| 1. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Management of disseminated midgut carcinoid tumours.
- 1991
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Ingår i: Digestion. - 0012-2823. ; 49:2, s. 78-96
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Tidskriftsartikel (refereegranskat)abstract
- Forty-one patients with disseminated midgut carcinoid tumours were treated over a 6-year period according to a strict programme including primary surgical treatment. In 10 patients, a total remission of the disease was obtained. Patients with bilobar hepatic disease had ischaemic treatment of their liver metastases by hepatic arterial embolisation after primary surgical and medical treatment (low dose octreotide). Thus, by combining surgical, radiological and medical treatment modalities, we wanted to offer these patients optimal palliation. This treatment programme resulted in good symptomatic relief in all patients accompanied by a marked reduction in 5-hydroxyindoleacetic acid (5-HIAA) levels. At recurrence of symptoms in combination with rising 5-HIAA levels, embolisation was repeated. Ten of the treated patients have deceased during the observation period, but only 5 from their carcinoid disease.
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| 2. |
- Andersson, Bert, 1952, et al.
(författare)
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Recovery from left ventricular asynergy in ischemic cardiomyopathy following long-term beta blockade treatment.
- 1994
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Ingår i: Cardiology. - : S. Karger AG. - 0008-6312 .- 1421-9751. ; 85:1, s. 14-22
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that long-term beta blockade treatment in congestive heart failure might be less effective in patients with ischemic cardiomyopathy as compared with patients having idiopathic dilated cardiomyopathy. This study was performed to evaluate the effect of long-term adrenergic beta blockade treatment on regional myocardial function in patients with ischemic cardiomyopathy. The regional wall motion (RWM) was evaluated in 12 patients with ischemic cardiomyopathy before and after long-term open treatment with metoprolol. On average, the patients were treated over 11 months (range 6-36 months). The regional left ventricular function was assessed using two-dimensional echocardiographic recordings by two independent blinded observers. The RWM score was evaluated in 16 segments of the left ventricle on a scale from 0 (hypercontractility) to 5 (dyskinesia). Following treatment, there was an improvement in general ventricular function (ejection fraction 0.24-0.31; p = 0.01) as well as in RWM (86 improved segments, 48 deteriorated, 49 unchanged; p < 0.002). Ventricular segments with poor contractility (RWM score > or = 3.5) tended to improve (53 improved segments, 16 deteriorated, 13 unchanged; p < 0.0001), whereas less severely impaired segments (RWM score < 3.5) did not improve (33 improved segments, 32 deteriorated, 36 unchanged; NS). It is suggested that poorly contracting myocardial segments might improve following beta blockade treatment, while an effect on less impaired segments might be lacking. An improvement in overall myocardial function would then be harder to detect.
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