| 1. |
- Arnbjornsson, E.
(författare)
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Acute appendicitis risk in various phases of the menstrual cycle
- 1983
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 149:6, s. 603-605
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Tidskriftsartikel (refereegranskat)abstract
- The significantly different age-specific incidence of acute appendicitis between males and females in the second, third and fourth decades of life led to a study of the frequency of acute appendicitis and the degree of appendiceal inflammation found at operation in the different phases of the menstrual cycle. The frequency of acute appendicitis was almost twice as high in the luteal phase as in the other half of the menstrual cycle. The proportion of gangrenous, perforated or normal appendices was significantly higher in the menstrual and follicular phases of the cycle. The study indicated that the female sex hormones may play an important etiologic part in acute appendicitis or may influence the inflammatory process in the appendix.
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| 2. |
- Arnbjornsson, E., et al.
(författare)
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Decreasing incidence of acute appendicitis, with special reference to the consumption of dietary fiber
- 1982
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 148:5, s. 461-464
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of acute appendicitis and the total number of appendectomies performed in the adult population admitted to our medical center are both decreasing. The cause is not clear. Better nutrition and the wide-spread use of antibiotics are two possible factors which come to mind, but we know of no scientific evidence that these are responsible. There has been a slight decrease in the mean dietary fiber content in the Swedish diet during the last three decades. The decreased incidence of acute appendicitis cannot therefore be correlated with an increase in the mean dietary fiber intake.
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| 3. |
- Arnbjornsson, E., et al.
(författare)
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Obstruction of the appendix lumen in relation to pathogenesis of acute appendicitis
- 1983
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 149:8, s. 789-791
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Tidskriftsartikel (refereegranskat)abstract
- The role of obstruction in the pathogenesis of acute appendicitis was studied by measuring the pressure in the appendix peroperatively in 33 patients undergoing appendectomy because of suspected acute appendicitis. The technique involved insertion of a fine needle via the apex into the lumen of the appendix and measurement of the hydrostatic pressure required to inject a saline solution. In all six patients with gangrenous appendix and in two patients with phlegmonous appendix there were signs of obstruction of the appendix lumen expressed as raised intraluminal pressure. In 19 patients found at operation to have phlegmonous appendix there were no signs of obstruction. The experimental data suggest that obstruction is not an important factor in the causation of acute appendicitis, but may develop as a result of the inflammatory process.
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| 4. |
- Bergqvist, D, et al.
(författare)
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Abdominal trauma in persons older than 60 years
- 1982
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 148:7, s. 569-573
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Tidskriftsartikel (refereegranskat)abstract
- Abdominal trauma occurring in persons older than 60 years over a 30-year period (1950-79) in a well defined region of Sweden was reviewed. The 177 patients comprised 12.5% of the total with abdominal trauma during that period. Road traffic accidents were the main cause of trauma (48% of cases). The incidence of motor-car accidents rose sharply during the first two decades of the study. Injuries to the liver and bile ducts and multiple intra-abdominal injuries were more common in the elderly than in younger patients, but injury to the abdominal wall was less common. A tendency towards more severe injuries and multiple trauma with extra-abdominal involvement emerged during the study period. The mortality rate was 27.6% in the patients older than 60, but 9.1% in the overall patient series with abdominal trauma. One-third of all the deaths among the older patients were directly due to the abdominal trauma. One consequence of the increasing numbers of old people in the general population is probably that more and more cases of abdominal trauma will be seen in the higher age groups.
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| 5. |
- Bergqvist, D, et al.
(författare)
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Extraanatomic vascular reconstruction in patients with aorto-iliac arteriosclerosis
- 1984
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 150:3, s. 205-209
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Tidskriftsartikel (refereegranskat)abstract
- During an 11-year period 117 extraanatomic reconstructions were made for aorto-iliac arteriosclerosis; 36 axillofemoral and 81 femorofemoral crossover bypasses. The patients were old and had several factors making them poor risks for surgery. Axillofemoral grafts were more often used in patients with malignant disease. Postoperative mortality was 10% without difference between the two types of reconstruction. Both early and late complications were significantly more frequent in patients with axillofemoral bypass. Reoperations for occlusion and symptoms from the donor side also were significantly more common among axillofemoral patients. Life table analysis showed a higher survival and patency rate among patients with crossover grafts.
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| 6. |
- Bergqvist, D, et al.
