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Biomedical subjects

V Falk

Publications and source records attributed to V Falk.

At least 127 records · Page 7Linked to original sources
PubMed1994

Hemodynamic assessment of the stentless Toronto SPV bioprosthesis by echocardiography.

Since March 1993 the Toronto SPVTM bioprosthesis has been implanted in 100 patients. Our prospective study evaluated the echocardiographic valve characteristics and the influence of the echocardiographic assessment on surgical technique. Transesophageal echocardiography (TEE) was applied before and during surgery, and transthoracic echocardiography (TTE) postoperatively. The average valve size implanted was 26.5 mm. Follow up was complete in 74 patients at six months and in 38 patients at one year. Pre-cardiopulmonary bypass (CPB) TEE valve sizing was accurate by +/- 1 mm in 81 patients as compared to mechanical sizing. Post-CPB valve closure was concentric in 99 patients. Minimal aortic incompetence was present in seven patients at one week, in two patients at six months and in one patient at one year. Mean pressure gradients ranged from 7.7 to 11.1 mmHg postoperatively. Overall mortality was 4%. One patient with non-structural dysfunction and another with endocarditis at one year postoperatively were reoperated successfully. At follow up there was a significant decrease in transvalvular pressure gradients and an increase in valve orifice areas. In 32 patients a decrease in left ventricular posterior wall (LVPW) hypertrophy was found (p < 0.001). There was a decrease in tissue depth and recurrence of the dynamic movement of the aortic root. It is concluded that TEE valve sizing is reliable for early valve selection. Valve incompetence is not a clinically relevant issue using the oversizing technique. Improved hemodynamics at follow up can be explained by remodeling of the aortic root and by a decrease in left ventricular hypertrophy. The excellent hemodynamic profile, resembling native aortic valve function, is impressive and has to be confirmed by long term evaluation.

Adult↗
PubMed1991

IMA-graft patency control by thermal coronary angiography during coronary bypass surgery.

Thermal coronary angiography (TCA) was evaluated for the intraoperative assessment of graft patency and flow in internal mammary artery (IMA) bypass grafts. TCA was performed in 210 patients undergoing 460 vein and 153 IMA bypass grafts after completion of the distal anastomoses. The IMA grafts and the recipient coronary arteries were delineated by the temperature differential between a cold epimyocardium and the perfusing warm blood after bulldog clamp release. TCA provided information about graft and anastomosis patency, initial flow patterns, and native coronary stenoses. TCA was performed in all studied IMA bypass grafts: 142 grafts were patent. Low flow but patency was observed in 24 IMA grafts and 11 IMA grafts showed no flow. Subsequently, 8 anastomotic failures and 3 proximal IMA graft occlusions were encountered. Based on these findings, 8 anastomoses were successfully revised and 7 additional vein grafts were added. One low flow IMA graft was not revised leading to postoperative ST elevation. Thirty-one distal native coronary stenoses were detected in the recipient LADs, 3 of which were not seen in the preoperative cineangiogram. In 20 instances, TCAs were obscured by an excess of fat or myocardium impeding image analysis. In 8 cases, TCA results were confirmed by conventional angiography postoperatively showing an excellent correlation in all cases. We conclude that intraoperative TCA demonstrates early IMA graft function and initial flow patterns. During our study, TCA documented a 7.2% IMA graft early failure rate. Intraoperative decision making was aided by TCA in 9.2% of all IMA grafts; this confirmed the clinical relevance of TCA.

Adult↗
PubMed1982

Primary surgical treatment of carcinoma stage I of the uterine cervix.

476 cases of Stage I-IV invasive carcinoma of the uterine cervix were treated at the Gynecology Departments in Karlstad and Orebro in 1965-75. 232 (48.7%) were classified Stage I, 198 (85.3%) of them were treated with primary surgery (57 Stage IA and 141 Stage IB). Thirty-four were given primary radiotherapy because of advanced age or co-existing conditions contra-indicating surgery. Of the 141 patients with primary surgery for Stage IB, squamous epithelial carcinoma was established in 88.7% and adenocarcinoma in 11.3%. Surgery revealed lymph node metastases in 13 (9.2%). Postoperative radiotherapy was given to all patients with lymph node metastases, to 3 patients with tumor thrombi in the parametrial vessels, and to 6 in whom surgery had conceivably not been radical. Urinary tract complications requiring reconstructive surgery occurred in 8 (4.0%). The 5-year survival rate with Stage IB was 91.5%, corrected for intercurrent diseases, 5-year survival was 92.8%. Of the 13 with lymph node metastases, 7 were still alive after 5 years. The 5-year survival rate for those without demonstrable lymph node metastases was 94.5%, corrected 96.0%.

