| 1. |
- Borowiec, Jan, et al.
(författare)
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Heparin-coated cardiopulmonary bypass circuits and 25% reduction of heparin dose in coronary artery surgery : a clinical study
- 1992
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734 .- 2000-1967. ; 97:1, s. 55-66
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Tidskriftsartikel (refereegranskat)abstract
- Cardiopulmonary bypass with systemic heparinization causes trauma to blood cells and coagulation defects. Artificial surfaces could be coated by end-linkage binding of heparin (Carmeda Bioactive Surface, CBAS). Use of such surfaces during cardiopulmonary bypass in animals resulted in less postoperative blood loss and better preservation of blood cells. In this study heparin-coated circuits were employed during coronary artery grafting in 7 patients (Group HC). Concomitantly, the heparin dose was reduced by 25% and an activated clotting time (ACT) of 300 sec was accepted. Additional 7 patients were operated with standard circuits (Group C), requiring ACT above 400 sec with normal doses of heparin. There were no thromboembolic complications in Group HC. The postoperative bleeding was generally low and without significant intergroup differences. Coagulation parameters displayed significantly lower ACT and anti-Factor Xa during bypass in Group HC. A tendency towards less blood cell trauma was observed with heparin-coated circuits. The protamine dose could be reduced by 50%, which significantly reduced the protamine/heparin quotient. This study indicates that routine cardiopulmonary bypass could be performed safely with heparin-coated circuits and reduced intravenous doses of heparin and protamine. It is suggested that the use of heparin-coated circuits may lead to less blood cell trauma.
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| 2. |
- Dubiel, T W, et al.
(författare)
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Mitral valve prosthetic implantation with preservation of native mitral valve apparatus
- 1994
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Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 28:3-4, s. 115-121
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Tidskriftsartikel (refereegranskat)abstract
- To avoid postoperative morbidity and mortality often associated with left ventricular dysfunction after mitral valve replacement (MVR) for chronic mitral insufficiency, reconstruction or preservation of the native mitral valve apparatus may be attempted during mitral prosthetic implantation (MPI). The effects of mitral surgery on heart function, studied with echocardiography and radionuclide angiography, were compared in seven patients with MPI (study group) and five with MVR (control group) who underwent complete preoperative, early postoperative and 3-6 months follow-up examinations. Preoperatively there was significant intergroup difference only in right ventricular ejection fraction measured at radionuclide angiography, which was lower in the MPI group (p < 0.05). At follow-up the MPI group had improved as regards this fraction (p < 0.005) and stroke volume index (p < 0.05). The number of patients with improved NYHA class at follow-up was significantly greater in the MPI group. Our preliminary experience with preservation of the native mitral valve apparatus thus suggests that the method offers haemodynamic advantages for postoperative right ventricular function.
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| 3. |
- Ni, W.-X., et al.
(författare)
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δ-function-shaped Sb-doping profiles in Si(001) obtained using a low-energy accelerated-ion source during molecular-beam epitaxy
- 1992
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Ingår i: Physical Review B. - 0163-1829. ; 46:12, s. 7551-7558
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Tidskriftsartikel (refereegranskat)abstract
- Two-dimensional (2D) buried delta-function-shaped Sb-doping profiles have been obtained in Si using a low-energy accelerated Sb-ion source during molecular-beam epitaxy. A combination of secondary-ion mass spectrometry (SIMS), capacitance-voltage (C-V) measurements, and cross-sectional transmission electron microscopy (XTEM) was used to investigate dopant distributions and to determine profile widths. The 2D-sheet Sb-doping concentration N(Sb), obtained by integrating SIMS delta-doping profiles in samples grown with substrate temperature T(s) = 620-degrees-C and Sb-ion acceleration potentials V(Sb) = 200 and 300 V, was found to vary linearly with the product of the Sb-ion flux and the exposure time (i.e., the ion dose) over the N(Sb) range from 5 X 10(12) to 2 X 10(14) cm-2. The full width at half maximum (FWHM) concentration of 8-doping profiles in Si(001) films was less than the depth resolution of both SIMS and C-V measurements (approximately 10 and 3 nm, respectively). High-resolution XTEM lattice images show that the FWHM was less-than-or-equal-to 2 nm. This is consistent with dopant incorporation simulations, based upon a multisite transition-state dopant incorporation model, which show that accelerated-beam dopant species are trapped in near-surface substitutional sites with atomic mobilities between those of surface and bulk atoms. Dopant surface segregation during growth is strongly suppressed, and the dopant distribution is determined primarily by the straggle in ion trapping distributions. The present results are compared with profile broadening observed in 8-doped layers obtained by solid-phase epitaxy of amorphous Si containing a buried Sb layer.
