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Biomedical subjects

B Jeppsson

Publications and source records attributed to B Jeppsson.

At least 163 records · Page 9Linked to original sources
PubMed1984

Hepatic rupture secondary to pre-eclampsia--report of a case treated conservatively.

Hepatic rupture during pregnancy is related to toxaemia and is most often fatal. Epigastric pain and signs of intra-abdominal bleeding are the most common presenting symptoms. In previous reports liver surgery has been considered the method of choice in all patients. However, we have successfully treated a patient with bilateral hepatic rupture and intra-thoracic bleeding with termination of the pregnancy but otherwise conservative measures. The importance of early diagnosis, by ultrasonography and/or explorative laparotomy, and early termination of the pregnancy is stressed. Also, it is suggested that liver surgery should be individually tailored and that it is preferably avoided in some patients.

Adult↗
PubMed1984

Bacterial contamination of blood transfusion: an unusual cause of sepsis.

Severe septicaemia resulted from transfusion of blood contaminated with Serratia liquefaciens. Although only a small volume of contaminated blood was administered, the patient reacted with severe hypotension, followed by renal, pulmonary, circulatory and hepatic failure together with protracted thrombocytopenia. The causal gram-negative rod, S. liquefaciens, frequently occurs in the oral cavity and is generally considered to be harmless. The source of the contamination was not detected, however. Early recognition of septicaemia and institution of intensive supporting treatment contributed to the rapid resolution in this case of multiple system failure.

Female↗
PubMed1983

Increased blood-brain transport of tryptophan after portacaval anastomoses in germ-free rats.

Portal-systemic shunting in rats results in altered plasma concentrations of the large neutral amino acids (NAA), and increased blood-brain barrier NAA transport. Bacterial ammonia production in the bowel, especially the colon, is thought to play a major role in the etiology of portal-systemic encephalopathy (PSE). In order to isolate the role of bacteria in PSE, plasma and brain amino acids and ammonia (NH3) were studied in germ-free (GF) rats with portacaval shunts (PCS). Germ-free rats underwent end-to-side portacaval shunt or sham operation under germ-free conditions and were kept in a germ-free isolator under careful bacteriologic control. Similar operations were carried out on conventional animals. Two weeks post-operatively blood-brain transport of the neutral amino acid tryptophan was studied and the animals sacrificed. Plasma NH3 rose after PCS both in GF and in conventional rats. In germ-free and conventional rats with PCS, there was a significant elevation in plasma of the aromatic amino acids and decreased concentrations of the branched-chain amino acids. In the brain, both groups had elevated aromatic amino acids, while the branched-chain amino acids remained normal. The blood-brain transport of tryptophan was elevated in portacaval shunted rats, whether germ-free or conventional. These studies suggest the elevated plasma levels of ammonia and disturbances in plasma and brain amino acids seen after portacaval shunt are not dependent on the presence of gut bacteria.

Amino Acids↗
PubMed1982

Blood-brain barrier derangement in uremic encephalopathy.

A disturbance of cerebral neurotransmitters and an accumulation of octopamine, a putative false neurotransmitter, have been found in patients with uremic encephalopathy who manifest disorientation, somnolence, asterixis, and coma--symptoms also seen in portal systemic encephalopathy (PSE). Altered plasma concentrations of the neutral amino acids (NAAs) and increased blood-brain NAA transport may play a role in PSE, and in the present study plasma amino acid concentrations and blood-brain barrier NAA transport were investigated in rats with acute and chronic uremia. Acute uremia was produced by unilateral nephrectomy and occlusion of the renal artery of the remaining kidney for 70 minutes; the animals were studied 24 hours later. Chronic uremia was produced by unilateral nephrectomy and 70% to 80% devascularization of the remaining kidney; these animals were studied 2 weeks later. Brain uptake was studied with the technique of Oldendorf, and blood and brain amino acids (AAs) were measured. The blood urea nitrogen (BUN) level in rats with acute uremia increased to 108 mg/dl, in rats with chronic uremic 54 mg/dl, and in sham-operated rats 22 mg/dl. In both uremic groups there was a decrease in plasma branched-chain AAs. In the brain these AA levels were normal, while levels of phenylalanine, tyrosine, and histidine were increased in uremic rats.

