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Biomedical subjects

H Ahlström

Publications and source records attributed to H Ahlström.

At least 91 records · Page 5Linked to original sources
PubMed1990

Magnetic resonance imaging of sacroiliac joint inflammation.

A consecutive series of 27 patients with symptoms compatible with sacroiliitis underwent magnetic resonance imaging (MRI) of the sacroiliac joints. The diagnostic sensitivity of MRI was similar to that of computed tomography or conventional radiography. However, MRI seems to have the potential of providing unique information about the disease process in sacroiliitis by demonstrating abnormalities in subchondral bone and periarticular bone marrow. The results of this study suggest that early inflammatory changes in sacroiliitis occur in the subchondral structures of the sacroiliac joints.

Adolescent↗
PubMed1990

Preoperative localization of endocrine pancreatic tumours by intra-arterial dynamic computed tomography.

Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography.

Adult↗
PubMed1989

A double-blind comparison between a new multidose powder inhaler (Turbuhaler) and metered dose inhaler in children with asthma.

Turbuhaler is a ready-loaded multiple dose inhaler which does not require co-ordination between release of dose and inhalation. 57 children with asthma participated in this clinical trial to compare the clinical effect and acceptance of terbutaline sulphate via Turbuhaler with that of metered dose inhaler (MDI). The trial consisted of two parts. In the first part of the study, which made use of a double-blind cross-over design, the clinical effect and number of treatment occasions with Turbuhaler were compared with those of MDI. In the second part, which was open, all patients were treated with Turbuhaler for 2 weeks. At the end of this period the patients were asked to make a subjective assessment of effect and to state their preference. There was no difference in clinical effect and number of treatment occasions between Turbuhaler and MDI. A majority of the patients thought Turbuhaler had the best effect and was easy to use.

Adolescent↗
PubMed1989

Treatment of asthma in pre-school children with inhalation of terbutaline in Turbuhaler compared with Nebuhaler.

The aim of this study was to evaluate the efficacy, safety and preference of pre-school children with regard to two different devices for treatment of bronchial asthma with terbutaline. Turbuhaler, a powder inhaler preloaded with pure terbutaline for inhalation, was compared with a pressurized metered dose inhaler, attached to a Nebuhaler. The study had an open, cross-over randomized design. Each treatment period consisted of 2 weeks. Diary cards were filled in every morning and evening by the parents regarding PEF, asthma symptoms, extra inhalations of terbutaline, and side effects. Twenty-one children (mean age 3.9 years) were included in the study. A highly significant (P less than 0.001) increase in peak expiratory flow (PEF) was obtained after inhalation with both devices. The PEF values in the mornings after inhalation of terbutaline with Turbuhaler were significantly higher (P = 0.046) than those with Nebuhaler. Further, the PEF baseline values in the evenings before inhalation were also significantly higher (P = 0.03) with Turbuhaler. No difference was found in asthma symptoms and extra medication between the two devices. Side effects were mild and few with both devices. The parents found Turbuhaler easier to handle and 19 of 21 preferred this device for future use.

Asthma↗
PubMed1989

The spatial distribution of parenterally administered monoclonal antibodies against CEA in a human colorectal tumour xenograft.

A recently developed experimental model consisting of athymic rats carrying human colonic tumours from the cell line LS 174 T in both hind legs was used. 125I-labelled anti-carcinoembryonic (anti-CEA) monoclonal antibodies were injected either intra-arterially after a bolus injection of mannitol, or intra-peritoneally with or without mannitol. On the fourth day the rats were killed and pieces from the tumours and various organs were measured in a well scintillation counter. Tumour pieces were then submitted to autoradiography and immunohistochemistry for examination of the antibody distribution at the cellular level. In all examined tumours injected with anti-CEA antibodies, most of the antibodies were located in the periphery close to fibrovascular septa. It appears, in addition to the specificity of the antibody for the CEA, that the tumour vascular permeability and anatomy are of utmost importance for tumour targeting in this experimental model with the particular antibody used.

Adenocarcinoma↗
PubMed1988

Vascularization of the continuous human colonic cancer cell line LS 174 T deposited subcutaneously in nude rats.

