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Biomedical subjects

B Ljunggren

Publications and source records attributed to B Ljunggren.

At least 37 records · Page 2Linked to original sources
PubMed1991

A case of photosensitivity and contact allergy to systemic tricyclic drugs, with unusual features.

A 43-year-old farmer on tricyclic antidepressive drugs developed a severe photodermatitis with associated liver involvement. The lesions spread to covered areas of the skin, suggesting photoallergy clinically. Patch and photopatch testing revealed photoallergy and contact allergy to clomipramine and contact allergy also to carbamazepine. In addition, the patient had positive patch test reactions to chlorpromazine, balsam of Peru and fragrance-mix, as well as a positive photopatch test to fentichlor. UVA and UVB erythema thresholds were normal. In this patient, an initial episode of photosensitization, probably elicited by clomipramine, was accompanied by contact allergy to this drug and to carbamazepine. The contact sensitivity to clomipramine could also be elicited by oral provocation without UV light. Hypothetically, a photoproduct of clomipramine may have been the original sensitizer, this compound subsequently cross-reacting with clomipramine and, possibly with carbamazepine.

Adult↗
PubMed1991

History of Clarke's stereotactic instrument.

The first original stereotactic instrument was designed by the turn of this century by the British surgeon, anatomist, and physiologist Robert Henry Clarke. In 1905 James Swift, in London, constructed the first machine, 'Clarke's stereoscopic instrument employed for excitation and electrolysis'. It was first used in 1906 by Clarke and Victor Horsley to create minute electrolytic lesions in the CNS of animals. The stereotactic apparatus was patented by Clarke in 1914 and cost 300 pounds. Two further instruments were made by Goodwin and Velacott in London and brought to the United States to be used for animal research. The principal of these machines constitutes the basis of modern stereoguides for human use designed after World War II. Clarke's original instrument was last used by Dr Barrington, a genitourinary surgeon in London in the early 1950s. It then disappeared but parts were detected by Dr Hitchcock in 1960 and the complete machine by Dr Merrington in 1970. It can now be found at the museum of University College Hospital in London.

History, 19th Century↗
PubMed1991

Simultaneous transcranial Doppler sonography and cerebral blood flow measurements of cerebrovascular CO2-reactivity in patients with aneurysmal subarachnoid haemorrhage.

Transcranial Doppler sonography (TCD) flow velocities and cerebral blood flow (CBF) measurements were evaluated in 14 patients who had suffered a major aneurysmal subarachnoid hemorrhage (SAH). Cerebrovascular reactivity to hypocapnia was evaluated simultaneously by the two methods. The measurements were performed under general anaesthesia preoperatively, within 72 hours after the bleed, during normocapnia and hypocapnia. There was poor correlation between absolute values of hemispheric CBF and corresponding TCD mean flow velocity. Controlled hyperventilation was associated with a significant decrease in CBF as well as TCD flow velocity (p less than 0.001). In terms of reactivity indices the correlation between the two methods was poor and not significant (r = 0.33, p = 0.09). The principal differences between the methods are discussed as well as the application of TCD in the evaluation of cerebrovascular reactivity.

Adult↗
PubMed1991

Diabolic hiccups.

Explore the source record for details and available documents.

History, Ancient↗
PubMed1991

Ultraviolet B irradiation inhibits the induction of photoallergy to systemically administered quinidine in the mouse.

In albino mice photosensitized to quinidine, 100 mg/kg by intraperitoneal injection, pretreatment of the induction area with ultraviolet B (UVB) on 3 consecutive days was shown to significantly reduce the inflammatory response when the mice were challenged at a distant site 1 week later. Mice controlled for phototoxicity did not react. The inhibition was dose-dependent within the UVB dose range tested (0.05-1.0 J/cm2 x 3), being almost complete with the highest doses. Inhibition, although somewhat less pronounced, was also seen when an area on the back, distant from the induction site, was preirradiated following a similar protocol. The reduced response at elicitation persisted when the time to challenge was increased up to 4 weeks. At 5 weeks, a second attempt to photosensitize the previously inhibited animals failed, suggesting that a state of tolerance had been acquired. The timing of the UV exposure in relation to the photoactive chemical is critically important in determining whether an exposure promotes or inhibits photoallergic sensitization.

