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Biomedical subjects

N R Lundström

Publications and source records attributed to N R Lundström.

At least 19 recordsLinked to original sources
PubMed1998

Hypoxic-ischaemic encephalopathy is associated with regional changes in cerebral blood flow velocity and alterations in cardiovascular function.

Doppler-derived indices of cerebral blood flow velocity (CBFV) and echocardiographic parameters of left ventricular function were measured in 18 patients with hypoxic-ischaemic encephalopathy HIE (group I) and in 28 normal controls (group II). Group-I infants had a subnormal distribution of CBFV values increasing over the first 85 h postnatally. CBFV values were constantly higher in the internal carotid than in the anterior cerebral artery. During the first 24 h postnatally, pulsatility and resistance indices of cerebral blood flow were significantly higher in group-I patients. From 30 to 85 h after birth, resistance indices were lower in group-I infants with severe HIE. Depressed left ventricular function and/or hypotension was documented in 50% of group-I patients.

Asphyxia Neonatorum↗
PubMed1995

Non-invasive imaging techniques in pediatric cardiology: impact on clinical decision-making.

To plan the treatment of congenital heart malformations, a detailed knowledge of anatomy and hemodynamics is essential. This has previously been obtained by heart catheterization and angiocardiography. During the past 20 years, several non-invasive techniques, such as echocardiography with Doppler, magnetic resonance imaging and isotope techniques have evolved. They have profoundly changed the way we practise pediatric cardiology. For the initial investigation of a patient with suspected heart disease, echocardiography is the routine method. For the less experienced, tele-transmission to a pediatric cardiology center can be used to complement to investigation. In the preoperative investigation, echocardiography with Doppler plays an important role. In some situations, such as aortic lesions or complex cardiac malformations, magnetic resonance imaging is useful. Isotope methods have been used mainly for quantification of the degree of left-to-right shunts. During a 5-year period, 695 infants and children were operated on for a heart malformation: 40% were operated on without previous heart catheterization. For patients needing surgery before 1 month of age, 58% could be operated on based on non-invasive data alone.

Child↗
PubMed1995

A postoperative follow-up study of infantile coarctation of the aorta.

Follow-up investigations were performed in 16 patients operated on for coarctation during infancy. The follow-up period ranged from 4.5 to 11 years (median 5.5 years). Four different surgical techniques were used: resection with end-to-end anastomosis (REE) (4 patients), subclavian flap aortoplasty (SFA) (10 patients), patch aortoplasty (1 patient) and resection and SFA (1 patient). One patient developed recoarctation (6%). She had been operated on by REE at 7 days of age. The other three patients operated on by REE had equal pulses in the arms and legs; none had hypertension and all had normal arm/leg pressure gradients at rest. Seven (58%) of the 12 patients operated on by SFA or aortoplasty had weak radial pulses in the left arm but no limitation of left arm function. The left a rm showed a normal bone age but was smaller and shorter than the right arm in 9 (81%) of the patients. None of the patients operated on by SFA had hypertension and the arm/leg gradient at rest was normal.

Aortic Coarctation↗
PubMed1992

Takayasu's aortitis with renovascular hypertension.

We report a case of Takayasu's disease with severe renovascular hypertension in a girl from Eritrea. In the "burn-out" phase after the erythrocyte sedimentation rate had normalized, reconstructive vascular surgery was performed as further progression of the disease seemed unlikely. However, probably due to her growth, the graft rotated and a second operation was successfully performed.

Anastomosis, Surgical↗
PubMed1992

Intracardiac rhabdomyomas in neonates: report of three cases.

Three cases of intracardiac rhabdomyomas in neonates are presented. All were diagnosed by ultrasound, one prenatally and two directly after birth. Two of the patients were operated on during the neonatal period. The operations were carried out on the ultrasound findings alone. One patient was considered inoperable and died at three weeks of age. The two surviving patients have no cardiac symptoms and involution of the tumors has taken place. Two of the three patients have shown signs of tuberous sclerosis.

Female↗
PubMed1992

Ductus arteriosus aneurysm imaging using modern diagnostic methods.

