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Biomedical subjects

C A Carlsson

Publications and source records attributed to C A Carlsson.

At least 19 recordsLinked to original sources
PubMed1989

The neurogenic overactive bladder. Classification based on urodynamics.

The aetiology and pathogenesis of bladder overactivity are very variable and the classification is rather crude. By careful interpretation of clinical findings and urodynamic assessments, refinement of the diagnosis is possible. From a therapeutic and prognostic stand-point, it is of interest to distinguish between "idiopathic detrusor instability" and the "uninhibited overactive bladder". Based on neurological investigation and cystometric recordings, including the ice water test, characteristics of the 2 entities are described.

Adult↗
PubMed1988

Epidural spinal electrical stimulation in severe angina pectoris.

The short term effects of epidural spinal electrical stimulation were studied in 10 patients with angina pectoris of New York Heart Association functional class III or IV. The antianginal pharmacological treatment given at entry to the study was regarded as optimal and was not changed during the study. The effects of epidural spinal electrical stimulation were measured by repeated bicycle ergometer tests. Treatment with epidural spinal electrical stimulation increased the patients' working capacity, decreased ST segment depression, increased time to angina, and reduced the recovery time. The observed effects did not seem to be correlated with any changes in myocardial oxygen demand during epidural spinal electrical stimulation and were additional to the benefits of the pharmacological treatment.

Aged↗
PubMed1987

Surgical and conservative treatment of cervical spondylotic radiculopathy and myelopathy.

One hundred and fourteen patients were admitted to our department for evaluation of their cervical spondylogenetic symptoms, including local cervical pain, radiculopathy and myelopathy. This retrospective study gives the results, expressed as improved, unchanged or worse, of anterior surgery, posterior surgery and conservative treatment. Local cervical pain improved in about half of the patients, without any difference between the groups. The effect of surgery on radiculopathy was superior to that of conservative treatment, 71 percent and 74 percent respectively, being improved after anterior and posterior surgery, compared to 19 percent in the conservatively treated group. The majority of patients with myelopathy were treated with posterior surgery and 69 percent had improved. The results were not influenced by the patients age or the duration of symptoms. It is argued that the positive effects of surgery on the radiculopathy are due to a segmental stabilisation rather then to decompression. The immediate post-operative improvement of the myelopathy is undoubtedly caused by the decompression while the long-termed improvement cannot with certainty be attributed to the operation.

Adult↗
PubMed1987

Long-term results by epidural spinal electrical stimulation (ESES) in patients with inoperable severe lower limb ischaemia.

Arterial reconstruction is the treatment of choice for patients with severe lower limb ischaemia, but may at times be technically impossible. Thirty-two consecutive patients with impending (n = 24) or already established (n = 8) distal arteriosclerotic or diabetic lower limb gangrene, in whom vascular surgery was either technically impossible or had failed, were treated with epidural spinal electrical stimulation (ESES) for 27 +/- 16 (S.D.) months. All patients had severe rest pain, which was reduced by ESES in 91% of the cases. Improved ulcer healing was noted in 58% of the patients who had skin ulceration. Eighty-three percent of those patients who did not have established gangrene when ESES was started, retained their leg after 1 year, and 54% after 3 years. These results suggest that ESES often provides pain relief and improves skin healing in patients with impending arteriosclerotic or diabetic gangrene in whom vascular surgery is impossible or has failed. Epidural spinal electrical stimulation (ESES) does not affect the progression of established gangrene but may provide pain relief. The observed outcome of severe limb ischaemia in this study could be used to compare with those after arterial reconstruction performed in patients with poor run-off vessels, and may allow us to examine the natural history of this disease when adequate pain relief is provided. The results reported here and the previously reported enhancement of cutaneous blood flow in severely ischaemic extremities by ESES may suggest, that ESES enhances limb salvage by improving skin blood flow.

Aged↗
PubMed1987

Treatment of spinal cord injuries in the thoracolumbar region.

Forty patients with spinal cord injuries in the thoracolumbar region were studied. Clinical and experimental data support the conservative approach. In some patients acute stabilisation is needed and in a few patients operative decompression may be considered. Promising experimental non-invasive techniques to improve recovery are presented, but there are no convincing clinical results so far. The authors believe that regeneration will be the key area for future research.

Early Ambulation↗
PubMed1986

Contelle: pelvic floor stimulator for female stress-urge incontinence. A multicenter study.

