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Biomedical subjects

B Zederfeldt

Publications and source records attributed to B Zederfeldt.

At least 19 recordsLinked to original sources
PubMed1999

Expression of tissue-type and urokinase-type plasminogen activator activities in chronic venous leg ulcers.

BACKGROUND: Chronic wounds have been shown to exhibit elevated levels of several classes of proteinases. Plasminogen activators (PAs) are proteinases which play a major role in the biological processes involved in wound healing and abnormalities in PAs may play a role in the pathology associated with chronic wounds. Here, we investigated the expression of tPA and uPA activities in chronic venous ulcer biopsies. PATIENTS AND METHODS: In 22 patients with chronic venous leg ulcers, punch biopsies were taken from the ulcer base, ulcer margin and uninvolved skin from the thigh of the affected limb and PA activities were assessed using in situ histological zymography. RESULTS: tPA is the main PA activity in uninvolved skin but was reduced in ulcer margin skin and venous leg ulcer tissue compared to normal skin. uPA activity appeared throughout the ulcer margin skin but was at low levels in normal skin. Ulcer base tissue appeared to exhibit a plasminogen-independent proteinase activity not seen in normal or ulcer margin skin. CONCLUSION: PA activities are altered in and around chronic venous leg ulcers and their distribution suggests that blood vessels in CVI may be damaged and that the tissue is in an inflamed state.

Aged↗
PubMed1999

Enhanced cytokine response to surgical trauma in patients with colorectal cancer.

OBJECTIVE: Cancer is an immunologic challenge, and it was hypothesized that the presence of a cancer could modulate the cytokine response to operative trauma. SETTING: University hospital, Sweden. SUBJECTS: Patients operated with colonic or rectal resections; 9 patients with colorectal cancer and 16 patients with benign lesions--8 of which were inflammatory. INTERVENTION: Venous blood samples were collected preoperatively; every 30 min intraoperatively; 6 h postoperatively and daily for 6 days in the postoperative period. MAIN OUTCOME MEASURES: IL-1beta and TNF-alpha were analyzed by commercial ELISAs, whereas IL-6 was analyzed by the B9 bio-assay. RESULTS: Preoperative cytokine levels were similar in the malignant and benign groups, but intraoperative IL-6, IL-1beta and TNF-alpha serum levels and postoperative IL-6 and TNF-alpha serum levels were significantly (p < 0.05) higher in the malignant group. CONCLUSION: The results indicate that colorectal malignancy enhances the IL-1beta, TNF-alpha and IL-6 response to surgical trauma.

Adult↗
PubMed1994

Experimental colonic healing in relation to timing of 5-fluorouracil therapy.

In an experimental study resembling clinical use of adjuvant 5-fluorouracil (5-FU) treatment of colorectal carcinoma, 97 male Wistar rats were operated on with a standardized left colonic resection. Treatment was given as a daily intraperitoneal injection. The animals were randomized to one of four groups: early treatment with 5-FU 20 mg/kg or saline 0.1 mol/l from the day of operation to day 7 after operation, and delayed treatment with 5-FU 20 mg/kg or saline 0.1 mol/l from the third day after operation to the day before killing. The animals were killed in groups on day 7 or 10 after operation. In the group receiving early 5-FU treatment there was an increased rate of anastomotic complications (seven of 26) compared with none in the control or delayed 5-FU groups. The anastomotic breaking strength in animals having early 5-FU treatment (day 7, median 1.45 (range 0.20-2.95) N; day 10, median 1.80 (range 0.95-3.20) N) was significantly lower than that in controls on both day 7 (median 3.20 (range 2.50-3.80)N) and day 10 (median 3.20 (range 2.20-3.60)N). In the delayed 5-FU treatment group anastomotic breaking strength did not differ from that in controls. Colonic healing was not impaired when intraperitoneal 5-FU treatment was started on day 3 after operation, whereas immediate postoperative administration of 5-FU had a detrimental effect on wound healing.

Animals↗
PubMed1994

The roles of nutritional depletion and drug concentration in 5-fluorouracil-induced inhibition of colonic healing.

This study was performed to investigate whether poor nutrition is responsible for 5-fluorouracil (5-FU)-induced inhibition of large bowel healing and if the concentration of intraperitoneal (ip) 5-FU affects anastomotic healing. Male Wistar rats underwent a left colonic resection and were randomly assigned to a control group (n = 9, ip NaCl, normal diet), a nutritional depletion group (n = 12, ip NaCl, restricted diet), or a 5-FU group (n = 12, ip 5-FU, normal diet). Treatment was started immediately after surgery and continued until sacrifice after 7 days. Although the weight loss in the nutritional depletion group exceeded that in the 5-FU group, the anastomotic and skin breaking strength was lower in the latter group compared with that in the former group (P < 0.01 and P < 0.05, respectively). There were no significant differences in breaking strength between the nutritional depletion group and controls. A second series of male Wistar rats were similarly operated on and randomly assigned to a control group (n = 6, ip NaCl), a 5-FU high-concentration group (n = 10, (5 mg/ml ip 5-FU) or a 5-FU low-concentration group (n = 10, (1 mg/ml ip 5-FU). The 5-FU dose was the same in the two latter groups. The anastomotic breaking strength on Day 7 was reduced to a similar extent in the 5-FU groups (P < 0.01). These results indicate that the impaired anastomotic healing after ip 5-FU is not mainly due to nutritional factors or drug concentration.

