Biomedical subjects

K Egeblad

Publications and source records attributed to K Egeblad.

At least 19 recordsLinked to original sources

PubMed1992

[Arteriosclerosis of the lower extremities--patients' contacts with alternative therapists].

During the period July 1987-April 1988, ninety-one patients with arterial insufficiency in the lower limbs were referred to the Department of Thoracic and Vascular Surgery at Aalborg Hospital. The mean delay between contact with the general practitioner and the vascular surgeon was nine months. Twenty-nine of the patients contacted alternative therapists before referral to the vascular surgeon. Twenty-five of these patients had suffered from intermittent claudication for at least two years and the total cost of treatment was 76,013 Danish crowns (900 Danish crowns or approximately pounds 75 per patient).

Adult↗

PubMed1990

[Recurrent nerve injury after goiter surgery].

During a period of five years, 230 patients were treated operatively on account of benign thyroid disease. The present investigation is particularly directed towards the frequency of transient/permanent and unilateral/bilateral pareses of the vocal cords resulting from lesion of the recurrent nerve during surgical intervention on the thyroid gland. The material consists of 199 women and 31 men. The average age for the entire material was 46 years. Seventy-one patients had been submitted to unilateral intervention and in 159 the intervention was bilateral. Indirect laryngoscopy was carried out on all of the patients before and after operation. The operations were carried out by surgeons-in-charge, registrars, trainee registrars and experienced house surgeons. Transient unilateral pareses developed postoperatively in 17 patients and transient bilateral pareses in five patients. Five patients had permanent unilateral pareses and one patient had permanent bilateral paresis, corresponding to frequencies of pareses of 2.6% and 0.4%. Two patients became chronic tracheostomy cases. Intensive control of vocal cord function and the importance of laryngoscopy are emphasized. The question of the ideal placing of thyroid surgery as regards training and the departments concerned is discussed.

Adolescent↗

PubMed1990

Forefoot transcutaneous oxygen tension at different leg positions in patients with peripheral vascular disease.

Transcutaneous oxygen tension (TcPo2) was measured on the forefoot of 150 limbs of 128 patients with different stages of peripheral vascular disease (PVD) and on 36 limbs of 18 healthy subjects in the sitting and supine position. The diagnostic value of TcPo2 measurements was tested and compared with indirect toe pressure measurements. TcPo2 measured in the supine position gives the best diagnostic discrimination between healthy controls and patients with PVD and between patients with different degrees of PVD. The median TcPo2 in patients with PVD and rest pain (severe PVD), patients with PVD without rest pain (moderate PVD) and control subjects was 12 mmHg (range 0-61), 50 mmHg (range 0-86), and 60 mmHg (range 35-78), respectively. In the supine position, 95% of the patients with severe PVD had TcPo2 values below 40 mmHg, as opposed to 28% of the patients with moderate PVD and 8% of the control subjects. TcPo2 below 40 mmHg measured on the forefoot in the supine position suggests severe ischaemia. The diagnostic value of TcPo2 measurement is comparable with that of toe systolic pressure measurement. As a diagnostic and quantitative non-invasive method of evaluating patients suspected of PVD, TcPo2 measurement is ideal as it is easy to perform, and does not cause discomfort.

Adult↗

PubMed1990

Aorto-iliac arteriosclerotic disease in young human adults.

A highly selected group of patients younger than 50 years of age operated on for isolated aorto-iliac arteriosclerotic disease over a 7 year period has been investigated. The group has a significant dominance of females, and the patients are further characterised by being apparently otherwise "healthy" individuals. The indication for surgery was intermittent claudication in 80% and rest pain/gangrene in the remainder, with a low postoperative morbidity and no mortality. The overall cumulative patency rate is 89% at 4 years. At follow-up, a large majority of the patients were free of symptoms and the long-term results were significantly better in females. The question arises whether our group of patients, especially the young females with isolated aorto-iliac arteriosclerotic lesion, represent a separate disease entity which, when properly treated, is a benign and curable condition.

Adult↗

PubMed1990

Assessment of intermittent claudication by means of the transcutaneous oxygen tension exercise profile.

Transcutaneous oxygen tension was measured simultaneously on both feet during exercise (TcpO2 exercise profile) in patients with claudication. The following groups were studied: 1) 21 control subjects; 2) 25 patients with bilateral claudication of whom eight had unilateral predominance; 3) 40 patients with unilateral claudication. The control group showed no significant decrease in TcpO2 during exercise. Patients with bilateral claudication and unilateral predominance showed a significant decrease in the TcpO2 exercise profile of both feet (P less than 0.05), the decrease in the more affected leg being significantly greater than that of the less affected leg (P less than 0.05). In patients without unilateral predominance of claudication there was a slight, yet significant decrease in TcpO2 of both legs. Patients with unilateral claudication were classified into three groups based on a constant work load of 50 W, which provoked typical leg pain during exercise (group I: 0-2 min; group II: 2-4 min; group III: greater than 4 min). The decrease in the TcpO2 exercise profile was always significant on the symptomatic leg. In the asymptomatic leg TcpO2 did not decrease. The changes in TcpO2 relative to values at rest of the symptomatic leg showed significant differences after 1 min in groups I, II, and III (P less than 0.05). In conclusion, the TcpO2 exercise profile appears to be a suitable objective method by which the peripheral arterial insufficiency during exercise in patients with intermittent claudication can be quantified.

