[Occluded tubes in infertility. Radiologic recanalization yields good results].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to L Ekelund.
Explore the source record for details and available documents.
Prospective studies of pregnant women were performed to compare individual variations in the plasma concentration of sex hormone binding globulin (SHBG) and pregnancy zone protein (PZP) during pregnancy, and to elucidate the degree of co-variation between these oestrogen sensitive proteins during gestation. The plasma concentration of SHBG manifested continuous increase reaching a 12-fold peak at delivery. The increase of the protease inhibitor PZP paralleled that of SHBG reaching a peak with a 25-fold increase by the beginning of the third trimester. Then it started to decline, while that of SHBG continued to increase. The synthesis of the protease inhibitor may also continue to increase during late gestation but its elimination from the circulation may be accelerated when the syncytiotrophoblastic area in contact with the maternal blood approaches its maximum. The unusually wide individual variation of PZP concentrations in non-pregnant women was confirmed. However, the individual levels increased proportionally during the progress of pregnancy, and we may speak of low, medium and high reactors for PZP. One initial conclusion to be drawn from the present findings is that the value of the plasma PZP concentration can only be interpreted from a pathophysiologic point of view if the patient's baseline level is known.
The Studies of Left Ventricular Dysfunction (SOLVD) trials were designed to evaluate the effects of enalapril on long-term mortality in patients with severe left ventricular (LV) dysfunction. Patients with LV ejection fractions less than or equal to 0.35 and symptoms of congestive heart failure (CHF) were enrolled in the treatment trial, whereas those with no history of overt CHF and taking no treatment directed for LV dysfunction were enrolled in the prevention trial. The baseline clinical characteristics of SOLVD patients were compared to characterize differences between patients in these 2 separate but concurrent trials. From over 70,000 patients screened with LV dysfunction, 4,228 patients were enrolled in the prevention trial and 2,569 patients in the treatment trial. Ischemic heart disease was the primary cause of LV dysfunction in both prevention (83%) and treatment (71%) trial patients. Prior myocardial infarction was present in 80% of the prevention and 66% of the treatment trial patients (p less than 0.001). In the prevention trial, infarction was recent (less than or equal to 6 months) in 27% patients and remote (greater than 6 months) in 57% patients. Treatment trial patients had proportionately more women (20 vs 13%; p less than 0.001) and non-Caucasians (20 vs 14%; p less than 0.001), as well as the coexisting risk factors of hypertension (42 vs 37%; p less than 0.001) and diabetes (26 vs 15%; p less than 0.001) than did prevention trial patients. Clinical characteristics of patients in both trials were influenced by the gender and race of enrolled patients. Similarly, coronary artery bypass surgery was performed less often in women and non-Caucasians.(ABSTRACT TRUNCATED AT 250 WORDS)
In a study of 30 patients with longstanding rheumatoid arthritis the diagnostic usefulness of ultra low field MR equipment was analyzed in assessing lesions of the craniocervical junction. It was found that at 0.04 T all the examinations were diagnostic and that in combination with plain radiography the diagnostic information obtained was valuable in further planning of the treatment strategies. The neurologic findings were related to the degree and severity of atlantoaxial luxation, either horizontal or vertical, and to the periodontoid pannus formation. The correlation between the degree of cord compression shown with MR imaging and the clinical symptoms, especially long tract symptoms, was poor. The only correlating factor was the duration of the disease.
Ultra-low-field (0.04 T) magnetic resonance imaging (MRI) was evaluated in 15 patients with acute trauma to the knee and clinically suspected injuries of the cruciate ligaments. Subsequent arthroscopy was performed within 14 days (mean: 3 days) in 14 patients and after 3 mo in one patient. At arthroscopy/arthrotomy tears of the anterior cruciate ligament (ACL) were verified in 13 patients (11 complete, 2 partial tears). An additional tear of the posterior cruciate ligament (PCL) was found in one patient. All the tears could be demonstrated by MRI. There was one false positive MR diagnosis of ACL tear. It is possible with low-field MRI to diagnose injuries of the cruciate ligaments with good accuracy.