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| 4. |
- Nordenfelt, E, et al.
(författare)
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Hepatitis C virus infection in hemodialysis patients in southern Sweden: epidemiological, clinical, and diagnostic aspects
- 1993
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Ingår i: Journal of Medical Virology. - : Wiley. - 1096-9071 .- 0146-6615. ; 40:4, s. 266-270
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Tidskriftsartikel (refereegranskat)abstract
- A prevalence of hepatitis C virus (HCV) antibodies of 12% was found in 276 patients from 11 dialysis units. Between zero and 22% of the patients in the different units were anti-HCV positive. The epidemiology of HCV was studied in two units during a 2 year period by antibody assays and the polymerase chain reaction and correlated with clinical manifestations. Two types of epidemiologic patterns were found that may explain the wide difference of HCV prevalence described in different dialysis units. In one unit there was no evidence of spread within the unit, and the prevalence of HCV was dependent on the status of the patients entering for treatment. In the other unit, a clustering of infected patients could be seen in which 13 of 36 were infected during a 3 year period. Some patients who had not received blood transfusions were among the infected. Hepatitis C infection was the most common explanation for repeated abnormal transferase levels. Most of the HCV-infected patients reacted both for anti-HCV and HCV RNA. HCV RNA was in general detected earlier than anti-HCV seroconversion. Among 20 HCV RNA-positive serum samples that were anti-HCV ELISA-positive 18 had indeterminate and two negative reactions by immunoblot (RIBA 2). Thus the RIBA 2 test should be used with caution as a confirmatory antibody test in this group of patients.
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| 5. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Adrenocortical carcinoma--diagnostic and therapeutical implications.
- 1993
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Ingår i: The European journal of surgery = Acta chirurgica. - 1102-4151. ; 159:3, s. 149-58
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the results of treatment of a consecutive series of patients with adrenocortical carcinoma who presented during the six year period 1985 to 1991.
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| 6. |
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| 7. |
- Borowiec, Jan, et al.
(författare)
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Decreased blood loss after cardiopulmonary bypass using heparin-coated circuit and 50% reduction of heparin dose
- 1992
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Ingår i: Scandinavian journal of thoracic and cardiovascular surgery. - 0036-5580. ; 26:3, s. 177-185
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Tidskriftsartikel (refereegranskat)abstract
- In a randomized, double-blind study of patients undergoing elective coronary artery grafting, the effect of heparin-coated circuit combined with 50% reduction of systemic heparin bolus was investigated. Ten patients comprised group HC (heparin-coated) and ten group C (controls). The mean total doses of heparin were 172 IU/kg in group HC and 416 IU/kg in group C and the respective protamine doses were 0.96 and 3.96 mg/kg (both p < 0.001). Activated clotting times during cardiopulmonary bypass were significantly shorter in group HC, and both intra- and postoperative bleeding was significantly less than in group C (7.7 vs. 11.7 ml/kg, p = 0.036, and 6.9 vs. 9.7 ml/kg, p = 0.004). Hemoglobin loss via the drains was 22.5 g in group HC and 43.7 g in group C (p < 0.005). Hemolysis at the end of bypass was significantly greater in group C. Apart from one perioperative myocardial infarction in group HC the postoperative course was uneventful. Use of a heparin-coated circuit is concluded to permit complication-free reduction of heparin and protamine doses and to decrease both intra- and postoperative bleeding, which may favorably influence the outcome of coronary artery grafting.
