Search PubMed⌕ Search

Biomedical subjects

S Lennquist

Publications and source records attributed to S Lennquist.

At least 55 records · Page 3Linked to original sources
PubMed1986

Serum phosphate and 2,3-diphosphoglycerate in severely burned patients after phosphate supplementation.

Serum phosphate (S-P) and 2,3-diphosphoglycerate (2,3-DPG) were monitored for 10 days after severe burn trauma in 16 patients treated with total parenteral nutrition, including supplementation with 25-75 mmol phosphate daily. Phosphate metabolism was previously shown to be disturbed in patients with severe burns, and hypophosphatemia has been reported to disturb oxygen transport by reducing synthesis of 2,3-DPG in the red cells. In this study, S-P was decreased in the first post-trauma week because of a negative phosphate balance the first 4 post-trauma days, but 2,3-DPG remained at normal concentrations. These findings indicate that post-traumatic disturbance in red-cell phosphate metabolism may be prevented by administration of phosphate and that such supplementation is important in the metabolic management of severely injured patients.

2,3-Diphosphoglycerate↗
PubMed1986

Insulinoma of the pancreatic head: results from two surgical strategies.

A rare location of insulin-secreting pancreatic tumour, which presents technical difficulties, is centrally in the pancreatic head close to the duodenal wall. Local excision or enucleation gives very high postoperative morbidity, with pseudocyst and fistula, and more extensive surgery such as pancreatoduodenectomy has a high mortality rate in these patients. At Linköping University Hospital, five patients with insulinoma at this particular site were diagnosed and operated on in 1978-84. After excision of the tumour, the enucleation cavity was treated with one of two surgical strategies--closure and drainage (3 cases) or drainage only (2 cases). The postoperative course differed greatly between the two groups. The experience from these cases suggests that endocrine tumours at this site in the pancreas can be excised locally, with strict safeguarding of the pancreatic duct, but that the cavity in the pancreas should be left open with long-term drainage.

Adenoma, Islet Cell↗
PubMed1986

"The low T3 syndrome" and impaired thyroid protein synthesis in experimental trauma.

The thyroid response was evaluated in the present trauma model. Trauma of varying severity was studied in 3 groups of anesthetized pigs. The animals were exposed to preparative surgery alone (n = 6) or followed by a standardized missile trauma to a hind leg (n = 10) or to the abdomen (n = 8). Post-trauma observation for 24-48 hours under continuous anesthesia included measurements of circulating T4, T3 and rT3. The serum concentrations of T4 and T3 fell significantly in all groups, the fall being exponential in the missile trauma groups. The reductions were greatest in the most severely injured group (abdominal trauma) and least in the group with preparative surgery only. The nadir of T4 concentration was reached at 24 hours in all groups. The T3 nadir occurred at 12 hours in the abdominal trauma group and at 24 hours in the groups with hind-leg trauma and preparative surgery. The rT3 concentration was significantly increased in the missile trauma groups. Thyroid protein synthesis was analysed in vitro by incubating thyroid tissue from pigs with missile trauma (n = 9) or with preparative surgery (n = 6). The 3H-leucine incorporation into the soluble thyroid proteins, measured as DPM/DNA, was 35% lower after missile trauma than after preparative surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Experimental posttraumatic pulmonary microembolism. Effects of methylprednisolone on its development.

The effects of methylprednisolone sodium succinate on the course of posttraumatic pulmonary microembolism were studied in pigs submitted to a reproducible high-energy trauma of the limb and then observed under long-term anesthesia. Methylprednisolone sodium succinate (30 mg/kg of body weight) was given one hour after trauma and thereafter every eighth hour during a 72-hour observation period. Intrapulmonary microembolism was quantitatively measured by repeated external detection of chromium 51-labeled platelets and iodine 125-labeled fibrinogen, sequential chest roentgenograms, and morphologic examination of the lungs post mortem. Methylprednisolone delayed the onset of pulmonary roentgenogram changes and modulated Pao2 and platelet count reductions, but, at the end of the observation period, the signs of microembolism changes were as pronounced as in the nontreated traumatized pigs. Methylprednisolone thus did not prevent posttraumatic pulmonary microembolism in this experimental situation.

Animals↗
PubMed1985

Pulmonary trapping of platelets and fibrin after musculoskeletal trauma: an experimental model.