An aneurysm of the ductus arteriosus carries a high risk of rupture. The radiologic findings are described, based on a review of the literature, and on our experience of 5 patients, successfully diagnosed and treated. A left-sided mediastinal mass is always present, obscured only if the aneurysm has already ruptured. Although the lesion seems to be congenital, conventional radiology sometimes demonstrates wall calcifications. Ultrasonography is well suited to demonstrate the vascular nature of the mass, but interpretation may be difficult because of intervening air-containing lung parenchyma. CT, especially using dynamic scanning with contrast enhancement, is an excellent noninvasive diagnostic method. Angiography is frequently necessary to demonstrate patency or occlusion of the aortic and pulmonary ends of the ductus. The differential diagnosis must include a large number of mediastinal tumors. A temporary widening of the ductus in the newborn is common and must be differentiated from a true aneurysm. Surgical treatment today is usually successful.

Aneurysm↗
PubMed1991

Cross-sectional echocardiographic measurements of right ventricular size and growth in patients with pulmonary atresia and intact ventricular septum.

Fifteen patients with pulmonary atresia or critical pulmonary stenosis and intact ventricular septum were studied. All were operated on in the neonatal period, with valvotomy or a systemic to pulmonary arterial shunt, or both. In 12 patients, right ventricular to pulmonary arterial communication was established in the neonatal period. In three patients, only systemic to pulmonary arterial shunts were constructed. Six patients died. The median follow-up period for the surviving patients was 64 months (range, 12-87 months). Right and left atrial and ventricular dimensions and areas, the tricuspid annular diameter, and the cross-sectional area of the aortic root were measured in cross-sectional echocardiograms from the neonatal period, at the age of 1 year, and at the latest clinical follow-up. A classification of right ventricular morphology was made, based on identification of the inlet, the trabecular, and the outlet parts. Most of the patients had hypoplastic right ventricles at birth but at the latest follow-up, seven of nine surviving patients had right ventricles in the normal range. Right ventricular growth was better in patients who were given a right ventricular to pulmonary arterial communication in the neonatal period and those with complete right ventricular anatomy. The patients who died had severely hypoplastic right ventricles and small tricuspid valves.

Child, Preschool↗
PubMed1990

Myocardial scintigraphy with 201thallium in pediatric cardiology: a review of 52 cases.

We report our experience of myocardial scintigraphy with 201thallium (201Tl) in 52 children, aged 4 days to 18 years, in which 80 studies were made primarily to demonstrate or exclude impaired myocardial perfusion. For analysis, the patients were divided into the following eight groups: group I, coronary artery malformations (five patients); group II, Kawasaki's syndrome (six patients); group III, arterial switch operation (seven patients); group IV, dilated cardiomyopathy (18 patients); group V, hypertrophic cardiomyopathy (four patients); group VI, myocardial dysfunction after surgery for congenital heart disease (five patients); group VII, pulmonary atresia (three patients); and group VIII, miscellaneous (four patients). Myocardial scintigraphy was performed with a planar or tomographic technique at rest or after exercise (four patients). Isotope-uptake defects, indicating impaired myocardial perfusion, were present in 14 patients, including small infants. Defects were seen in all groups except those with hypertrophic cardiomyopathy and pulmonary atresia. The absence of such defects in several of the patients with Kawasaki's syndrome was particularly valuable as it made coronary angiography unnecessary. In the other groups of patients myocardial scintigraphy was a valuable adjunct to other investigations.

Adolescent↗
PubMed1988

Cross-sectional echocardiographic measurement of right atrial and right ventricular size in children with atrial septal defect before and after surgery.

A total of 25 children operated on for atrial septal defect were studied by cross-sectional echocardiography before and after operation. Right atrial and right ventricular dimensions and areas were measured preoperatively and 1-4 years (median, 32 months) postoperatively. The length, width, and area of the right atrium (RA) and the right ventricle (RV) were measured in the apical and the subcostal four-chamber views. The dimension of the RV outflow tract (RVOT) was measured in the parasternal short-axis view. Preoperatively, all group mean values except the subcostal four-chamber length of the RV were significantly larger than normal. After surgery, there was a significant decrease in all of the parameters studied, except for RV length. The mean postoperative values of RA measurements in the apical four-chamber view and of RVOT were still significantly larger than normal. The RV four-chamber measurements except the apical four-chamber length were not significantly enlarged. The greatest decrease in RA and RV size occurred in the first postoperative year. Longer follow-up periods did not change the measurements significantly.