Twenty-four patients (25 knees) with osteoarthrosis (OA) and 19 patients (20 knees) with rheumatoid arthritis (RA) were operated with bi-tricompartmental knee arthroplasty. The patients were randomized to cemented or cementless fixation of the tibial component. The fixation of the tibial components was examined with roentgen stereophotogrammetric analysis (RSA) up to 24 months after operation. The following parameters representing tibial component micromotion were measured: (1) maximum migration of the prosthetic edge (maximum total point motion, MTPM); (2) distal migration of the prosthetic center (subsidence); (3) maximum proximal movements of the prosthetic edge ("lift-off"); and (4) prosthetic rotations, corresponding to internal/external rotation, adduction/abduction, and forward/backward tilt of the tibial component. All prostheses displayed significant micromotions, which tended to decrease 3-6 months after the operation. The average migration after 2 years, when measured as maximum single axis rotation, and MTPM were about 0.9 degrees-1.5 degrees and 1.0-1.5 mm, respectively, in all four groups. There were no statistically significant differences between cemented and cementless prostheses in either the OA or the RA group. The fixation in the RA patients did not significantly differ from that of the OA patients, perhaps because the RA patients had lower weight and were living a more sedentary life.
Radioimmunoscintigraphy (RIS) was performed in 20 patients with gynecologic tumors, 14 ovarian, 5 cervical, and one endometrial carcinoma. One murine monoclonal antibody (mab) against placental alkaline phosphatase (H7) was used after radiolabeling with 131I. The labeling procedure yielded antibodies with specific activity varying between 60 and 73 MBq/mg mab. Each patient received 57 to 100 MBq of the preparation. RIS was performed 7 to 35 days later. Patients with ovarian adenocarcinoma had an accumulation of activity on RIS at tumor sites (79%, 11/14) verified by ultrasonography, CT, and clinical examination. A low or absent accumulation of activity was seen in patients with cervical tumors. The patient with an endometrial adenocarcinoma was seen to have an activity accumulation at RIS corresponding to tumor sites determined by ultrasound and/or CT. It is concluded that RIS using monoclonal antibodies against placental alkaline phosphatase can provide information which will supplement that gained from other investigations of patients with ovarian adenocarcinomas.
The central, peripheral and renal haemodynamic effects after intravenous infusion (1 ml/s) of high doses (4 mg I/kg) of two low osmolar, chemically and physically similar non-ionic contrast media (iohexol and iopentol) were investigated in 16 pigs. Both contrast media induced a significant increase of mean arterial, mean right atrial, mean pulmonary arterial and mean pulmonary arterial occlusion pressure along with an increase in cardiac output. The systemic vascular and pulmonary vascular resistances were decreased. Renal venous blood flow and renal vascular resistance were not significantly changed after infusion of contrast media. There were no differences in haemodynamic effects between the two media studied.
The three-dimensional kinematics of the Tricon-M knee prosthesis during active knee flexion and extension were recorded in 11 patients with arthrosis or rheumatoid arthritis using roentgen stereophotogrammetric analysis. Twenty-three normal knees constituted the control group. The prosthetic knees displayed the same degrees of freedom regarding rotational and translational movements as the normal knees, although the kinematics were different. A combination of internal rotation, abduction, and lateral translation of the tibia was recorded during flexion, and the reversed movements were recorded during extension. During the first 25 degrees of flexion, these movements were small, reflecting the high congruency between the articular surfaces, while beyond 25 degrees they increased. The normal knees displayed a combination of internal rotation, adduction, and medial translation of the tibia during flexion and the reversed movements during extension. The prosthetic knees also exhibited an increased posterior displacement during increasing flexion when compared with the normal knees. There was a correlation between the positioning of the femoral component in the sagittal plane and the recorded anterior/posterior translations. In conclusion, the kinematics of the Tricon-M knee prosthesis significantly differ from the normal knee, probably because of the design of the prosthesis and the absence of the cruciate ligaments.
