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Biomedical subjects

B Ljunggren

Publications and source records attributed to B Ljunggren.

At least 127 records · Page 7Linked to original sources
PubMed1983

Temporary clipping during early operation for ruptured aneurysm: preliminary report.

Temporary arterial occlusion was performed in 16 patients undergoing early aneurysm operation. Ten patients had a ruptured middle cerebral artery (MCA) aneurysm, and 6 had a ruptured anterior communicating artery aneurysm. Premature aneurysm rupture during operation necessitated temporary arterial occlusion in 10 patients. In 5 patients, temporary arterial occlusion was performed to facilitate dissection of the aneurysm. In 1 patient with a large MCA aneurysm, temporary occlusion was performed to provoke collapse of the completely exposed aneurysm sac, thus making clipping of the base possible. The results do not indicate that temporary occlusion by the standard aneurysm clips now in general use leads to angiographically detectable arterial wall changes or increased thromboembolic complications. Temporary clipping of the MCA proximal to the perforating arteries may be well tolerated for up to 20 minutes during early aneurysm operation. Temporary occlusion of one or both anterior cerebral arteries or temporary pericallosal clipping need not unconditionally lead to disastrous consequences if rendered necessary during aneurysm operations performed in the acute stage.

Adult↗
PubMed1983

Causes of unfavorable outcome after early aneurysm operation.

In a consecutive series of 160 patients in Hunt and Hess Neurological Grades I to III who were operated upon for a ruptured supratentorial aneurysm within 3 days after the hemorrhage, 42 patients (26%) had an unfavorable outcome. Delayed ischemic cerebral dysfunction with permanent deficit accounted for the unfavorable outcome in 18 patients (43% of all unfavorable results or 11% of the total series), whereas the unfavorable outcome was due to deficit ascribed to surgical trauma in 11 patients (26% of all unfavorable results or 7% of the total series) and to the initial hemorrhage in 7 patients (17% of all unfavorable results or 4% of the total series). Impaired outflow of cerebrospinal fluid with shunt dependency occurred in 3% of the total series. Of the patients with an unfavorable outcome, 17 (40%) had had arterial hypertension before the hemorrhage. The incidence of unfavorable outcome in good grade patients (Grades I and II) was not influenced by timing of operation (Day 1, 2, or 3 after hemorrhage). The results favor the opinion that it is principally the patient's condition during the acute stage that determines the outcome. (Neurosurgery 13:629-633, 1983).

Acute Disease↗
PubMed1982

The outcome in 100 consecutive cases of early aneurysm surgery.

A retrospective study has been carried out on 100 consecutive patients undergoing direct surgery for ruptured aneurysms of the anterior part of the Circle of Willis within 3 days following subarachnoid haemorrhage. All patients were preoperatively in neurological Grades I, II or III. 76% of the patients made a good recovery whilst the morbidity was 10% and the mortality 14%. The results are compared with the estimated results of delayed treatment as well as with the natural history of the disease. The incidence of hydrocephalus requiring a shunt procedure was 2% and the incidence of permanent ischaemic deficits of delayed onset 16%.

Adolescent↗
PubMed1982

Early management of aneurysmal subarachnoid hemorrhage.

The Lund Clinic serves a population of 1.46 million inhabitants. During the calendar year 1981, 72 patients presented with a ruptured supratentorial aneurysm, diagnosed either at angiography or at autopsy. Upon admission, 60% of the patients were in good condition and 40% were in poor condition. Eighty-three per cent were admitted within 72 hours after the subarachnoid hemorrhage (SAH). In the total series, 50% made a good recovery; the overall management morbidity was 19% and the management mortality was 31%. Thirty-one patients in Grades I-III underwent early operation (43% of the total series), with a favorable outcome in 74% and 7% mortality. Of the 35 patients who were admitted early and in good condition, 71% made a good recovery, and the management mortality was 9%. These figures may be compared to the 51% favorable outcome and 27% mortality reported from the Cooperative Aneurysm Study with late operation. In the early operation cases, the incidence of significant arterial narrowing at postoperative angiography performed on Day 9 +/- 2 after SAH was 30% and the incidence of permanent neurological deficits of delayed onset was 10%. Two of the early operation patients developed permanent symptomatic hydrocephalus.

Adult↗
PubMed1982

The case of General Wood.

