Search PubMed⌕ Search

Biomedical subjects

D Bergqvist

Publications and source records attributed to D Bergqvist.

At least 379 records · Page 21Linked to original sources
PubMed1989

Leukotriene B4-induced permeability increase in postcapillary venules and its inhibition by three different antiinflammatory drugs.

Leukotriene B4 (LTB4) is a potent chemotactic and chemokinetic substance that causes leukocyte accumulation and increases vascular permeability. We have used the hamster cheek pouch model to study the effect of some different antiinflammatory drugs on the LTB4-induced microvascular permeability. Intravascular fluorescein-labeled dextran (mol wt 150,000) was used as a tracer of macromolecular leakage, which was measured as the number of venular leaky sites and as efflux of the vascular tracer. Topical application of LTB4 (10(-8) M, 5 min) resulted in a reversible increase of the vascular permeability and could be repeated with 40-min intervals without any significant reduction in permeability response. The LTB4-induced response could be inhibited by budesonide (a glucocorticoid) given locally, by iloprost (a prostacyclin analog) given intravenously and by a combined local and intravenous treatment with terbutaline (a beta 2-receptor agonist) but not by local terbutaline treatment only.

Animals↗
PubMed1989

Pharyngeal function after carotid endarterectomy.

Neurologic deficiencies, with special reference to pharyngeal function, were studied prospectively in 12 patients before and after they underwent carotid endarterectomy. Pharyngeal function was monitored with cineradiography. Five patients developed pharyngeal dysfunction: defective closure of the laryngeal vestibule, epiglottic dysmotility, and pharyngeal constrictor paresis 1 week postoperatively. In 2 patients this dysfunction remained, while in 3 it had resolved 4 weeks after the operation. Pharyngeal dysfunction was more common in patients with preoperative minor stroke and a temporary perioperative carotid shunt and in patients with a long operation time. The registered transient pharyngeal dysfunction may be due to manipulation of the cervical structures including the vagus nerve and the pharynx or due to cerebrovascular damage during the operation. Our findings support careful monitoring of postoperative oral finding in patients at risk.

Adult↗
PubMed1989

Recurrent thromboembolism in pregnancy and puerperium. Is there a need for thromboprophylaxis?

By sending a questionnaire (response rate 93%) to 321 women with a history of venous thromboembolism and previous coagulation tests, 72 patients were identified who had a total of 87 pregnancies after the thromboembolic episode. The main aim of the study was to analyze the influence of prophylaxis during pregnancy and delivery on the development of further thromboembolic complications. During pregnancy there was no difference in frequency of thromboses between the group given prophylaxis (n = 20) and the group not receiving it (n = 67). At delivery the frequency of thrombosis was 5.3% among the 57 women given prophylaxis and 11.1% among the 30 without prophylaxis, a difference that is not significant. The implication of these findings is discussed both concerning the indications for giving prophylaxis and concerning the problem of designing relevant prophylactic trials.

Female↗
PubMed1989

Lipid peroxidation and activity of antioxidant enzymes in muscle of the lower leg before and after arterial reconstruction.

Reperfusion syndrome and lipid peroxidation due to toxic effects of free oxygen radicals might be one pathophysiological cause of the oedema that develops during the first week after a femoro-popliteal reconstruction. This paper reports the activity of the protecting antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase and catalase in gastrocnemic muscle before and after reperfusion of chronically ischaemic legs with comparison to activities in non-ischaemic muscle. Furthermore the susceptibility to lipid peroxidation in the muscle was measured as thiobarbituric acid reactive material (TBAR). The activities of CuZn SOD, Mn SOD and glutathione peroxidase were equal in normally perfused and chronically ischaemic muscle and there was no difference after reperfusion. Muscle catalase activity was low compared to activity of red blood cells and could not be reliably estimated. There was no difference in iron-stimulated lipid peroxidation of ischaemic and non-ischaemic muscle but in reliably estimated. There was no difference in iron-stimulated lipid peroxidation of ischaemic and non-ischaemic muscle but in muscle biopsied 10 min after reperfusion there was a significant increase in production of TBAR indicating an increased susceptibility for lipid peroxidation at this time. The finding is compatible with the occurrence of an oxidant insult on the muscle at reperfusion. Ischaemia--or reperfusion--induced reductions in activity of antioxidant enzymes are however not related to this reaction.

Arteriosclerosis↗
PubMed1989

Evaluation of ulceration in the extracranial carotid artery with ultrasonography: a comparison with arteriography.