Amino Acids↗
PubMed1982

[New principles in liver surgery].

39 patients with metastases to the liver from colorectal cancer were treated with liver resection. The average survival time was 25 months. 11 patients are alive after 10 to 102 months. 18 patients had liver resection for primary liver cancer. The average survival time was 27 months. 4 patients are alive after 27 to 84 months. 16 patients had temporary dearterialisation for carcinoid. All the surviving patients were free from symptoms for at least 6 months.

Aged↗
PubMed1982

A simple modification of Greiner electronics selective analyser G300 permitting use of capillary blood samples.

A simple modification of Greiner electronics selective analyser G300 allowing direct transference of serum samples to the process tubes is described. The modified instrument permitted use of pediatric and capillary blood samples. Eight different capillary analyses were tested on the modified instrument and the results agreed with those obtained by the ordinary analytical macroprocedures of the instrument.

Automation↗
PubMed1981

Blood-brain barrier derangement in sepsis: cause of septic encephalopathy?

Patients with sepsis often manifest disorientation, somnolence, asterixis and coma, symptoms also seen in portasystemic encephalopathy. Altered plasma concentrations of the neutral amino acids and in creased blood-brain transport of these acids may play a role in portasystemic encephalopathy. Plasma amino acids and blood-brain barrier transport of neutral amino acids were investigated in a rat model of abdominal sepsis, cecal ligation and puncture. The blood-brain transport was studied by the technique of Oldendorf with carbon-14-amino acids 12 and 24 hours after the induction of sepsis. In similar groups of animals, isolation of brain capillaries was carried out by the technique of Hjelle and the capillaries were incubated with carbon-14-amino acids to study transport activity. Plasma and brain amino acids were deranged in a fashion similar to the derangements seen in portasystemic encephalopathy, with a decrease in plasma branched chain amino acids and an increase in most neutral amino acids in brain. The changes were most pronounced after 24 hours. The brain uptake of several neutral amino acids was increased in the septic rats, while the uptake of lysine, a basic amino acid, was normal. In the brain capillaries isolated from septic rats, tyrosine and leucine transport was also greater than in sham-operated animals. Elevated neutral amino acids may play a role in the encephalopathy encountered in septic patients similar to its role in patients with portasystemic encephalopathy, as similar mechanisms appear to be operating.

Abdomen↗
PubMed1981

Uptake of amino acids by brain microvessels isolated from rats after portacaval anastomosis.

The uptake of amino acids by microvessels isolated from brains of rats was studied. Previous studies have demonstrated alterations in blood-brain amino acid transport after portacaval shunt in rats. In order to elucidate whether such changes in the blood-brain barrier were located in the microvessels, brain microvessels were isolated from both rats with portacaval shunt and controls. Brain microvessels from rats 2 weeks after shunt operations took up significantly greater amounts of 14C-labeled neutral amino acids, but not of glutamic acid, lysine, or alpha-methylaminoisobutyric acid than microvessels from sham-operated controls. Measurement of uptake kinetics showed a higher Vmax for phenylalanine and leucine uptake and a lower Vmax for lysine uptake in microvessels from shunted rats compared with control, whereas the respective Km's of uptake were similar in both preparations. The results suggest that changes in brain microvessel transport activity account for altered brain neutral amino acid concentrations after portacaval shunt and that such changes can be studied in vitro in isolated microvessels.

Amino Acids↗
PubMed1981

[Organization of diagnosis, treatment, and further measures for patients with gastrointestinal cancer (author's transl)].

