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Biomedical subjects

B Jeppsson

Publications and source records attributed to B Jeppsson.

At least 91 records · Page 5Linked to original sources
PubMed1992

Increased passage of bovine serum albumin over the respiratory tract after intratracheal instillation during septic shock in rats.

Sepsis may initiate acute respiratory distress syndrome which may be accompanied by an increased pulmonary epithelial-endothelial permeability. In this study, sepsis was induced by an intraperitoneal implantation of gelatine capsules containing Escherichia coli/Bacteroides fragilis/adjuvant substance. The importance of bacteria in sepsis-related lung injury was studied in rats given an intraperitoneal injection of E. coli or in rats given the adjuvant substance alone in capsules intraperitoneally. Rats with empty capsules were used as controls. The rats were intratracheally instilled with bovine serum albumin (BSA) directly after the capsule implantation or the injection of E. coli, and the passage over the lower respiratory tract was assessed as blood plasma levels of immunoreactive BSA. The plasma BSA levels in the control rats increased continuously up to 24 h after intratracheal instillation. This increase was significantly augmented already 1 h after the septic challenge, i.e. before any clinical symptoms were observed, in both the septic rats and the rats with the E. coli injected intraperitoneally. Furthermore, the time required to obtain maximal plasma BSA levels was shorter in septic, adjuvant-exposed and in E. coli-injected rats than in the controls. The plasma levels and the total BSA passage over the lower respiratory tract was significantly higher (p less than 0.001) in the septic and in the E. coli-injected rats than in the adjuvant-exposed and the control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Peripheral parenteral nutrition: effect of a standardized compounded mixture on infusion phlebitis.

The incidence and severity of infusion phlebitis was evaluated prospectively in 142 surgical patients who received peripheral parenteral nutrition (PPN) for a total of 700 days. In a first study phase 83 patients were given PPN for a total of 424 days. All nutrient solutions were delivered over a 12-h period from a 3-litre bag and the infusion sites rotated daily. These methods resulted in an incidence of phlebitis of 18 per cent, 75 per cent of the patients being fed successfully by PPN until resumption of oral nutrition. In an attempt to assess the importance of the method of delivering nutrient solutions, the next 59 patients were randomized to receive PPN as a compounded mixture or by a conventional technique with simultaneous infusion from separate bottles. Infusion phlebitis was significantly more frequent (P less than 0.001) in patients infused with separate bottles. There was no difference between the groups with regard to duration of nutrition or the need to establish central venous access. We conclude that PPN is a safe and cost-effective means of providing total parenteral nutrition in most surgical patients. The use of compounded mixtures significantly reduces the incidence of phlebitis without increasing total costs.

Aged↗
PubMed1991

Liver cirrhosis in rats: regeneration and assessment of the role of phenobarbital.

A common model for producing experimental liver cirrhosis is the administration of CCl4 to phenobarbital (PhB)-stimulated rats. However, concern may arise due to the complex actions of PhB upon liver metabolism. This study examined the role of PhB in the production of CCl4-induced liver cirrhosis in the rat. In addition, regenerative capacity of the liver after partial hepatectomy (PH) or portal branch ligation (PBL) was studied in cirrhotic rats, rats treated with CCl4 alone, and in PhB-treated controls. In rats given PhB throughout the CCl4-induction period, ascitic form of micronodular cirrhosis was found in 93% with only 3% mortality. In contrast, rats pretreated with PhB for only 2 weeks followed by CCl4 alone for 18 weeks did not develop liver cirrhosis. In most of the cirrhotic rats, PH induced hepatic regeneration associated with improved liver histology. PBL was less effective. Treatment with PhB alone for 10 weeks resulted in liver atrophy and reduced hepatic regenerative capacity. Impaired regeneration response was also found in rats treated with CCl4 alone. In conclusion, treatment with PhB throughout the CCl4-induction period seems necessary for the production of liver cirrhosis in rats. However, prolonged treatment with PhB alone results in liver atrophy and an impaired regenerative response. Therefore, though necessary for the cirrhotic model, PhB by itself has negative hepatotrophic influences which questions the thoroughness of the PhB/CCl4 experimental model.