The macro- and microvasculature of the human colonic cancer cell line LS 174 T, 2-8 weeks after subcutaneous deposition in both hind legs of congenitally athymic rats was investigated by light microscopy, angiography, and microvascular corrosion casting with analysis in a scanning electron microscope. The tumour blood vessels were connected to branches of the femoral artery. Only the outer 200-500 micron of the tumour was extensively vascularized, with several concentric, incomplete layers of tortuous vessels, resembling onion skin. Light microscopy revealed necrosis and bleeding in the centre of the tumour, especially in the older tumours, which corresponded well to the central avascularity observed in the casts. There was an increase in venular and capillary density and tortousity towards the tumour in the adjacent muscular fascia. It is concluded that the cell line LS 174 T grows invasively inwards and recruits its vessels from the nude rat host. The overall tumour vascular pattern was unorganized, suggesting limited control of new vessel formation. Extravasations of resin, which were encountered in all cast tumours, can be a rough indicator of enhanced vascular permeability.

Adenocarcinoma↗
PubMed1987

An experimental model for pharmacokinetic studies of monoclonal antibodies in human colonic cancer.

An experimental model consisting of athymic rats carrying human colonic tumours from cell line LS 174T in both hind legs was used. 125I-labelled anti-carcinoembryonic antigen (anti-CEA) monoclonal antibodies were injected intra-arterially (i.a.), either alone (21 rats) or together with degradable starch microspheres (6 rats). As a control, an irrelevant antibody was injected i.a., alone (6 rats) or together with microspheres (3 rats). An intra-arterial injection was given on the side bearing one tumour in each rat, while the contralateral tumour served as an 'intravenous' control. The rats were submitted to external gamma measurements daily for four days. On the fourth day they were killed and pieces from the tumours and from various organs were examined by in vitro measurements. The results indicate strong expression of CEA in LS 174T cells grafted to athymic rats. No lasting enhancement of the tumour uptake was achieved by intra-arterial injection of antibodies as compared with the control tumours.

Animals↗
PubMed1987

Enhanced uptake of intra-arterially injected anti-CEA monoclonal antibodies in human colonic cancer after mannitol infusion in an experimental model.

In a previous report athymic rats carrying transplanted human colonic tumours from cell line LS 174T in both hind legs were injected intra-arterially (i.a.) with 125I-labelled anti-carcinoembryonic (anti-CEA) monoclonal antibodies. The i.a. injection was given on one side bearing a tumour in each rat, while the contralateral tumour served as an 'intravenous' control. In the same experimental model and treated in the same way, 10 rats were injected i.a. with anti-CEA monoclonal antibodies after an i.a. mannitol infusion. In both groups of rats external gamma measurements were performed daily for four days. On the fourth day the rats were killed and pieces of the tumours and of various organs were weighed and the activity was determined with a gamma-counter. The tumour uptake of antibodies was significantly enhanced after mannitol infusion.

Animals↗
PubMed1986

Inoperable biliary obstruction treated with percutaneously placed endoprosthesis.

Biliary obstruction was treated with endoprosthetic drainage in 30 patients with pancreatic, 10 with gallbladder and 27 with biliary duct cancer, and 13 of the patients received more than one endoprosthesis. The median survival time in the respective cancer groups was 12, 10 and 9 weeks, including 6, 3 and 4 weeks spent in the patients' own homes. The patients with multiple endoprostheses had 24 weeks median survival with 22 weeks at home. Another patient, with a medically treated malignant endocrine tumour of the pancreas, lived for more than 3 years after biliary tract stenting. Complications associated with insertion of endoprosthesis were few, and clinical cholangitis occurred in seven cases. For individual patients it is difficult to predict the benefit of endoprosthetic drainage, but the procedure seems questionable if the predrainage bilirubin level is very high.

Aged↗
PubMed1982

Brain-orientated intensive care treatment in severe neonatal asphyxia. Effects of phenobarbitone protection.

The effect of applying brain-orientated neonatal intensive care for term infants with severe neonatal asphyxia was studied. Such treatment included protective phenobarbitone administration together with assisted ventilation and other measures to counteract postasphyxial cerebral oedema and any abrupt changes in blood pressure and oxygenation. The mortality rate and incidence of long-term sequelae were reduced appreciably, resulting in a 0-1 year mortality rate of 14% (previously 50%) and an incidence of neurodevelopmental handicap at 18 months of 17% (previously 50%). It is important in the management of infants with severe asphyxia at birth to avoid blood pressure fluctuations and to control neuronal epileptic activity by the use of barbiturates and early ventilator treatment.

Asphyxia Neonatorum↗
PubMed1982

Delivery and long-term outcome of very low birth weight infants.

