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Biomedical subjects

R Andersson

Publications and source records attributed to R Andersson.

At least 307 records · Page 17Linked to original sources
PubMed1987

Influence of dextran on pneumococcal septicemia in splenic artery-ligated or splenectomized rats.

Splenic artery ligation is one of several methods in splenic preservation. In this experimental work the susceptibility of splenectomized rats and rats treated with splenic artery ligation to pneumococcal infection and the influence of the plasma expander dextran in the same groups were studied. The mortality among splenectomized rats was 100% vs nil after sham operation. Animals treated with splenic artery ligation and saline had a 23% mortality in pneumococcal septicemia, significantly different (P less than 0.05) from the 59% mortality after splenic artery ligation and dextran. A significant increase (P less than 0.05) in number of abscesses was also seen among rats given dextran.

Abscess↗
PubMed1987

T cell subsets and expression of immunological activation markers in the arterial walls of patients with giant cell arteritis.

Immunohistochemical features of infiltrating mononuclear cells (MNC) and resident cells were studied in the temporal artery biopsy specimens of 13 patients with histological verified giant cell arteritis (GCA) and in six biopsy specimens from patients with GCA with negative histological findings. Eight temporal artery biopsy specimens from seven patients with unrelated diseases served as controls. In all patients with GCA proved by biopsy an infiltration of T lymphocytes in the arterial wall was observed, most being of the helper/inducer subset. No B lymphocytes, or very few, were seen. Lymphocytes in 10 out of the 13 positive biopsy specimens displayed staining for the class II major histocompatibility complex (MHC) antigen HLA-DR, whereas this was found in only two of eight controls. A minor number of the infiltrating T lymphocytes from seven out of 13 patients with GCA proved by biopsy stained for transferrin receptors, and in six out of the 13 cases they reacted with anti-interleukin 2 receptor antibody. In the arterial wall from all patients with histologically verified GCA we also found an increased number of macrophages, many of them expressing HLA-DR antigens and transferrin receptors. The immunohistochemical pattern of cell phenotypes found in the arterial wall of patients with GCA suggests that the infiltrating T cells are immunologically activated. This finding supports the hypothesis of a predominantly cellular immunological pathogenesis of giant cell arteritis.

Aged↗
PubMed1987

Malignant abdominal hemangiopericytoma. Case report.

A case of malignant abdominal hemangiopericytoma in a 74-year-old man is presented. The tumor was surgically removed. A large local recurrence and a minor abdominal metastasis were excised 5 years later. The patient is well and apparently tumor-free 6 months post-operatively. Other methods of treatment are discussed.

Abdominal Neoplasms↗
PubMed1987

Transient ischemic colitis. Case report.

A 78-year-old man had profuse bloody diarrhea of sudden onset following a traffic accident associated with mild hypothermia. Rectoscopy performed one day later showed severe acute inflammatory changes, and biopsy revealed acute necrotizing colitis. Treatment was conservative. At control colonoscopy 3 weeks later the mucosa was mainly normal.

Accidents, Traffic↗
PubMed1986

Determinants of survival in liver resection for colorectal secondaries.

All 72 resections for colorectal liver secondaries during the period 1971-1984 were analysed retrospectively. Liver tumours were single in 35 (49 per cent), unilateral in 55 (76 per cent) and associated with extrahepatic disease in 12 (18 per cent) patients. Operative mortality was 5.6 per cent. With respect to the disease in the liver, the presence or absence of four or more metastases was the predominant prognostic determinant with a 5 year survival rate of 20 per cent in patients with less than four liver tumours, and no 3 year survivor among patients with four or more tumours. When the number of liver tumours was less than four, the prognosis in patients with unilateral disease was not significantly better than in patients with bilateral disease (P = 0.19). No other liver disease variable seemed to play any role in the prognosis. Extrahepatic disease was associated with a poor prognosis and no 5 year survivor. The length of the tumour-free resection margin was the only treatment variable that varied with the outcome: a resection margin of less than 10 mm was followed by a poor survival. Variables that did not influence survival included uni- or bilateral disease, liver tumour volume, tumour size, type of liver resection, Dukes' classification, differentiation of the primary tumour and synchronous or metachronous disease. It is concluded that resection for liver colorectal secondaries is indicated when there are less than four liver tumours, even if bilateral, no extrahepatic disease is present, and a resection margin of at least 10 mm can be obtained. It should not be performed unless all of these requirements are met.

Adult↗
PubMed1986

Long-term survival in giant cell arteritis including temporal arteritis and polymyalgia rheumatica. A follow-up study of 90 patients treated with corticosteroids.

Ninety patients with giant cell arteritis (GCA) were followed for 9-16 years after diagnosis. Corticosteroids were given to all but one patient. Forty-two patients died during the observation period (27 women and 15 men). The survival was compared with that in the general population and found not to be reduced among the GCA patients. In fact, we found a lower mortality than expected after five years from diagnosis (p less than 0.05). We did not see any increase in deaths due to vascular or malignant diseases in our patients.

Adrenal Cortex Hormones↗
PubMed1986

Acute phase reactants in the initial phase of giant cell arteritis.

The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen and haptoglobin were followed weekly during the initial phase of corticosteroid treatment in 18 patients with 19 episodes of giant cell arteritis (GCA). Fibrinogen and CRP decreased most rapidly, with normal values in 67% of the patients after two weeks of treatment. After two weeks 56% of the patients had normal ESR values and 76% after five weeks. Haptoglobin normalised most slowly, no patient having a normal value after one week, 29% after two weeks and 75% after six weeks. For routine clinical use, we found the ESR alone sufficient for monitoring the initial steroid treatment.

