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Biomedical subjects

C Lund

Publications and source records attributed to C Lund.

At least 73 records · Page 4Linked to original sources
PubMed1986

Epidural morphine improves pain relief and maintains sensory analgesia during continuous epidural bupivacaine after abdominal surgery.

Twenty patients scheduled for elective major abdominal surgery were matched into two groups with regard to age, sex, height, body weight, and surgical procedure. Both groups received general anesthesia plus lumbar epidural analgesia with similar loading doses of bupivacaine 0.5% (23.1 +/- 1.0 and 23.3 +/- 0.8 ml) (mean +/- SEM) followed by continuous infusion of plain bupivacaine 0.5% (8 ml/hr) plus, in one group, epidural morphine (0.5 mg/hr). Pain score on a 5-point scale and sensory analgesia (pin prick) were assessed hourly for 16 hours after skin incision. If sensory analgesia decreased more than 5 segments from preoperative levels or if pain scores reached 2 (moderate pain), the patients were removed from the study, and pain was treated with other methods. Preoperative mean (+/- SEM) sensory levels of analgesia were similar in the bupivacaine and the bupivacaine-morphine groups (T3.4 +/- 0.5 and T3.3 +/- 0.4, respectively). In the group receiving only bupivacaine, sensory analgesia regressed over time with a simultaneous increase in pain score. Thus, within 10 hr after skin incision, seven patients in this group were discharged from the study, and 16 hr after incision only one patient maintained initial level of sensory analgesia. In contrast, each patient receiving bupivacaine plus morphine had stable sensory analgesia and was completely free of pain as indicated by a mean pain score of zero during the 16-hr observation period. Thus epidural morphine may improve pain relief and maintain analgesia during continuous epidural bupivacaine administration after abdominal surgery.

Abdomen↗
PubMed1985

Systemic morphine enhances spread of sensory analgesia during postoperative epidural bupivacaine infusion.

Eight patients undergoing abdominal surgery received epidural analgesia with 0.5% plain bupivacaine at a fixed dose rate (8 ml/h) for postoperative pain relief. Mean sensory level of analgesia (pin prick) was assessed hourly and regressed from a mean preoperative level of T3.7 (+/- 0.3 SEM) to T10 (+/- 0.7) at an average of 8.9 +/- 1.4 h post skin incision (range 4-16 h). Simultaneously, pain scores (4-point scale) increased from zero to 2.1 +/- 0.2. When analgesia regressed greater than or equal to 5 segments, administration of 10 mg morphine intravenously led to a pronounced cephalad increase in sensory analgesia; the initial level of analgesia was achieved in every case despite unchanged bupivacaine infusion. Simultaneously, pain score decreased to 0.3 +/- 0.3. This synergistic effect of systemic morphine on the extent of neural blockade with epidural bupivacaine may have an important role in improving postoperative pain relief.

Adult↗
PubMed1985

Bronchial carcinoid tumours. A clinicopathologic study of 82 cases.

A clinical and "blind" histologic review of 82 cases of bronchial carcinoid tumour is presented. The malignant potential of the tumours was only partly predictable from their histologic appearance. Histologically 65 of the tumours were typical benign carcinoids. Regional metastases were found at operation in two of these patients. Fatal carcinoid syndrome with regional and distant metastases appeared in two patients about 1 and 3 years postoperatively. One of the patients with regional metastases at operation is clinically free from carcinoid 12 years later. Malignancy was histologically suspected in 17 cases, in ten of which regional metastases were found at operation. Three of these ten patients are alive 6 to 16 years postoperatively, but two without regional metastases at operation died of local recurrence and distant metastases after 3 to 4 years. Carcinoid syndrome was not seen in these 17 patients. There was one peroperative death. Altogether ten patients (12%) died of recurrence. Among the cases judged at the "blind" histologic review to be suspectedly malignant, the corresponding figure was 50%. For typical carcinoids, conservative resection, including lymph-node metastases, is the treatment of choice. Wedge or sleeve resection with or without pulmonary resection were employed in ten cases. Suspectedly malignant carcinoid tumours may require more extensive surgery.

Adolescent↗
PubMed1984

Navicular bone disease: results of treatment using egg-bar shoeing technique.

