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Biomedical subjects

B Eklund

Publications and source records attributed to B Eklund.

At least 127 records · Page 7Linked to original sources
PubMed1977

Peptic ulceration in kidney transplantation.

Gastroduodenal ulceration occurred in 45 patients during the post-transplantation period in a series of 500 transplantations of 434 patients. The mortality rate of this complication was high, 42%. Bleeding and perforation were the main problems. These complications occurred frequently during treatment for acute rejection. Present day prophylaxis, which is based on the use of antacids, seems to be inadequate for controlling these complications. Other possibilities for reducing the incidence of gastroduodenal ulceration in transplant patients are discussed. Since increased serum gastrin concentrations are often observed in these patients, prophylactic treatment should be based on preoperative evaluation of gastric secretion and serum gastrin determinations. The new histamine (H2) blocking agents should be evaluated in these patients.

Cimetidine↗
PubMed1977

Arteriovenous fistulas for hemodialysis and the diabetic. A report on eighteen patients.

Twenty-three subcutaneous arteriovenous fistulas were created for hemodialysis in 18 patients with terminal renal failure due to juvenile diabetes. Seventeen patients received well-functioning fistulas. Four patients needed reoperations due to late failure and the reoperations were successful in three. Venous hypertension syndrome developed in two patients because of thrombosis of the vein proximally to the anastomosis. In one patient extensive arteriosclerotic disease was the cause of late failure of two fistulas. Sepsis with low flow state was the cause of failure in one patient. None of the patients developed clinical signs of arterial insufficiency in the operated limb.

Adult↗
PubMed1977

Surgical complications in 500 kidney transplantations.

The surgical complications in a series of 500 transplantations done by a single transplantation unit with over ten years' experience in the field are reported. The complications are divided into vascular, urological and gastrointestinal. In addition, renal rupture, primary wound infections and operative deaths are reported. Most of the losses of transplants caused by surgical complications are due to renal rupture and vascular complications, accounting for 3.6 and 2 percent of losses respectively out of the 500 kidney transplants. The urological complications caused a loss of the remaining 1.2% of a total of 6.8%. tthe overall mortality was highest in gastrointestinal complications with 6% of the total of 10% deaths following surgical complications. The mortality rate in the group of patients with gastrointestinal bleeding and perforations and with acute pancreatitis was extremely high. More accurate screening for potential candidates for gastroduodenal ulceration and better prophylactic treatment is needed. More active treatment of acute pancreatitis is suggested.

Adolescent↗
PubMed1977

Renal transplantation in patients with diabetic nephropathy.

Renal transplantations were performed over a period of three years to twenty patients with end-stage diabetic nephropathy. Two of the patients were transplanted with kidneys from living donors, others with cadaver kidneys. One year after the transplantation 6 patients out of 12 were alive, after two years one out of four. Graft survival after one year was 4 out of 12, and after two years one out of four patients. Eight patients had died, the primary causes of death having been infection or infarction. Late complications in the form of gangrene occurred in four patients with a functioning transplant. The issue of priority, criteria for selection, and the use of living donors are discussed.

Adult↗
PubMed1977

Arterial stenosis in renal transplantation.

Stenosis of the renal artery of the transplant (RAT), is reported with a frequency of 5-10% (Nerstrøm, Ladefoged & Lund 1972, Nilsson, Henriksson & Thoren 1976, Beachley, Pierce, Boykin & Lee 1976). The stenosis is significant if it deteriorates the renal function or elevates the arterial blood pressure. The angiographic impression of a stenosis depends on the projection and it is difficult to correlate the radiological findings with the blood flow. Moreover both renal failure and hypertension might depend on other factors than stenosis of the RAT. The aim of this study was to establish how often a reconstruction of a RAT suspected of being stenotic would benefit the patient.

Graft Rejection↗
PubMed1976

Removal of exogenous plasma triglycerides in forearm muscle and subcutaneous tissue of hyper-and normotriglyceridaemic men.

