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Biomedical subjects

G Helmius

Publications and source records attributed to G Helmius.

At least 19 recordsLinked to original sources
PubMed1994

Distribution of coronary atherosclerosis and its correlation to metabolic risk factors and femoral atherosclerosis.

Coronary angiography was performed in 216 men of whom 78 also had a cine-angiogram of one femoral artery. Stenoses of the coronary arteries were measured with a pair of calipers and the femoral angiograms were computer-analysed. The patients were divided into 2 groups according to whether the bulk of the coronary stenoses affected the central or the peripheral part of the coronary arteries. The groups were investigated regarding differences in lipid and metabolic risk factors. Coronary atherosclerosis was most often found in the proximal part of the right coronary arteries. No significant correlation between coronary and femoral atherosclerosis was found. Previous myocardial infarction was associated with more coronary artery stenosis (p < 0.003). No pattern of risk factors was found to discriminate between central and peripheral coronary atherosclerosis.

Adult↗
PubMed1992

The "adult" form of the scimitar syndrome.

One hundred twenty-two cases of the adult form of the scimitar syndrome were collected from different cardiologic centers. The clinical, radiographic and hemodynamic findings are described. The scimitar syndrome is defined as an anomalous right pulmonary venous drainage, partial or complete, to the inferior vena cava. Additional characteristics of this syndrome such as hypoplasia and abnormalities of the vascular supply to the right lung, dextrocardia and abnormalities of the bronchial segmentation are common; bronchiectases are rare. The left to right shunt was less than 50% in 100 of the 122 patients. The pulmonary arterial pressures were normal in 94 patients and slightly elevated in 28. A follow-up study of these patients showed that, without surgical correction, they lead a normal life. An awareness of this syndrome may avoid unnecessary invasive diagnostic procedures and surgical treatment for most patients.

Adult↗
PubMed1992

Adenosine induced chest pain--a comparison between intracoronary bolus injection and steady state infusion.

OBJECTIVE: Adenosine may induce chest pain in at least two ways, either by direct stimulation of sensory afferents before actual ischaemia occurs or secondary to ischaemia. The aim was to study if the mechanism of pain induction may depend on the method of adenosine administration. METHODS: Increasing doses of adenosine were given to seven male patients with ischaemic heart disease referred for coronary angiography: first as a bolus intracoronary injection (2.5-50 mumol), second as a 1 ml.min-1 steady state infusion (0.01-20 mumol.min-1) and third as an intravenous steady state infusion (0.076-0.76 mumol.kg-1 x min-1). Pain, rate-pressure product, coronary sinus blood flow, and ECG were monitored. Lactate was analysed in coronary sinus and arterial blood. RESULTS: After intracoronary bolus injection there were no signs of myocardial ischaemia, whereas during intracoronary steady state infusion, and in spite of a lower, but definite, degree of pain, 5/7 patients showed myocardial lactate production and three patients showed ST depression. During the intravenous steady state infusion 6/6 patients showed ST depression. CONCLUSIONS: These findings suggest that when using adenosine for studies on the mechanisms of chest pain in patients with ischaemic heart disease it is preferable to use an intracoronary bolus injection technique rather than a steady state infusion, as the risk of inducing ischaemia with the latter model cannot be ignored.

Adenosine↗
PubMed1992

Complications of percutaneous pericardiocentesis under fluoroscopic guidance.

Complications in 352 cases of fluoroscopy-guided percutaneous pericardiocentesis accomplished through an indwelling catheter were reviewed following surgery and non-surgery. Thirteen major complications were found, namely 3 cardiac perforations, 2 cardiac arrhythmias, 4 cases of arterial bleeding, 2 cases of pneumothorax in children, one infection, and one major vagal reaction. No significant difference in complications was found between pericardiocenteses for pericardial effusions after cardiac surgery (n = 208) and those for effusions of non-surgical (n = 144) origin. Fluoroscopy-guided pericardiocentesis by the subxiphoid approach with placement of an indwelling catheter is a safe method for achieving pericardial drainage in both surgical and non-surgical effusions. Accidental cardiac perforation with a fine needle is a minor complication as long as the needle is directed towards the anterior diaphragmatic border of the right ventricle and drainage is achieved with a reliable indwelling catheter.

