| 1. |
- Adell, Gunnar, et al.
(author)
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Occurrence and prognostic importance of micrometastases in regional lymph nodes in Dukes' B colorectal carcinoma : an immunohistochemical study
- 1996
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In: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 162:8, s. 637-642
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate the incidence and prognostic importance of micrometastatic disease in regional lymph nodes from Dukes' B colorectal carcinomas.DESIGN: Retrospective study.SETTING: University hospital, Sweden.SUBJECTS: 100 patients operated on for primary colorectal carcinoma, classified as Dukes' B lesions.INTERVENTIONS: The regional lymph nodes were re-examined immunohistochemically using monoclonal antibodies against cytokeratin.OUTCOME MEASURES: Incidence and prognostic importance of micrometastases.RESULTS: Micrometastases were found in 39% (39/100) of the patients. The number of positive cells in the lymph nodes examined varied from 1 to over 100. They appeared as single cells or small clusters of cells located within the capsule or in the peripheral sinus of the lymph node. At least three sections from each of three lymph nodes had to be examined to identify 95% of the patients with lymph node micrometastases. The outcome of the patients with micrometastases was not significantly different from that of patients with no epithelial cells in the lymph nodes.CONCLUSION: Micrometastases in regional lymph nodes are a interesting phenomenon but clinically seem to be of only weak prognostic value.
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| 2. |
- Ahlman, B., et al.
(author)
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Elective abdominal surgery alters the free amino acid content of the human intestinal mucosa
- 1995
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In: European Journal of Surgery. - Stockholm, Sweden : Taylor & Francis. - 1102-4151 .- 1741-9271. ; 161:8, s. 593-601
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Journal article (peer-reviewed)abstract
- Objective: To assess the impact of a standard moderately severe surgical operation on the mucosal amino acid content of the duodenum and the colon.Design: Open study.Setting: University hospital, Sweden.Subjects: Nine patients who were to undergo elective open cholecystectomy.Interventions: Endoscopically obtained biopsy specimens from the intestinal mucosa. Main outcome measures: Changes in the content of free amino acids in the duodenum and colon at three days postoperatively.Results: The concentration of glutamine in the duodenum increased by 27% and that of glutamic acid by 34% after operation, whereas their content in colon remained unaltered. The concentration of branched chain amino acids increased by 26% in the duodenal mucosa after operation and by 24% in the colonic mucosa. The total concentration of amino acids (excluding taurine) increased by 9% in the duodenum, but remained unaltered in the colon.Conclusion: This study shows characteristic and consistent alterations in the free amino acid content of the intestinal tract after a moderately severe operation.
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| 3. |
- Alberth, Gunnar, et al.
(author)
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Blood loss in prosthetic hip replacement is not influenced by the AB0 blood group
- 2001
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 167:9, s. 652-655
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Journal article (peer-reviewed)abstract
- Objective: To find out if there is a correlation between AB0 type and the amount of blood lost at operation. Design: Retrospective study. Setting: One county and one university hospital, Sweden. Subjects: 540 patients who underwent primary prosthetic hip replacement under regional anaesthesia. Albumin (n = 298) or dextran (n = 242) were used as plasma substitutes. Main outcome measures: Estimated blood loss and number of units of red cell concentrates transfused. Results: The characteristics of the study groups were similar. In patients given albumin, the mean (SD) intraoperative loss with blood group 0 (n = 100) was 718 (413) ml and 2.7 (1.9) red cell units were given. Those with other blood groups (n = 198) lost 713 (469) ml and were given 2.5 (2.0) units. In patients given dextran with blood group 0 (n = 82), the intraoperative blood loss was 650 (337) ml, the postoperative loss 480 (222) ml and they received 2.1 (2.1) units. The corresponding values in the patients with other blood groups (n = 160) were 665 (351), 498 (208) and 2.5 (2.1) units. Conclusion: Blood group 0 was not associated with increased blood loss.
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| 4. |
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| 5. |
- Andersson, Roland, et al.
(author)
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Why does the clinical diagnosis fail in suspected appendicitis?
- 2000
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In: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 166:10, s. 796-802
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Journal article (peer-reviewed)abstract
- Objective: To identify systematic errors in surgeons' estimations of the importance of diagnostic variables in the decision to explore patients with suspected appendicitis. Design: Prospective case series. Setting: Two emergency departments, Sweden. Patients: 496 patients with suspected appendicitis on admission, of whom 194 had a correct operation for appendicitis and 59 had a negative exploration. Main outcome measures: Predictors of a negative exploration expressed as the odds ratio (OR) for negative exploration. Variables influence on the decision to operate, expressed as the OR for operation, compared with the true diagnostic importance, expressed as the OR for appendicitis. Results: Predictors of negative explorations were high ratings in variables describing pain and tenderness (patient's perceived pain, abdominal tenderness, rebound tenderness, guarding or rectal tenderness), weak or absent inflammatory response, female sex, long duration of symptoms and absence of vomiting, with OR of 1.8-3.0. Pain and tenderness had too strong an influence on the decision to operate whereas the lack of an inflammatory response, no vomiting, and long duration of symptoms were not given enough attention. There was no sex difference in the proportion of patients with non-surgical abdominal pain (NSAP) who were operated on, but NSAP was more common and appendicitis less common among women, leading to a larger proportion of negative appendicectomies among women. Conclusion: Negative explorations in patients with suspected appendicitis are related to systematic errors in the clinical diagnosis with too strong an emphasis on pain and tenderness, and too little attention paid to duration of symptoms and objective signs of inflammation. Rectal tenderness is not a sign of appendicitis. The risk of diagnostic errors is similar in men and women.
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| 6. |
- Bark, Tor, et al.