Acute-Phase Reaction↗
PubMed1986

Long-term corticosteroid treatment in giant cell arteritis.

Ninety patients with giant cell arteritis were followed up 9-16 years (median 11.3 years) after diagnosis. The mean duration of corticosteroid therapy was 5.8 years (range 0-12.8 years). Together, the patients had received corticosteroids for 492 patient-years. Five years after diagnosis, 43% of the patients were on corticosteroid therapy. After 9 years, 15 of 60 surviving patients (25%) were still being treated with 1.25-10 mg of prednisolone daily (median dose 5 mg). The relapse rate was about 50%, regardless of the time after diagnosis, when an attempt to withdraw the treatment was made. Forty-six per cent of the relapses occurred within one month and 96% within one year of the end of treatment. Most of the flare-ups occurred during the first year of therapy and in 55% of the patients on a prednisolone dosage of 5 mg or less. We did not find any increase in morbidity in our patients compared to the general population. Nor did we see any significant complications which we could attribute to the steroid treatment.

Aged↗
PubMed1986

Major liver resection: perioperative course and management.

This report investigates the perioperative course in 81 consecutive major liver resections, performed mainly because of primary liver cancer or colorectal liver secondaries. The liver was resected transabdominally with or without prior ligation of hilar structures. Intravenous nutrition consisted of 10% dextrose alone and was started preoperatively. Albumin or plasma was used rarely and only in conjunction with massive intraoperative transfusion of blood. Major complications, including four operative deaths (4.9%), consisted of bleeding and/or infection in eight (10%) patients and overt liver failure in two patients (2%) and occurred only after right and extended right lobectomies. Intraoperative blood loss was significantly larger in patients with postoperative complications than in patients with an uneventful postoperative course. The direct parenchymal approach was associated with a shorter operative time and an unchanged intraoperative bleeding. Coagulopathy and hypoalbuminemia did not cause any problems. Blood glucose levels were stable, and no patient suffered from hypoglycemia. It is concluded that major liver resection should be based on prevention of intraoperative bleeding and that preresection ligation of hilar structures offers no advantage in this respect. Infusion of hypocaloric glucose solutions should be started the day before operation, and routine administration of other nutrients does not seem necessary.

Adenoma, Bile Duct↗
PubMed1986

Nonoperative treatment of blunt trauma to liver and spleen.

Nonoperative management of 20 cases of liver injury in 1969-1984 and 13 of splenic injury in 1977-1984, all due to blunt abdominal trauma, is retrospectively reviewed. The total of blunt hepatic injuries treated in the same period was 63 and that of blunt splenic injuries 52. There were no major differences in etiology, age, sex distribution or need for blood transfusion between the liver and splenic trauma cases. After initial resuscitation and diagnostic work-up with angiography, computed tomography, ultrasonography and/or scintiscan, circulatorily stable patients were selected for nonoperative treatment. These patients showed evidence of mild trauma with few associated major injuries, few complications and no mortality. Following initial bedrest and observation, they were gradually mobilized and could leave the hospital after about 2 weeks.

Adolescent↗
PubMed1986

Ranitidine therapy of Barrett's ulcer. Case report.

A Barrett's ulcer in a 58-year-old man was healed by 8 weeks of ranitidine therapy, as was an episode of erosive esophagitis a year later. Pharmacotherapy combined with antireflux measures can be an alternative to surgery for Barrett's esophagus, at any rate in patients who are unfit for surgery.

Barrett Esophagus↗
PubMed1986

Outcome of pneumococcal challenge in rats after splenic artery ligation or splenectomy.

Reports of postsplenectomy septicemia led to development of various methods for splenic salvage, including ligation of the splenic artery. For study of susceptibility to pneumococci after splenectomy or splenic artery ligation, 35 Sprague-Dawley rats, in three groups, underwent splenectomy or central ligation of the splenic artery, or sham operation with omental resection. Blood cell counts prior to injection of pneumococci (3 X 10(3) intravenously in each rat) showed no intergroup differences. All the splenectomized rats died, but only 20% of those with splenic artery ligation (p = 0.000047). None of the rats with sham operation died, but this was not significantly different from the mortality in the group with splenic artery ligation (p = 0.22).

Animals↗
PubMed1985

Ophthalmological, psychometric and therapeutic investigation in two sisters with hereditary glutathione synthetase deficiency (5-oxoprolinuria).

Two sisters with hereditary glutathione synthetase deficiency (5-oxoprolinuria) were investigated. Assays of erythrocyte enzyme levels in relatives revealed additional clinically healthy carriers. The girls had chronic metabolic acidosis, which was corrected by substitution with bicarbonate. They had an increased rate of hemolysis which was well compensated. Their granulocyte function was normal when tested in vitro. In both girls mental retardation developed progressively without additional clinical neurological symptoms. Their electroretinograms were abnormal indicating disturbed retinal electrophysiological function. Therapeutic trials were performed with oral administration of glutathione (Tathion), mercaptopropionylglycine (Thiola) and vitamin E. None of these compounds had an effect on the urinary excretion of 5-oxoproline, acid-base balance, pathological electroretinograms or the clinical condition. Initially, Thiola therapy increased the low levels of glutathione in patient erythrocytes but after several months of treatment the concentration of glutathione declined to pretreatment levels. There was no indication that orally administered glutathione, mercaptopropionylglycine or vitamin E had a beneficial effect in the doses used. Nevertheless, vitamin E administration has been continued in addition to the correction of acidosis with sodium bicarbonate.

Adolescent↗