Extremely low field magnetic resonance imaging (MRI) was evaluated in 16 patients with bone and soft tissue tumors, both benign and malignant. Twelve of the lesions were located in the lower extremity, 2 in the gluteal and 2 in the shoulder region. The findings were compared to the results of computed tomography (CT). Low signal-to-noise ratio and poor spatial resolution result in an image quality which is inferior to that obtained with MR imaging at higher field strengths. In spite of this, the diagnostic information seems to be at least comparable to that obtained from CT.
Three monoclonal antibodies and their Fab and Fab'2 fragments with specificity against human placental alkaline phosphatase (PLAP) were evaluated for tumour immunolocalization of human PLAP-producing Hela Hep 2 tumours in nude mice. The antibodies and their fragments were labelled with 125I and injected intraperitoneally in mice with developing Hep 2 tumours. The animals were followed individually for 14 days with repetitive computerized gamma-camera recordings, which enable quantitation of several crucial parameters, i.e. the time-dependent antibody uptake in the tumours, decrease in background activity and tumour/background ratio. Excellent radioimmunolocalization was obtained with both the intact PLAP-specific immunoglobulins and their fragments but not with the nonspecific antibodies. No background subtraction had to be used. As much as 15% of the initially injected dose could be visualized in the tumours and for the uncleaved mab up to 80% of the radioactivity in the animals was retained in the tumours after 14 days, a considerably longer observation time than usually reported in such tumour xenograft models. The Fab and Fab'2 fragments were found to be excreted fast with less than 5% of the injected dose remaining in the animals after 48 h, but still with positive specific localization to the tumours after an initial high uptake in the kidneys. The results are encouraging and indicate significant potentials of the PLAP-antiPLAP mab system for immunolocalization studies in patients.
Explore the source record for details and available documents.
Angiography may play an important role in the evaluation of patients with erectile failure and in whom abnormal Doppler studies indicate arterial insuffiency. The angiographic examination should give information about major pelvic arteries as well as the peripheral branches of the internal pudendal artery. We describe a method for performing pharmacoangiography of the penile arteries, which involves the local injection of a vasodilator into the corpus cavernosum. Angiography during pharmacologic erection provides optimal visualization of the penile arteries and helps to differentiate functional from organic vascular disorders.
Angiography, cavography, ultrasound (US), computed tomography (CT), and low-field magnetic resonance imaging (MRI) were used to explore venous tumor invasion in 86 patients with renal cell carcinoma. The findings confirm previous experience that ultrasound and dynamic CT are reliable methods for the evaluation of venous invasion. Low-field magnetic resonance imaging does not improve tumor staging. In case of equivocal findings, vena cavography should be used as a complementary examination.
Pudendal angiography was done before and thirty minutes after intracavernous administration of 6 mg phenoxybenzamine in 8 men in whom screening with ultrasound Doppler had revealed abnormalities of the penile blood flow. Five vessels were not visualized until phenoxybenzamine was given. Four vessels displayed marked dilatation, three had moderate and one had slight dilatation after the pharmacologic erection was provoked. The method appears to be of value to increase the quality of the angiographic examination.
The effect of maternal diabetes on functional and biochemical maturation of the fetal lung was studied in a rabbit model. Pregnancy was initiated only after diabetes had been established. Both the pregnant doe and its fetuses were hyperglycemic. For comparison, the fetal heart and liver were also studied. In the diabetic group, the DNA content was lower in the fetal heart and lung while the protein content was higher in all three tissues. The glycogen levels were higher only in the fetal lung. Glycogen synthase was higher in the fetal lung and heart while phosphorylase activity was higher in all three tissues from the diabetic group. The activities of key enzymes involved in glycolysis were not affected. No difference was observed in the concentration of total phospholipids or in the ability of the airway fluid to reduce surface tension. In contrast, fetal lungs from diabetic does did not expand as well as the controls and retained less air on deflation. These findings suggest that the utilization of glycogen in fetal lungs from the diabetic does was not complete and that the increased incidence of respiratory distress in infants of diabetic mothers may not be due to a lack of surfactant.
Explore the source record for details and available documents.
Explore the source record for details and available documents.