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Träfflista för sökning "hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Kirurgi) ;pers:(Norgren Lars)"

Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Kirurgi) > Norgren Lars

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1.
  • Norgren, Lars, et al. (författare)
  • Immune response to collagen impregnated Dacron double velour grafts for aortic and aorto-femoral reconstructions
  • 1990
  • Ingår i: European Journal of Vascular Surgery. - 0950-821X. ; 4:4, s. 379-384
  • Tidskriftsartikel (refereegranskat)abstract
    • This study presents 20 patients, randomised to receive either a collagen-treated or an ordinary Dacron graft for aortic reconstructions, and the results of a skin-prick test, blood parameters and ELISA for anti-collagen antibodies as well as NMR pictures during a 6 week follow-up period. Forty per cent (4/11) of those receiving a collagen impregnated graft had a significantly increased titre of antibodies and NMR revealed in two out of 11 patients either a slightly increased amount of fluid or fibrosis around the graft, both collagen impregnated. No differences were found between the graft groups concerning body temperature and leucocyte or platelet counts. The skin-prick test for collagen was negative in all cases.
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2.
  • Sjöberg, Trygve, et al. (författare)
  • Antagonism of thromboxane receptor induced contractions in isolated human groin lymphatics
  • 1989
  • Ingår i: Lymphology. - 0024-7766. ; 22:3, s. 135-140
  • Tidskriftsartikel (refereegranskat)abstract
    • In vitro studies were performed on lymphatics obtained from the groin in 19 patients undergoing vascular surgery. The lymphatics were mounted in tissue baths, and isometric contractions were induced by increasing concentrations of the thromboxane A2 (TXA2) mimetic U-46619. In comparison to K+ (124mM)-induced contraction, which were used as an internal standard, the response to U-46619 had an Emax of 105 +/- 5.9%. The pEC50-value was 8.14 +/- 0.09. The effects of two thromboxane receptor (TP-receptor) antagonists, L-636,499 and BM-13,505, were investigated. Both antagonists caused concentration-dependent right-ward shifts without depression of Emax of the U-46619 concentration-response curves. The slopes of the regression lines in a Schild plot for both antagonists did not differ from one, indicating competitive antagonism. The pA2-value of BM-13,505 (7.89) was 65 times higher than that of L-636,499 (6.08). The results suggest that the receptor involved in the prostanoid contraction in human groin lymphatics is of the TP-subtype.
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3.
  • Sjöberg, Trygve, et al. (författare)
  • Comparative effects of the alpha-adrenoceptor agonists noradrenaline, phenylephrine and clonidine in the human saphenous vein in vivo and in vitro
  • 1989
  • Ingår i: Acta Physiologica Scandinavica. - 0001-6772. ; 136:3, s. 463-471
  • Tidskriftsartikel (refereegranskat)abstract
    • The alpha-adrenoceptor-mediated contractile effects of noradrenaline (alpha 1 + alpha 2), phenylephrine (alpha 1) and clonidine (alpha 2) on human saphenous veins were investigated in vivo and in vitro. By infusion (0.3 ml min-1) of the drugs (increasing concentrations in the infused solution) into distended (40 mmHg) saphenous veins in six healthy subjects, local vasoconstriction was induced, measured by a photo-electric device. The drugs induced dose-dependent contractions in all subjects, and dose-response curves were constructed. These were compared with concentration-response curves based on in-vitro results. Macroscopically normal saphenous veins, taken at saphenousectomies, were used, and the preparations were contracted isometrically in organ baths by the agonists. From the curves obtained in vivo and in vitro, the relative potencies of phenylephrine and clonidine (in relation to noradrenaline) were calculated and compared. The relative potencies of phenylephrine in vivo (76%) and in vitro (82%) did not differ significantly. However, the relative potency of clonidine was significantly (P less than 0.05) lower in vivo (90%) than in vitro (99%). Thus, it is concluded that there are differences between the results obtained in vivo and in vitro, stressing the importance of comparative in vivo-in vitro studies.
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4.