Animals↗
PubMed1990

Advances in the management of victims struck by ruptured intracranial aneurysms.

The advances in management of victims struck by the rupture of an intracranial aneurysm is reviewed. In the 1970s the management outcome was still far from acceptable; many victims who had 'recovered' following a major aneurysmal subarachnoid haemorrhage (SAH) succumbed or became crippled as the result of repeat bleeds and/or delayed SAH-induced ischaemic deterioration ('cerebral vasospasm'). The era of prosperity for microneurosurgery, the introduction of the calcium channel blocker nimodipine and the accumulation of cases in centres with a team of dedicated aneurysm surgeons form the basis of a recent breakthrough in the previously gloomy management outcome. With microsurgical techniques elective surgery can now be performed in the acute stage thereby preventing disastrous reruptures which occur frequently in the early phase after the first bleed. The concomitant use of nimodipine minimizes delayed SAH-induced ischaemic deterioration. Today a management regime including early operation combined with nimodipine has led to grossly improved results. Nevertheless cognitive disturbances and psychosocial maladjustment are frequent sequelae following a major aneurysmal bleed. Hope for further improvements could depend on the development of techniques which may allow identification of intracranial aneurysms before they rupture and increased knowledge of the aetiology of such cerebral arterial wall lesions.

Aged↗
PubMed1990

Early aneurysm surgery and preventive therapy with intravenously administered nimodipine: a multicenter, double-blind, dose-comparison study.

A European, multicenter, prospective, randomized, double-blind, dose-comparison study on preventive therapy with intravenously administered nimodipine was performed to evaluate the efficacy and tolerability of two different doses: 2 and 3 mg/h. Two hundred four patients fulfilled the criteria for enrollment in the study: surgery within 72 hours after the last subarachnoid hemorrhage, and age between 16 and 72 years. All patients who had Hunt and Hess grades of I to III were operated upon; patients who had poor Hunt and Hess grades (IV-V) were operated on according to the surgeon's choice. This treatment regimen was associated with a low incidence of delayed neurological dysfunction with no significant difference between the two dosage groups: three patients (1.5%) remained severely disabled and two (1%) moderately disabled due to vasospasm with or without additional complications. Among the patients with Hunt and Hess grades of IV or V, the long-term outcome was favorable (good-fair) for 40% and unfavorable for 60%. Among the patients with grades of I to III, the long-term outcome was favorable for 89% and unfavorable for 11%.

Dose-Response Relationship, Drug↗
PubMed1990

Ondine's curse with Hirschsprung's disease.

Hirschsprung's disease can be associated with other congenital abnormalities, some of which are neural in origin. A rare association is with congenital failure of automatic control of respiration--central hypoventilation syndrome, sleep apnoea or Ondine's curse. Patients with this combination tend to have a short life expectancy. Diaphragmatic pacing by electrophrenic stimulation has proven useful in management of patients with central hypoventilation. Three children, two females and one male, with this combination are described. The male child, who had total intestinal aganglionosis, died at the age of one month despite an ileostomy and nocturnal mechanical ventilation. The two females had aganglionosis more typical of Hirschsprung's disease, one requiring colostomy. At the ages of 2 and 6 years, respectively, phrenic nerve stimulators were implanted. Both girls remain independent of nocturnal, mechanical ventilation two and three years after commencement of diaphragm pacing. In patients with Ondine's curse and Hirschsprung's disease in whom the aganglionosis can be effectively managed, diaphragm pacing may lead to independence from mechanical ventilation and prolongation of life of an acceptable quality.

Child↗
PubMed1990

Correlation of transcranial Doppler sonography findings with timing of aneurysm surgery.

Thirty-six patients with a proven first subarachnoid hemorrhage (SAH) from a ruptured supratentorial aneurysm were subjected to repeated transcranial Doppler sonography assessments. Eighteen individuals (Group A) were operated on within 48 hours, while the other 18 (Group B) had surgery between 49 and 96 hours after SAH. The patients represented two clinically comparable groups. In the first 72 hours post-SAH, no increased flow velocities suggestive of arterial narrowing or vasospasm were recorded. There was no significant difference in preoperative flow velocities between the groups. Postoperative flow velocities were significantly lower in patients operated on within 48 hours (p less than 0.001). Two patients, who had surgery on Day 4 post-SAH and who showed the highest recorded postoperative flow velocities, died from cerebral vasospasm and infarction. The results favor a referral system which enables early surgical intervention not only to prevent rebleeds but also aimed at reducing delayed ischemic dysfunction.