The first successful operation ever on a parasagittal meningioma was performed in 1910 by Harvey Cushing. The operation turned out to be critical event in his career as a neurosurgeon and made him confident about the possibilities of brain surgery. The patient was Leonard Wood, Major General and Chief of Staff of the United States Army, who was a military surgeon turned career officer. In the election campaign or the president to succeed Woodrow Wilson in 1920, Leonard Wood, the personification of competence, became the Republican favorite. General Wood was, however, eliminated from the presidential election campaign by complicated intrigues. From the next year on, General Wood experienced increasing warning signs of a recurrent tumor, which he unfortunately neglected. Not until 1927 did Wood again come under the care of Dr. Cushing, who had just returned from Britain, where in the course of a single month he had been awarded no less than seven distinctions from different medical societies. Deeply concerned at Wood's condition. Cushing decided to attempt extirpation of the recurrent tumor. General Wood died a few hours after the operation. No tragedy caused Cushing more distress than the death of General Wood, who 7 years earlier had been on the verge of being President of the United States.

History, 19th Century↗
PubMed1981

Effects of extracellular calcium and of calcium antagonists on the contractile responses of isolated human pial and mesenteric arteries.

In isolated human pial arteries (diameter 0.4-0.5 mm), contractions were produced by potassium, noradrenaline, serotonin, and prostaglandin F2 alpha. For comparison, experiments were also performed on human mesenteric arteries. Threshold concentration for potassium-induced contraction in pial arteries was about 10 mM; in mesenteric arteries it was 3-5 mM higher. In pial arteries the calcium antagonists nifedipine and nimodipine caused an almost complete relaxation of contractions induced by potassium at drug concentrations relaxing prostaglandin F2 alpha-contracted vessels to only about 60%. Both nifedipine and nimodipine effectively inhibited contraction elicited by noradrenaline and serotonin in pial arteries. Nifedipine had a higher potency for relaxing cerebral than mesenteric arteries contracted by potassium (p less than 0.001). No such difference was demonstrated for nimodipine. In pial arteries pretreated in a calcium-free medium for 30 min, potassium depolarisation elicited contractions reaching a maximum amplitude of about 40% of that evoked in normal Krebs solution. Both nifedipine and nimodipine effectively inhibited contractions induced by calcium in pial arteries pretreated in a calcium-free medium and depolarised by potassium. The results suggest that potassium, amines, and prostaglandin F2 alpha activate isolated pial and mesenteric arteries by different calcium-dependent mechanisms and confirm the potent relaxant effects of nifedipine and nimodipine in these vessels.

Calcium↗
PubMed1981

Dose-response relations in phototoxicity due to 8-methoxypsoralen and UV-A in man.

Serum levels and skin photosensitivity following different oral doses of 8-methoxypsoralen (8-MOP) were studied in 8 healthy volunteers. Two hours after ingestion of drug, serum levels of 8-MOP determined by high pressure liquid chromatography correlated well with oral dose. Serum concentrations after 8-MOP doses of 0.3, 0.6 and 0.9 mg/kg bodyweight were 25.9 (+/- 7.2), 148.9 (+/- 24.4) and 311.4 (+/- 55.6) ng/ml (mean and SEM) respectively. The minimal phototoxic dose (MPD) of UVA 2 hr after ingesting 8-MOP was determined in 6 volunteers for each of the 3 before-mentioned 8-MOP doses. The UV-A doses correlated inversely with the serum level for each individual (r = 0.92 +/- 0.02 SEM). For higher 8-MOP doses the numerical product of UV-A dose and 8-MOP serum concentration in each individual tended to be constant, indicating a reciprocal relationship between 8-MOP and UV-A doses in this interval. This did not hold true for the lowest 8-MOP-dose. These data confirm the relevance of using 8-MOP blood level determinations in monitoring psoralen-UV-A phototoxicity.

Adult↗
PubMed1981

Contact dermatitis to estradiol benzoate.

Three patients developed facial dermatitis after contact with preparations containing estradiol benzoate. Patch tests were positive to estradiol benzoate 0.1% in MEK but negative to other related estrogens including estradiol. All three patients also had positive tests to resorcinol monobenzoate and two out of three to balsam of Peru. Most likely estradiol benzoate was the primary sensitizer.

Adult↗