  • Sjöberg, Trygve, et al. (författare)
  • Contractile response in isolated human groin lymphatics
  • 1987
  • Ingår i: Lymphology. - 0024-7766. ; 20:3, s. 152-160
  • Tidskriftsartikel (refereegranskat)abstract
    • Lymphatics from the human superficial groin removed at operation in 21 patients (one with lymphedema) were examined in vitro. Histochemically no nerves were identified with either specific catecholamine fluorescence or immunoreactivity to tyrosine hydroxylase or dopamine beta-hydroxylase. Ring preparations of the lymphatics were mounted in tissue baths and isometric induced contractions were recorded after administration of K+ (124 mM), acetylcholine, selected amines and prostanoids. Noradrenaline (NA), adrenaline, dopamine, and acetylcholine had no or only weak contractile effects. In some segments, serotonin induced contractions. Prostaglandin E2 showed no contractile effect and prostaglandin F2 alpha induced contraction in most of the tested lymphatics. The prostaglandin-endoperoxide analogue U44069 uniformly elicited marked concentration-dependent contraction. In the lymphatic segment from the patient with lymphedema, a slightly greater contractile response to NA and serotonin was observed. The results overall suggest an absence of sympathetic innervation and contraction-mediating alpha adrenergic receptors in human superficial groin lymphatics, and support that certain prostanoids may be important regulators of human lymphatic contractility.
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5.
  • Sjöberg, Trygve, et al. (författare)
  • Contractility of human leg lymphatics during exercise before and after indomethacin
  • 1989
  • Ingår i: Lymphology. - 0024-7766. ; 22:4, s. 186-193
  • Tidskriftsartikel (refereegranskat)abstract
    • Subcutaneous lymphatics in the lower leg were catheterized in the retrograde direction in 6 healthy male subjects. The catheter was connected to a pressure transducer, and pressure was measured during three stages of exercise including standing, tip-toeing, and running in place. Before the third stage, indomethacin (50mg) was given i.v. Rhythmic pressure waves were registered in each subject. During the second stage, when the subjects were "warmed up," the frequency (min-1) was 2.4 +/- 0.5 (mean +/- SEM). The corresponding values during tip-toeing and running were 5.8 +/- 0.7 (p less than 0.05) and 5.4 +/- 0.5 (p less than 0.05), respectively. The amplitudes (mean values between 3.2-4.7mmHg while standing) were not consistently altered during tip-toeing or running in any of the three stages. During standing there was a negative correlation between frequency and amplitude. No such correlation was found during tip-toeing or running, or after injection of indomethacin. Indomethacin did not significantly alter any of the measured parameters, but in two subjects the frequencies and amplitudes were decreased (about 50%) during standing, tip-toeing, and running.
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6.
  • Herbst, Andreas, et al. (författare)
  • Infections and antibiotic prophylaxis in reconstructive vascular surgery
  • 1989
  • Ingår i: European Journal of Vascular Surgery. - 0950-821X. ; 3:4, s. 303-307
  • Tidskriftsartikel (refereegranskat)abstract
    • In 98 patients undergoing elective vascular surgery, specimens for bacterial cultures were obtained from urine, ischaemic ulcers, incisional wounds and the implanted grafts. Wound and graft infections were registered and compared with the results of these cultures and suspected risk factors in an attempt to find the source of infections. Antibiotic prophylaxis with cefuroxime was given for 24 h beginning at the start of surgery. Patients with ischaemic ulcers also received "spread prophylaxis", directed against isolated bacteria, for ten days. Three cases of graft infection and twelve cases of wound infection occurred. Positive postoperative cultures from wounds did not correlate with pre- or peroperative cultures. Peroperative cultures revealed small numbers of staphylococcus epidermidis in eleven patients, and none of them developed graft infection. Ischaemic ulcers, diabetes or re-do procedures were not accompanied by a significantly increased frequency of wound or graft infection, although each of three patients with graft infection had one of these risk factors. Bacteria, sensitive to cefuroxime, were found in one graft infection, six wound infections, and in two patients with urosepsis, whereas cefuroxime resistant organisms were isolated from one graft infection and three infected wounds. One of the three graft infections was probably caused by bacteria originating from the patient's ischaemic ulcer. In the other two patients the source of bacteria could not be determined. Cefuroxime seems to be an adequate alternative for prophylaxis of vascular graft infection, but in some patients with bacteriuria or indwelling catheters, a one day regimen may be too short.
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7.