One third of the total surgical care at the Department of Surgery, University of Lund, Sweden, is for cancer patients. Gastrointestinal cancer occupies 9,000 of a total of 12,000 bed-days and this disease is usually handled by the team who cares for the specific organ in which the cancer is localized. A particularly important part of gastrointestinal care is endoscopy (gastroscopy and colo-sigmoideo-rectoscopy). These diagnostic procedures can sometimes be curative. The value of preoperative liver tests for diagnosing liver metastases in colorectal cancer is very low because of the low prevalence of liver metastases in this population. Palliative therapeutical procedures, such as Celestin-tubes for esophageal or cardia carcinoma and transhepatic endoprostheses for bile duct occlusive cancer, have been tested. Palliative cytostatic therapy is partly established, i.e., intraarterial infusion of 5-FU for recurrent rectal carcinoma in the lower pelvis. This type of treatment has a very good pain relief effect. Cytostatic therapy for tumour control in patients without symptoms e.g. primary or secondary liver carcinomas, has not yet been established. Most of the patients with cytostatic therapy are treated on an outpatient basis. The cytostatic therapist must always be properly protected when working with cytostatic drugs. It is very important that the patient who gets cytostatic therapy is followed in order to see if the drug has any growth-controlling effect. A cost-benefit analysis of the therapy should also be made.

Antineoplastic Agents↗
PubMed1980

Oral bioavailability of apomorphine in the rat with a portacaval venous anastomosis.

Orally administered apomorphine failed to produce stereotyped behavior in sham-operated rats, but did so following portacaval venous anastomosis. Brain and serum levels of apomorphine were highly correlated and corresponded with ratings of stereotypy. Tissue levels were undetectable after oral administration of apomorphine in intact rats but in shunted rats, were similar to those found after s.c. injection. These results suggest that a strong first-pass hepatic metabolism may account for the low oral bioavailability of catechol-aporphines.

Administration, Oral↗
PubMed1980

Decreased startle reactivity in the end-to-side portacaval shunted rat.

A rat with an end-to-side portacaval anastomosis (PCA) is an extensively used experimental animal for characterization of biochemical alterations following diversion of portal blood flow from the liver; but few behavioral abnormalities have been detected. Biochemical changes observed in rats after PCA include increased plasma and brain levels of the serotonin precursor tryptophan, with increased brain serotonin and its metabolite 5-hydroxyindoleacetic acid. Accumulating evidence indicates that serotonin may be involved in the modulation of the startle response in the rat. In this study, the magnitude of startle responses to both tactile and auditory stimuli were shown to be abnormally decreased in chronic PCA rats. The simplicity of this animal model and the reproducibility of the effect suggest that evaluation of startle responses in rats with PCA may enable assessments of the efficacy of putative therapeutic strategies for the treatment of some of the dysfunctions associated with hepatic encephalopathy.

Acoustic Stimulation↗
PubMed1979

Hyperammonaemia, plasma aminoacid imbalance, and blood-brain aminoacid transport: a unified theory of portal-systemic encephalopathy.

It is proposed that hyperammonaemia in liver cirrhosis or after portacaval shunt contributes to plasma neutral aminoacid imbalance and to increased activity of the blood-brain neutral amino-acid transport system. Plasma neutral aminoacid concentrations are deranged, partly, but not completely, because ammonia stimulates glucagon secretion; a high rate of gluconeogenesis and hyperinsulinaemia follow. Brain uptake of neutral aminoacids rises because ammonia stimulates brain-glutamine synthesis, which results in rapid exchange of brain glutamine for plasma neutral aminoacids. Hyperammonaemia therefore contributes to encephalopathy indirectly, by raising the brain concentration of neutral aminoacids which after neurotransmitter metabolism, rather than directly, by toxic effects on neuronal metabolism.

Amino Acids, Branched-Chain↗
PubMed1979

Hepatic necrosis in the pig produced by transient arterial occlusion.

The effects of transient liver ischaemia were studied in young pigs. At operation, a specially designed ligature sling was placed around the hepatic artery and brought out through the abdominal wall so that it could be later tightened. All other routes of arterial supply to the liver were divided. The arterial supply was occluded for 1, 2, 4 or 12 h on the 1st and 3rd postoperative days. Ischaemic damage was assessed histologically and by serum ASAT and acid hydrolase levels. Liver necrosis developed after 1--2 h of occlusion and increased after 4 and 12 h of occlusion. Ischaemic liver damage was reduced when the operation and occlusion were separated by 72 hr.

Animals↗