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Biomedical subjects

C Eriksen

Publications and source records attributed to C Eriksen.

13 recordsLinked to original sources

Videothoracoscopic lung biopsy by a stapling technique.

OBJECTIVES: To describe initial experience with a new technique for obtaining lung biopsy specimens using video-thoracoscopy and Multifire Endo GIA (U.S. Surgical Corporation) stapler. DESIGN: Retrospective study. SETTING: Central hospital, Denmark. SUBJECTS: Nine patients with suspected pulmonary fibrosis. MAIN OUTCOME MEASURES: Diagnosis, morbidity, and mortality. RESULTS: The endoscopic method provided a specimen of lung tissue large enough to secure a reliable diagnosis in all cases. CONCLUSION: The thoracoscopic technique implies less surgical trauma than thoracotomy resulting in less postoperative pain and a better cosmetic result. In patients suitable for general anaesthesia the endoscopic method for obtaining lung tissue specimen seems to be the ideal method.

Adult↗

Recovery from repeated sudden hearing loss with corticosteroid use in the presence of an acoustic neuroma.

Sensorineural hearing loss of sudden onset may be the presenting symptom in up to 14% of patients with acoustic neuroma. We present the first reported case of sudden hearing loss in an only hearing ear with recovery to normal levels after steroid therapy on four separate occasions. Evaluation revealed a 1.5-cm acoustic neuroma. After middle cranial fossa decompression, a fifth episode with recovery after steroid use was documented. A review of the recent literature is presented, emphasizing the possible causation of sudden sensorineural hearing loss with recovery to normal in patients with acoustic neuroma. Modalities of therapy for the dilemma of the acoustic neuroma in an only hearing ear are discussed, including surgery, radiotherapy, and chemotherapy. An aggressive approach to the evaluation of the cause of sudden hearing loss is suggested.

Audiometry, Pure-Tone↗

Diagnosis and management of cleft larynx. Literature review and case report.

Laryngeal cleft is a rare congenital laryngeal anomaly that has been recognized more frequently in recent years. It can be a serious problem, consisting of separation of the arytenoids with a fissure resulting from a defect in the fusion of the posterior cricoid cartilage lamina. Dysphagia with aspiration of food is commonly seen with resultant bouts of pneumonia. Surgical repair has been successful in a handful of cases. This communication will review our institution's recent handling of a case successfully treated. The epidemiology, embryology, classification, diagnosis, and suggested treatment regimen for laryngeal cleft will also be outlined.

Humans↗

Pharmacological manipulation of adynamic ileus: controlled randomized double-blind study of ceruletide on intestinal motor activity after elective abdominal surgery.

In a double-blind placebo-controlled trial of patients undergoing elective abdominal surgery (n = 91), a single intravenous infusion of ceruletide (2.5 ng kg-1 min-1 for 1 hour) resulted in audible bowel sounds in 42/47 patients as opposed to 30/44 receiving placebo (P less than 0.025). Excessive bowel sounds were noted in 16 patients in the ceruletide group and four receiving placebo (P less than 0.01). Significantly more patients (P less than 0.01) in the ceruletide group (22/45 versus 9/44) passed flatus per rectum between the second and third post-operative day. Ceruletide infusion was accompanied by a significant increase in the incidence of nausea and vomiting (P less than 0.005, P less than 0.0025) but these side effects were short-lived. These results indicate that ceruletide is likely to be a useful therapeutic agent for acute intestinal adynamic motility disorders.

Abdomen↗

Perivascular axillary block VII: the effect of a supplementary dose of 20 ml mepivacaine 1% with adrenaline to patients with incomplete sensory blockade.