A new experimental model is described in which pulmonary changes identical with the adult respiratory distress syndrome (ARDS) can be induced by reproducible musculoskeletal trauma in anesthetized pigs. The pigs were studied in maintained anesthesia for 3 days after the trauma under standardized conditions. The intrapulmonary aggregation of platelets and fibrin was monitored by external detection of radioactivity arising from pretrauma intravenous injection of 51Cr-labeled platelets and 125I-labeled fibrinogen. Pulmonary trapping of platelets and fibrin was significantly greater in the traumatized pigs than in nontraumatized but otherwise identically handled controls. Radiologic and morphologic changes corresponding to ARDS developed in the traumatized animals, but not in the controls. The experimental model offers new possibilities for study of factors influencing the occurrence and development of ARDS. After further experimental evaluation, the procedure for registering pulmonary microembolism by external detection may be useful in the clinical management of ARDS.

Animals↗
PubMed1985

Microbiologic progression of post-traumatic peritonitis.

The natural course of post-traumatic peritonitis was studied in 17 pigs. Following a standardized missile wound to the abdomen the pigs were operated on and observed in continuous anesthesia for periods up to 3 days. Bacterial density was measured in peritoneal exudate, parietal peritoneum, laparotomy wound, and projectile entrance and exit wounds at this operation and also at relaparotomy, which terminated the experiments. The bacterial density showed significant perioperative fall, averaging X 1,905 in peritoneal exudate and X 40 in parietal peritoneum. From a low postoperative level (mean c. 10(2)/ml or /gm), bacterial density increased significantly in the observation period. In peritoneal exudate the increase was X 4,073 and in peritoneum X 2,630. In laparotomy and projectile entrance and exit wounds the corresponding figures were X 234, X 126, and X 15. The bacterial population's perioperative reduction and subsequent proliferation were interpreted as reflecting the host defense, which accordingly was limited in capacity and duration.

Abdominal Injuries↗
PubMed1985

Betablockers compared with antithyroid drugs as preoperative treatment in hyperthyroidism: drug tolerance, complications, and postoperative thyroid function.

Subtotal thyroid resection or hemithyroidectomy was performed for hyperthyroidism on two groups of patients: 84 treated before surgery with antithyroid drugs and thyroxin and 111 given only beta-blocking agents before surgery. These two patient groups were compared with reference to preoperative medication, operation, immediate postoperative course, and late results, with follow-up for 3 to 7 years. The advantages of beta-blockers compared with conventional antithyroid medication were lack of adverse reactions, rapid effect of treatment, considerably shortened preoperative treatment time, and fewer outpatient visits, with consequent financial benefit. No disadvantages of beta-blockers were found except that 18% of the patients required additional propranolol in the immediate postoperative period. There were no surgical complications in either group other than a mild persistent hypocalcemia in two patients from the beta-blocked group. The serum thyrotropin levels during the first 6 postoperative months were significantly higher in the patients treated with antithyroid drugs. The frequency of postoperative thyroid dysfunction showed no intergroup difference during the observation period. Signs of hypofunction, necessitating thyroxin supplementation, were observed in 28.6% of patients in the antithyroid drug/thyroxin group and in 25.7% in the beta-blocker group. Toxic recurrence occurred in 1.8% of the group that received beta-blockers and in 1.2% of the other patients. The study demonstrated that beta-adrenoceptor blockade is a safe method for preoperative treatment in hyperthyroidism, with advantages for patients and regarding costs.

Adrenergic beta-Antagonists↗
PubMed1985

Posttraumatic respiratory distress syndrome and high-dose corticosteroids.

Many authors have advocated glucocorticoids for prophylaxis against or treatment of Adult Respiratory Distress Syndrome (ARDS) or post-traumatic pulmonary microembolism. One of the theories underlying this advocacy is that the activation of the complement system possibly is preventable by pharmacologic doses of corticosteroids. Studies on traumatized patients are difficult to standardize, and clinical observations are correspondingly difficult to evaluate. Animal models for study of the microembolism syndrome have often comprised too short a time and most have greatly differed from the clinical situation. We have earlier evolved an experimental model by means of which changes identical to the microembolism syndrome can be induced from a reproducible musculo-skeletal trauma in pigs observed under long-term anesthesia under standardized conditions. In this study, early and long-term effects of corticosteroids on the course of post-traumatic microembolism was evaluated by following the pulmonary function and X-ray appearance, pulmonary trapping of platelets and fibrin and histologic changes in pigs, using this standardized trauma model. Methylprednisolone sodium succinate (30 mg/kg bw) was given to 9 pigs one hour after trauma and thereafter every 8th hour during a 72 hour observation period. Two other groups of animals were used for comparison, 13 traumatized, non-treated and 15 non-traumatized, non-treated pigs. Intrapulmonary microembolism was measured quantitatively by repeated external detection of labelled platelets (51Cr) and fibrinogen (125I), sequential chest X-rays and morphologic examination of the lungs post mortem.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Effect of propranolol on post-traumatic hypophosphataemia and catecholamine secretion.

