result after surgery. In about half of the patients whose pain was relieved, the left ventricular ejection fraction was increased postoperatively. However, in many patients, who were subjectively improved, the ejection fraction was unchanged or even decreased.
The occurrence and degree of peripheral atherosclerosis in 30 male patients with symptoms of intermittent claudication were studied by arteriography. The changes observed in the angiograms were codified. In all patients the concentrations of triglycerides and cholesterol were determined in whole serum and in the three major lipoprotein classes--very low density, low density and high density lipoproteins. These data were compared with those of a control material and were also correlated to the codified angiographic findings in each individual patient. Positive significant correlation was not found between the arteriographic changes and the serum concentrations of lipids and lipoproteins, which might be explained by an advanced stage of the disease where such relationships might not appear.
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The ejection fraction of the left ventricle was determined by videodensitometry in 121 patients with angina pectoris. The mean value was 31 per cent. This estimation, which is easily performed by the method described, gives important and accurate information on the left ventricular function which, added to other parameters, should increase the reliability of the clinical evaluation of the patient.
Angiocardiograms have been widely used to calculate volumes of cardiac chambers. By determining the left ventricular volume in end-diastole and end-systole the ejection fraction can be calculated. The ejection fraction is considered a clinically useful index of left ventricular function and is widely used in the preoperative evaluation of patients with cardiac disease.
Videodensitometry has made it possible to determine not only total but also regional blood flow within the kidney. In animal experiments good agreement was found between the measurements by videodensitometry and isotope technique, taking vein samples, using 125I-labelled Angiografin. The blood flow in 21 human kidney has been determined by both videodensitometry and Xe wash-out method. The correlation was fairly good.
Frequency and pathogenetic factors involved in arterial segmental vasoconstriction observed in a series of 55 patients are analyzed. A large number presented peripheral nutritional disturbance and these included 5 patients with definite or highly possible Buerger's disease. The possibility that in certain patients segmental vasoconstriction may be an early sign of systemic or local arterial disease is discussed.
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