Perivascular axillary blockade was performed on 233 patients with the aid of a catheter technique. All patients received a primary injection of 50 ml of mepivacaine 1% with adrenaline. Sensory blockade was evaluated 20, 30 and 40 min after injection, and a complete sensory blockade was found in 90 (39%), 131 (57%) and 146 (63%), respectively. The blockade effect of a supplementary perivascular injection of 20 ml of the same agent was investigated on the remaining 87 blockades, which could be divided into three categories: blockades which at 20 min showed lack of analgesia in several cutaneous segments of the hand (34 patients); blockades which at 30 min showed a total lack of sensory blockade within a limited area (29 patients); and blockades which at 40 min showed signs of blockade of all cutaneous segments, but one or several segments were not blocked with an intensity compatible with surgery (24 patients). Blockades of categories 1 and 2 were at 20 and 30 min, respectively, randomly allocated to control or to perivascular supplementation groups, while blockades of category 3 all had supplementation at 40 min. Sensory blockade was reevaluated 10 and 20 min after group allocation, and it was found that perivascular supplementation had no significant effect on the sensory blockade in category 1 and 2, while 68% of the blockades in category 3 improved to a complete blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Perivascular axillary block III: blockade following 40 ml of 0.5%, 1% or 1.5% mepivacaine with adrenaline.

Perivascular axillary blockade was performed on 90 patients with the aid of a catheter technique. All blockades were performed by the same anaesthetist, who practised perivascular axillary blockade three or four times a day. The patients were randomly allocated to three groups. The injected volume of local anaesthetic was constant in each group: 40 ml mepivacaine with adrenaline. The concentration and, consequently, the amount (mg) were variable factors: 1/2% (200 mg), 1% (400 mg) and 1 1/2% (600 mg). Sensory and motor blockade were tested 30 min after each injection. All three groups showed a high incidence of analgesia (70%-100%) in all cutaneous segments, and none of the blockades showed total failure of the sensory blockade. The lowest incidence of sensory blockade was found in the areas innervated by the axillary, the radial and the musculocutaneous nerves, but no difference was found between the groups. However, the motor blockade was found to improve with increasing concentration of local anaesthetic solution.

Adult↗

Haemodynamic effects of calcium chloride administered intravenously to patients with and without cardiac disease during neurolept anaesthesia.

During neurolept anaesthesia, calcium chloride (15 mg/kg) was administered intravenously to two different groups of patients undergoing vascular surgery on the abdominal aorta. The patients in group I all suffered from cardiac disease and were treated with digoxin, while the patients in group II had no cardiac symptoms. Cardiovascular measurements were made during steady-state anaesthesia. In group I, CaCl2 increased cardiac index (CI) significantly while systemic vascular resistance index (SVRI) remained unchanged. Mean arterial pressure (MAP) increased. In group II, both MAP and SVRI increased while CI remained unchanged. No significant changes in heart rate were observed and no arrhythmias occurred. It is concluded that CaCl2 administered intravenously is an effective means of improving cardiac function when it is depressed by anaesthesia, underlying cardiac disease, or both.

Aged↗

Perivascular axillary block. I: blockade following 40 ml 1% mepivacaine with adrenaline.

Perivascular axillary block was performed on 80 patients by a catheter technique. All patients had a standard dose of 40 ml mepivacaine 1% with adrenaline. Thirty minutes after the injection, the motor and sensory blockade was determined. Eighty-six per cent of the patients had a distinct motor blockade, whereas the remaining 14% had only a slight motor blockade. The sensory blockade was complete in 63%, whereas 37% had lack of analgesia in one or several cutaneous areas. Lack of analgesia was most often found in the cutaneous area of the axillary, musculocutaneous and radial nerves. The frequency of analgesia in the three areas of innervation was analysed with reference to the influence of the age, height and weight of the patient, and of differences in technique: paraesthesias, position of catheter, and unintended puncture of blood vessels. None of these variables seems to be important for the low frequency of analgesia in the three areas of innervation.

Adolescent↗

Vagal paragangliomas: a report of nine cases.

Vagal paragangliomas are rare tumors of neural crest origin: fewer than 175 cases have been reported in the English literature. This slow-growing tumor occurs most often at the base of the skull in the parapharyngeal space, but may arise anywhere along the course of the vagus nerve and its branches. Nine clinical presentations and the surgical outcome in seven patients with vagal paragangliomas treated at our institution are reported. A review of the literature, emphasizing evaluation and treatment of these potentially fatal neoplasms, is discussed. Surgical removal is the treatment of choice with vagal tumors. Complications related to the ablation or injury of cranial nerves IX, X, XI, and XII are commonly seen. Surgical techniques that may prevent injury to these vital neural structures are outlined. The postoperative treatment of patients with impaired deglutition secondary to multiple cranial neuropathies is discussed.

Adult↗