(författare)
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Intestinal trauma, Analysis of 101 cases
- 1981
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 147:8, s. 629-635
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Tidskriftsartikel (refereegranskat)abstract
- Intestinal injuries sustained by 101 Swedish patients during the period 1950-1979 are reviewed. The abdominal trauma was blunt in 78 cases and penetrating in 23. Small-bowel and mesenteric, but not large-bowel, injuries showed increasing frequency. This was associated with rising numbers of motorcar accidents. Injuries to other abdominal organs were found in 56 of the 101 patients, particularly in those with mesenteric or large-bowel trauma. Clear physical signs of intra-abdominal injury led to rapid surgical exploration in most cases, but some operations were performed after relatively long observation. Most injuries, including those in the colon, were treated with primary repair or resection. Decompressive colostomy or exteriorization were rarely performed. Deaths were mainly caused by other factors than the type of operation. The mortality rate (35%) was constant.
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| 7. |
- Bergqvist, D, et al.
(författare)
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Upper gastrointestinal trauma. Analysis of 45 cases of gastric, duodenal or pancreatic injury
- 1981
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 147:8, s. 637-643
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Tidskriftsartikel (refereegranskat)abstract
- Injuries to the upper gastrointestinal tract occurring over a 30-year period in a geographically well defined region were analyzed. The incidence was low in comparison with other abdominal injuries, but duodenal and pancreatic injuries were increasingly common in the study's last decade. The stomach injuries were mainly caused by penetrating trauma. The duodenal and pancreatic injuries most commonly resulted from road-traffic accidents. Two duodenal injuries were overlooked at the initial exploration, in which the duodenum was incompletely exposed. Anastomotic insufficiency occurred in one of the three patients who underwent duodenal resection. Most of the pancreatic injuries were contusions that could be managed with drainage. The pancreas was severely damaged in five patients, all of whom had multiple intra-abdominal injuries. Three of the five patients died before or during operation.
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| 8. |
- Bowald, S, et al.
(författare)
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Pulmonary microembolism during and after aortic cross-clamping in heparinized and non-heparinized pigs.
- 1980
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Ingår i: Acta chirurgica Scandinavica. - 0001-5482. ; 146:5, s. 351-6
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Tidskriftsartikel (refereegranskat)abstract
- The occurrence of pulmonary microembolism after aortic clamping and declamping was investigated in 21 young pigs. The prophylactive effect of heparin was also examined. Eight animals were heparinized, while 13 did not receive heparin. In 15 pigs the plasma concentration of fibrinogen was determined before, during and after clamping of the aorta. External detection of 51Cr-labelled platelets and 125I-labelled fibrinogen was performed. Lung tissue from these animals was homogenized and analysed for radioactivity. Specimens were taken from the lungs of all animals for morphological investigation. A significant decrease in plasma fibrinogen concentration was noted during the aortic clamping in non-heparinized animals. Morphological studies of lung tissue revealed numerous fibrin/platelet thrombi, leukocyte and platelet aggregates, atelectases and bleedings. In homogenized lung tissue, areas with elevated radioactivity were found, indicating fibrin/platelet entrapment. No such changes were seen in pigs pretreated with heparin. It was found that pulmonary microembolism occurs frequently after aortic clamping if heparin is not given at an early stage of the procedure.
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| 9. |
- Claesson, B, et al.
(författare)
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Biliary microflora in acute cholecystitis and the clinical implications
- 1984
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 150:3, s. 229-237
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Tidskriftsartikel (refereegranskat)abstract
- A prospective bacteriologic investigation was made in 43 consecutive patients (mean age 63 years) operated on for acute cholecystitis. Gallbladder bile and wall were cultured, using four methods and with special attention to optimal anaerobic technique. Cultures were positive in 72% of the patients, yielding a wide variety of species (21 species among 48 isolates). Anaerobes constituted 23% of the isolates. Cultures from gallbladder bile and from gallbladder wall gave almost identical results, as did sampling at the beginning and at the end of cholecystectomy. Bactibilia was found in all patients operated on within 48 hours after the onset of symptoms. Bactibilia and postoperative septic complications showed statistically significant correlation with high patient age. Bactibilia and gallbladder gangrene were significantly correlated with preoperative temperature greater than 38.5 degrees C. There was coincidence of strains isolated from local wound sepsis and from peroperatively sampled gallbladder bile. Adequate preoperative or peroperative antibiotic therapy according to susceptibility testing was associated with significantly reduced rate of postoperative septic complications. The study indicates that bacteria are present early in the course of acute cholecystitis and that they are causally important for postoperative morbidity and mortality.
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| 10. |
- Hafstrom, L., et al.