Absolute arterio-venous removal and fractional removal of blood-borne exogenous triglyceride particles by skeletal and subcutaneous tissues were determined in eight normotriglyceridaemic and six hypertriglyceridaemic men. Estimations were made by simultaneously sampling blood from catheters inserted into a brachial artery, and in the distal direction, into a superficial and deep vein, draining subcutaneous tissue and skeletal muscle respectively. During the infusion of the fat emulsion IntralipidR for 3 hours steady arterial concentrations of exogenous TG particles were found, indicating first order kinetics. In all subjects absolute arterio-venous and fractional removal of triglycerides were about twice as high in skeletal muscle as in subcutaneous tissue. In skeletal muscle the fractional removal and absolute removal were significantly higher in normotriglyceridaemic than in hypertriglyceridaemic subjects (p less than 0.001). No decrease in removal with time was observed, which would have suggested saturation of removal sites. Mean fractional removal in skeletal muscle was significantly correlated with the k2 value determined by an intravenous fat tolerance test before the infusion study (r = 0.61, p less than 0.05). In subcutaneous tissue fractional removal was also significantly higher in normotriglyceridaemic subjects (p less than 0.05). The results suggest that in both skeletal muscle and subcutaneous tissue the removal system is impaired in hypertriglyceridaemic subjects. This finding supports the concept that a decreased elimination capacity in these tissues may partly account for triglyceride elevation in hypertriglyceridaemic subjects.

Adipose Tissue↗
PubMed1976

Arterial concentration and forearm extraction of glucose and insulin during the early phase of a glucose infusion.

The concentrations of glucose and insulin were determined with high precision at half minute intervals in arterial and deep forearm vein blood after a bolus injection of glucose (4 g), followed by a constant i. v. infusion (200 mg/min), in four healthy subjects. The values for the deep vein were corrected for the transit time, which was determined by injection of Cardio-green. Arterial glucose peaked at the end of the bolus injection, venous glucose 1 1/2 min later. Arterial insulin reached its maximum later than glucose, after 2 1/2-4 min. The venous insulin reached its maximum later and was much lower than the arterial level, in two cases only around 50% of the arterial concentration. It is concluded that early after glucose administration there is a considerable extraction of both glucose and insulin by the forearm. Since the insulin extraction was quite variable venous insulin concentrations cannot be used for the assessment of early insulin response to glucose.

Adult↗
PubMed1976

Effect of regional alpha- and beta-adrenergic blockade on blood flow in the resting forearm during contralateral isometric handgrip.

In a previous study we have shown that an isometric handgrip is accompanied by a rapid decrease in vascular resistance in the resting (contralateral) forearm, lasting for about 1 min, which in all probability is neurogenic. 2. In the present study the distribution of the vasodilatation was investigated by analysing O2 saturation in a deep vein, draining mainly muscle tissue. Some possible neurogenic mechanisms for the vasodilatation were tested by repeating the handgrip after local beta- and alpha-adrenergic blockade of the resting forearm with propranolol and phentolamine, respectively. 3. Without blockades the forearm vascular resistance decreased and the deep vein O2 saturation increase to similar degrees on contralateral handgrip. Propranolol markedly reduced both the decrease in resistance and the increase in deep vein O2 saturation. Phentolamine did not alter the initial decrease in resistance, but with phentolamine resistance continued to decrease after 1 min. 4. It is concluded that the rapid decrease in vascular resistance in the resting forearm on contralateral handgrip takes place, to a great extent, in muscle. It is mediated by neurogenic beta-adrenergic mechanisms and if the contraction is prolonged it gradually changes to a vasoconstriction mediated by alpha-adrenergic mechanisms.

Adult↗
PubMed1975

Studies in asymptomatic primary hyperlipidaemia. V. Peripheral circulation.

The occurrence of early signs of peripheral vascular disease (PVD) of the lower limbs has been studied with digital pulse plethysmography in 160 men and 123 women above the age of 35, who were all subjectively healthy but were found to have primary hyperlipoproteinaemia (HLP) at a health control centre. Quantitative analysis of serum lipoproteins with cholesterol and triglyceride (TG) determination of each of the very low (VLDL), low (LDL) and high (HDL) density lipoprotein clases together with lipoprotein paper electrophoresis was performed. Identical investigations were performed on control subjects with non-elevated serum lipids. Inclination time (IT) was substantially prolonged in 12% of HLP males and 7% of HLP females. The frequency of male subjects with prolonged IT was lower when only LDL was elevated (type IIA) than in the other types of HLP. The subjects with prolonged IT had three characteristic features. 1) Moderate elevations of both serum cholesterol and TG. These elevations occurred often in both VLDL and LDL lipoprotein classes. IT prolongations were not seen when VLDL or LDL lipoproteins were singly maredly elevated. 2) High frequency of smokers. 3) Most of the subjects were above the age of 50. The results suggest that the most atherogenic lipoprotein abnormalities to the arteries of the lower limb are on the one hand the relatively TG-rich part of the LDL (LDL1) fraction and on the other hand the relatively cholesterol-rich part of the VLDL fraction. Furthermore the results stress the deleterious influence of smoking even in the preclinical stage of PVD.

