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Biomedical subjects

C Thorén

Publications and source records attributed to C Thorén.

12 recordsLinked to original sources

Repair of complete atrioventricular canal. 15 year's experience.

Corrective surgery for complete atrioventricular canal was performed over a 15-year period on 72 patients, 49 of whom had Down's syndrome: 46 were without major associated cardiac anomalies and 15 had previously undergone pulmonary artery banding. The pressures in the right and left ventricles equilibrated in 77% of the patients. The early mortality rate was 18% and the late mortality 7%. At follow-up 4% of the patients had severe mitral incompetence and 6% had severe tricuspid incompetence. The mean reduction of pulmonary artery pressure was 40 mmHg. The mean peak systolic pressure ratio between pulmonary artery and aorta was 0.73 before repair and had fallen to 0.38 at follow-up catheterization, when 88% of the patients were asymptomatic. Early repair in the first year of life is nowadays preferred in order to avoid progressive pulmonary vascular disease. Although the alternative of first-stage pulmonary artery banding gave lower (13%) mortality at the corrective operation, it cannot be recommended if atrioventricular valvular incompetence is significant.

Cardiac Catheterization

Function and dimensions of the circulatory system in anorexia nervosa.

The functional and dimensional components of the oxygen transporting system was studied in 17 female and 11 male patients suffering from anorexia nervosa. Both groups were 14.9 years old, on average, and had lost about 25% of their weight. Measurements at rest included blood and heart volume, heart rate, blood pressure, oxygen uptake (VO2), RQ, blood lactate (LA) and in 6 of the patients cardiac output. During bicycle ergometry the determinations of heart rate, blood pressure, LA, VO2 and cardiac output were repeated and maximal aerobic power was determined. A low metabolic rate with bradycardia and hypotension was apparent at rest. Blood and heart volume was decreased proportionally to the weight loss. On a given work load VO2 was lowered to the same extent as the resting metabolic rate. At maximal effort VO2 was reduced out of proportion to the circulatory dimensions and maximal heart rate was low. During exercise cardiac output was normally related to VO2 and stroke volume was maintained, indicating a normokinetic circulation and an unimpaired myocardial function. The main cause of the low maximal aerobic power seems to be the reduced muscle mass.

Adolescent

Limb circulation in anorexia nervosa.

Blood flow, skin temperature and blood pressure of the lower limbs and the effect of indirect, radiant heat on calf blood flow and leg skin temperature was determined in sixteen children with anorexia nervosa (group A) and fourteen healthy children (group H) of the same age and body height. Calf blood flow as measured by venous occlusion plethysmography. Arm blood pressure was obtained by tourniquet and toe pressure and digital plethysmograms by a strain-gauge. Skin temperature was measured with a thermocouple. In group A calf blood flow was about 50--60% lower than the mean values observed in group H and a marked difference was maintained after the heat load. Skin temperature of the knees and toes were higher in group H. Systolic arm blood pressure and toe pressure were on the average 20 mmHg and 13 mmHg lower in group A. It is suggested that there is a heat-conserving, selective peripheral vasoconstriction in the anorexic patients.

Adolescent

Total body potassium fat free weight and maximal aerobic power in children with anorexia nervosa.

Body composition and aerobic work performance have been studied in 5 boys and 10 girls suffering from anorexia nervosa. The average ages of the two groups of children were 15.4 (boys) and 15.2 (girls) years respectively. Measurements of body composition included height, weight (W), body potassium (40K), skinfold thickness (SFT) at triceps and subscapularis, blood volume (BV) and femoral condylar and radioulnar breadths. From these measurements estimates of fat free weight (FFW), skeletal weight (S) and lean body mass (LBM) were made. Work performance was assessed by measurement of the maximal aerobic power (VO2 max). The patients had lost on average 26% of their former body weight. The boys had on average greater than 7% of their body weight as fat compared with greater than 9% in the girls. However, the loss of weight was not solely due to loss of body fat, but could also be ascribed to a decrease in soft fatfree tissue. LBM or FFW could be estimated as well from SFT as from 40k. vo2 max averaged 1.43 1/min (35.1 ml/kg/min) in the anorexic boys and 1.24 l/min (33.2 ml/kg/min) in the girls and was associated with FFW and LBM. However, VO2 max was lower in relation to LBM than in healthy children of the same age. Thus it was suggested that the emaciation in anorexia is directly attributable to loss of both fat and muscle and accounts in part for the reduction of aerobic power observed. However, an important factor may be the debilitating effect of starvation on the patient, particularly in its advanced and later stages, which reduces his/her level of habitual physical activity.

Adolescent

Long-term effect of previous swimtraining in girls. A 10-year follow-up of the "girl swimmers".

Thirty girls, studied in 1961 after 2.5 years of intensive swimtraining, were the subject of a follow-up for ten years. When last examined, seven and ten years after the original study, all the girls had given up swimtraining. The increased values for vital capacity observed in 1961 remained unchanged, but residual volume, functional residual capacity and total lung capacity showed small increases even after corrections for body growth. Such increases are, however, normal in these years. Heart volume which was high originally, was found to be lower ten years later, although mean values were still higher than normal. The decreases seen from 1961 to 1971 could mainly be ascirbed to a decrease in the subjects with the larges hearts originally. Both total hemoglobin and blood volume decreased to normal values in relation to body size. Maximal oxygen uptake, though, fell from 2.80 l/min (51. 4 ml/kg X min) to 2.18 l/min (36.4 ml/kg X min) ten years later. It is suggested that the functional capacity of the cardiovascular system declined more markedly than its dimensions.

Adolescent

Exercise testing in children.

Exercise testing has a definite role in pediatrics today. Different methods are presented, and the value of maximal exercise with determination of oxygen uptake and blood lactate is stressed. In children with heart disease, exercise testing with precordial electrocardiogram can be of both diagnostic and prognostic value. The cardiovascular function at different intensities of exercise is evaluated, serious dysrhythmias may be revealed, hypertension judged and the effect of drug therapy can be checked by exercise testing. It is an important way in assessing the child's functional capacity after heart surgery in the decision whether she or he should take part in physical education and sports activities and in the choice of profession. It is also of great psychological value to the parents and the patient himself. In children with other chronic diseases, e.g., diabetes, obesity, asthma, neurocirculatory dysfunctions--physical training together with exercise testing is of importance for therapy and rehabilitation.

Adolescent

Spontaneous rupture of a congenital diverticulum of the right ventricle in a 1-month-old child.

Spontaneous rupture of a thin fibrous congenital subepicardial diverticulum of the right ventricle of the heart resulted in a sudden death of an 1-mth-old child. Heart catheterization with angiocardiography at 1 and 2 wk of age revealed a truncus arteriosus type A 1 with a small frontal outbulging in the level with the outflow of the right ventricle, interpreted as a blind infurdibular chamber. At autopsy this outbulging was identified as a congenital fibrous diverticulum of the right ventricle. Death was due to rupture of the diverticulum and hemopericardium. The case motivated a reviewing of the literature dealing with congenital diverticula of the right ventricle of the heart, as well as a discussion of problems with the diagnosis of the diverticulum.

Diverticulum