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- Lindholm, C E, et al.
(author)
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Arterial rupture after microwave-induced hyperthermia and radiotherapy. With reference to two patients treated for recurrence in previously operated and irradiated areas
- 1990
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In: International Journal of Hyperthermia. - : Informa UK Limited. - 0265-6736 .- 1464-5157. ; 6:3, s. 499-509
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Journal article (peer-reviewed)abstract
- Two patients who developed frank arterial bleeding after combined microwave-induced hyperthermia and radiotherapy are described. One patient received re-irradiation and hyperthermia for recurrent metastatic neck nodes of a mesopharyngeal carcinoma. Full course radiotherapy had been given 6 years previously and a right-sided radical neck node dissection had been performed 4 months earlier because of recurrent neck node metastases. Six weeks after the combined therapy for a second recurrence, which achieved complete remission, a fatal rupture of the carotid artery occurred. The other patient received re-irradiation and hyperthermia for a chest wall recurrence of a breast carcinoma, treated 5.5 years previously by sector resection and tangential beam radiotherapy, and treated again 2 years earlier with extensive surgery for a local recurrence. A frank arterial bleeding from the treated region was seen after 7 months, but could be arrested with surgery. This important complication in combined hyperthermia and radiotherapy does not seem to have been recognized before. Different explanations are discussed, such as the previous local treatment as well as high temperature and atherosclerosis per se.
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| 4. |
- Otto, Gisela, et al.
(author)
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Virulence factors and pap genotype in Escherichia coli isolates from women with acute pyelonephritis, with or without bacteremia.
- 1993
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In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - 1058-4838. ; 17:3, s. 448-56
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Journal article (peer-reviewed)abstract
- Bacteremia develops in a subgroup of patients with acute pyelonephritis. This study examined isolates of Escherichia coli from the urine and the blood of 25 bacteremic and 67 nonbacteremic women with this acute disease. P-fimbriated strains were found in 100% of bacteremic patients without complicating factors but in only 71% of nonbacteremic patients without complications (P < .05). Non-P-fimbriated strains were only found to cause bacteremia in three patients with compromising host factors. Strains from the bacteremic group and those from the nonbacteremic group did not differ significantly in terms of hemolysin or aerobactin production or of serum resistance. The P-fimbriated strains from both groups of patients carried pap DNA sequences of the papGIA2 adhesin type; prsGJ96 homologous DNA sequences were rare. The results suggested that P fimbriae and compromising host conditions independently increase the risk for bacteremia during acute pyelonephritis.
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- Vagianos, C, et al.
(author)
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Intraoperative collection of shed blood with citrated compresses for autotransfusion. An experimental study in pigs
- 1990
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In: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:2, s. 121-126
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Journal article (peer-reviewed)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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| 7. |
- Vagianos, C, et al.
(author)
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Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs
- 1990
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In: Acta Chirurgica Scandinavica. - 0001-5482. ; 156:10, s. 671-675
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Journal article (peer-reviewed)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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