Adult↗
PubMed1975

Oscillography and digital pulse plethysmography in occlusive disease of the subclavian artery and the brachiocephalic trunk. A pre- and postoperative study.

Patients with occlusive disease of the subclavian artery or brachiocephalic trunk were examined by oscillography (17 cases) and digital pulse plethysmography (19 cases) before and after reconstruction of the occluded vessel. Before surgery the oscillographic amplitudes were significantly lower on the occluded than the contralateral arm, with no difference between the registration levels. Shape analysis of the digital pulse curve recordings gave significant differences in all variables, between the occluded and the contralateral arm, inclination time and RAMP25 being most sensitive. Idential studies repeated up to 6 months after surgery demonstrated a marked increase in oscillometric amplitudes at all levels on the operated side. In the digital pulse-curve recordings the greatest improvement was found in inclination time and RAMP25.

Adult↗
PubMed1975

Extraction of endogenous plasma triglycerides by the working human forearm muscle in the fasting state.

The extraction of triglycerides (TG) by the working forearm was determined in eight healthy fasting men, both by the measurement of chemical arterial-deep venous (a-dv) TG differences and by the a-dv differences in TG radioactivity after endogenous labeling with tritiated palmitate. Measurements were made before and then during nicotinic acid infusion. Correction for plasma water shift in the forearm vasculature was made by estimating the (125I)albumin activity after an intravenous injection. The overall mean value +/- S.E.M. without and with nicotinic acid was for TG arterial concentration (mumol/1) 713 +/- 153 and 695 +/- 140, TG a-dv concentration difference (mumol/1)-14 +/- 7 and -6 +/- 4, TG arterial radioactivity (cpm/ml) 1650 +/- 469 and 1471 +/- 342, TG a-dv radioactivity difference 12 +/- 24 and -2 +/- 13. The average standard errors for the determinations of triglycerides were 0.85% and 1.5% for the chemical and the isotope methods, respectively. In conclusion, no significant average a-dv difference in TG concentration as determined by either the chemical or the isotope method was detected. With the standard errors achieved, however, a-dv differences of less than around 20 mumol/lcould not be discovered. Such an extraction of endogenous plasma TG could, if oxidized, account for about 25% of the oxygen extraction by the eercising forearm.

Adult↗
PubMed1974

Blood flow in resting (contralateral) arm and leg during isometric contraction.

1. Blood flow in resting forearm and calf were measured plethysmographically in healthy young men during isometric contraction performed both as a handgrip and as a dorsiflexion of the foot. The isometric contraction was maintained for 2 min at one third maximal voluntary contraction for the handgrip and half maximal voluntary contraction for the dorsiflexion of the foot. In some experiments the possible influence on blood flow of inadvertent muscle activation in the resting limb was checked by recording the e.m.g.2. Both handgrip and dorsiflexion of the foot produced substantial increases in heart rate and mean arterial pressure, the pressure rise being almost linear with time throughout the contraction.3. Isometric contraction produced a rapid increase in forearm blood flow which reached a maximum on average two and a half times the resting value after 1 min and then declined slightly. Similar increases in forearm blood flow were produced by handgrip and dorsiflexion of the foot.4. Unlike in the resting forearm, the blood flow in the resting calf increased only slightly during the first minute of contraction and then decreased again to the resting level.5. The flow increase in the resting limbs could not be ascribed to inadvertent muscle activation as judged from the e.m.g. recordings.6. It is concluded that isometric muscle contraction produces a rapid increase in blood flow in the resting forearm, but only a very slight flow increase in the calf. Since the flow increased faster than the arterial pressure it must to a certain extent be induced by active neurogenic vasodilatation. Similarly, the relative flow decrease during the latter half of the contraction concomitantly with a progressively rising arterial pressure suggests that the neurogenic effect on the resistance vessels changes character, becoming more vasoconstrictive, and this might be related to increased effort in sustaining the contraction.

Adult↗