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Biomedical subjects

J K Johansen

Publications and source records attributed to J K Johansen.

At least 19 recordsLinked to original sources

[Legal abortion. An analysis of factors which can affect frequency of complications].

INTRODUCTION: Due to a rather high complication rate, we decided to analyze data from women, who were readmitted to hospital with complications to legal abortion. MATERIAL: 760 legal abortions performed in 1993-1994 were retrospectively reviewed for complications. RESULTS: We found 66 complications (8.7% (95% confidence limits (6.7-10.7)), that resulted in readmission to hospital. The distribution of complications was as follows: retention 41 (62% (50-74)), infection 12 (18% (9-27)), bleeding and pain 11 (17% (8-26)) and perforation two (3% (0-7)). There was a slight correlation between a stronger midline echo on ultrasound measurement of the uterine cavity and finding placental tissue on histological examination of the material obtained from reevacuation. The time interval between legal abortion and reevacuation was nine days. Retroflexio uteri was not correlated with reevacuation. CONCLUSIONS: We found a statistically increased risk of complications following legal abortion relative to the figures reported by the national health authority, but not significantly higher than that found in other reports. Moreover, a conservative attitude to retention can reduce the number of reevacuatio uteri after legal abortion.

Abortion, Induced↗

[Surgeons' experience of complication frequency--registration validity for legal abortion].

INTRODUCTION: The aim was to investigate the degree to which experience influenced the complication rate (cr) in legal abortion. We also compared our cr with that registered by the National Health Service for the same group of patients. MATERIAL: 760 legal abortions from 1993 to 1994 were reviewed retrospectively. RESULTS: We found an overall cr of 8.7% (95% confidence limit: 6.7-10.7). The cr was the same for all groups of doctors, from the youngest to the most senior and experienced surgeons. The experience in months of the younger surgeons was noted for each intervention, and we found that they did not improve their results over time or by practice. In the same study, we found that the National Health Service had received, registered, and published statistical data from the hospitals, which were not entirely accurate. CONCLUSION: The complication rate was not associated with the experience of the surgeon.

Abortion, Induced↗

[Intravesical drug therapy in women with severe urge incontinence. Clinical experiences from a department of gynecology].

Conventional oral pharmacotherapy for urge incontinence remains problematic because of limited efficacy and systemic side effects. In this study 27 patients with severe urge incontinence were treated with intravesical drugs (emepron 200 mg or oxybutynin 5 mg) twice a day. They had previously on average undergone 3.3 other treatment options without satisfactory effect. The average age was 62 years, and their incontinence had on average lasted for 15 years. Seven percent were cured and 41% were improved. Fifty-two percent had no satisfactory effect of the treatment. The number of side effects was low, and none left the study for this reason. Intravesical anticholinergic pharmacotherapy can be a treatment option in women with severe urge incontinence.

Administration, Intravesical↗

[Imperforate hymen. A simple, but overlooked diagnosis].

About one among 2000 girls have hymen imperforatus. Some are recognized because of mucocolpos at birth, but the diagnosis is usually not detected before puberty. Menstrual blood will accumulate behind the imperforate hymen, and result in abdominal pain, distension of the lower abdomen and often in acute urinary retention. The diagnosis and treatment is easy, but many patients have seen several doctors before the diagnosis is clear.

Abdominal Pain↗

Prognosis after the first episode of gastrointestinal bleeding or coma in cirrhosis. Survival and prognostic factors.

Hepatic encephalopathy and gastrointestinal (GI) bleeding are the most serious complications in cirrhosis. The purpose of this study was to examine survival after the first episode of GI bleeding or coma, or both, and to identify variables associated with the subsequent survival in 284 consecutive patients with cirrhosis admitted to one division of hepatology over a period of 81 months. Patients who only bled had markedly longer survival than those who only had coma, whereas those who had both bleeding and coma had by far the poorest survival, only 15% being alive 1 year later. Several other variables showed a significant association with survival. In a Cox multiple regression analysis the following four variables showed significant association with a short survival: coma and bleeding at the episode, ascites, low prothrombin index, and high serum creatinine. The prognostic index derived from the Cox model, which was validated by a split-sample testing technique, may be used to refine prognostic estimation in this subgroup of severely ill cirrhotic patients.

Adult↗

Disturbance in rhythm in 2 patients with a permanent pacemaker and two endocardial electrodes.

Rhythm disturbances are described in 2 patients with an implanted permanent pacemaker. Both patients had nonfunctioning electrodes retained after previous complications. It was possible to observe, in both patients, during fluoroscopic examination that the electrodes occasionally touched each other. The etiology of the rhythm disturbances are discussed on the basis of the technical specifications of the pace makers. The interpretation of rhythm disturbances in patients with implanted pacemakers presents special problems. Disturbances in rhythm can be spontaneous and have no relation to, but possibly modified, by the implanted pacemaker. However, the rhythm disturbances can also result from the technical specifications of the implanted pacemaker or from defects in the same. The following case histories disturbances in rhythm in two patients, who both had 2 endocardial electrodes of which only one was connected to the implanted pacemaker.

Animals↗

Regional pulmonary blood flow in mitral disease studied by xenon radiospirometry.

Regional lung perfusion was measured in the sitting position by 4 external detectors after intravenous injection of 133Xe in 24 patients with mitral valve disease and in 8 people with no cardiopulmonary disease acting as normal controls. Right- and left-sided heart catheterization was carried out on the patients on the following day. Mitral valve stenosis was found in 9, mitral valve regurgitation in 8, and both stenosis and regurgitation in the remaining 7. Regional lung perfusion in the normal people fell linearly from the basal to the apical sections of the lungs. The perfusion distribution in patients with mitral valve disease and a pulmonary capillary vein (PCV) pressure lower than 15 mmHg (2-0 kPa) did not differ significantly from that of the controls. A redistribution of the regional perfusion, with an increase in the apical perfusion and a fall in the basal perfusion of the lungs, was seen in patients with a raised PCV pressure. The hyperperfusion of the apical lung sections correlated with the mean pressure in the pulmonary artery (r=+0-795, P less than 0-001), while the basal hypoperfusion correlated with the PCV pressure (r=0-842, P less than 0-001). The PCV pressure can be predicted with an exactitude of +/- 7 mmHg (0-9 kPa) (95% confidence limits). Neither the cardiac index nor the pulmonary vascular resistance correlated with the changes in perfusion. Xenon radiospirometry is a rapid and reliable method for evaluating PCV pressure before or after operation in patients with mitral valve disease.

Adult↗

Displacement of endocardial pacemaker electrodes. A comparison between Elema 588 B and Chardack 5818.

The implantation of a permanent pacemaker has been carried out on 159 patients suffering from Adams-Stokes seizures. Elema 588 B electrodes were implanted in 119 patients and Chardack 5818 electrodes in 40 patients. The two types of electrodes differ with regard to both the implantation technique and weight and thickness. No difference was found in the incidence of electrode displacement or survival between the two groups, similarly the experience of the physician with regard to implantation had no influence on the frequency of displacement. Displacement on the other hand occurred significantly more frequently in those patients suffering from heart disease demonstrable by x-ray examination.

Adams-Stokes Syndrome↗