Although the diagnostic criteria of navicular disease are generally accepted in practice, their limitations are recognised. However, the authors believe that navicular disease per se is reversible and that only secondary changes like adhesions to the deep flexor tendon or spur formations are irreversible. This hypothesis is supported by the results presented of the effect of the application of an egg-bar shoe, which caused permanent cessation of signs of navicular disease in more than 50 per cent of treated cases. The egg-bar shoeing technique can be usefully applied in practice.

Animals↗
PubMed1983

Pulmonary histiocytomas.

Five cases of pulmonary histiocytomas are presented (four "endobronchial" and one "pulmonary"). They occurred in two children, and three adults over a five year period. Our center has a catchment of 1 million inhabitants. The possible nature and diagnostic possibilities are discussed. The prognosis is good in young people with this disease, which, in principle, does not differ from the same proliferating histiocytic and fibroblastic disorder arising elsewhere. The histological diagnosis was based upon characteristic and consistent morphological features, common to all cases.

Adult↗
PubMed1982

Histological study of navicular bone disease.

A histological investigation of navicular bones from 8 horses with navicular disease was carried out to investigate the aetiology of the radiological findings. Two of the horses were double labelled with tetracycline before slaughter in order to assess the vitality of the diseased navicular bone. The examinations revealed no evidence of loss of vitality in the diseased bone areas or in surrounding tissues. A very high rate of remodelling indicated by resorption and formation of bone was present in all cases. This was shown microscopically by the high number of osteoclasts and osteoblasts present, osteoid formation and particularly by a high rate of intravital uptake of tetracycline by the bone. The findings are considered to indicate that navicular disease is not primarily caused by ischaemia and subsequent necrosis, but rather is a consequence of increased activation of bone remodelling caused by altered pressure from the deep flexor tendon on the bone and increased load on the caudal part of the foot. This is further supported by the clinical changes seen after alterations occur in the hoof conformation. The disease is, therefore, considered to be reversible and may be alleviated by altering the load on the navicular bone by special shoeing. Only secondary lesions such as adhesions and spur formation render the disease irreversible.

Animals↗
PubMed1979

Laryngeal carcinoma. I. Treatment results.

A series of 359 patients with carcinoma of the larynx was found to be very close to being representative of the northern part of Jutland, Denmark (north of Kongeåen). No unequivocal change in the disease as regards sex, age, histology, symptoms and signs, and stage of disease could be observed during the period 1963 to 1972. A not statistically significant improvement in the corrected mortality appeared. The level of complications after irradiation and secondary surgery was found to be low. A statistically significant, better prognosis was found for females than for males in the glottic group.

Adult↗
PubMed1979

Laryngeal carcinoma. II. Analysis of treatment results using the Ellis model.

An analysis of 308 patients with carcinoma of the larynx was performed with respect to local recurrence and complications in relation to treatment level. The patients received primary irradiation with some difference in absorbed dose but with an equal fractionation schedule. Analysed in subgroups, correlations between local recurrence and treatment level were either demonstrated or strongly indicated. This is confirmed in a comparison with approximately 1 500 cases collected from the literature. Correlations between complications and treatment level were not found, but nevertheless indicated with respect to late edemas, which again are supported by comparison with approximately 800 cases collected from the literature. The risk of pharyngo-cutaneous fistula after total laryngectomy seems to be rather independent of irradiation level, although slightly dependent on field size. An optimum level of treatment has been estimated and brought into use since January 1978.

Cobalt Radioisotopes↗
PubMed1979

Laryngeal carcinoma. III. Treatment results in relation to microscopic score.

Long term treatment results for 254 patients with laryngeal carcinoma, primarily treated by irradiation, have been analysed according to a microscopic score, indicating the degree of malignancy. Deaths from carcinoma are significantly correlated to the microscopic score. It is strongly indicated that such correlations also exist for local recurrence/residual tumour and regional lymph node metastases. Therefore it is concluded that the microscopic grading system is a valuable prognostic factor supporting, and additional to, the T.N. classification. Larger series are needed in order to obtain correlations in subgroups, and accordingly primary therapeutic consequences can only be suggested, in doubtful cases.

Carcinoma↗