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Biomedical subjects

B Frenckner

Publications and source records attributed to B Frenckner.

At least 37 records · Page 2Linked to original sources
PubMed1995

Carmeda surface heparinization in neonatal ECMO systems: long-term experiments in a sheep model.

The thromboresistance in three Carmeda (Stockholm, Sweden) heparin-coated neonatal ECMO systems with a runtime of 45, 56 and 96 hours, respectively, and three noncoated systems with a runtime of 12, 42 and 66 hours, respectively, were compared using a sheep model. The flow rate was 200 ml/min and the activated clotting time (ACT) was kept at approximately 120 seconds. At the end of the experiment, the heparin-coated systems only contained minimal clotting while the controls showed major clotting in the entire system. Fibrin monomers were not detected until after 24 hours in the heparin-coated group, but demonstrated within 60 minutes in the noncoated group. It is concluded that the Carmeda heparin coating has a thromboresistant effect, and may be used to reduce the need for systemic heparinization in ECMO treatment of neonates.

Animals↗
PubMed1993

Esophageal atresia: mortality and complications related to gastroesophageal reflux.

Low birthweight and associated anomalies are important risk factors in patients with esophageal atresia. Gastroesophageal reflux is also a common problem in these patients and can lead to serious complications. The aim of this retrospective study was to analyse complications and mortality in 110 patients treated for esophageal atresia between January 1971-December 1987, in order to determine what role reflux may play. Symptoms of reflux were common in most patients during the first years of life. In some cases the symptoms were serious and even caused some late deaths by aspiration. The overall mortality was 12% (13/110). Early mortality (six patients) was caused by prematurity and associated anomalies, whereas late mortality often was caused by aspiration or other respiratory complications. Patients who had been operated with a circular myotomy showed more complications, but did not show a higher mortality rate than the remainder. This study confirms the importance of identifying patients with reflux at an early stage in order to prevent serious complications and mortality.

Child, Preschool↗
PubMed1992

Sacrococcygeal teratoma in Sweden: a 10-year national retrospective study.

Thirty-two children with sacrococcygeal teratoma have been treated during the last 10 years (1980 to 1989) in Sweden. A retrospective study was performed in four departments of pediatric surgery that treat sacrococcygeal teratomas in children from the whole of Sweden. Prenatal and perinatal histories were reviewed together with interval to diagnosis, Altman classification, histology, and serum alpha-fetoprotein. Details of surgical management +/- adjuvant chemotherapy and outcome of patients were also documented. In 8 patients the teratoma was diagnosed prenatally by ultrasonography and there was one postoperative death in this group. Multiagent chemotherapy was used in all but one of 11 patients with malignant teratomas (in 8 of them a cisplatin, bleomycin, vinblastine combination). Only one patient with a malignant tumor treated by single-agent chemotherapy died, 8 others were still alive and tumor-free after 1 to 9 years (mean time, 5.4 years). Two patients developed late relapses and were treated by surgical resection. Metastases occurred in five of the 11 malignant tumors, one at presentation and in four patients 10 to 29 months following surgery. All relapses had distant metastases as well as local disease. Serum alpha-fetoprotein was used in monitoring some of these patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

High and intermediate imperforate anus: results after surgical correction with special respect to internal sphincter function.

Embryologically a fistula in an anorectal malformation can be regarded as an ectopic anus. Since 1984 the so-called fistula has been saved and used as the new anal canal in the surgical reconstruction of 48 patients with high or intermediate imperforate anus. A positive rectoanal inhibitory reflex indicating internal sphincter function was recorded in 32 of 43 patients investigated with anorectal manometry. These patients showed significantly better anal continence. It is concluded that there is an internal sphincter "anlage" in the fistulous connection from the bowel to the urogenital tract. Internal sphincter function can be obtained in the majority of the patients, which seems advantageous for their anal function.

Adolescent↗
PubMed1992

Diaphragmatic hernia in infancy and childhood--20 years experience.

Congenital diaphragmatic hernia through the foramen of Bochdalek usually presents with severe respiratory symptoms soon after birth. Despite successful repair of the defect the mortality rate still remains high. This may be due to co-existing pulmonary hypoplasia with pulmonary hypertension and concomitant right-to-left shunting. In order to find factors that predispose for good or bad outcome as well as to compare different modalities of treatment being used at our hospital, this twenty-year retrospective study was undertaken. It is confirmed that the extent of pulmonary hypoplasia at birth rather than the promptness of surgical repair and the skill of intensive care appears to be the major mortality factor. Initial experiences from extracorporeal membrane oxygenation (ECMO) are promising.