Trauma may induce disturbance in the homeostasis and metabolism of phosphate. Serum phosphate decreases rapidly after trauma, and this rapid fall is followed by more slowly progressing hypophosphataemia, reaching minimum values on post-trauma days 2-5. The effect of propranolol on post-traumatic hypophosphataemia was studied in an experimental model, using anaesthetized pigs. Propranolol prevented the initial rapid decrease in serum phosphate. Twelve hours after the trauma, however, both the propranolol-treated and the untreated pigs showed significant serum phosphate depletion, with progression during the 48-hour observation period. The urinary phosphate excretion did not differ between the two groups, and after 48 hours the cumulative loss was the same in both groups. The adrenergic response to trauma was significantly greater in the propranolol-treated than in the untreated group. The results suggested that the rapid serum phosphate fall immediately after trauma was caused by adrenaline release. The second, slower phase was not related to adrenaline or noradrenaline release, but showed correlation with the urinary loss of phosphate.

Animals↗
PubMed1984

Changes in calcium and phosphate and their regulating hormones in patients with severe burn injuries.

Changes in the calcium- and phosphate homeostasis and its regulating hormones calcitonin (CT) and parathyroid hormone (PTH) are of great importance for several pathophysiological reactions after trauma. In this study calcium, phosphate, CT, PTH and nor-adrenaline, were followed during 14 days after trauma in 20 patients with severe burn injuries. The results showed significantly reduced serum phosphate (S-P) during the first week after trauma, and low ionized calcium fraction (CaF) during the 14 post-traumatic days that were studied. Urinary calcium output was low, about 4.5 mmol/day and urinary phosphate output was as high as 30 mmol/day, despite the low S-P. Plasma nor-adrenaline was elevated with maximum concentrations 6 days after trauma. CT was very high with levels around 1 000 pmol/l after one week. PTH remained within the reference interval, although a statistically significant increase was observed four days after the trauma. The results suggest that the observed changes in calcium- and phosphate homeostasis were related to the humoral response to trauma.

Adolescent↗
PubMed1984

Serum thyroglobulin in differentiated thyroid carcinoma.

Serum thyroglobulin (S-Tg) concentrations were measured in 262 patients with differentiated thyroid carcinoma. Analysis of S-Tg with respect to histology showed that the follicular variety of carcinoma had the highest S-Tg values preoperatively and postoperatively when metastases were found. The S-Tg levels during thyroxine treatment accurately predicted the results of 131-I total body scan in all but two cases. In another patient both S-Tg and total body iodine scan were negative at the time when metastases were discovered at X-ray examination. All but two patients with negative scan had S-Tg less than 10 micrograms/l, whereas patients with metastases had values between 11 and greater than 5000 micrograms/l. In patients with residual thyroid bed uptake the S-Tg range was from less than 2 to 84 micrograms/l. The authors conclude that determination of the S-Tg level can replace total body iodine scan in most patients who have undergone ablative therapy for differentiated thyroid carcinoma.

Adolescent↗
PubMed1984

Evaluation of preoperative diagnosis and surgical management of thyroid tumors.

The difficulty of obtaining an accurate diagnosis in nodules of the thyroid gland without operation and histologic examination is well documented. Surgical intervention has therefore been recommended, though opinions differ concerning the indications for surgery. Experience from 276 patients operated on for thyroid gland nodules is reported in the present paper. The decision to operate was based on a standard schedule with relatively wide indications for surgery. Complete hemithyroidectomy was performed in all surgically managed cases. The accuracy of preoperative diagnosis was evaluated against the histologic findings. Experience of hemithyroidectomy as the standard procedure is also reviewed. The incidence of malignancy with this active policy was 9% in the series as a whole and 12% in solitary adenoma of the thyroid. Total thyroidectomy was routinely performed when malignancy was demonstrated; 24% of the malignancies were bilateral. Although fine-needle biopsy and clinical evaluation were entrusted only to experienced investigators, the results confirmed earlier reports that no hitherto available diagnostic procedure can adequately distinguish malignant from benign thyroid lesions without surgery. The value of scintigraphic thyroid scan in the preoperative assessment seemed to be insufficient to warrant its use. No persistent complications arose from hemithyroidectomy. Complete hemithyroidectomy is always the operation of choice in such cases since, should be histologic examination show malignancy, the requisite additional surgery will not involve a thyroid lobe with previous surgical interference.

Adult↗