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| 8. |
- Borowiec, Jan, et al.
(författare)
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Heparin-coated circuits reduce activation of granulocytes during cardiopulmonary bypass : A clinical study
- 1992
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Ingår i: Journal of Thoracic and Cardiovascular Surgery. - 0022-5223 .- 1097-685X. ; 104:3, s. 642-647
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Tidskriftsartikel (refereegranskat)abstract
- Activated granulocytes release highly active enzymes such as myeloperoxidase and lactoferrin, which can be involved in tissue destruction mediated by oxygen free radicals. Cardiopulmonary bypass has been reported to activate granulocytes. Bypass circuits coated with heparin have been shown to reduce release of granulocyte factors in experimental studies. In the present study, heparin-coated circuits were compared with noncoated circuits. In seven patients undergoing coronary bypass, heparin-coated circuits were used (group HC), and seven served as control patients (group C). In group HC the heparin dose was reduced to 75% (225 IU/kg). Group C had the standard dose of 300 IU/kg. No preoperative differences in myeloperoxidase and lactoferrin were observed between the groups. At the end of bypass in both groups, there was a significant increase of these enzymes (p less than 0.001) followed by a later decrease. In group HC, however, the release of myeloperoxidase was significantly lower than in group C (215 +/- 24 versus 573 +/- 133 micrograms/L, mean +/- standard error of the mean). The release of lactoferrin was significantly lower in group HC than in group C both at the end of cardiopulmonary bypass (659 +/- 79 versus 1448 +/- 121 micrograms/L) and 3 hours after bypass (224 +/- 37 versus 536 +/- 82 micrograms/L). Granulocytes as well as total number of leukocytes continued to increase until 1 hour after bypass (p less than 0.001) and then manifested a slow decrease. It was concluded that the use of heparin-coated circuits reduced the release of granulocyte factors because of lower activation of leukocytes.
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| 9. |
- Brabant, G, et al.
(författare)
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E-cadherin: a differentiation marker in thyroid malignancies.
- 1993
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Ingår i: Cancer research. - 0008-5472. ; 53:20, s. 4987-93
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Tidskriftsartikel (refereegranskat)abstract
- Loss of E-cadherin (uvomorulin), a Ca(2+)-dependent cell adhesion molecule required for normal epithelial function, has been attributed a pathogenetic role in tumor invasion. The expression of E-cadherin was studied in normal and neoplastic follicular epithelium of the human thyroid by Northern blot analysis and immunofluorescence on frozen tissue sections. In the normal thyroid (n = 10) and in benign thyroid disorders (n = 21; toxic diffuse goitre; multinodular goitre; follicular adenomas), E-cadherin mRNA levels were equally high and the follicles were generally stained, mainly along the lateral surface of the epithelial cells, by the anti-E-cadherin monoclonal antibody. In anaplastic thyroid carcinomas (n = 6) E-cadherin expression was very low or lacking. In papillary carcinomas (n = 23), E-cadherin mRNA levels varied from nearly normal to highly reduced, which roughly correlated with the overall immunofluorescence intensity. However, the immunostaining also revealed a heterogeneous "all-or-nothing" expression of E-cadherin among adjacent cells in the same tumor. In the follicular carcinomas (n = 9), E-cadherin mRNA levels were in general rather high but the immunostaining varied considerably. A few papillary and follicular tumors lacked immunoreactive E-cadherin in spite of high mRNA levels. In oxyphilic (Hürthle) cell tumors, comprising both adenomas (n = 4) and carcinomas (n = 2), E-cadherin immunoreactivity was reduced and distributed intracellularly rather than at the cell surface. The expression of E-cadherin in relapsing thyroid carcinomas and in tumors with metastatic spreading was, irrespective of the histiotype, low or lacking. Sequential Northern analysis revealed a close correlation between the expression levels of E-cadherin and the thyrotropin receptor. Together, the data suggest that in human thyroid malignancies both gene expression and posttranscriptional control of E-cadherin may be impaired.
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| 10. |
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