Adult↗
PubMed1990

Vilhelm Magnus--pioneer neurosurgeon.

In parallel with but completely independent from Harvey Cushing, Norway had its own giant in the establishment of the special field of neurological surgery. Vilhelm Magnus (1871-1929), born in the United States in Fillmore County, Minnesota, was Norway's pioneering neurosurgeon. Following graduation in Oslo, he started his clinical training in neurology and became an early member of the small group of neurologists of the time who were dissatisfied with the therapeutic nihilism generally accepted in relation to diseases of the nervous system. After working with Victor Horsley, whom he held in high esteem. Magnus devoted himself to surgically treatable lesions in the nervous system. During a quarter of a century he single-handedly established the special field of neurological surgery in Norway. Magnus was a far-seeing and brilliant surgeon with a broad intellectual mind, a startling diligence, and wide research activities. He published his first scientific paper in 1899 and his total contribution to the literature amounted to 70 papers. In 1901 he was able to demonstrate the importance of the corpus luteum in the first 3 weeks of pregnancy. As early as 1903 Magnus manifested his interest in the surgical treatment of brain tumors. In 1926 his surgical material comprised 216 patients, with an 8% operative mortality rate among 161 cases of supratentorial tumor versus 17% for 55 cases of infratentorial tumors, including 14 cases of acoustic tumor. Vilhelm Magnus, who visited Harvey Cushing in 1928, has hitherto not been given the attention he merits.

Female↗
PubMed1990

Quinine and quinidine cross-react after systemic photosensitization in the mouse.

Using a protocol for induction of photoallergy in the mouse after systemic administration, quinine was shown to be just as potent a photosensitizer as its d-isomer, quinidine. The dose-response curves for the two isomers followed a similar course both for induction and elicitation. Cross-reaction experiments, where induction and challenge were performed with different isomers, indicated that quinine and quinidine cross-react. Traces of the isomer as a contaminant in the test compound are not likely to account for this cross-reactivity. For practical purposes, photosensitization to one of these two quinoline methanol isomers seems to exclude the future use of the other.

Animals↗
PubMed1990

Systemically induced photoallergy to quinine in the mouse can be elicited topically--and vice versa.

Groups of female albino mice were photosensitized and photochallenged to quinine using protocols for either systemic or epicutaneous administration. Compared with control groups, statistically significant inflammatory reactions, measured as wet weight increase in ear tissue, could be obtained both with systemic and epicutaneous administration. Topically induced photoallergy to quinine could be elicited not only by topical, but also by intraperitoneal administration of the drug, and vice versa. The strongest response at challenge was obtained when the induction was performed topically and the challenge by the systemic route. These data suggest that epicutaneous and systemic photoallergy to quinine have mechanisms in common, and that the route of introduction of the sensitizer into the skin is not the crucial factor. This experimental model may be useful in the elucidation of the mechanisms of systemic photoallergy.

Administration, Topical↗
PubMed1990

Severe phototoxic burn following celery ingestion.

A 65-year-old woman developed a severe, generalized phototoxic reaction following a visit to a suntan parlor. History taking revealed that she had consumed a large quantity of celery root (Apium graveolens) 1 hour earlier. With the use of thin-layer chromatography, methoxsalen (8-methoxypsoralen) and 5-methoxypsoralen were identified in the extract from a similar celery root. The biologic activity of this extract, as evaluated with the semiquantitative Candida albicans inhibition technique, indicated a total psoralen dose of approximately 45 mg. Substantial amounts of psoralen may be absorbed from vegetables, such as celery, and under unusual circumstances, this may constitute a health hazard.

Aged↗
PubMed1989

[Favourable surgery of cervical neck instability in rheumatism].

A team project commenced 20 years ago can now present results of 150 surgical stabilising procedures for cervical neck instability in rheumatoid arthritis. The favourable results indicate widened indications. MR examination demonstrated regression of soft tissue swelling ("pannus") after surgery, which possibly contributed to the good results.

Aged↗