The accuracy of duplex-scanning and angiography in detecting ulceration in the carotid arteries was evaluated. Sixty-nine patients underwent duplex-scanning and carotid arteriography, and the findings were blindly compared to the operative specimens. Duplex-scanning had a significantly higher sensitivity (90 vs 48%, P less than 0.001) and accuracy (88 vs 59%, P less than 0.001) than angiography. There was no difference in specificity (84 vs 89%, P = 0.28). Comparison was also made between conventional arch angiography and selective carotid angiography in detecting ulceration. There was no significant difference between the methods (sensitivity 47 vs 50%, specificity 82 vs 100%). Finally, interobserver variability in detecting ulceration with duplex-scanning was evaluated in double-blind evaluation of the duplex-scans. The interobserver agreement was 84%. Duplex-scanning seems to be superior to angiography in detecting ulcerations in the extracranial carotid artery.

Adult↗
PubMed1989

Arterial 6-keto-PGF1 alpha and TxB2 release in ex vivo perfused canine vessels: effects of pulserate, pulsatility, altered pressure and flow rate.

Certain experimental conditions are known to influence the release of prostacyclin and thromboxane from the vessel wall. The specific effects of altered pulsatility, pressure, and flow rate on intraluminal release of 6-keto-PGF1 alpha and thromboxane B2 were assessed in canine arteries perfused ex vivo for five 15 min periods with arachidonic acid (AA) added during the last period. Control arteries were perfused at 100 mmHg with pulsatile flow of 90 ml/min. Experimental arteries were perfused at 7, 50 and 200 mmHg with pulsatile flow of 90 ml/min, and at 100 mmHg pressure with pulsatile flow of 20, 60, 130 and 180 ml/min, as well as at 100 mmHg with 90 ml/min nonpulsatile flow. Perfusion pump rates of 44 and 96 beats/min were also assessed. The lowest perfusion pressure, 7 mmHg, resulted in a lesser initial release of prostacyclin compared to higher pressures, and there was a tendency to a higher release of prostacyclin with increasing pressures. There was also a tendency for a lesser response to AA in arteries perfused at 200 mmHg, perhaps due to endothelial cell damage. Nonpulsatile flow was associated with a decreased initial release of prostacyclin, and diminished release following addition of AA when compared to pulsatile flow. Altered flow rate elicited no difference in prostacyclin release, although there was a tendency towards a lesser release when perfused at 20 ml/min compared to 130 ml/min or 180 ml/min. Thromboxane release was decreased by nonpulsatile flow but was otherwise unaffected by the experimental conditions tested. It is concluded that pulsatility enhances release of prostacyclin from arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Ultrasound screening of the abdominal aorta in patients with intermittent claudication.

The presence of abdominal aortic dilatations and aneurysms (AAA) among 372 patients (302 men and 70 women) who originally presented with intermittent claudication was studied. The cohort was analysed in two ways, first retrospectively from the date of diagnosis of intermittent claudication until 1st of August 1985 (mean follow-up time being 70 months), second those alive at that date and who had not been operated on were offered ultrasound screening of their aorta. Retrospectively nine male patients were found to have had an operation for an aneurysm, one because of a rupture. Of the 110 patients who died and had not had surgery, 88 (73 men, 15 women) were autopsied and AAA was found at autopsy in six males and one female. Two males died of rupture. Ultrasonographic screening of the abdominal aorta was performed in 183 patients (147 men and 36 women) and dilatation was found in 25 patients (24 men, 1 woman). In the male part of the total material (n = 257) there were 39 patients (15%) with aneurysm or dilatation. Male patients with AAA or dilated aortas were significantly heavier, with a lower ankle arm index and higher serum cholesterol values than patients without AAA or aortic dilatation.

Adult↗
PubMed1989

Local versus general anaesthesia in carotid surgery. A prospective, randomised study.

A randomised, prospective study was performed to compare local (LA) and general anaesthesia (GA) in carotid surgery with special emphasis on complications and the need for intra-operative shunting. Fifty-six patients were randomised to LA and 55 to GA. Eight patients in the LA group required a GA for various reasons. During the same period 14 patients were not randomised. Seven perioperative neurological deficits occurred (5.6%), four in the LA group, two in the GA group, and one in the non-randomised group (NS). Selective shunting was used, in the Ga group according to stump pressure or in cases with a previous stroke and in the LA group according to the appearance of neurological symptoms. In the GA group 25 patients were shunted and in the LA group five patients (P less than 0.001) needed a shunt. If strict pressure criteria for shunting had been used in the LA patients, ten would have been shunted and three of the patients who developed symptoms during clamping would not have been shunted. During surgery the highest recorded systolic pressure was significantly higher in the LA group (210 mmHg versus 173 mmHg, P less than 0.001). LA for carotid endarterectomy is comparable with general anaesthesia regarding peroperative complications but produces significantly higher blood pressures than general anaesthesia. On the other hand it allows the possibility of neurologic monitoring of the patient and leads to significantly less use of an intra-operative shunt.

Adult↗
PubMed1989

Solitary aneurysms of the iliac arterial system: an estimate of their frequency of occurrence.

