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Biomedical subjects

S Boström

Publications and source records attributed to S Boström.

At least 19 recordsLinked to original sources
PubMed2005

Behçet's disease, associated with subarachnoidal heamorrhage due to intracranial aneurysm.

Behçet's disease is an unusual medical condition in central Europe and North America, however more common in Turkey and Japan. It was originally described in Turkey, characterized by recurrent oral ulcers, genital ulcers and also uveitis. A variety of vascular lesions such as venous occlusions, arterial aneurysms and varices account for the high rate of morbidity and mortality with this disease. Arterial aneurysms most commonly occur in the abdominal aorta, femoral arteries and in the pulmonary arteries. To our knowledge there have been seventeen documented reports of patient's with Behçet's disease combined with aneurysms of cerebral arteries. We describe a patient with Behçet's disease and subarachnoid haemorrhage due to a ruptured cerebral aneurysm.

Adult↗
PubMed2005

Improved brain protection at decompressive craniectomy--a new method using Palacos R-40 (methylmethacrylate).

A new method is described for protecting the brain after decompressive craniectomy in which a temporary methylmethacrylate flap is formed, somewhat larger than the original bone flap, thus gaining "extra" volume for the oedematous brain in which to expand. The present procedure was developed as a part of ordinary clinical practice particularly in response to demands from the NICU staff and our colleagues at other clinics who were responsible for the care of the patient in the post NICU period. They made us keenly aware that these patients frequently lack optimal co-ordination and balance and therefore run an increased risk of trauma to the unprotected brain when falling. This prompted us to develop a method for brain protection after decompressive craniectomy aiding in the care and rehabilitation until the final installation of the patient's own bone flap can be performed.

Bone Transplantation↗
PubMed2005

A new scaled microgauge for use in neurosurgery.

A new scaled microgauge is described for measuring anatomical structures during microsurgery. The instrument has a tip marked in millimetres, which can be positioned in any desired angle enabling measurement in confined areas.

Anthropometry↗
PubMed2004

Postoperative pseudoaneurysm of the superficial temporal artery (S.T.A.) treated with Thrombostat (thrombin glue) injection.

BACKGROUND: Pseudo-aneurysm is a rare complication of craniotomy. Blunt injury to the temporal artery region is the usual cause, but still a rare complication. CLINICAL PRESENTATION: A patient with subarachnoid hemorrhage was successfully treated by aneurysm clipping. The patient developed hydrocephalus, and was admitted for a shunt operation seventeen days later. The craniotomy had healed normally, but a palpable temporal lump was present in the skin incision. INTERVENTION: The pulsating mass proved to be a postoperative aneurysm of the superficial temporal artery (S.T.A.) and was successfully occluded with 500 units Thrombostat (thrombin glue) which was injected into the aneurysm sac using a 22-gauge needle guided by ultrasound. The permanency of the obliteration was verified by ultrasound examination.

Aged↗
PubMed2002

Exploring sex differences in case fatality in acute myocardial infarction or coronary death events in the northern Sweden MONICA Project.

OBJECTIVES: To investigate sex differences in reaching diagnosis, medical management and case fatality (CF) in acute myocardial infarction (AMI) in the population aged 35-64 years in northern Sweden. METHODS: Within the framework of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) Project, definite AMI was monitored in people aged 35-64 years from 1989 through 1995 (target population 510 000 in 1991). SETTING: In a population based coronary register, all coronary events were recorded in nine hospitals in 1989-95. RESULTS: The number of events included in the definite coronary myocardial infarction register was 2483 men and 669 women. On admission, a higher proportion of men with definite AMI had chest pain or ECG changes typical for AMI (P < 0.0001). Disagreement between clinical diagnosis and classification by MONICA criteria occurred more often in women (P=0.008). A significantly higher proportion of men was admitted in the coronary care unit and they were significantly more often treated with thrombolytics, nitroglycerine, beta-blockers, or antiplatelet agents. Women received significantly more diuretics, inotropics or calcium antagonists. Diabetes, conferring a worse prognosis, was more common in women (20 vs. 15%; P=0.003). Prehospital CF was significantly higher in men (24.1 vs. 18.3%; P=0.005), but in patients treated in hospital, the CF was significantly lower in men (12.7 vs. 21.2%; P < 0.001). Total CF was equal in men and women. CONCLUSIONS: Several factors contributing to the excess in-hospital CF in women were identified, including greater problems in diagnosis of AMI in women which may be one of the reasons for less intensive treatment in women. Differences in co-morbidity, most notably diabetes and medical treatment between men and women with acute AMI may also have played a part.