Adenocarcinoma↗
PubMed1982

Antibiotic treatment of acute salpingitis. A study of plasma concentrations of two tetracyclines (doxycycline and lymecycline).

A group of 782 patients with a diagnosis of acute salpingitis (a few of the patients because of other infection in the pelvis) were treated with the recommended oral dose of doxycycline (200 mg the first day and 100 mg once daily for at least the following 9-12 days) in combination with 1 g benzyl penicillin and 0.6 g procaine penicillin twice daily intramuscularly for 5-7 days. The plasma concentrations of doxycycline were determined on the third day of treatment before the next dose was given. In 26.5% of the patients the concentrations were below 1 microgram/ml plasma, considered as the minimum therapeutic level. The dose of doxycycline was increased to 200 mg a day in these patients and the plasma concentrations increased accordingly. In another group of 80 patients, 40 were treated with the standard doxycycline dose, and the other 40 patients with the standard lymecycline dose (300 mg twice a day). The plasma concentrations, determined before the dose on the third day, were below 1 microgram/ml in 35% of the patients treated with doxycycline, and in 5% of those treated with lymecycline. Since acute salpingitis in most cases is a serious complication to a lower genital tract infection, often a sexually transmitted disease caused by tetracycline-sensitive organisms, the importance of achieving and determining the therapeutic plasma concentrations of tetracyclines is stressed.

Acute Disease↗
PubMed1980

Genital tuberculosis in women. Analysis of 187 newly diagnosed cases from 47 Swedish hospitals during the ten-year period 1968 to 1977.

A retrospective analysis of symptomatology, diagnostic procedures, and treatment of all 155 new cases of genital tuberculosis at 47 Swedish gynecology departments in the period 1968-77 was performed. The frequency of genital tuberculosis was 0.002% of all patients admitted for gynecologic disease. Genital tuberculosis occurred more frequently in the postmenopausal period. The most common symptoms were metorrhagia, pain, and infertility. Chemotherapy alone was used in 40% of the cases. Conservative surgery was attempted in 8%, and 38% had radical surgery. No intrauterine and four tubal pregnancies occurred after therapy. We conclude that primary treatment should be conservative, although the chances of having a normal pregnancy are almost nil and the risk of an ectopic pregnancy is great.

Female↗
PubMed1980

Adherence in vitro of Neisseria gonorrhoeae. Escherichia coli and group B streptococci to vaginal epithelial cells of post-menopausal women.

The adherence of Neisseria gonorrhoeae, Escherichia coli and group B streptococci to vaginal epithelial cells from post-menopausal women was studied by an in vitro test system. It was found that the adherence rate of gonococci to vaginal cells from women on oestrogen treatment was statistically significantly higher (p less than 0.001) as compared to those without such a treatment. No increased adherence was found for E. coli and group B streptococci. The cellular and functional bases of these findings are discussed.

Aged↗
PubMed1979

Variations in attachment of Neisseria gonorrhoeae to vaginal epithelial cells during the menstrual cycle and early pregnancy.

An in vitro system was used to study the ability of virulent gonococci to adhere to vaginal epithelial cells obtained from healthy donors during the pre- and postmenstrual phases, and from those in early pregnancy. It was found that more gonococci adhered to the cells from donors in the postmenstrual phase than to cells from those in the premenstrual one. This difference was statistically highly significant. The attachment rate of gonococci to vaginal epithelial cells was similar in early pregnancy and in the premenstrual phase.

Adhesiveness↗
PubMed1978

Changes in the incidence of acute gonococcal and nongonococcal salpingitis. A five-year study from an urban area of central Sweden.

The incidence of acute gonococcal and nongonococcal salpingitis for a five-year-period (1970--74) was studied retrospectively in an urban area of central Sweden. The investigation was undertaken to see if the reported decrease of gonorrhoea in Sweden had been followed by a change in the incidence of gonococcal salpingitis--the most common complication of gonorrhoea. The study showed that the relative incidence of acute gonococcal salpingitis had decreased even more than urogenital gonorrhoea and these findings thus indicate a real decrease of gonorrhoea. At the same time there were more patients with nongonococcal salpingitis. During the period of the study the gonococcal complement-fixation test (GCFT) gave positive results in 40% to 80% of the patients with gonococcal salpingitis. The yield with this test was only 4% in patients with nongonococcal salpingitis during 1970 but it increased successively and was 23% in 1974. This increase was statistically highly significant (P less than 0.001).

Acute Disease↗