(författare)
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Blood flow in experimental liver tumors : Effect of vasoactive drugs
- 1980
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 146:3, s. 149-153
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Tidskriftsartikel (refereegranskat)abstract
- The effects of infused glucagon, histamine and vasopressin on blood flow in anesthetized rats with intrahepatic tumors were studied using microspheres labelled with 99Tcm or 51Cr isotopes. Considerable circulatory effects were noted both in central hemodynamic parameters as well as in organ and tissue blood flows. Glucagon infusion increased blood flow in the spleen and small intestine while hepatic artery flow was unchanged. Histamine induced a decrease in hepatic and pulmonary blood flow. Vasopressin showed a pronounced decrease in blood flow in all organs measured. Relative tumor blood flow was registered as the ratio between tumor flow and arterial hepatic flow. A relative decrease of tumor blood flow in relation to surrounding liver tissue blood flow was registered after infusion of vasopressin. No effects were seen after glucagon or histamine infusion.
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| 11. |
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| 12. |
- Mätzsch, Thomas, et al.
(författare)
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Cholescintigraphy: a valuable diagnostic method in acute cholecystitis
- 1983
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 149:2, s. 187-191
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Tidskriftsartikel (refereegranskat)abstract
- In 91 patients (36 men, 55 women) who were hospitalized with symptoms of acute cholecystitis, cholescintigraphy was performed with 99m-Tc-ethyl-IDA, in order to evaluate the method in the diagnosis of acute inflammatory disease of the gallbladder. Five groups of patients were recognized: (A) abnormal scintigraphy and verified gallbladder disease, (B) abnormal scintigraphy without verified gallbladder disease (false positive). (C) normal cholescintigraphy but cholelithiasis (false negative), (D) normal cholescintigraphy and no gallbladder disease, and (E) cholescintigraphy in icteric patients. In the diagnosis of acute cholecystitis the sensitivity was 92% and the specificity was 88%. Cholescintigraphy is a useful method for proving or disproving a diagnosis of acute cholecystitis with non-patent cystic duct. It does not reveal calculi in biliary ducts or in a gallbladder with patent cystic duct. In icteric patients, cholescintigraphy has restricted usefulness at serum bilirubin level around 120 mumol or more.
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| 13. |
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| 14. |
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| 15. |
- Tegner, Yelverton, et al.
(författare)
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Traumatic disruption of the thoracic aorta
- 1984
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 150:8, s. 635-8
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Tidskriftsartikel (refereegranskat)abstract
- Fourteen cases of injury to the thoracic aorta treated in 1959-1981 are reviewed. Acute rupture was present in nine patients and chronic post-traumatic aneurysm in five. Most of the patients had other, associated injuries, and physical signs of the aortic injury were often scanty. Widening of the mediastinum was the most common roentgenographic finding. All the aortic ruptures were localized to the isthmus. One patient declined surgery. Another died on the operating table just before surgery was started. A third patient died peroperatively from severe bleeding when the aneurysm was dissected free. All of the other 11 patients survived operation without major complications. At follow-up (mean 10 years), ten patients were alive and well and one had died of unrelated cause. The most recent operations were performed with the aid of a TDMAC (Gott) shunt, which makes aortic repair safe and simple. Because aortic trauma often is accompanied by other, severe injuries which make transportation of the patient risky, and so as not to delay operation, the aortic lesions should be repaired at general surgical units. If necessary, a thoracic surgeon should be brought to the hospital
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| 16. |
- Ware, James H., et al.
(författare)
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Osmolar changes in haemorrhage : The effect of an altered nutritional status
- 1982
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Ingår i: Acta Chirurgica Scandinavica. - : Almqvist & Wiksells. - 0001-5482. ; 148:8, s. 641-646
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Tidskriftsartikel (refereegranskat)abstract
- Fed and 24-30 hour starved rats were submitted to haemorrhagic hypotension, 70 mmHg, with a modified Wigger's system. Neuroleptanalgesia was used to ensure a normal degree of stress reactivity. Despite fed animals losing 53% of their original blood volume (BV) and starved animals 47% (BV=6% prestarved body weight), blood gas data and creatinine levels confirmed a well intact and compensated status in both groups. Fed animals compensated for the greater haemorrhage with a haematocrit reduction which was double that in starved animals. When the alterations in osmole skeletons were compared, evidence for an intracellular fluid (ICF) shift to the interstitium was obtained infed rats. Their NaCl space increased by 5.5%. Glucose increased its osmolar effect by 224% among fed animals and was reduced in those which had been starved. Glucose was identified as the solute causing an acute mobilisation of ICF to the interstitium.
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