Adult↗
PubMed2000

Mobile computerized tomography scanning in the neurosurgery intensive care unit: increase in patient safety and reduction of staff workload.

OBJECT: Transportation of unstable neurosurgical patients involves risks that may lead to further deterioration and secondary brain injury from perturbations in physiological parameters. Mobile computerized tomography (CT) head scanning in the neurosurgery intensive care (NICU) is a new technique that minimizes the need to transport unstable patients. The authors have been using this device since June 1997 and have developed their own method of scanning such patients. METHODS: The scanning procedure and radiation safety measures are described. The complications that occurred in 89 patients during transportation and conventional head CT scanning at the Department of Radiology were studied prospectively. These complications were compared with the ones that occurred during mobile CT scanning in 50 patients in the NICU. The duration of the procedures was recorded, and an estimation of the staff workload was made. Two patient groups, defined as high- and medium-risk cases, were studied. Medical and/or technical complications occurred during conventional CT scanning in 25% and 20% of the patients in the high- and medium-risk groups, respectively. During mobile CT scanning complications occurred in 4.3% of the high-risk group and 0% of the medium-risk group. Mobile CT scanning also took significantly less time, and the estimated personnel cost was reduced. CONCLUSIONS: Mobile CT scanning in the NICU is safe. It minimizes the risk of physiological deterioration and technical mishaps linked to intrahospital transport, which may aggravate secondary brain injury. The time that patients have to remain outside the controlled environment of the NICU is minimized, and the staff's workload is decreased.

Ambulances↗
PubMed1999

A new bone dust packer for use in neurosurgery.

A new tool for the packing of bone dust has been developed. The instrument compresses a mixture of bone dust and saline into suitable cylindrical plugs, fitting neatly into craniotomy burrholes. The skullbone at the craniotomy area will heal neatly also assuring the best healing possibilities for the overlying skin. The cosmetic results are excellent as no skin dents or cavities will be formed over the burrholes.

Adult↗
PubMed1999

Mite fauna in the home and sensitivity to house-dust and storage mites.

In search of potential new indoor allergen sources, all mites in dust from homes of 55 asthmatic children living in three climatic regions in Sweden were counted and identified by light microscope. Antibodies of the IgE class against three house-dust mites and three storage mites were measured in corresponding serum samples. Mites were found in all but two homes from the northernmost area, where levels also were lower than in the other regions. The highest mite densities were most often found in bedrooms (50%) and living rooms (40%). Mite density was increased in homes with high humidity and was higher in bungalows than in flats. House-dust mites predominated in the south and storage mites in the east central area, particularly in kitchens and bathrooms. Mite-density and IgE-antibody levels against house-dust mites were significantly associated. The same association applied to storage mites. Other species numbered around 100 mites/g dust in some homes. Microscopy helps to identify potentially important mites. Analysing home dust only for house-dust mites will underestimate mite exposure. Storage mites may be as relevant to sensitivity as house-dust mites. As other species occasionally were found in high numbers, their relevance should also be assessed.

Allergens↗
PubMed1999

Late complications of Silastic duraplasty: low-virulence infections. Case report.

