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Biomedical subjects

L Norgren

Publications and source records attributed to L Norgren.

At least 163 records · Page 9Linked to original sources

Acute intestinal ischemia. A 14-year retrospective investigation.

The records of 60 patients with acute intestinal ischemia treated between 1969 and 1982 were studied retrospectively. Fifty-three patients (88%) had thrombosis or embolus of the superior mesenteric artery and 7 patients (12%) occlusion of the superior mesenteric vein. Initial symptoms were obscure, although 25% presented with signs of peritonitis. The most frequently used investigation was plain abdominal X-ray with a positive finding in only 1/3. Forty-three patients (72%) were operated on. In 18 patients irreversible changes were found. Total mortality rate was 82%, in SMA-thromboembolism 85% and in SMV-thrombosis 57%. To improve the prognosis clinical awareness of the problem and attempts towards early diagnosis should be raised.

Acute Disease↗

A randomized clinical trial of PTFE versus human umbilical vein for femoropopliteal bypass surgery. Preliminary results.

PTFE (Goretex) and modified human umbilical vein (Biograft) vascular grafts were compared in femorodistal popliteal artery bypass surgery in a randomized clinical multicentre trial. During 18 months 104 patients (104 limbs) entered the trial. Twenty-five patients suffered from claudication, 54 suffered rest pain and 25 patients had ulceration or gangrene. The median preoperative ankle-arm blood pressure index was 0 . 34. Twenty-three limbs had 3 patent tibial arteries, 45 limbs had 2 tibial arteries, 31 limbs had 1 tibial artery while 5 limbs had an isolated popliteal segment. Thirty-six of the operations were redo-operations. Fifty-four patients were allocated to PTFE and 50 to umbilical vein. During follow-up (maximum 650 days) 24 PTFE grafts occluded against 12 umbilical veins. The 1-year patency rate was 40 per cent in the PTFE group against 75 per cent in the umbilical vein group (P = 0 . 014, Gehans test). During the first year the PTFE failure rate was on average 3 . 1 times higher than that of the umbilical vein.

Aged↗

A comparison of two methods of labelling autologous platelets with 111In-oxine in five different species.

Several different methods for labelling autologous platelets with 111In-oxine have been described. However, no comparative study has been reported. In the present investigation two different labelling methods were compared in terms of labelling efficiency and platelet function in five species: human, dog, pig, rabbit and rat. One of the labelling methods, utilising among other things a serum albumin gradient separation of platelets and incubation of 111In-oxine in a water bath at 37 degrees C, was superior in all species with significantly higher labelling efficiency and unchanged platelet function.

Animals↗

A randomized trial comparing cadexomer iodine and standard treatment in the out-patient management of chronic venous ulcers.

Ninety-three patients with treatment-resistant venous ulcers were included in a multicentre randomized trial to compare cadexomer iodine and the standard treatment used in each centre combined with compression bandages, in healing venous ulcers. The mean duration of ulcers before the trial was more than 2 years. With standard treatment the mean ulcer size increased slightly during the 6-week trial whereas with cadexomer iodine the ulcer size was significantly reduced. Cadexomer iodine was more effective than standard treatment for reduction of pain, removal of pus and debris, removal of exudate, stimulation of granulation and reduction of surrounding erythema. Bacterial infection of ulcers increased or did not change during treatment with the standard therapy whereas cadexomer iodine significantly reduced infection with Staphylococcus aureus, Pseudomonas aeruginosa and other pathogenic organisms. A correlation was seen between the time taken to reduce or eliminate infection with Staphylococcus aureus and rate of ulcer healing. Four patients complained of transient pain in the ulcer after application of the cadexomer iodine. It is concluded that cadexomer iodine increased the rate of healing of infected chronic venous ulcers.

Administration, Topical↗

Streptokinase treatment of deep venous thrombosis and the postthrombotic syndrome. Follow-up evaluation of venous function.

The conditions of 35 patients with deep venous thrombosis treated with streptokinase were reevaluated after a mean of 29 months with clinical examination, venous plethysmography, foot volumetry, phlebography (28 patients) and femoral vein pressure measurement (24 patients). At follow-up, 25 patients (71%) had symptoms and 22 (63%) had signs of venous insufficiency. Plethysmography was abnormal in 29 patients (83%) and foot volumetry in 25 (72%). Only two (6%) of the patients had normal plethysmography and foot volumetry and were free from symptoms and signs. No leg ulcer or severe postthrombotic syndrome was found. Phlebography showed that no patient had a normal deep venous system. Six of earlier thrombotic iliac veins (38%) and femoral veins 14 (48%), respectively, remained occluded. Increased femoral venous pressure, more pronounced during and after exercise, was found when iliac vein was diseased. Our results emphasize the importance of functional evaluation of the patient with a postthrombotic leg.

Adult↗

Axillofemoral bypass reconstructions in sixty-one patients with leg ischemia.

During a 5-year period, 61 axillofemoral bypass operations have been performed in patients regarding as poor risks for conventional bifurcations procedures with arteriosclerotic occlusive disease and in patients with graft infections. Velour-Dacron grafts and expanded polytetrafluoroethylene (PTFE)-grafts have been used. The results are encouraging with a 3 year graft patency rate of 75% and a 3 year limb salvage rate of 90%. The expanded PTFE graft is a suitable graft for this purpose, and the use of axillofemoral bypass grafting is recommended as an alternative to the conventional aortoiliac/femoral bypass graft when dealing with high risk patients and patients with graft infections.

Aged↗

Aorto-iliac disease in premenopausal women.

Fifteen premenopausal women had by-pass reconstruction performed for aorto-iliac disease. A high prevalence of smoking, oral contraception and hyperlipemia was found. The outcome of reconstructive surgery was initially excellent. Serious complications and progress of the arteriosclerosis, however, made the late results more doubtful.

Adult↗

[Ultrasound diagnosis of non-aneurysmic pulsating abdominal tumors].

Ninety-two patients with a pulsating abdominal mass and suspected abdominal aortic aneurysm (AAcA) were examined by ultrasonography. We diagnosed 48 cases (52%) of AAA and 5 unexpected lesions ventral to the aorta (5%), but in 39 cases (42%) we were not able to explain the symptom in spite of extensive diagnostic efforts and follow-up. Changes of the aorta or transmission of the pulse by adjacent structures are the main cause of a pulsating abdominal mass. Ultrasound examination appears to be optimal screening method for diagnosing AAA as well as the other symptoms no further diagnostic efforts are necessary after a negative ultrasound study.

Abdominal Neoplasms↗

Synthetic arterial grafts. III. The outcome in 22 patients with synthetic axillofemoral bypass grafts.

During the 4-year period 1973--76, 22 patients were operated upon with axillofemoral bypass grafts at the Department of Surgery in Lund. They were high-risk patients with severe ischaemia of the leg or previous graft infections. Fourteen of the 22 grafts were well-functioning after the longest observation time of 32 months. The operative procedure is described and postoperative compliations are reviewed. The axillofemoral bypass reconstruction is recommended as an alternative for this category of patients in whom the conventional aortic bifurcation graft is unsuitable.

Aged↗