Animals↗
PubMed1991

Sclerotherapy for ablation of the gallbladder after gallstone lithotripsy with a mechanical lithotriptor. An experimental study in pigs on the effect of absolute ethanol on edematous gallbladder wall.

Chemical ablation of the gallbladder with absolute ethanol following mechanical lithotripsy with the RotoLith lithotriptor was attempted in 10 pigs after open cholecystostomy. Two gallbladders removed immediately after the sclerotherapy demonstrated extensive ulcerations of the mucosa with preserved glands and sinuses under the ulcerations. In 8 gallbladders removed 8 weeks after sclerotherapy a gallbladder remnant with hydrops and/or mucus and more or less intact epithelium was seen in all the pigs. In order to prevent regeneration of epithelium from gallbladder sinuses and glands, more effective sclerosing agents must be found.

Animals↗
PubMed1991

Needs and care of patients undergoing subtotal pancreatectomy for cancer.

Charts of 45 patients, who underwent subtotal pancreatectomy for cancer, at the University Hospital in Lund, over a 5-year period, were reviewed. The aim was to determine how the patients' symptoms and needs were assessed and cared for as documented by medical and nursing professionals. Data were collected on 107 items of interest for nursing care. The symptoms the patients experienced had consequences on many aspects of their lives. Basic functions, such as eating and elimination, were seriously disturbed before surgery, as well as after the first 3 weeks and 3 months. Pain and changes in sleeping pattern and in mood state were recorded for a majority of the patients. Due to inadequate notes the study cannot reveal the total care given to assist these patients with symptom control. However, certain insufficiencies could be found. The conclusion is that nurses can take a more active part in caring for patients with pancreatic cancer. By using assessment tools, and in cooperation with the surgeons, nurses can assist the patients with nutritional support, pain management, information and emotional support, as well as with physical training, leading to qualitative improvements in the lives of patients with pancreatic cancer.

Adult↗
PubMed1990

Repeated dearterialization of hepatic tumors with an implantable occluder.

A new implantable device for repeated hepatic dearterialization was evaluated in 13 patients with tumors of the liver. Eleven patients had colorectal secondaries and also received cyclic intraperitoneal infusion of 5-fluorouracil. Two patients had primary hepatocellular cancer (HCC). Four patients had a variant arterial supply. The hepatic artery was occluded repeatedly for 1 hour twice daily for 1 to 17 months (mean, 8.5 months). A complete transient occlusion was obtained in all but three patients, in whom minor collaterals were missed at the initial operation. Collaterals developed in two patients during therapy. Leakage from the balloon occurred in two patients after 5 and 12 months. Two patients developed thrombosis of the hepatic artery during therapy due to the cuff being placed too tightly around the vessel. A complete remission was demonstrated in one patient with HCC, a partial response in three patients (one HCC and two metastatic), stable disease in two patients, and progression in five patients. Median survival for colorectal lesions was 15 months (range, 2 to 23 months) from start of the occlusions. Four of nine patients developed calcifications of their lesions during therapy. One patient with HCC was alive and free of disease 18 months after the start of the occlusions. Both patients with HCC had an obstructed portal vein which may have contributed to the favorable outcome. The occluder was uniformly accepted by the patients who were able to do their occlusions at home.

Adult↗
PubMed1990

A technique for isolated liver perfusion in the rat with survival and results of cytotoxic drug perfusion on liver tumor growth.

The toxic side effects of many chemotherapeutic agents prevent their use in high concentrations. Isolated perfusion techniques have been used most commonly for malignancies involving the extremities, but recently also for irresectable liver tumors. This paper describes a technique for in vivo isolated liver perfusion for 30 min with oxygenated blood through the portal vein and hepatic artery simultaneously. There was a 14% mortality rate. There was some initial hepatocellular death, which resolved quickly and did not seriously affect liver function. There was only a small leak from the perfusion system to the systemic circulation. We tested the system on an experimental liver tumor from a colonic adenocarcinoma. Perfusion with added 5-FU in a toxic dose of 70 mg/kg to the medium significantly retarded tumor growth evaluated 10 days after perfusion compared to rats perfused without 5-FU. This model closely resembles the technique applied clinically and will enable further work on effects of perfusion in an experimental rat liver tumor model.