The obstetric and the neonatal management of 72 infants weighing less than 1 500 g at birth were evaluated. Sixty per cent of the mothers were delivered by cesarean section. The neonatal mortality (27%) was equal in the cesarean section and the vaginally delivered groups, but intraventricular hemorrhage was a more frequent autopsy finding in the latter group. At follow-up, 88% of all surviving infants are neurologically normal at two years of age. Of the vaginally delivered infants, three suffered from cerebral palsy, but none in the cesarean section group. The present results reveal that an active management including cesarean section in the delivery of very low birth weight infants is justified and leads to a favorable prognosis.

Cesarean Section↗
PubMed1981

Pulmonary mechanics in early infancy. Subclinical grunting in low-birth-weight infants.

Pulmonary mechanics were studied with the constant pressure body plethysmography method in 78 infants during the first year of life. Registrations of breathing frequency, tidal volume, minute volume, dynamic compliance, pulmonary functional resistance, and end-expiratory resistance were made at rest and during carbon dioxide-induced hyperventilation. Data from 70 infants demonstrated strong correlations (p less than 0.001) between all pulmonary function parameters and length. Carbon dioxide-induced hyperventilation was achieved mainly by an increased tidal volume. Pulmonary functional resistance did not change with hyperventilation, indicating wider airways during forced ventilation. A special breathing pattern called "subclinical grunting" was found in 16 of 45 infants who were low birth weight but without clinical signs of hyaline membrane disease. The pattern was characterized by a high resistance during most of the prolonged expiration. It was identical to that previously described in cases of hyaline membrane diseases. All re-examined low-birth-weight infants with subclinical grunting developed a normal breathing pattern.

Biomechanical Phenomena↗
PubMed1980

Continuous positive airway pressure: modes of action in relation to clinical applications.

Some physical effects of CPAP are discussed, as are the various devices used for CPAP in infants. Some of the controversies about CPAP may be related to the unsuitability of certain techniques. Use in hyaline membrane disease, extrathoracic and intrathoracic airway obstruction, congestion of overperfusion of the lungs in diseases of the heart and great vessels, apnea repetens of immaturity, and phrenic nerve palsy is presented.

Airway Obstruction↗
PubMed1980

Evaluation of mechanical ventilation in newborn infants. I. Techniques and survival rates.

The short-term outcome with survival rate, causes of death and neonatal complications in a 6-year material comprising 253 infants treated with intermittent positive pressure ventilation (IPPV) in the neonatal period has been analyzed in relation to different primary disorders necessitating IPPV treatment. The total survival rate was 53%. For the different diagnoses the survival rates were: hyaline membrane disease (HMD) 41%, apnoea repetens of immaturity 85%, severe birth asphyxia 46% and septicemia 59%. The total rate of pneumothorax during IPPV was 15% but occurred more often in the HMD group (28%). Trends in survival rates over the study period are discussed as are measurements for improvements.

Asphyxia Neonatorum↗
PubMed1980

Evaluation of mechanical ventilation in newborn infants. II. Pulmonary and neuro-developmental sequelae in relation to original diagnosis.

The incidence of bronchopulmonary dysplasia (BPD) and neuro-developmental sequelae in 135 infants surviving intermittent positive pressure ventilation (IPPV) in the newborn period were studied in relation to primary disorders requiring IPPV. The rate of BPD increased over the 6-year study period in hyaline membrane disease survivors from 14% to 28%, but decreased in infants with apnoea repetens from 38% to 13%. Immaturity seemed to be one important factor for development of BPD. The incidence of neuro-developmental sequelae in IPPV treated infants fell from 22% to 13% over the years. In infants with birth weight below 1501 g the rate of neurological handicaps was 11%.

Airway Resistance↗
PubMed1979

Consecutive study of early CPAP-application in hyaline membrane disease.

Continuous positive airways pressure (CPAP) has been applied with a face-chamber in 74 infants with hyaline membrane disease (HMD) before 10 h of age. The total survival rate was 91% and the complication rate of pneumothorax was low (5%). The incidence of long term developmental and neurological sequelae was also low (4%). Among the 19 surviving very low birth-weight (VLBW) infants below 1501 g, only one has shown neurological sequelae at follow-up examinations after 18 months to 3 years of age. The incidence of cerebellar hemorrhage was not higher in infants treated with the CPAP face chamber than in infants not receiving assisted ventilation. Bronchopulmonary dysplasia did not occur in any infant treated with CPAP face chamber only. The main advantages with the face chamber technique are: no disturbance of glottis function, no mucosal damage and tube obstruction, or sudden pressure drops, as seen with other modes of CPAP application. The face chamber technique is suitable for early application of CPAP in infants with HMD as it is efficient, without hazards, and easily applied.

Age Factors↗