Biomedical subjects
Publications and source records attributed to K Fabrin.
Metastasis to the ureter is very rare. In most published cases, the diagnosis is only made at postmortem examination or when gross metastasis is present. This report presents a case in which the metastasis from a colonic tumour occluded the ureteral lumen from inside.
Laparoscopic surgery appears to be less traumatic to the patient than open surgery, but its influence upon coagulation and fibrinolysis is incompletely elucidated. Our aim was to measure markers of coagulation and fibrinolysis before, during. and after laparoscopic cholecystectomy (LC). Blood samples drawn on admission, on four occasions during operation as well as 2 hours after operation and on the first postoperative day in 50 patients undergoing elective LC were analyzed for prothrombin fragment 1+2 (F1+2), soluble fibrin (SF), D-dimer (DD), fibrin degradation products (FbDP), tissue-type plasminogen activator (tPA) activity and antigen, and plasminogen activator inhibitor (PAI) activity and antigen. F1+2, SF, DD, and FbDP levels increased significantly after LC. Differences between pre- and postoperative PAI and tPA levels were not significant apart from a transient increase in tPA antigen levels. tPA activity was significantly increased during operation.
OBJECTIVE: To evaluate whether the activation of the extrinsic tissue-type plasminogen activator-related fibrinolysis is implicated in the blood loss in patients with benign prostatic hyperplasia, undergoing transurethral prostatic resection (TURP). PATIENTS AND METHODS: TURP was performed in 24 men and the operative and post-operative blood loss determined. The activation of the tissue-type plasminogen activator-related fibrinolysis was followed using new sensitive and specific assays, and the changes related to the blood loss. Measurements of the plasma concentrations of free tissue-type plasminogen activator (t-PA) activity, tissue-type plasminogen activator (t-PA) antigen, plasminogen activator inhibitor (PAI) activity, plasminogen activator inhibitor 1 (PAI-1) antigen, plasminogen (Plg) activity, plasminogen (Plg) antigen, alpha 2-antiplasmin (alpha 2-AP), D-dimer and fibrin degradation products (FbDP) were all determined and the area under the curve (AUC) for each of these quantities correlated with the blood loss. RESULTS: TURP was followed by a marked activation of the fibrinolytic system. There was an immediate increase in systemic t-PA activity and t-PA antigen, coinciding with a significant drop in PAI activity. Post-operatively, PAI activity and PAI-1 antigen increased. The formation of plasmin was indicated by a fall in the plasma concentration of Plg activity and Plg-antigen and alpha 2-AP but which increased significantly at the end of the study period. Increased systemic fibrinolytic activity was further confirmed by a marked increase in fibrin D-dimer and FbDP. There was no correlation between the AUC in the operative period of any of the fibrinolytic variables and the measured blood loss. In the post-operative period, t-PA antigen (P = 0.004), PAI activity (P = 0.043), PAI-1 antigen (P = 0.016) and alpha 2-AP (P = 0.047) all correlated with the post-operative blood loss, while there was no correlation between fibrin D-dimer or FbDP and blood loss. CONCLUSION: The fibrinolytic system is activated during and after TURP, but the increased activity is not of pathophysiological importance for the blood loss.
OBJECTIVE: To evaluate whether post-operative blood loss in patients with benign prostatic hyperplasia, undergoing transurethral resection of the prostate (TURP), depends on in situ fibrinolysis in urine, and to determine the relative contributions of the urokinase and tissue-type plasminogen activator systems. PATIENTS AND METHODS: TURP was performed in 24 men (median age 68.5 years, range 52-78) and the weight of resected tissue, the operative and post-operative blood loss determined. The concentrations of the urokinase- (u-PA) and tissue-type plasminogen activator (t-PA)-related fibrinolysis in their urine was followed using sensitive and specific assays, and the changes related to post-operative blood loss. Measurements of the urinary concentrations of free t-PA activity, t-PA antigen, free u-PA activity, u-PA antigen and fibrin degradation products (FbDP) were determined and the area under the curve for each of these quantities correlated with the post-operative blood loss. RESULTS: The post-operative blood loss correlated significantly with the per-operative loss (P = 0.047) and the weight of resected tissue (P = 0.029). There was a highly significant correlation between the area under the curve of FbDP in the urine and the post-operative blood loss (P < 0.005), while there was no significant positive correlation between the PA concentration or activity in the urine and post-operative blood loss. There was a significant correlation between the urinary t-PA activity and the amount of FbDP in the urine (P = 0.047), and a significant correlation between the weight of resected tissue and the amount of FbDP in the urine (P = 0.014). CONCLUSION: The post-operative blood loss after TURP is significantly related to an increase of the urinary fibrinolytic activity and the enhanced fibrinolytic activity is probably caused by t-PA.
OBJECTIVE: To investigate if double gloving can reduce the rate of perforation of glove barriers during abdominal surgery. DESIGN: Randomised controlled trial. SETTING: County hospital, Denmark. SUBJECTS: 400 glove barriers from principal surgeons and first assistants used at consecutive abdominal operations. INTERVENTION: Each participant was randomised to wear either a pair of single or double gloves. MAIN OUTCOME MEASURES: The number of perforated glove barriers in the two study groups. RESULTS: 40 single glove barriers perforated (20%) and in 8 of the double glove group both gloves perforated (4%) (p < 0.001). Glove barriers on non-dominant hands were more often perforated than those on dominant hands, and both the duration of the operation and the seniority of the doctor were associated with increased rates of perforation. CONCLUSION: Double gloving reduces the rate of perforation of glove barriers during abdominal surgery and thereby the number of episodes in which transmission of disease from patient to surgeon would be possible.
Non-surgical procedures are increasingly being used for drainage of pancreatic pseudocysts. We describe the results of placement of a double pigtail cystogastric stent under ultrasonographic and gastroscopic guidance. The stent was placed in 22 of 25 pseudocysts. There was no mortality associated with the procedure and the total complication rate was 20%. The cysts resolved in all patients and 87% reported reduction of abdominal pain. The median stent-time was 347 days and there were no cyst recurrences or complications during that time. After removal of the stent four out of 19 patients had recurrences. After placement of a second stent in these four patients there were no recurrences. Treatment with a cystogastric stent is comparable to surgical cystogastrostomy as regards to results and has fewer complications.
Acute herniations through a posterolateral diaphragmatic defect (Bochdalek hernia) are rare in adults. Most of these hernias are on the left side causing gastrointestinal symptoms. We present af case of a Bochdalek hernia on the right side, where incarceration and distension of the stomach was followed by dyspnoea and haemoptysis. Aetiology, symptoms, diagnosis and treatment are discussed.
Facing conflicting results from centers working with vitreous fluorophotometry, we performed a series of methodological studies of the technique preceding clinical studies. A major problem is the resolution power of the system. This is predicted to be dependent on the size of the fiberoptic probe, the slit width and angle between incident and detecting light beam, which is shown to be true in experiments with glass cuvettes and in studies of the eyes of 10 healthy volunteers. In the in vivo studies, variations of slit height could also influence readings. The selection of appropriate filters is important to reduce reflexes and autofluorescence of the ocular media, which otherwise must be accounted for.
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