Animals↗
PubMed1990

Implantable drainage after major abdominal surgery in compromised patients.

The risk of superinfection following routine abdominal drainage after major surgery is debated. Especially in patients with malignant diseases and a compromised host defense, this might be a factor increasing morbidity and mortality. During a 3-year period (1986-1988) 41 patients operated on for malignant abdominal conditions received a peritoneal catheter connected to a subcutaneous portal inserted in order to participate in a trial on postoperative intraperitoneal chemotherapy using 5-Fluorouracil. No abdominal drains were inserted. In 15 patients, the subcutaneous portal was used for evacuation of postoperative fluid accumulation within the abdomen. The mean age was 53 (range 41-70) years. Inserted catheters were used for drainage up to 14 days postoperatively. The daily amount of fluid drained varied from 20 to 2,000 ml with a mean of 610 ml/patient and day. One patient required removal of the catheter due to infection around the subcutaneous chamber. Otherwise, the catheter system was not associated with any other complications or complaints. One patient developed a postoperative left subphrenic abscess drained percutaneously by the guidance of ultrasonography, a complication that could not be attributed to the catheter system but merely to the major operation per se. An implantable device for peritoneal access thus also seem useful for drainage of postoperative fluid collection, as evaluated in this preliminary report.

Abdominal Neoplasms↗
PubMed1990

Beneficial effect of hepatic arterialization on hypogonadism in male rats with portacaval shunt.

The effect of portacaval shunt (PCS) with and without hepatic arterialization (HA) upon the liver morphology, hemodynamics, and in relation to testicular weight, histology, and plasma sex steroid levels has been investigated in male rats. PCS rats showed a significant decrease in hepatic blood flow, body and liver weights, together with signs of severe hypogonadism. In contrast, in HA rats the increment in liver blood flow was associated with higher body and liver weights. In spite of total portal blood shunting, a beneficial effect on testicular morphology and an increase in plasma testosterone level were observed. In respect to plasma estradiol levels the intergroup differences could not be evaluated due to large individual variations. This was probably caused by the presence of cross-reactive plasma component(s) masking the level of endogenous estrogen. It is concluded that portosystemic shunting is not of primary importance in the etiology of PCS-related hypogonadism in the male.

Animals↗
PubMed1990

The effects of ammonia tolerance tests on the cerebrospinal fluid concentrations of amino acids and indoleamines in patients with liver cirrhosis.

To study the effect of ammonia administration on amino acids and indoleamines in cerebrospinal fluid (CSF) and on amino acids, insulin, and glucagon in plasma in humans with liver cirrhosis, we performed seven ammonia tolerance tests on six patients with stable liver cirrhosis. The grade of encephalopathy was determined by psychometric tests. Only one of the patients had pronounced encephalopathy. The other patients had no or only slight encephalopathy. The plasma concentrations of valine, leucine, isoleucine, phenylalanine, tyrosine, and methionine decreased after the ammonia load, whereas no changes were found in the plasma concentrations of glucagon and insulin. In CSF the concentrations of glutamine, aromatic amino acids, and indoleamines increased only in the patient who had pronounced encephalopathy, whereas no changes were found in the other patients. The effect of an ammonia load on the concentrations of neutral amino acids in CSF in patients with pronounced encephalopathy remains to be demonstrated.

5-Hydroxytryptophan↗
PubMed1989

Alcohol sclerotherapy of non-parasitic cysts of the liver.

