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Biomedical subjects

H B Andersen

Publications and source records attributed to H B Andersen.

At least 37 records · Page 2Linked to original sources

Sham-feeding decreases cardiac output in normal subjects.

The cardiovascular effect of sham-feeding was measured in seven healthy non-obese human subjects by the Fick principle using the carbon dioxide rebreathing method. The subjects were resting in the sitting position and were exposed to the sight and smell but not the taste of a breakfast meal. Cardiac output decreased significantly from a mean value of 4.0 1 min-1 to 3.5 1 min-1 during sham-feeding (Friedman, P = 0.004). The cardiac output returned to basal values in all seven subjects when the sensory stimulus was removed. The decrease in cardiac output was due to a decreased stroke volume, whereas heart rate and blood pressure did not change. The mechanism of the decrease in cardiac output during sham-feeding remains to be established.

Adult↗

A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain.

We conducted a randomized, double-blind trial to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 mL) on the postoperative pain of 37 patients scheduled for elective inguinal herniotomy. The demand for additional postoperative analgesics occurred earlier in those who received lidocaine infiltration after incision (165 min) than in those who received preincisional lidocaine (225 min, P less than 0.05). The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (P less than 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method of providing postoperative analgesia than is postincisional infiltration.

Adolescent↗

Lipid peroxidation in early experimental diabetes in rats: effects of diabetes and insulin.

The degree of lipid peroxidation was measured in organs from diabetic rats receiving no treatment, and in those from insulin-treated diabetic rats and controls. Lipid peroxidation was measured as organ content of malondialdehyde, a degradation product of polyunsaturated fatty acids. In the kidney, lipid peroxidation was increased after one week of diabetes; insulin treatment reduced the level of lipid peroxidation to levels lower than seen in controls. In the liver, diabetes caused an increased lipid peroxidation, which could be reversed by insulin; no additional effect of insulin was found. In heart and pancreas no effects of diabetes or insulin were demonstrated. The present paper provides evidence that lipid peroxidation is increased in the early stages of experimental diabetes and is reversible by insulin treatment. Hyperinsulinaemia may, in itself, counteract lipid peroxidation in kidney.

Animals↗

[Endoscopic bipolar electrocoagulation in gastroduodenal hemorrhage].

During a one year period (1988-1989), 40 consecutive patients were submitted to emergency gastroduodenoscopy because of severe gastroduodenal bleeding. Indications for emergency endoscopy were red or black haematemesis with melaena or melaena with signs of haemodynamic instability. Twenty-nine of the patients fulfilled the criteria for emergency surgery because of major bleeding and alterated circulation. Twenty-five with surgery demanding gastroduodenal ulcer bleeding and one with Dieulafoy's erosion, were treated with endoscopic bipolar electrocoagulation. Primary haemostasis was achieved in 20 patients (80 per cent). Definitive haemostasis was obtained in 11 patients (44 per cent) with major ulcer bleeding. Nine patients bled again after electrocoagulation, and seven of these underwent surgery. The mortality was 20 per cent (five patients). In eight patients with minor active bleeding or visible vessels, electrocoagulation resulted in 100 per cent definitive haemostasis. No complications attributable to the electrocoagulation were observed. Endoscopic haemostatic treatment with e.g. bipolar electrocoagulation should be the first treatment in patients with gastroduodenal bleeding as emergency operation can be avoided in approximately 50 per cent of the cases.

Adult↗

Influence of renal function on the elimination of morphine and morphine glucuronides.

The influence of renal function, measured by 51Cr-EDTA clearance, on morphine and morphine glucuronide kinetics has been studied in 13 patients after a single i.v. injection of morphine. Unconjugated morphine and morphine glucuronides were measured by a sensitive, specific RIA after extraction from plasma. No significant correlation was found between total body clearance of unconjugated morphine and 51Cr-EDTA clearance. However, patients with renal insufficiency had impaired elimination of morphine glucuronides, and the apparent clearance was significantly correlated with the 51Cr-EDTA clearance (r = 0.94, p less than 0.001). A relatively long terminal elimination of half-life of morphine was found in all patients (mean +/- SD: 9.2 +/- 2.5 h), irrespective of glomerular function.

Aged↗

Pharmacokinetics of intravenous, intrathecal and epidural morphine and fentanyl in the goat.

Intrathecal and epidural catheters and an intravenous cannula were inserted in 10 goats. After administration of either morphine 4 mg, intravenously, 1 mg intrathecally or 4 and 8 mg epidurally, or fentanyl 0.1 mg intravenously, 0.05 mg intrathecally or 0.1 and 0.2 mg epidurally, venous blood and CSF were sampled at 2, 5, 10, 15, 30 min and 1, 2, 4, 6, 8 and 24 h. The concentrations of the drugs were measured by radioimmunoassay. After administration of intravenous morphine the plasma concentration-time curve fitted a 3-compartment model (body clearance = 84 +/- 23 ml/min/kg, mean +/- s.d., N = 5), while after fentanyl the plasma concentration-time curve was best described by a 2-compartment model (body clearance = 3.9-5.8 ml/min/kg, N = 3]. After intrathecal injection the elimination rates of the opioids from CSF were 0.3 to 2.0 and 0.6 to 2.4 ml/h/kg for morphine and fentanyl, respectively (N = 3). The time to reach maximum CSF concentration after epidural administration was 0.22 +/- 0.14 h for morphine (N = 6) and 0.22 +/- 0.13 h for fentanyl (N = 8). In the same goat the CSF availability was 2.3 and 11.3% for morphine and 0.8 and 3.3% for fentanyl following epidural administration of the low and high doses, respectively. After epidural administration, morphine and fentanyl are absorbed into CSF at the same rate but the relative amount of drug absorbed may be higher for morphine than fentanyl. Bulk flow is supposed to be the principal mechanism of opioid elimination from CSF.

Animals↗

Subcutaneously implanted injection system for epidural administration.

Six patients with advanced disseminated cancer were treated by operatively implanting a subcutaneous injection system for epidural opiate injection. The system consisted of an access port connected to an epidural catheter. The median period of treatment during hospitalization was 16 days (9-64). Two discharged patients were treated for 9 and 150 days, respectively. The median number of injections was 92 (48-542). Patient compliance was good in all cases. There was no case of displacement, kinking or occlusion of the catheters. All patients experienced sufficient pain relief, although four, before epidural opiate treatment, had their pain triggered by activity.

Humans↗

Microscopic epidural lesions in goats given repeated epidural injections of morphine: use of a modified autopsy procedure.

Epidural catheterization was performed in six goats. Five days later either saline or 20 mg (5 mg/ml) preservative free morphine was injected epidurally once daily for 8 days. The goats were sacrificed 4, 24 or 48 hours after the last injection. The lumbar part of columna was removed in toto for microscopic examination of the spinal cord and the entire epidural space after decalcification and transverse sectioning. After saline, minimal changes including a fibrous membrane surrounding the catheter, scattered fat cell necrosis, scattered small focal cell infiltrations and occasionally focal haemorrhages were seen. After morphine the changes were considerably more severe including diffuse cellular inflammatory reaction in the epidural space, fat cell necrosis, occasionally focal exudative inflammation and chronic inflammatory reaction in the vicinity of the fibrous membrane demarcating position of the catheter. It is concluded that the present modified autopsy procedure permits microscopic examination of the epidural space. It has been shown that repeated administration of morphine caused tissue damage in the epidural space of goats. The human predictability of the results obtained is unknown. However, the results are encouraging for investigations with similar procedure in humans.

Animals↗