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Biomedical subjects

F Efsen

Publications and source records attributed to F Efsen.

At least 55 records · Page 3Linked to original sources
PubMed1979

DC-conversion of atrial fibrillation after mitral valve operation. An analysis of the long-term results.

In a prospective study comprising 43 patients with atrial fibrillation after mitral valve surgery, an evaluation was made of the prognostic significance of clinical, radiological, haemodynamic and operative factors for the maintenance of sinus rhythm after DC-conversion. Atrial fibrillation with a duration of less than 12 months proved to be the only single factor of significance for sustained sinus rhythm after 12 months and it is suggested as a simple clinical criterion for selection of patients for DC-conversion after mitral valve operation.

Adult↗
PubMed1979

Anomalous pulmonary venous drainage from the left lung to the right atrium. Successful surgical treatment in an 11-year-old girl.

An 11-year-old girl with anomalous pulmonary venous drainage from the left lung to the right atrium was corrected by anastomosing the anomalous trunk to the left auricular appendage. Postoperatively she developed a left-sided chylothorax which resolved on medical treatment. A postoperative angiocardiography one year after surgery showed a well-functioning anastomosis.

Cardiac Catheterization↗
PubMed1979

Cervical aortic arch with ventricular septal defect. A differential diagnosis from interrupted aortic arch.

A case of right cervical aortic arch with a large ventricular septal defect and a bicuspid aortic valve is reported. The angiographic diagnosis was interruption of the aortic arch type II, with aberrant right subclavian artery, a closed ductus arteriosus and retrograde vertebral-subclavian flow to the descending aorta. The cervical arch, demonstrated post mortem, was located high and deep in the neck. This differential diagnosis may have potential importance, as reported experience shows that a surgical aortic anastomosis is not required in cervical aortic arch.

Aortic Arch Syndromes↗
PubMed1978

Non-operative treatment of retained bile duct calculi in patients with an indwelling T tube.

The results of combined instrumental and chemical treatment of retained bile duct calculi in 18 patients with an indwelling T tube are reported. The instrumental extraction of stones was carried out through the T tube channel using a modified Dormia apparatus. The chemical method involved continuous infusion through the T tube of heparin in saline alternating with sodium cholate. The treatment was successful in 16 of 18 patients with from 1 to 14 residual stones. The instrumental extraction of stones is recommended as the treatment of choice 5--6 weeks after choledochotomy in patients with residual stones and an indwelling T tube. Subsequent chemical treatment is recommended if remnants of stones are left in the bile duct after instrumental treatment.

Adult↗
PubMed1978

Phlebography in long-term catheterization of the subclavian vein. A retrospective study in patients with severe gastrointestinal disorders.

The frequency of superior central venous thrombosis was studied in a consecutive retrospective series of 27 patients with severe gastrointestinal disorders in whom long-term catheterization of the subclavian vein for parenteral nutrition was carried out. The patients had 35 periods of catheterization ranging from 14 to 766, mean 86, days and a total of 51 catheter periods. Only one patient showed clinical signs of thrombosis in spite of phlebographic findings revealing seven cases of central venous thrombosis. Recanalization was not seen. Exchange of catheter was performed 17 times in 10 patients using the Seldinger technique. This did not influence thrombosis rate. Septicaemia was found in five patients subsiding after catheter exchange. No fatalities occurred, and no correlation between the septicaemia and thrombosis rate was found. Catheters used for more than 100 days showed changes of mechanical properties. It is therefore advisable to exchange catheters after 3 months' use by the Seldinger technique. The discrepancy between the clinical and phlebographic findings emphasizes that repeated subclavian catheterization should be preceded by bilateral phlebography.

Adult↗
PubMed1978

Congenital apical aneurysm of the left ventricle: surgical removal in two infants.

The case histories are described of 2 infants, representing either type of congenital apical left ventricular aneurysm. Case 1 had a finger-like, pulsatile, actively contracting aneurysm which was associated with a split distal end of the sternum and a ventral hernia. In contrast to most of the 55--60 cases hitherto described, no other cardiovascular anomalies were detected at heart catheterization with angiocardiography. The aneurysm was resected at the age of 23 days. Postoperative angiocardiography demonstrated a normal-sized left ventricle with good contractions and no residual aneurysm. He was last seen at the age of 15 mth, doing well. Case 2 had a noncontractile aneurysm and congenital pyloric stenosis, which hitherto has not been found in association with this type of aneurysm in the about 20 reported cases. The aneurysm was resected at the age of 9 mth; the estimated reduction of the left ventricular cavity was 20%. 1 yr after operation the patient was doing well, but the chest roentgenogram was unchanged and at angiocardiography the left ventricular appearance was largely unchanged compared to the preoperative findings. He was last seen at the age of 2 yr, doing well. The long-term prognosis in the latter type of aneurysm has still to be elucidated.

Angiocardiography↗
PubMed1977

Percutaneous transhepatic cholangiography in diagnostic evaluation of 160 jaundiced patients. Results of an improved technic.