Adult↗

PubMed1990

Profundaplasty as the only reconstructive procedure in patients with severe ischemia of the lower extremity.

Twenty-one profundaplasties were performed as the only reconstructive procedure. All of the patients had severe ischemia of the lower extremity with serious symptoms, such as rest pain or gangrene, or both. There was no postoperative mortality. Two patients had a crural amputation, and one patient, a femoral amputation performed during the first three months postoperatively. All of the other patients improved, and there was a significant rise in distal blood pressures after one week, further increasing after three months. At follow-up study, 15 of the patients had considerably less symptoms than preoperatively or were free of symptoms. There was a limb salvage rate of 83 per cent after 60 months. The operation is recommended whenever possible in patients with severe ischemia of the lower extremity when the possibilities of other reconstructive procedures are considered to be poor.

Aged↗

PubMed1989

[Social aspects of reconstructive vascular surgery in patients under 60 years of age].

The effect of initial elective arterial reconstructive surgery was evaluated in relation to employment and social status. Ninety patients with intermittent claudication were followed for a period of 3.5 years. The male to female ratio was 1:12. At the time of operation, all the patients were under the age of 60 years and potentially professionally active. The indication for operation in fifty-nine patients was intermittent claudication. For thirty-one patients, the indication for operation was ischaemic rest pain, gangrene or ulcer. Fifty-six patients (74%) returned to active employment following vascular reconstructive surgery. It is concluded that reconstructive vascular surgery is of great importance for rehabilitation and in the success of resumption of active employment.

Adult↗

PubMed1989

[Secondary aorto-enteric fistula].

On the basis of five case histories, the causes, symptoms, investigations, diagnosis and treatment of secondary aorto-enteric fistulae are reviewed. In a patient in whom reconstruction in the aortoiliac segment has been undertaken, recurrent haematemesis and melaena, pyrexia and septicaemia and abdominal pain should lead to investigation for aorto-enteric fistula by means of oesophagogastro-duodenoscopy and radiological investigations if the condition permits this. Otherwise, emergency laporotomy with thorough examination of the intestine should be undertaken. The condition is associated with a considerable mortality but the prognosis is improved by rapid intervention. In cases where aorto-enteric fistula is suspected, the patient should be referred to a department for vascular surgery.

Aorta, Abdominal↗

PubMed1989

The ischaemic leg: a long-term follow-up with special reference to the predictive value of the systolic digital blood pressure. Part I: No arterial reconstruction.

The course of 53 patients presenting with 76 legs with ischaemia, defined by blood pressure on the big toe below 30 mmHg, were investigated. The series consists of those patients who after an angiography were considered non-candidates for arterial reconstructive surgery. There were 38 limbs with low pressure and severe ischaemic symptoms, i.e. rest pain and/or gangrene and 38 limbs with low pressures and only intermittent claudication or no leg symptoms at all. There were statistically significant differences in the fate of the limbs in the two groups, the first group suffering a 68 per cent risk of amputations compared to only 16 per cent in the second group. The corresponding risk of death was approximately 60 per cent and 10 per cent. The social fate was poor in the group with rest pain and/or gangrene due to the high number of amputations.

Adult↗

PubMed1989

The ischaemic leg: a long-term follow-up with special reference to the predictive value of the systolic digital blood pressure. Part II: After arterial reconstruction.

Ninety-five patients with 122 legs with a systolic blood pressure on the big toe below 30 mmHg were the subject of arterial reconstructive surgery. Investigating the limb survival rate we found the systolic blood pressure on the big toe to be the most important predictor, whereas there was found no predictive value of the ankle pressure/index. Preoperative clinical symptoms, which are closely related to the digital blood pressure, were significant predictors of the limb survival rate: the low-pressure limb with no symptoms or intermittent claudication had a significantly higher survival rate than the limb with rest pain and/or gangrene. Following arterial reconstructive surgery the social fate of patients with threatened legs was fairly good as 83% became fully independent.

Adult↗

PubMed1989

Major vascular injury during gynecologic laparoscopy. Report of a case and review of published cases.

Serious complications following gynecologic laparoscopy are rare. We report a case of a 24-year-old woman who had a common iliac artery and vein injured by the trocar, resulting in deep shock. The arterial lesion was repaired with an allograft and the vein sutured. The patient recovered with light sequelae. The literature was reviewed and we found 15 cases described in varying detail. In most cases the injury was caused by the pneumoperitoneum-needle and in only 2 by the trocar. Characteristically the terminal aorta and its major branches were injured. All the patients had a large retroperitoneal hematoma and only minimal free blood in the peritoneum. Signs of bleeding were nearly always acute. Most lesions could be treated by simple suture. Recovery is the rule, but 2 of the 15 died. Examiner's experience and correct technique are important to prevent this potentially lethal complication which is also probably underreported.