The clinical efficacy of a new device for treatment of female incontinence was studied in a multicenter trial. The device consists of an inflatable electrode carrier and an external stimulator unit. Forty women were treated: 10 had primary or recurrent genuine stress incontinence, 15 had urge incontinence due to idiopathic detrusor instability, not responding to drug treatment, and 15 had stress incontinence combined with detrusor instability. Twenty-five patients were improved by the treatment. Another 8 reported an excellent result of treatment and remained free of symptoms for more than six months after withdrawal of the treatment. The results were more favorable in patients with bladder hyperactivity than in genuine stress incontinence. The patients' general ratings of treatment efficacy correlated well with their recordings of urinary frequency and consumption of incontinence pads. The functional bladder capacity increased in improved patients, but normalization of urodynamic parameters was no prerequisite for clinical improvement. We found intravaginal electrical stimulation to be a valuable alternative to medical and surgical intervention in patients with detrusor instability.

Adult↗
PubMed1986

Generalised use of contrast degradation and contrast improvement factors in diagnostic radiology. Application to vanishing contrast.

Although field area and object thickness are important parameters in comparisons of techniques for optimal reduction of scattered radiation to the image, they are in practice seldom varied. For this reason, we suggest that contrast degradation (CDF) and contrast improvement (CIF) factors be more frequently used and appropriately defined to make the dependence of CDF and CIF on field area (collimation) and object thickness (compression) explicit. Definitions are formulated and the results of experiments and Monte Carlo calculations (comprising effects of collimation, compression, air gap, antiscatter grid, detector thickness) cited to illustrate their usefulness. Currently used expressions for CIF (derived assuming monoenergetic radiation) lack a factor to account for the change in primary contrast caused by the antiscatter method when this affects the energy distribution of the transmitted primary photons (grids and compression) or the fractions of photon energy imparted to the detector (when comparing different detectors). Values of this factor are calculated for some cases. Also, the appropriate choice of physical quantity to be used in the formulae for CDF and CIF is discussed. The energy imparted to the detector is advocated since this is directly related to the detector signals forming the image on, e.g. the x-ray film.

Humans↗
PubMed1986

Relations between effective dose equivalent and mean absorbed dose (energy imparted) to patients in diagnostic radiology.

Values of HE/D, the ratio of the effective dose equivalent HE to the mean absorbed dose D to the total body, have been derived as a function of beam quality (HVT) for a variety of Roentgen diagnostic examinations of the adult trunk and head, using tabulations from the literature. Problems in specifying beam quality are discussed. The energy epsilon imparted to the patient can, in Roentgen diagnostic examinations, be determined using a transmission chamber. Since, however, HB/epsilon depends more critically than HE/D on the mass M of the patient (D = epsilon/M), the latter quantity is preferred for risk assessment. HE/D takes values in the range 0.44-2.8 Sv Gy-1. This includes the value 1 Sv Gy-1 resulting from a uniform whole-body irradiation independent of M. The corresponding value of HE/epsilon = 1/M Sv J-1 if M is in kg. It is therefore recommended that clinical measurements of epsilon be supplemented by measurements of the patient's mass so that D = epsilon/M can be estimated and tabulations of organ absorbed doses be supplemented with values of D so as to allow accurate derivation of the ratio HE/D. In optimising the technical parameters of a given examination using the transmission chamber, HE/D as a function of beam quality must be known.

Humans↗
PubMed1986

Serum immunocomplexes in patients with subarachnoid hemorrhage.

Immunocomplexes (IC) in serum were analyzed in 54 patients with subarachnoid hemorrhage (SAH) from ruptured arterial aneurysms. A previous study had shown that patients with SAH and vasospasm had a significantly higher incidence of ICs in the blood than patients without vasospasm. The aim of the present study was to study how the IC content varied with time and compare this pattern with the clinical picture. Forty-two patients presented clinical or radiological signs of cerebral vasospasm during their hospital stays, whereas 12 patients showed no such signs. The patients with vasospasm had a significantly higher amount of ICs in serum than those without vasospasm. In 37 patients with vasospasm, the changes of IC content during the 1st weeks after SAH correlated well with the clinical course. Data indicated that a high IC content preceded the onset of vasospasm and a low content preceded clinical improvement. This observation supports the idea that the presence of ICs might be the cause and not the result of vasospasm.