Anastomosis, Surgical↗
PubMed1994

The effect of 5-fluorouracil on wound healing and collagen synthesis in left colon anastomoses. An experimental study in the rat.

In an experimental study resembling clinical use of adjuvant 5-fluorouracil (5-FU) treatment of colorectal carcinoma 86 male Wistar rats were operated with a standardized left colon resection and anastomosis with interrupted sutures. Treatment was given as daily intraperitoneal (i.p.) injections. The animals were randomized to one of two groups: (A) 5-FU (20 mg/kg) i.p., and (B) NaCl i.p. from the day of operation to sacrifice. Anastomotic complications were registered. In experiment 1 animals were randomized within treatment groups to be tested for anastomotic breaking strength with or without sutures in place when sacrificed 7 days postoperatively. In experiment 2 collagen synthesis was studied by an in vivo incorporation and hydroxylation of 3H-proline in the anastomotic segment during 24 h prior to sacrifice. The animals were sacrificed in groups on the third or seventh postoperative day. A higher number of anastomotic complications was registered when 5-FU was given. The anastomotic breaking strength was only 40% of controls both when tested with and without sutures. A reduced radioactivity of 3H-hydroxyproline in the anastomotic segment after 7 days of 5-FU treatment was found implying a reduction in collagen synthesis. In our model colonic healing was impaired after i.p. 5-FU treatment and this could be attributed to a reduced collagen synthesis in the wound gap as well as in the adjacent tissue responsible for the suture-holding capacity.

Anastomosis, Surgical↗
PubMed1994

Preoperative irradiation and colonic healing.

OBJECTIVE: To find out if preoperative irradiation of 10 + 10 Gy influences anastomotic healing in the lower left colon of the rat. DESIGN: Randomised study. MATERIAL: 120 male Wistar rats. INTERVENTIONS: Rats were randomised to be given localised preoperative irradiation or sham treatment 8 and 4 days before a standardised left colon resection. The post-operative course was studied for up to two months. MAIN OUTCOME MEASURES: Changes in body weight, white cell count, haemoglobin and albumin concentrations, anastomotic complications, anastomotic breaking strength, hydroxyproline content and myeloperoxidase activity in the anastomotic segment. RESULTS: General effects of irradiation were seen as delayed increase in body weight and low white cell count. Anastomotic complications were not increased. Anastomotic breaking strength was similar in the early postoperative phase but reduced after 2 months. Hydroxyproline content and myeloperoxidase activity of the anastomotic segments were similar in irradiation and control animals. CONCLUSION: Anastomotic healing was not compromised by preoperative irradiation. Late effects may be present in the bowel wall but further investigation is required.

Anastomosis, Surgical↗
PubMed1993

Editorials.

Explore the source record for details and available documents.

Journal Article↗
PubMed1993

Effects of dextran and crystalloids on subcutaneous oxygen tension and collagen accumulation. A randomized study in surgical patients.

Twenty-nine patients, subjected to major abdominal surgery, were randomized to different types of postoperative fluid replacement, given on the basis of subcutaneous oxygen tension measurements (PscO2). One regimen consisted of crystalloids, the other of a combination of crystalloids and colloids (dextran 70). Perioperative fluid replacement was given according to clinical criteria and postoperatively according to polarographic PscO2 measurements. PscO2 was measured by a silicone catheter implanted in the upper arm. Two tubes of expanded polytetrafluoroethylene (ePTFE) were implanted next to the silicon catheter. They were removed on day 5 and 7, and analysed for hydroxyproline content. Total postoperative fluid support was equal in the two groups, and so was the hydroxyproline content on day 7. In conclusion, postoperative fluid substitution with dextran has no advantages over crystalloids only, with regard to granulation tissue formation if postoperative fluid support is optimum, according to PscO2 measurements.

Adult↗
PubMed1993

Quality of life in chronic leg ulcer patients. An assessment according to the Nottingham Health Profile.