Between 1980 and 1987, nine patients with non-parasitic cysts of the liver were treated with computed tomography-guided percutaneous puncture and evacuation of the cyst contents followed by injection of absolute alcohol as a sclerosing agent. During the same period only one patient was treated with surgery. The patients included seven women and two men with a mean age of 62 years. Three patients had a single cyst and six patients had multiple cysts. The size of the largest cysts varied between 5 and 20 cm (mean 10 cm). Patients with multiple liver cysts had repeated punctures and sclerosing procedures (up to eight times); 50-3100 ml of cyst fluid (mean 650 ml) was drained per procedure. One patient had symptoms of moderate alcohol intoxication; otherwise no complications were noted. Follow-up was performed with computed tomography or ultrasonography for 8-54 months (median 18 months). The results have been considered successful in eight out of nine patients who had cyst regression and reduced symptoms. Two patients, however, required additional surgical treatment due to residual and multiple cysts. Computed tomography-guided alcohol sclerotherapy of non-parasitic liver cysts appears to be a safe and effective initial therapy.

Adult↗
PubMed1989

The effect of ammonia infusion on brain monoamine metabolism in portacaval-shunted rats.

The effect of ammonia infusion on monoamine metabolism was studied in the rat brain. Seven days after portocaval shunt (PCS) or sham operation animals were infused with ammonia or saline. Brain metabolism of serotonin and norepinephrine was studied after injection of a decarboxylase inhibitor (m-hydroxybenzylhydrazine, NSD 1015) which blocks the conversion of 5-hydroxytryptophan to serotonin and dihydroxyphenylalanine to dopamine. Neurologic testing was conducted before killing. Plasma and brain amino acids were measured. PCS animals infused with ammonia were in deep coma after 6 h infusion, whereas sham-operated animals were virtually unaffected. Brain amino acid analyses demonstrated increased concentrations of the aromatic amino acids and a tenfold increase in glutamine. Serotonin metabolism was diminished after 6 h. Dopamine synthesis was normal, but norepinephrine levels were low after 6h. The study suggests that hyperammonemia in PCS rats results in a depression of the serotonin synthesis rate in accordance with two previous studies but in contrast to previous hypotheses on the regulation of serotonin metabolism.

5-Hydroxytryptophan↗
PubMed1989

Insulin response to glucose challenge after transient hepatic dearterialization for rat liver malignancy.

In the palliative treatment of liver malignancy, hepatic dearterialization is being increasingly used. To study the metabolic consequences of this treatment, the present investigation was conducted to elucidate the insulin, glucose, and lactate responses to an intravenous glucose challenge after transient hepatic dearterialization in a liver tumor model in inbred Wistar-Furth rats. We found that nonfasted rats bearing dearterialized liver tumors showed slightly higher basal plasma glucose levels and an exaggerated elevation of plasma glucose during the glucose infusion compared to the controls. Further, they had a depressed insulin response to the glucose challenge. Their glycogen stores were at the same time depleted, in both the liver and the tumor tissues, and the plasma lactate production during the glucose infusion was elevated after dearterialization. We conclude that immediately after hepatic dearterialization in rats with liver malignancies, glucose intolerance and impaired glucose-induced insulin secretion exist.

Adenocarcinoma↗
PubMed1989

Glucose turnover in rats undergoing transient dearterialization for liver malignancy.

With the development of new techniques for hepatic dearterialization, their use in the treatment of liver malignancies has increased. It is therefore important to study the metabolic consequences of hepatic dearterialization. The present investigation determined the glucose turnover during hepatic dearterialization in the rat with the use of a primed tracer [( 3-3H]glucose) infusion technique. It was found that the glucose elimination rate was diminished during dearterialization in both tumor-free and tumor-bearing rats in the fasting state. Hepatic glucose production was maintained in tumor-free rats leading to hyperglycemia, but hepatic glucose production decreased in tumor-bearing rats resulting in hypoglycemia. Pretreatment of tumor-bearing rats overnight with an intravenous glucose infusion did not counteract the reduced hepatic glucose production during dearterialization in tumor-bearing rats. The hypoglycemic tendency therefore remained. This could be caused by the exaggerated glucose consumption that is known to occur in tumor tissues. It is concluded that hepatic dearterialization reduces glucose elimination in rats, and, in tumor-bearing rats, the procedure also reduces hepatic glucose production.

Animals↗