  • Thörne, Johan, et al. (författare)
  • Effect of ticlopidine and prostaglandin E on endotoxin-induced pulmonary platelet sequestration in vivo
  • 1986
  • Ingår i: Circulatory Shock. - 0092-6213. ; 20:1, s. 61-69
  • Tidskriftsartikel (refereegranskat)abstract
    • Prostaglandin E1 has earlier been shown to decrease pulmonary platelet trapping (PPT) following shock. This experiment was performed to evaluate a new method to study PPT in vivo, and to study the effect of prostaglandin E1 and a new antiplatelet drug (ticlopidine) on PPT in rabbits after i.v. administration of endotoxin. Following platelet labeling with In-111, the rabbits were placed under a scintillation camera for continuous measuring of the activity distribution for 40 minutes. The first five minutes represented reference values, whereafter endotoxin E. coli was injected i.v. The following 2-4 minutes showed a sudden increase of radioactivity over the lungs and a simultaneous decrease over the heart, indicating PPT in the nontreated animals, followed by a slow decrease to almost preshock values during the following 30 minutes. Animals receiving prostaglandin E1 showed a significantly lower activity peak in the lungs after the administration of endotoxin, while the corresponding peak in ticlopidine-treated animals did not differ from that seen in the nontreated animals. In all groups, endotoxin caused a decrease in platelet count, but it was significantly lower in the PGE1-treated animals. The results have shown that this diagnostic model for PPT is reliable and may be used for evaluation of the effect on platelet aggregation in vivo of different drugs
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8.
  • Björck, M, et al. (författare)
  • Twenty years with the Swedvasc Registry.
  • 2008
  • Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 35:2, s. 129-30
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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9.
  • Dreifaldt, Mats, 1959- (författare)
  • Conduits in coronary artery bypass grafting surgery : Saphenous vein, radial and internal thoracic arteries
  • 2013
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • A novel technique for saphenous vein (SV) graft harvesting, the No-touch technique (NT), has been developed at the Dept. of Cardiovascular surgery, Örebro University hospital. With NT the SV is harvested with a pedicle of surrounding tissue. This avoids graft spasm and eliminates the need for distension. The surrounding tissue acts as a structural support and is a rich source of vaso-dilating agents. A randomized controlled trial (RCT) has shown a significantly higher patency rate for NT SV grafts compared to SV grafts harvested with conventional technique (CT). This thesis evaluates some of the properties of the surrounding tissue and compares patency rates between NT SV and radial artery (RA) grafts and patency rates for internal thoracic artery (ITA) grafts harvested with and without surrounding tissue. Paper I investigated vasa vasorum (VV) in SV grafts and showed that the NT preserves an intact VV whereas CT does not. This could be one of the mechanisms underlying the improved patency for NT SV grafts. Paper II evaluated VV and associated nitric oxide (NO) in SV and arterial grafts. SV grafts showed a higher number and larger VV, which correlated with NO production, compared to arterial grafts. NT SV grafts showed higher activity for e-NOS compared to CT SV grafts. Paper III is a RCT comparing patency rates between NT SV and RA grafts, three years after surgery, showing a significantly higher patency rate for NT SV grafts. Paper IV is a RCT comparing patency rates for ITA graft harvested with and without surrounding tissue and did not show any difference between graft preparations. In conclusion, the NT for SV graft harvesting preserves an intact vasa vasorum and associated NO production. NT SV grafts show a higher patency rate than RA grafts. Harvesting of ITA with or without surrounding tissue does not affect patency rate. 
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10.
  • Hörer, Tal M., 1971-, et al. (författare)
  • Complications but not obesity or diabetes mellitus have impact on the intraperitoneal lactate/pyruvate ratio measured by microdialysis
  • 2010
  • Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 45:1, s. 115-121
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Studies have shown a higher risk of postoperative complications in diabetic and obese patients. An increased intraperitoneal lactate/pyruvate ratio as measured by microdialysis has been reported before postoperative complications have been discovered. It is not known whether diabetes or obesity have any influence on the intraperitoneal metabolism (lactate/pyruvate ratio, glucose, glycerol) in relation to major abdominal surgery. The aim of this study was to investigate the postoperative intraperitoneal and subcutaneous carbohydrate and fat metabolism as measured by microdialysis in obese and diabetic patients after major abdominal surgery without postoperative complications.Material and methods: Seven obese patients (body mass index > 30 kg/m(2)) and six diabetic but non-obese patients were studied up to 48 h after major abdominal surgery and were compared with 31 non-diabetic, non-obese patients, all without complications. Microdialysis was performed to measure glucose, lactate, pyruvate and glycerol intraperitoneally and subcutaneously. The lactate/pyruvate ratio was calculated.Results: The lactate/pyruvate ratio did not differ between the groups. In the diabetic patients, glucose levels were higher intraperitoneally at both Days 1 and 2 compared to controls. Higher glycerol levels were found subcutaneously in obese patients at Day 2. CONCLUSIONS: The lactate/pyruvate ratio does not increase intraperitoneally after non-complicated major abdominal surgery in diabetic and obese patients. Obese patients have increased release of free fatty acids and glycerol subcutaneously, while diabetic patients show higher glucose levels intraperitoneally than controls.
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