Adolescent↗
PubMed1990

Intracoronary adenosine causes angina pectoris like pain--an inquiry into the nature of visceral pain.

STUDY OBJECTIVE: The aim was to study the tentative role of adenosine as a messenger between myocardial ischaemia and angina pectoris. DESIGN: Adenosine was administered in serial doses of 0.1-20 mg either as an intravenous bolus, or intra-arterially over 10 s into the left coronary artery, the aorta and the iliac artery. Coronary sinus flow was determined by thermodilution. ECG was monitored continuously. The patient was not aware of which site or dose was used. After each injection, the start of, maximum, end, magnitude, and location of pain were noted. PATIENTS: Six patients with angina pectoris referred for coronary angiography entered the study. MEASUREMENTS AND RESULTS: After intracoronary adenosine injection in the absence of ischaemic ECG changes, a dose dependent degree of chest pain was experienced not different in quality or location from the patients' habitual angina pectoris. Adenosine into the aorta provoked pain in lower chest and upper abdomen, whereas injection into the iliac artery provoked pain in the ipsilateral leg. On intravenous injection equipotent doses of adenosine caused chest pain of the same degree and quality as after intracoronary injection. Immediately after intracoronary injection the coronary sinus blood flow started to increase, but the onset of chest pain was delayed. Onset of pain was earlier the higher the dose, the maximum dose resulting in onset after 18(SEM 2) s. Coronary sinus blood flow increased dose dependently after left coronary artery injection but following intravenous injection no further increase was seen beyond that induced by the lowest dose. CONCLUSIONS: We suggest that adenosine is an important messenger for the sensation of angina pectoris and the effect is not due to coronary steal leading to myocardial ischaemia.

Adenosine↗
PubMed1990

Effects of exogenous adenosine in a patient with transplanted heart. Evidence for adenosine as a messenger in angina pectoris.

In this pilot study some cardiac effects of exogenous adenosine on the denervated heart were studied in a patient with transplanted heart since 3 years. He was instrumented with catheters into the left coronary artery, the coronary sinus and the right ventricle. Adenosine was given in increasing doses intracoronarily, into the aorta at the diaphragmal level and into a peripheral vein. When given into the aorta pain was provoked dose-dependently and not different from a reference group. When given intracoronarily no pain was provoked except at the highest dose when a slight discomfort of the chest was provoked. After intravenous injection no pain was provoked in the chest or in adjacent structures. Coronary sinus flow increased dose-dependently and not different from the reference group. No increased heart rate response occurred after intravenous or intracoronary injections. Extensive degrees of sinus and AV nodal blockade occurred. In conclusion, the results are in keeping with a role for adenosine as a messenger between myocardial ischaemia and angina pectoris and cardiac sympathetic pressure response. The importance of innervation for proper sinus and AV nodal function was also illustrated.

Adenosine↗
PubMed1987

The internal mammary artery as subclavian artery substitute in repair of coarctation of the aorta with subclavian flap technique.

In three children, aged 11, 11 and 13 years, long isthmic tubular hypoplasia of the aorta technically precluded resection and end-to-end anastomosis. The coarctation was instead corrected by means of a subclavian flap. Anastomosis between the distal end of the left internal mammary artery and the descending aorta permitted perfusion of the remaining portion of the subclavian artery. At invasive reexamination 6 months after surgery, there was adequate functional and anatomic relief of coarctation in all three children. The three mammary artery-aorta anastomoses were patent, which probably prevented the potential ischemia of the left arm after ligation of the subclavian artery.

Adolescent↗
PubMed1984

Sexual and contraceptive experience among teenagers in Uppsala.

A questionnaire was offered to 181 sixteen-year-old boys (n = 88) and girls (n = 93) in different schools in the city of Uppsala. The questionnaire was introduced to the students by a nurse midwife during a regular lesson and included over 100 questions dealing partly with sexual education, attitudes towards sex and own experience of sex and contraception. Of the girls, 47% and of the boys, 31% answered that they had had intercourse. Twenty-eight per cent of the girls and 21.5% of the boys had had their first intercourse before the age of 15. Contraception was used at the first intercourse by 59% of the girls and by 70% of the boys. At the very first intercourse, the condom was the most commonly used contraceptive method. Increasing sexual experience changed the contraceptive pattern and at their last intercourse 48% of the girls were on the pill and 33% of the boys said that their girl friend was on the pill.

