| 1. |
- Alston-Smith, J, et al.
(författare)
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Endotoxin, epinephrine, glucagon, insulin and calcium ionophore A23187 modulation of pyruvate kinase activity in cultured rat hepatocytes
- 1990
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Ingår i: Acta chirurgica Scandinavica. - : Taylor & Francis. ; 156:10, s. 677-681, s. 677-681
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Tidskriftsartikel (refereegranskat)abstract
- Altered glucose metabolism is one of the commonly observed sequelae of sepsis and septic shock. The present investigation was undertaken to determine the role of endotoxin (ET) upon hepatocyte glucoregulation, by measuring the activity of pyruvate kinase (PK), a key glycolytic enzyme. Hepatocytes were exposed to endotoxin concentrations known to occur in vivo during sepsis, i.e., from 1 X 10(-14) to 1 X 10(-8) g/ml. The alteration of the enzyme activities after addition of epinephrine, glucagon, insulin and calcium ionophore A23187 with and without ET preincubation were also examined. ET alone decreased the PK activity by 12% at all concentrations tested. The basal inhibition of the enzyme caused by epinephrine (-48%) was partially blocked by ET preincubation above 1 X 10(-10) g/ml. There were no ET-(glucagon, calcium ionophore, insulin) interaction. These in vitro results do not support pyruvate kinase as a site of hepatic enzyme regulation defect in endotoxaemia.
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| 2. |
- Bergenfelz, A, et al.
(författare)
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Intraoperative fall in plasma levels of intact parathyroid hormone after removal of one enlarged parathyroid gland in hyperparathyroid patients
- 1991
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 157:2, s. 12-109
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Tidskriftsartikel (refereegranskat)abstract
- Plasma levels of intact parathyroid hormone (PTH) were measured intraoperatively before and after removal of one enlarged gland in 20 hyperparathyroid patients. In 13 patients with a single parathyroid adenoma, plasma levels of intact PTH-(1-84) had declined at 15 min after removal of the adenoma by 86.5 +/- 4.4% of baseline in the antecubital vein and by 85.6 +/- 4.2% in the ipsilateral internal jugular vein. In seven patients with parathyroid hyperplasia, the corresponding figures for decline at 15 min after removal of one enlarged parathyroid gland were only 26.6 +/- 6.4% and 7.8 +/- 29.4%. The fall in PTH levels was significantly less in hyperplasia than in adenoma (p less than 0.001). Thus 15 min after removal of one enlarged parathyroid gland, the decline in plasma level of intact PTH may distinguish between single adenoma and multiglandular disease as the cause of hyperparathyroidism.
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| 3. |
- Mätzsch, Thomas, et al.
(författare)
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Low molecular weight heparin compared with dextran as prophylaxis against thrombosis after total hip replacement
- 1990
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:6-7, s. 445-450
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Tidskriftsartikel (refereegranskat)abstract
- The effect of low molecular weight (LMW) heparin given once daily as prophylaxis against venous thrombosis was compared with that of dextran 70 in an open randomised trial of 100 patients undergoing elective total hip replacement. Four patients were withdrawn after randomisation and thus 96 were included in the final analysis. The development of thrombus was surveilled by the 125I fibrinogen test, and positive readings were verified by venography. Nine of 47 patients given LMW heparin developed thromboses (19%) compared with 18 of 49 given dextran (37%) (p = 0.09). Two further patients who received LMW heparin developed thromboses after leaving hospital (clinical signs became apparent on days 13 and 17, respectively), giving an overall rate of thrombosis in this group of 23%. Minor wound haematomas occurred in two of 47 in the LMW heparin group and three of 49 in the dextran group (4% and 6%, respectively), and blood loss, transfusion requirements, and reduction in postoperative haemoglobin concentration did not differ between the two groups. The studied LMW heparin given subcutaneously once a day was no less safe or effective than dextran in preventing thromboembolism after total hip replacement.
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| 4. |
- Udén, P, et al.
(författare)
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Preoperative localization in unilateral parathyroid surgery. A cost-benefit study on ultrasound, computed tomography and scintigraphy
- 1990
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:1, s. 29-35
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Tidskriftsartikel (refereegranskat)abstract
- In 50 patients with primary hyperparathyroidism, investigation before initial neck exploration included ultrasonography, computed tomography and 99technetium-201thallium subtraction scintigraphy. The sensitivity for correct preoperative localization was 50%, 54% and 56%, respectively. There was marked inter-observer variation in assessment of ultrasonography and computed tomography, while scintigrams were evaluated by only one person. The scintigraphic sensitivity increased with size of the glands. In cases where correct preoperative localization permitted unilateral parathyroidectomy, the time for surgery and anesthesia was significantly reduced. A cost-benefit analysis, however, revealed that the financial saving from this time reduction was outweighed by the cost of the localization procedures. The authors conclude that investigations for definition of enlarged parathyroid glands are not indicated prior to unilateral parathyroidectomy.
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| 5. |
- Vagianos, C, et al.
(författare)
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Intraoperative collection of shed blood with citrated compresses for autotransfusion. An experimental study in pigs
- 1990
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:2, s. 121-126
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Tidskriftsartikel (refereegranskat)abstract
- Six pigs were used to study whether the collection of shed blood by means of surgical compresses instead of suction traumatizes such blood. In an in vivo part of the study, the whole blood volume of the pigs was retransfused after treatment with citrated compresses, and in an in vitro part the blood was treated extensively with compresses and analyzed. All animals survived, with a minor fall in hemoglobin after 48 hours and a rise in serum citrate concentration at the end of the experiment. A study of the coagulation system revealed no important change after retransfusion of compress-treated blood. In the in vitro part of the study, repeatedly squeezing blood from the compresses increased the concentration of free hemoglobin to a maximum of 5 g/l after ten squeezes, whereas platelets were numerically unchanged. The study indicates that collecting shed blood by means of surgical compresses may be a safe and efficient method.
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| 6. |
- Vagianos, C, et al.
(författare)
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Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs
- 1990
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Ingår i: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:10, s. 671-675
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Tidskriftsartikel (refereegranskat)abstract
- Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to more than 7 mmol/l. The aortic pressure was consistently within normal values in the groups treated with calcium, but in the group that was not treated the blood pressure fell dramatically. There was no correlation between electrocardiographic changes and ionised calcium concentrations. In summary, calcium was an effective antidote to lethal citrate intoxication, and the only reliable method of determining the necessary dose of calcium was monitoring of ionised calcium concentrations.
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| 7. |
- Wadström, J, et al.
(författare)
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Closure of the abdominal wall; how and why? Clinical review.
- 1990
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Ingår i: Acta chirurgica Scandinavica. - 0001-5482. ; 156:1, s. 75-82
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Tidskriftsartikel (refereegranskat)abstract
- Closure of the abdomen after surgery has been performed in a multitude of fashions and the literature is flooded with differently tailored studies of this matter. In this paper the available literature in the field has been reviewed with special emphasis on the advantages and disadvantages of continuous or interrupted, mass or layered closure, and on the choice of monofilament or multifilament, resorbable or non-resorbable suture material. After weighing up all the aspects, the authors recommend that the abdomen should be closed with a continuous mass closure technique, using a monofilament suture. No firm conclusion can be drawn from the literature as to whether resorbable or non-resorbable suture should be chosen.
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