Adult↗

PubMed1988

Transcutaneous oxygen tension exercise profile. A method for objectively assessing the results after reconstructive peripheral arterial surgery.

Transcutaneous oxygen tension during exercise (TcPo2 exercise profile) was measured on the foot in 10 patients before reconstructive vascular surgery and 9 and 18 months later. The preoperative TcPo2 exercise profiles were abnormal in all 10 patients. In 9 of the patients the reconstructions were successful. In these patients the TcPo2 exercise profiles reverted to normal. In a control group of six healthy persons no significant changes in TcPo2 were observed during the follow-up period of 18 months. The reproducibility determined as the total week-to-week variation of claudicants and controls was 8%. The TcPo2 exercise test is suitable for monitoring the patient after reconstructive surgery, because it is based exclusively on objective data is non-invasive and the measurements are reproducible.

Adult↗

PubMed1988

Popliteal arterial aneurysm.

Popliteal arterial aneurysms are rare in young individuals. A case without a penetrating trauma presenting in a young woman is described. Complications may lead to vascular emergencies. Early diagnosis and surgical treatment is important.

Adolescent↗

PubMed1988

Incidence of ureteral obstruction after aortic grafting: a prospective analysis.

In this prospective analysis of the incidence of ureteral obstruction after aortic bifurcation grafting, 120 patients were entered into the study: 19 were subsequently excluded for cause, and 101 patients were studied by isotope renography. The renographic findings were indicative for subsequent intravenous pyelography, which was performed in 26 patients. In two cases supplementary retrograde pyelograms were done. Two patients (2%) had ureteral obstruction related to the vascular prosthesis, and in one of these patients the process was bilateral. The lesions were asymptomatic in both patients.

Adult↗

PubMed1987

Myoglobin and creatine phosphokinase in serum during and after aortic bypass grafting.

In 10 patients undergoing aortic bypass grafting with peroperative aortic cross-clamping we measured the levels of myoglobin and creatine phosphokinase. The duration of peroperative lower limb arterial clamping ranged from 50 min to 95 min. No significant increase in either serum myoglobin or in serum creatine phosphokinase was found during lower limb arterial clamping or for the first two hours after release of ischemia. Both parameters reached a maximum value at 24 hours after release of ischemia, with a median serum myoglobin concentration of 565 micrograms/l (range: 132-2688 micrograms/l) and a median serum creatine phosphokinase activity of 457 U/l (range: 190-1602 U/l). The increase in serum myoglobin and creatine phosphokinase was not associated with the duration of lower limb arterial clamping. Renal impairment was not found in these patients, as evaluated by the serum concentration of beta 2-microglobulin.

Aged↗

PubMed1987

Lower limb transcutaneous oxygen tension during aortic bypass grafting.

Transcutaneous oxygen tension (tcPO2) was measured continuously at the foot of 10 patients during abdominal aortic bypass grafting. Median tcPO2 before surgery was 38.5 mmHg (range: 14-74 mmHg) increasing to 79.0 mmHg (range 44-104 mmHg) after insertion of the vascular prosthesis (p less than 0.01). Eight successful vascular reconstructions were correctly identified intraoperatively. One was correctly identified as failed and one was correctly identified as unchanged compared with the preoperative clinical status. Our results indicate that tcPO2-monitoring may contribute to quality assurance by intraoperative identification of failed or insufficient vascular reconstructions.

Adult↗

PubMed1987

Hypermyoglobinemia after successful arterial embolectomy.

Myoglobin concentrations in serum and urine were measured in eight patients who underwent successful arterial embolectomy in the femoral or iliac arteries. Median serum myoglobin levels significantly increased after revascularization to a maximum of 4741 micrograms/L (reference range: 0 to 80 micrograms/L) 2 hours postoperatively, with a concomitant and correlated increase in the urine myoglobin concentration. Three days after the operation, serum myoglobin concentrations were still substantially elevated in three patients. None of our patients suffered permanent renal damage, but transient renal impairment was noted in five patients, as evaluated from the serum and urine beta 2-microglobulin concentrations. We found an association between the concentrations of myoglobin in serum and urine (Spearman's rho: 0.66; p less than 0.001) and between the concentrations of myoglobin in urine and beta 2-microglobulin in urine (Spearman's rho: 0.65; p less than 0.001). Our results indicate a transient renal impairment associated with hypermyoglobinemia and myoglobinuria, even after successful arterial embolectomy.

Aged↗

PubMed1986

A simple method for predicting pulmonary function after lung resection.

A simple method for preoperative prediction of lung function following pulmonary resection is described. The principle of the method is assessment of the ventilated part of the lung which possibly will have to be resected. It is based on careful evaluation of the bronchoscopic and radiologic studies always performed in this category of patients. The accuracy of the predicted postoperative change in FEV1 sec and VC is comparable to results obtained from standard radioisotope split lung function tests. The lung function seemed to improve between 1 and 6 months postoperatively.

Adult↗