Chronic leg ulcer is a disease of long duration, occurring predominantly in elderly people. Traditionally, little interest has been devoted to the study of the impact of this disease on life quality. In the present study the Nottingham Health Profile (NHP) was used to assess disease influence on six areas of daily life, namely: pain, physical mobility, sleep, energy, emotional reactions and social isolation. Standard questionnaires were distributed to patients with chronic leg ulcers of venous, arterial or mixed venous-arterial origin, treated at the Department of Dermatology. Complete data were obtained from 125 patients. The disease had a marked impact on the patient's subjectively perceived health. Males exhibited remarkably elevated scores, compared to the normative scores for men, especially in the areas of pain, emotional reactions, social isolation and physical restrictions. For women the impact of leg ulcer disease, although obvious, seems much less marked than for males. An exceptionally long median duration of leg ulcer disease was found among shop-assistants. It is possible that preventive measures should be undertaken in this group. The duration of leg ulcer disease did not seem to influence the quality of life. Patients with long disease duration in fact reported fewer problems than those with shorter duration, suggesting adaptive mechanisms. This study indicates that male leg ulcer patients should be more closely observed for symptoms of emotional stress, pain, social isolation and impaired physical mobility. More efforts should be made to alleviate pain. Above all this study underlines the importance of considering not only the ulcer but the whole patient.

Adult↗
PubMed1993

Radiation effects in the colon. An experimental study in the rat.

In an experimental study, resembling a clinical trial of preoperative irradiation, 10 + 10 Gy was given to the pelvic and lower abdominal region of rats with a 4-day interval. The early effect on the colonic wall was evaluated by myeloperoxidase activity and hydroxyproline content of the bowel wall and correlated to histological findings. Groups of animals were followed up to eight months after irradiation for evaluation of later effects. General effects of irradiation were seen as low WBC during the first week and delayed body weight development up to two months after irradiation. Local effect in the colonic wall was noted as an increase in myeloperoxidase activity (indicating a leucocyte accumulation) in irradiated parts of colon during the first 11 days and again significantly elevated after two months in parts of colon, irradiated as well as protected. This correlated well with histological findings of inflammatory reaction, atypia and dysplasia during the first 10 days after irradiation but not at two months after irradiation. Hydroxyproline content was not affected. There were no major complications due to irradiation seen in the late course of the study period.

Animals↗
PubMed1992

Influence of 5-fluorouracil and folinic acid on colonic healing: an experimental study in the rat.

Male Wistar rats were subjected to colonic resection and randomized to one of four groups: control group (intraperitoneal NaCl, intravenous NaCl); 5-fluorouracil (5-FU) group (intraperitoneal 5-FU, intravenous NaCl); folinic acid group (intraperitoneal NaCl, intravenous folinic acid); and 5-FU-folinic acid group (intraperitoneal 5-FU, intravenous folinic acid). Treatment was started immediately after surgery and continued until the animals were killed at 3 or 7 days. Anastomotic complications (abscesses or dehiscence) occurred in four of 33 animals in the control group, 12 of 36 in the 5-FU group, one of 32 in the folinic acid group and nine of 36 in the 5-FU-folinic acid group. Anastomotic and skin breaking strength did not differ between groups on day 3 but by day 7 were significantly reduced in the 5-FU group. In rats given 5-FU-folinic acid, breaking strength was also reduced, but less so than in the 5-FU group. Breaking strength in animals receiving folinic acid was similar to that in the control group. In this model colonic healing was impaired after intraperitoneal 5-FU administration, but when folinic acid was added no further deterioration occurred.

Anastomosis, Surgical↗
PubMed1992

Leg and foot ulcers. Nursing care in Malmö, Sweden.

Questionnaires concerning nursing care of leg and foot ulcer patients in three major care-giving sectors of the national health service, namely the Department of Dermatology, general hospital wards/clinics, and primary care, have been analysed. The overall response rate was 88% (primary care: 100%). Forms regarding 193 patients with leg ulcers and 64 patients with foot ulcers were analysed. Substantial differences in nursing care were noted between the three sectors. In 55% of the leg ulcers and 45% of the foot ulcers fibrin slough was present in the ulcer. Black, necrotic tissue was present in 8% of the leg ulcers and 22% of the foot ulcers. Profuse ulcer-exudation was most commonly reported for leg ulcer patients treated at the Department of Dermatology, while the majority of foot ulcers had only a mild exudation. Frequency of dressing changes varied between 1.4 times/week for leg ulcers at the Department of Dermatology and 9.2 times/week (foot ulcers 11.6) at general hospital clinics. Local wound dressings were exclusively chosen by physicians at the Department of Dermatology, mainly by physicians at general hospital clinics, and equally often by physicians and nurses in primary care. Time since last evaluation of the ulcer by a physician varied. At the general hospital clinics, 89% of the patients with leg ulcers had been seen by a physician within the last 2-month period. At the Department of Dermatology, 89% and in primary care 61% of the patients were examined within this period. 11% of the patients in primary care had never consulted a physician for their ulcers.(ABSTRACT TRUNCATED AT 250 WORDS)

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