Adolescent↗
PubMed1988

Dimensions of cardiac chambers and great vessels by cross-sectional echocardiography in infants and children.

A total of 120 healthy infants, children, and teenagers were examined by cross-sectional echocardiography. Right and left atrial and ventricular dimensions and areas were measured in the parasternal, apical, and subcostal views. Dimensions of the inferior caval vein, the pulmonary artery and the aorta were obtained in the parasternal, suprasternal, and subcostal views. Reproducibility was studied in separate material consisting of 19 children with various forms of congenital heart disease examined consecutively by two different observers. Interobserver reproducibility was expressed as the 95% tolerance limit for the difference between two measurements. Good correlation with body surface area was demonstrated for all measurements, and the regression equations for the normal values of the parameters studied are given. Interobserver reproducibility was fairly good for measurements in the parasternal views, but moderate or low for measurements in the apical and the subcostal four-chamber views. Measurements in cross-sectional echocardiography are clinically useful, especially in the study of the right-sided cardiac structures that are difficult to evaluate with M-mode echocardiography, but the problems of reproducibility have to be taken into account.

Adolescent↗
PubMed1988

A new type of muscular dystrophy in two brothers: analysis by use of DNA probes suggests autosomal recessive inheritance.

X-chromosome-specific DNA probes were used to study a new type of muscular dystrophy (MD) presented by two boys in a family in which there was no previous history neuromuscular disease. Clinical investigations showed evidence of myogenic myopathyia, but its exact nature could not be established. The results of the DNA analysis exclude DMD, BMD and EMD. We suggest a probable autosomal recessive inheritance for the MD seen in this family.

Adolescent↗
PubMed1986

Estimation of outflow tract pressure gradients by continuous wave Doppler in children.

Continuous wave Doppler echocardiography was used to estimate pressure gradients in 27 children with right or left ventricular outflow tract obstruction. The pressure gradients predicted by Doppler were compared to peak-to-peak and instantaneous gradients measured at cardiac catheterization. When the Doppler study was performed the pressure gradient obtained at catheterization was not known to the examiner. A correlation coefficient of 0.76 was found for the comparison between the Doppler predicted gradient and the peak-to-peak gradient and 0.78 for the comparison with the instantaneous pressure gradient. Clinically significant obstructions could be reliably separated from insignificant obstructions by the Doppler technique.

Adolescent↗
PubMed1986

Diagnostic accuracy of two-dimensional echocardiography combined with Doppler echocardiography in neonates and infants with cardiac symptoms.

In a previous study the diagnostic accuracy of two-dimensional echocardiography was demonstrated. In a review of our clinical material from the last three years the additional value of Doppler echocardiography was evaluated. Doppler echocardiography did improve the diagnostic accuracy in a few groups of patients (patent ductus arteriosus, aortic stenosis and to some extent coarctation of the aorta). The main value of Doppler was however the possibility to obtain information about flow patterns, valve obstruction or regurgitation.

Child, Preschool↗
PubMed1986

Clinical outcome and circulatory effects of fetal cardiac arrhythmia.

By means of abdominal fetal ECG and non-invasive ultrasound blood flow studies 113 cases of fetal cardiac arrhythmia were classified according to the origin of arrhythmia. Pregnancy outcome was characterized by an increased frequency of fetal distress and heart malformation, and increased fetal and neonatal mortality. The following types of arrhythmia were identified: supraventricular extrasystoles (n = 84), paroxysmal tachycardia (n = 6), sinus bradycardia (n = 3), atrial flutter (n = 1), ventricular extrasystoles (n = 14), and atrioventricular block (n = 5). In 37 cases the combined Doppler and real-time ultrasound technique was used to measure fetal aortic blood flow as a means of studying the circulatory effects of the arrhythmia. Increased peak velocity, rising slope and acceleration were found in the first post-pausal beat after a supraventricular extrasystole or a missed beat; this supports the validity of Frank-Starling law for the fetal heart and suggests that a strong relationship exists between these variables and myocardial contractility. In two cases of intra-uterine heart failure, the effect of digoxin treatment in utero on the fetal aortic flow variables was studied, results indicating a positive inotropic effect of the drug on the fetal myocardium. The estimation of fetal aortic volume blood flow in cases of fetal cardiac arrhythmia is useful for early detection of fetal cardiac failure, and for monitoring the effects of intra-uterine treatment.

Adult↗