Solitary iliac artery aneurysms are rare, and most reports have been presented as case reports. By combining autopsy records and operating records, a total of 13 cases were found: during a 15-year period (1971 to 1985), 42,010 of the inhabitants of Malmö died (population 230,000) and 35,265 (including 9014 forensic autopsies) underwent autopsy (84%). Solitary iliac artery aneurysms were found in seven (0.03%) of the 26,251 patients who underwent autopsy at the hospital; six of those had been asymptomatic and one was ruptured. Among the 9014 persons who underwent forensic medical autopsy, there were two with ruptured solitary iliac artery aneurysms. Four patients had clinically detected solitary iliac artery aneurysms, three of which were ruptured. All patients underwent surgery, and two of the three patients with ruptured solitary iliac artery aneurysms left the hospital well. The rupture rate of iliac aneurysm among those found at autopsy was one of seven (14%) and among those clinically detected three of four.

Adult↗
PubMed1989

Thromboprophylaxis in hip arthroplasty. Dextran with graded compression or preoperative dextran compared in 150 patients.

Totally, 150 patients, subjected to total hip arthroplasty, were randomly allocated into three prophylactic groups with either conventional dextran alone or with additional graded compression stockings or with additional preoperative administration of dextran. The overall frequency of deep venous thrombosis (DVT), as studied by radioactive fibrinogen uptake test and ascending phlebography of the operated on thigh was in the conventional dextran group 46 percent, the additional stockinged group 30 percent, and in the additional preoperative dextran group 52 percent. In the stockinged group, there was a lower frequency of DVT in the nonoperated on leg as well as, on an average, about 350 mL less peroperative bleeding as compared with the other two groups. No adverse reaction occurred from dextran administration. Increased and prolonged postoperative administration of dextran decrease the number of femoral DVTs.

Aged↗
PubMed1988

Low molecular weight heparin given the evening before surgery compared with conventional low-dose heparin in prevention of thrombosis.

A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a low molecular weight heparin fragment for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the heparin fragment was given the evening before surgery, and further doses were given thereafter every evening. There were 1002 analysable patients, 826 having received correct prophylaxis. Of these 1002 patients, 64 per cent were operated on for malignant disease. A total of 20 patients died, 10 in each group. The frequency of deep vein thrombosis was significantly reduced among patients with correct prophylaxis with the heparin fragment (9.2-5.0 per cent, P = 0.02) [corrected]. The frequency of bleeding was 6.7 per cent among the heparin fragment patients and 2.7 per cent among the patients given conventional heparin (P = 0.01), but all bleeds were of minor degree and there was no difference in the reoperation rate for bleeding, or in the transfusion requirements. Local pain at the injection site was reported significantly less often among patients given the heparin fragment.

Abdomen↗
PubMed1988

Comparison of static incubation versus physiologic perfusion techniques for quantitation of luminal release of prostacyclin and thromboxane in canine arteries and veins.

Intraluminal release of 6-keto-PGF1 alpha and TxB2 in ex vivo canine arteries and veins was assessed during five consecutive 15-min periods using static incubation and physiologic perfusion techniques. Arterial segments were perfused with 90 ml/min pulsatile flow at 100 mm Hg and vein segments with 90 ml/min nonpulsatile flow at 7 mm Hg. During the final 15-min period vessels were stimulated with arachidonic acid (AAS). Perfusion of vein segments caused a higher release of 6-keto-PGF1 alpha during the first 30 min (P less than 0.05) and following AAS (P less than 0.05) than did static incubation. Perfused arterial segments exhibited a higher release than did incubated segments of 6-keto-PGF1 alpha for 45 min (P less than 0.01) as well as following AAS (P less than 0.01). TxB2 release was higher during the entire observation period in perfused arteries and veins compared to incubated vessels (P less than 0.01 and less than 0.05, respectively). There was no correlation between the amounts of 6-keto-PGF1 alpha or TxB2 released when comparing values obtained by one technique to values obtained by the other (P greater than 0.1). These data suggest that flow related shear stress alters vascular prostanoid production, and that such should be accounted for when interpreting results of studies on prostacyclin and thromboxane release from intact vessels.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Long-term results after carotid artery surgery.

This study presents the results from a follow-up after 414 carotid reconstructions performed on 352 patients during the years 1971-82. At the end of the follow-up period 267 patients were alive (75.8%) and 253 patients remained asymptomatic. The median follow-up time was 35 months (6 months-12 years). Patients with coronary artery disease (CAD) had a significantly lower survival than patients without signs of CAD. Coronary artery disease was significantly more frequent among patients with bilateral carotid lesions compared to patients with unilateral lesions. The actuarial stroke frequency, operative morbidity included, on the operated side was 2.5%/year. However, from 6 months postoperatively up to 8 years the stroke frequency was 1%/year. In the stroke frequencies all neurological deficits of more than 24 h duration are accounted for. Although there was a trend toward higher stroke rates among older patients there were no significant differences between age groups. Assuming a 10% stroke frequency during the first year after a TIA and a 6% annual stroke rate thereafter our results would cross even such a natural course curve at 18 months.

Actuarial Analysis↗