The authors describe three patients with expanding hemorrhagic mass lesions who presented 13 to 18 years after undergoing Silastic duraplasty. In all patients, results of bacteriological cultures of the masses obtained intraoperatively were positive, revealing low-virulence bacteria. Two of the patients were treated with antibiotic drugs and made a good recovery. The third did not receive antibiotic medications initially and later developed an epidural empyema that necessitated reoperation, but subsequently made a complete recovery. Vascularized neomembranes are generally agreed to be causes of the expanding masses, but the possibility that patients could be harboring chronic infections must be considered. Thus, on removal of duraplasty materials a complete bacteriological culture should be obtained, and if it is positive the proper antibiotic therapy should be administered. Furthermore, the creation of a registry of patients who have received implants is advocated to facilitate tracking of implanted material in case of complications.

Adult↗
PubMed1998

The dual-tube microsurgical suction instrument.

A dual-tube suction instrument intended for both macro- and microsurgery has been developed. A detachable air-tight inner tube is fitted into a conventional suction instrument; extending the ordinary sucking tube. The inner tube can easily be fitted, as well as removed from the other tube; a particular advantage in case the inner tube becomes obstructed. On removal of the inner tube the outer tube becomes cleaned and is at once, ready for re-use. Since the suction instrument does not have to be removed from the suction hose, valuable time is saved, enabling permanent sucking capacity.

Equipment Design↗
PubMed1998

Reversibility of severe sagittal sinus thrombosis with open surgical thrombectomy combined with local infusion of tissue plasminogen activator: technical case report.

OBJECTIVE: To explore the controversial issue of anticoagulant therapy and indications for surgery in association with severe sinus thrombosis. METHODS: During the last 4 years, we have treated three patients with severe sinus thrombosis of the dural sinuses. All three patients received systemic anticoagulant therapy and, after experiencing neurological deterioration, underwent open thrombectomy and local thrombolysis. After the operation, aggressive intensive care was given and included cerebral perfusion monitoring, barbiturate administration, hyperventilation, and osmotherapy. The treatment was guided by repeated neuroradiological investigations. RESULTS: All three patients returned to their normal lives. CONCLUSION: Intracranial sinus thrombosis, even in the worst neurological state, should be treated aggressively. A cornerstone in treatment is systemic anticoagulant therapy and repeated neuroradiological studies. When, despite adequate anticoagulant therapy and intensive care, neurological deterioration occurs, a combination of open thrombectomy and local thrombolytic therapy should be considered.

Adult↗
PubMed1998

Environmental assessment of Dermatophagoides mite-allergen levels in Sweden should include Der m 1.

The major allergen of Dermatophagoides microceras, Der m 1, as well as the allergens of D. pteronyssinus and D. farinae, Der p 1 and Der f 1, were analyzed in the homes of 111 asthmatic children in three climatic regions in Sweden. The numbers and species of mites were determined by microscopy, and circulating IgE antibodies against mites were measured. Der f 1 was the predominant house-dust-mite (HDM) allergen, Der p 1 the least often found, and Der m 1 represented 31% of the allergen load. However, in the Linköping area, Der m 1 was the major HDM allergen (58%). Mite counts and allergen levels correlated well. Current exposure to HDM allergens at home was associated with the serum IgE antibody response to HDM in the children with no threshold level. Of the children with IgE antibodies against HDM, 67% reacted to all three mites. Mite sensitization rates were marginally increased (7%) by the addition of IgE analysis of D. microceras to the routine analysis of IgE antibodies against D. pteronyssinus and D. farinae. Thus, Der m 1 may be an important HDM allergen and should be considered when HDM exposure data are assessed in areas with a climate like that of Sweden.

Adolescent↗
PubMed1997

Determination of the kinetic constants of tissue factor/factor VII/factor VIIA and antithrombin/heparin using surface plasmon resonance.