Adult↗
PubMed1985

Epidural electrical stimulation in severe limb ischemia. Pain relief, increased blood flow, and a possible limb-saving effect.

Peripheral vascular disease of the extremities causes ischemic pain and, at times, skin ulcerations and gangrene. It has been suggested that epidural spinal electrical stimulation (ESES) could improve peripheral circulation. Since 1978 we have used ESES in 34 patients with severe limb ischemia; all had resting pain and most had ischemic ulcers. Arterial surgery was technically impossible. Twenty-six patients had arteriosclerotic disease, one had Buerger's disease, and seven had severe vasospastic disorders. Ninety-four per cent of the patients experienced pain relief. ESES healed ulcers in 50% of those with preoperative nonhealing skin ulcerations. Seventy per cent of the patients showed improved skin temperature recordings. Only 38% of the stimulated arteriosclerotic patients underwent amputations during a mean followup period of 16 months, as compared to 90% of a comparable group of unstimulated patients. ESES is very promising in severe limb ischemia where reconstructive surgery is impossible or has failed.

Adult↗
PubMed1985

The effects of transcutaneous electrical nerve stimulation in patients with severe angina pectoris.

The pain-relieving effects of transcutaneous electrical nerve stimulation (TENS) were investigated in patients with severe angina pectoris first with respect to systemic and coronary hemodynamics and myocardial metabolism during pacing-induced angina and second in a controlled long-term study. Two series of patients with severe angina pectoris (NYHA class III to IV) were studied (13 patients in the pacing study and 23 in the long-term study). In the pacing-induced angina study there was increased tolerance to pacing (142 +/- 23 compared with 124 +/- 20 beats/min tolerated, p less than .001), improved lactate metabolism (2 +/- 36% compared with -18 +/- 43%, p less than .01), and less pronounced ST segment depression (2.3 +/- 1.1 compared with 2.9 +/- 2.6 mm, p less than 0.05) with TENS. In the long study the effects of TENS were measured by means of repeated bicycle ergometer test, frequency of anginal attacks, and consumption of short-acting nitroglycerin. TENS was used regularly for 1 hr three times per day. The TENS treatment group had increased work capacity (637 +/- 308 vs 555 +/- 277 W . min, p greater than .001), decreased ST segment depression (2.3 +/- 1.1 vs 3.6 +/- 1.6 mm, p less than .001), reduced frequency of anginal attacks (p less than .05), and reduced consumption of short-acting nitroglycerin per week (p less than .05) compared with the control group. The observed effects were mainly due to decreased afterload resulting from systemic vascular dilatation.

Adult↗
PubMed1985

Painful scars after thoracic and abdominal surgery.

Painful scars after thoracic or abdominal surgery were treated in 37 patients with various methods, including analgesic block, transcutaneous nerve stimulation (TNS), neurotomy, scar resection, epidural spinal electrical stimulation and thermocoagulation. At follow-up, three patients were free from pain and three experienced significantly less pain as a result of the treatment. In two other patients the pain had spontaneously diminished. The results indicate that surgery on peripheral structures is not effective, which suggests that the source of the pain is to be found in central structures. The authors advocate conservative measures such as blockade, TNS and physiotherapy in combination with psychologic support.

Abdomen↗
PubMed1979

Relationships between energy fluence and energy incident on, emitted by or imparted to a body.

From knowledge of the energy and angular distribution of the fluence around a body, the energy incident on, emitted by or imparted to a body can be calculated. The calculation is easily performed if the quantity 'vectorial fluence' is used. Examples taken from the literature are used to illustrate the erroneous results obtained by integrating energy fluence over area instead of integrating the scalar product of vectorial energy fluence and vectorial area.

Energy Transfer↗
PubMed1979

Effect of dorsal column stimulation on pain-induced intracerebral impulse patterns.

Evoked electrical potentials were recorded via intracerebral electrodes in a patient with stump and phantom limb pain who had a previously implanted dorsal column stimulator. When pain was elicited by peripheral stimulation it was found that positive deflections appeared in the ventrolateral nucleus of the thalamus at time latencies corresponding to the propagation velocities of A delta- and C-fibres. Dorsal column stimulation completely eliminated the C-fibres. Dorsal column stimulation completely eliminated the C-fibre deflection and partially eliminated the A delta-fibre deflection.

Adult↗