Extracorporeal Membrane Oxygenation↗
PubMed1992

Surface-heparinized neonatal ECMO circuit--an experimental animal study.

The present experiment examined the capacity of the Carmeda Bioactive Surface to prevent clot formation in an ECMO circuit designed for neonatal use. The Terumo Capiox oxygenator was used in the seven experiments. Mongrel dogs were perfused with veno-arterial bypass at a low flow rate of 200 ml/min. Without any blood heparinization, the circuit was totally occluded within a few hours. With a very low heparin infusion (10 IUxkg -1xh -1) extracorporeal blood flow could be maintained despite some clots forming in the oxygenator. With a small bolus injection of heparin (20 IU/kg) and a low continuous heparin infusion (20 IUxkg -1xh -1) the ECMO circuit showed negligible clotting. With better haemodynamic design of the device in combination with a thrombo-resistant surface, it may be possible to decrease the need for blood heparinization in the neonatal ECMO circuit.

Animals↗
PubMed1991

Extracorporeal membrane oxygenation in a European center--clinical experience.

Extracorporeal membrane oxygenation (ECMO) has rapidly become the treatment of choice for critically ill newborn infants with reversible pulmonary disease refractory to conventional treatment. Since 1987 ECMO has been available at our hospital and up to December 1989 11 patients have been treated. Eight patients could be weaned from ECMO. The aim of this study was to describe the procedure and its implications in the neonatal and pediatric age groups and to present our experience. It is concluded that even though ECMO in the short term is a costly and personnel-consuming procedure it is well documented, safe and life-saving.

Carbon Dioxide↗
PubMed1991

Patient complications during extracorporeal membrane oxygenation (ECMO).

Extracorporeal membrane oxygenation (ECMO) has rapidly become the treatment of choice for critically ill newborns with reversible pulmonary disease not responding to conventional treatment. Since 1987 ECMO has been available at our hospital and up to December 1989 11 patients were treated. Several patient complications were seen. The aim of this study was to register the incidence and treatment of these complications and to compare our results with international ECMO experience. It is concluded that many of the complications seen during ECMO can be successfully managed.

Adolescent↗
PubMed1990

In-vitro evaluation of neonatal ECMO cannulae with regard to flow characteristics.

One of the crucial points in a neonatal ECMO circuit is to obtain adequate venous drainage from the cannula in the right jugular vein, as the vessel diameter limits the size of cannula that can be used. For this reason the design of the cannula is of utmost importance. The aim of this paper was to compare different commercially available ECMO cannulae, and to try to find the cannula which had the best flow characteristics. Venous cannulae were evaluated with regard to maximum drainage capacity at different hydrostatic levels. For arterial use, pressure drop over the cannulae at different flow rates was measured. Of the cannulae studied, those from Biomedicus and Elecath had the best flow characteristics for both venous and arterial use.

Catheters, Indwelling↗
PubMed1987

Age related variations of serum concentrations of normally occurring IgG antibodies to Clostridium perfringens.

In studies using indirect immunofluorescence IgG antibodies to Clostridium perfringens were found in sera from healthy adults. Sera from 236 healthy children were examined. The normally occurring IgG antibodies to C perfringens were found to have an age related variation. Preliminary data suggest that they are not correlated to C perfringens alpha toxin. The antigen(s) against which the antibodies are directed is/are probably part of the cell wall, but its/their exact nature is not known.

Adolescent↗
PubMed1986

Increased anal resting pressure following the Ripstein operation. A contribution to continence?

To investigate the physiology of improvement in continence following the Ripstein operation for procidentia, preoperative and postoperative anorectal manometry was performed on 11 patients. The mean maximum anal resting pressure increased from 39 to 55 mm Hg (P = 0.01). This probably reflects improved function of the internal anal sphincter, which might contribute to better continence by increasing the closing capacity of the anal canal.

Anal Canal↗
PubMed1985

Anal sphincter function after surgery for high imperforate anus--a long term follow-up investigation.

37 children were treated for high imperforate anus during the years 1944-1965. Eighteen of these 37 participated in a follow-up examination at the age of 18-35 years. The examination consisted of an anorectal manometry, EMG of the external sphincter, a digital anal examination, and an interview. Special attention was paid to anal continence. Fourteen patients did not admit any major anal problems, and eight of them had a good continence. Anorectal manometry showed an absence of internal sphincter function in all patients. During voluntary squeeze the continent patients increased anal pressure significantly more than the incontinent ones, and they were also aware of significantly smaller distensions of the rectal ampulla. The present investigation shows the necessity of well-functioning striated sphincter muscles to achieve good continence, and therefore also the importance of careful dissection and identification of the striated sphincter muscles during the operation.

Adolescent↗