Association of factor VIIa (FVIIa) with tissue factor (TF) is generally believed to be a critical step in the initiation of blood coagulation. In this study the rate constants for the complex formation and dissociation between FVII/FVIIa and TF were studied in real time using surface plasmon resonance, the BIAcore technique. Employing this technique ka and kd were determined and yielded a KD of 1 nM for FVII and 0.5 nM for FVII, respectively. The association and dissociation between antithrombin (AT) and the FVIIa/TF complex was also studied. In the presence of heparin, AT was bound to the FVIIa/TF complex in a dose-dependent manner with ka of 2 x 10(3) M-1 s-1. The binding of AT to FVIIa/TF increased the dissociation of FVIIa from TF about 20-fold.

Antithrombin III↗
PubMed1996

Intracranial subdural haematoma--a rare complication following spinal anaesthesia.

We present a rare case with postspinal headache resulting in an intracranial subdural haematoma. After 5 days of persistant headache the condition was recognized and diagnosed on a computerized tomography-scan (CT) of the skull. The patient was operated with evacuation of the haematoma 2 weeks after the spinal anaesthesia and recovered completely.

Aged↗
PubMed1996

Different fibrinolytic potentials between human umbilical vein endothelial cells and human adult vein endothelial cells.

Endothelial cells play a central role in fibrinolysis due to their production of both tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1). The purpose of this study was to test the hypothesis that the production of t-PA and PAI-1 from human umbilical vein endothelial cells (HUVEC) and from human adult vein endothelial cells (HAVEC) adopt the same pathways for the regulation of fibrinolysis, and that differences in PAI-1 and t-PA production are only quantitative. HUVEC and HAVEC cultures were exposed to phorbol ester (PMA), endotoxin (LPS) or thrombin, singly or in combination with forskolin or H7. The conditioned medium was collected after 16 h and analyzed for t-PA and PAI-1 antigens. The basal production of both t-PA and PAI-1 was significantly higher from HUVEC than from HAVEC. Exposure to PMA, thrombin or forskolin gave a similar response from the two cell types. In contrast, the results from HUVEC and HAVEC differed significantly, not only in magnitude but also in direction, when the cells were exposed to forskolin coincubated with PMA, LPS or thrombin, and in magnitude alone when exposed to LPS only. The results indicate that there are not only quantitative but also qualitative differences in the production of t-PA and PAI-1 from HUVEC and HAVEC. These differences must be taken into account when data from cells of different origin are compared.

Adult↗
PubMed1995

Complex intracellular signal transduction regulates tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type-1 (PAI-1) synthesis in cultured human umbilical vein endothelium.

Endothelial cells are central in fibrinolysis because of their high production of both activators (t-PA, uPA) and inhibitors (PAI-1). The t-PA and PAI-1 synthesis could be regulated by signals transduction at several cellular levels. The purpose of this in vitro study, on cultured endothelial cells, was to explore the receptor/second messenger regulation of the t-PA and PAI-1 synthesis. Quiescent confluent human umbilical vein endothelial cells, cultured in passage 1, were exposed to different test substances. Samples from the conditioned medium were collected after 16 and 24 h and analysed for t-PA and PAI-1 antigen. All data presented were related to the data from control dishes (= 100%), in the same experiment. The results from the present study (mean +/- 95% confidence interval) demonstrated the following. (1) Forskolin, with a documented direct cAMP-inducing effect, decreased the basal PAI-1 production to 61 +/- 15%, and Na-nitroprusside, with a documented cGMP-inducing effect, increased the basal PAI-1 production to 141 +/- 38% without affecting the basal t-PA production. The surface receptor agonists isoprenalin or ephedrine, which indirectly affect adenylate cyclase, had no effect on t-PA or PAI-1 production. (2) Phorbolester (PMA), which directly activates proteinkinase C (PKC), increased the basal t-PA and PAI-1 production to 350 +/- 71%, and 163 +/- 35% respectively. (3) Thrombin, but not endothelin-1 (ET-1), increased the basal t-PA and PAI-1 production to 195 +/- 34% and 136 +/- 18%, respectively, indicating an PKC-mediated thrombin effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