Adolescent↗
PubMed1983

Measurement of regional lung blood flow by videodensitometry.

The pulmonary blood flow in patients with embolism, emphysema or a tumour of the lung was measured by videodensitometry in 27 lungs from 17 patients. The results suggest that the relative regional and total lung blood flow can easily be estimated. It is also easy to demonstrate abnormalities in the distribution of the lung blood flow. The mean transit time in the normal lung is considered to be 1.5 to 4 seconds.

Absorptiometry, Photon↗
PubMed1982

On the pathophysiology of left ventricular aneurysm. An analysis by cineangiography and videodensitometry.

In 16 patients with left ventricular aneurysm, ventriculography has been performed and recorded upon videotape. By means of videodensitometer the ejection fraction of the total ventricle and its parts have been analysed. The videodensitometric result explained the ejection fraction pattern which is caused by the moment of the contrast medium in different parts of the ventricle. The regurgitation phenomenon in the contractile and non-contractile parts of the ventricle is explained by a turbulent movement of contrast medium between the different parts of the ventricle. This turbulence should be included in the criteria of a left ventricular aneurysm.

Absorptiometry, Photon↗
PubMed1982

Computerized quantitation of atherosclerosis in an experimental model. Arteriography and microdensitometry.

Model investigations for computerized quantitation of atherosclerotic plaques by a combination of arteriography and microdensitometry were performed. The correlation between real and densitometrically determined plaque volumes was high (r = 0.987) in examinations of randomly distributed plaques. The results indicate that this method can be useful in the clinical examination of patients with atherosclerosis.

Angiography↗
PubMed1982

Myocardial infarction without coronary occlusion. A morphologic study in sheep.

The macroscopic, histologic and enzyme-histochemical characteristics of the myocardial lesion obtained after heating of a thermoprobe in a branch of the left coronary artery in sheep is reported. In 13 sheep such myocardial lesions were produced distal to the location of the thermoprobe. Alterations were observed in accordance with generally accepted morphologic criteria for myocardial infarction. The coronary artery branch in which the thermoprobe was located showed erythrocyte and platelet aggregates immediately after the heating episode, which disappeared within a few min, as demonstrated by coronary arteriography. Injection of radiolabelled microspheres into the coronary circulation after induction of the myocardial lesion, cryosectioning of the heart and autoradiography revealed a lack of blood flow in the damaged myocardial region. We consider this new method a suitable tool for further studies on the complex pathology involved in the development of myocardial infarction.

Animals↗
PubMed1981

Complications of coronary angiography.

The new Kifa catheter decreased the rte of complications related to the nature of the catheter, enabled the examination to be performed more safely and reduced the examination time compared with the Cook catheter. The Kifa catheter for the right coronary artery could also be used for a subsequent left ventriculography.

Angiography↗
PubMed1980

Videodensitometry and thermodilution for measuring left ventricular function.

In animal experiments contrast medium and physiologic saline were found to be equivalent as indicator substances in thermodilution. The ejection fraction is determined with approximately the same accuracy with thermodilution as with videodensitometry. The cardiac output, on the other hand, is smaller when determined with videodensitometry than with thermodilution. The results indicate that thermodilution gives too high values.

Animals↗
PubMed1980

Coronary by-pass operation--graft and left ventricular function.

Of 121 patients surviving a by-pass operation 114 have been folowed up hitherto. At first follow-up - usually one year after operation - the angina pectoris was relieved in 87% of the patients and in 85% at least one vein by-pass was patent. A high correlation was found between subjective result and graft patency. Advanced arterial changes at preoperative coronary angiography did not prevent good result after surgery. In about half of the patients whose pain was relieved, the left ventricular ejection fraction was increased postoperatively. However, in many patients, who were subjectively improved, the ejection fraction was unchanged or even decreased.

Adult↗