(author)
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Food deprivation increases bacterial translocation after non-lethal haemorrhage in rats
- 1995
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In: European Journal of Surgery. - : Taylor & Francis Scandinavia. - 1102-4151 .- 1741-9271. ; 161:2, s. 67-71
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Journal article (peer-reviewed)abstract
- OBJECTIVE:To investigate whether brief fasting before the induction of hypotension by non-lethal haemorrhage may induce translocation of enteric bacteria to mesenteric lymph nodes or blood in rats.DESIGN:Laboratory experiment.SETTING:University departments of surgery and microbiology, Sweden.MATERIAL:39 Male Sprague-Dawley rats.INTERVENTIONS:20 animals were fasted for 24 hours, all 39 then underwent controlled haemorrhage for 60 minutes that reduced the blood pressure to 55 mm Hg.MAIN OUTCOME MEASURES:Differences in blood loss, blood glucose concentrations, and packed cell volume; and aerobic cultures of mesenteric lymph nodes and blood.RESULTS:Fasted rats (n = 20) lost 2.3% of blood volume compared with 2.8% in fed rats(p < 0.001). Packed cell volume dropped by 11.3% in fasted rats and 16.5% in fed rats (p < 0.001). Glucose concentrations rose by 7.0 mmol/l in fasted rats compared with 21.0 mmol/l in fed rats (p < 0.001). Mesenteric lymph nodes contained enteric bacteria in 14/20 fasted rats compared with 6/19 fed rats (p < 0.05). In 4 fasted rats blood cultures grew pathogenic bacteria compared with no fed rats (p = 0.11). The number of bacteria found in mesenteric lymph nodes was significantly greater in fasted than in fed rats (p = 0.01).CONCLUSIONS:Brief fasting before hypotension caused by non-lethal haemorrhage was associated with significantly increased bacterial translocation compared with fed animals. Increases in blood glucose concentrations and plasma refill may have had a protective effect in fed rats. These experiments may be of clinical relevance as elective operations are usually preceded by overnight fasting.
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| 7. |
- Bark, Tor, et al.
(author)
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Glutamine supplementation does not prevent bacterial translocation after non-lethal haemorrhage in rats
- 1995
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In: European Journal of Surgery. - : Taylor & Francis Scandinavia. - 1102-4151 .- 1741-9271. ; 161:1, s. 3-8
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Journal article (peer-reviewed)abstract
- OBJECTIVE:To find out whether supplementation of an enteral diet with glutamine would reduce translocation of bacteria to mesenteric lymph nodes or blood after major haemorrhage in rats.DESIGN:Open randomised study.SETTING:University departments of surgery and microbiology, Sweden.MATERIAL:49 Sprague-Dawley rats.INTERVENTIONS:Rats were fed enterally for 7 days on diets supplemented with either glutamine or an isonitrogenous amount of non-essential amino acids. After feeding, 8 experimental and 8 control rats underwent sham operation; 9 and 7, respectively, underwent moderate haemorrhage (to 65 mm Hg); and 9 and 8, respectively, underwent severe haemorrhage (50 mm Hg) without reinfusion.MAIN OUTCOME MEASURES:Microbiological analyses of samples of blood and mesenteric lymph nodes taken 24 hours after haemorrhage.RESULTS:The median (interquartile) number of colony forming units/mesenteric lymph nodes after moderate haemorrhage in animals who were given glutamine supplementation was 11 (0-34) and in control animals 20 (0-178). After severe haemorrhage the corresponding figures were 199 (10-310) and 22 (0-187). No pathogens were isolated from blood cultures.CONCLUSION:Glutamine supplementation before haemorrhage did not reduce bacterial translocation to mesenteric lymph nodes in this rat model.
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| 8. |
- Berglund, Jan, et al.
(author)
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Rapid increase in volume of the remnant after hemithyroidectomy does not correlate with serum concentration of thyroid stimulating hormone
- 1998
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 164:4, s. 257-262
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the effect of postoperative thyroxine on the volume of the thyroid remnant after lobectomy for benign nontoxic goitre. DESIGN: Prospective, randomised study. SETTING: University hospital, Sweden. SUBJECTS: 50 consecutive patients who underwent lobectomy for benign non-toxic goitre. INTERVENTIONS: Patients were randomised postoperatively to take thyroxine 0.1 mg or placebo daily. MAIN OUTCOME MEASURES: The median volume of the remaining thyroid lobe measured by ultrasound. Serum concentrations of thyroxine, triiodothyronine (T3) and thyroid stimulating hormone (TSH) were measured preoperatively and 1, 3, 6, 12 months postoperatively. RESULTS: The median volume of the remaining lobe had increased significantly compared with preoperatively by 1 month postoperatively by 30% in the thyroxine group and 25% in the placebo group (p < 0.01). The difference between the groups was not significant. After the first month the volume did not change significantly. In the thyroxine group, the TSH concentration was unchanged and the thyroxine concentration increased significantly throughout the study. In the placebo group there was a significant increase in TSH concentration and a significant decrease in that of thyroxine at all follow-up examinations. CONCLUSIONS: There is a significant increase in the volume of the remaining thyroid 1 month after lobectomy that persisted throughout the first year. Thyroxine given in a dose that kept the serum TSH concentration at the same level as preoperatively did not seem to influence volume changes; consequently we consider that these are caused by factors other than TSH.
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| 9. |
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| 10. |
- Bergqvist, David, et al.
(author)
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Paediatric arterial trauma
- 1998
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In: European Journal of Surgery. - : Oxford University Press (OUP). - 1102-4151 .- 1741-9271. ; 164:10, s. 723-731
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Journal article (peer-reviewed)
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