Percutaneous transhepatic cholangiography (PTC) was carried out in 160 patients with jaundice in whom the diagnosis could not be established by means of conventional methods of investigation. In PTC, selective catheterization of the common bile duct was employed and cholangiograms of high quality were obtained. In patients with obstruction of the biliary passages, the catheter was left indwelling centrally in the biliary passages for external bile drainage. The investigation, thus, did not necessitate immediate operation in these patients. PTC was successful in 113 of the 115 patients with obstructive jaundice. In forty-five patients the suspicion of obstruction could be discharged. Normal biliary passages were demonstrated in twenty-six patients. In nineteen patients it was impossible to cannulate the biliary tree and this was tantamount to nonobstructive jaundice. Complications occurred in six patients, but were not exclusively due to PTC. PTC provides a possibility for differentiation between obstructive and nonobstructive jaundice and thereby laparotomy can frequently be avoided. The incidence of complications may be maintained at an acceptable, low level provided the technic is meticulously observed.

Biliary Tract Diseases↗
PubMed1977

Natural history of vascular ring with clinical manifestations. A follow-up study of eleven unoperated cases.

A clinical follow-up study was performed in 11 unoperated patients with symptoms due to vascular ring. The age at diagnosis was 2-48 months (mean 13 months); 7 of the patients were less than 12 months old. The follow-up time varied between 1 and 22 years (median 7 years). Nine patients were entirely free of symptoms, which they had outgrown in the course of 1-2 years after the diagnosis was made; none of these 9 had symptoms after the age of 4 years. Two patients had symptoms due to either oesophageal compression or to severe associated neuromuscular lesions; the follow-up time was 3 and 1 years, respectively. Our findings lead us to support a conservative attitude regarding surgery, at least if only mild symptoms are present, If the patients can be satisfactorily treated medically, they seem to outgrow their symptoms in early childhood.

Aortic Arch Syndromes↗
PubMed1976

Comparative study of ultrasound, 131I-19-iodocholesterol scintigraphy, and aortography in localising adrenal lesions.

Twenty-seven consecutive patients with endocrinological disease necessitating adrenal surgery underwent blind preoperative investigation with ultrasound, renal aortography, and adrenocortical scintigraphy for an adrenal lesion. Nine patients had pituitary-dependent Cushing's syndrome, five had pituitary-independent Cushing's syndrome, four had an adrenocortical androgenic excess, and nine had a preoperative diagnosis of phaeochromocytoma. The predictive value of preoperative ultrasound was 100% for a positive finding and 79% for a negative result. Preoperative aortography had a predictive value of 83% for a positive finding and 64% for a negative result; and the predictive value of adrenocortical scintigraphy was 100% for a positive finding and 85% for a negative finding. In localising biochemically suspected adrenal lesions ultrasound should be the first choice, since it is rapid, noninvasive, cheap, and reasonably accurate. Adrenocortical scintigraphy has a similar diagnostic value, especially in Cushing's syndrome, but it is time consuming. Nevertheless, it may be preferable for diagnosing small glucocorticoid-secreting adenomas. Aortography should be reserved for cases with inconclusive diagnoses and suspected extra-adrenal phaeochromocytomas.

Adolescent↗
PubMed1976

Survival among patients with liver metastases from cancer of the colon and rectum.

Factors influencing spontaneous survival in 49 patients with liver metastases after cancer in colon/rectum were evaluated. In addition the same evaluation was performed in 12 patients treated with 5-Fluoro-uracil systemically of intraarterially in the hepatic artery. Alkaline phosphatases, elevated more than 4 times normal values, elevated serum alanine aminotransferase, or jaundice are all unfavorable prognostic signs in the spontaneous group. In the 5-Fluoro-uracil treated group only elevated serum dilirubin had the same unfavorable prognostic sign. Even though it seems to be an increased survival time in the 5-Fluoro-uracil treated group it is concluded that metastases to the liver from cancer in colon/rectum assume to be more or less resistent to 5-Fluoro-uracil.

Adolescent↗
PubMed1976

Duplication of the inferior vena cava in retrocaval ureter. A case of peroperative urodynamic investigation.

A patient with partial duplication of the inferior vena cava and a retrocaval ureter was preoperatively studied by uro-cavography and renography. Peroperatively intrapelvic pressure measurements were made, and simultaneous EMG recordings were taken from the pelvis, and from the ureter proximal and distal to the retrocaval segment. The electrophysiological activity was normal with normal anterograde impulse transmission. Renal pelvic pressure and pressure increase during forced diuresis was within a normal range.

Action Potentials↗
PubMed1975

Arteriographic exposition of the parathyroids.

Arteriographic exposition of the parathyroids in 52 patients consecutively referred for primary hyperparthyroidism is reported. Thirty-nine patients under-went neck exploration. In 29 patients pathologic parathyroids were found. The arteriographic evaluation was based on observation of the course of the inferior thyroid artery and the presence of parenchymal opacification. Comparison of arteriography and surgical findings revealed that selective angiograpy of the inferior thyroid artery had a high sensitivity and specificity in the detection of pathologic parathyroids far exceeding that of a non-selective technique.

Adult↗