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Biomedical subjects

B Börjesson

Publications and source records attributed to B Börjesson.

At least 37 records · Page 2Linked to original sources
PubMed1978

Isobutyl 2-cyanoacrylate (bucrylate) in obliteration of gastric coronary vein and esophageal varices.

Percutaneous transhepatic portography was performed in 22 patients with liver cirrhosis and portal hypertension. All patients had bled or were bleeding from presumed esophageal varices. One or more veins feeding esophageal varices were occluded with bucrylate. Follow-up examination in eight patients 1-12 months later showed recanalization of previously obliterated veins in six; however, these veins were markedly smaller than before the procedure. In patients where veins were still occluded, new veins had opened up and carried blood to the esophageal varices, which were filled to a lesser degree than before. In our experience, bucrylate is superior to Gelfoam, thrombin, and Etolein in producing venous occlusion.

Adult↗
PubMed1977

Heme catabolism in liver cirrhosis with portal hypertension after shunt surgery.

Endogenous production of carbon monoxide (VCO), total and direct reacting serum bilirubin (TSB, DRB) were determined in 26 patients with liver cirrhosis and portal hypertension to evaluate the effect of various shunt operations on total heme catabolism. The material was divided into 3 groups. In group I, 11 patients not operated upon, mean VCO (+/- S.D.) was 18.4 +/- 6.0 micronmol/mmol total body heme per day (reference value 12.6 +/- 2.9). In group tii, 7 patients operated upon with subcutaneous transposition and a subtotal resection of the spleen, mean VCO (14.4 +/- 4.7) was not significantly raised. In group III, 8 patients operated upon with a modified distal splenorenal shunt, the highest mean VCO (26.1 +/- 9.0) was found. Mean TSB in the three groups was 34.8 +/- 29.2, 11.2 +/- 3.0, and 46.4 +/- 41.0 micronmol/l, respectively, and mean DRB 18.2 +/- 20.8, 3.7 +/- 1.0, and 26.8 +/- 34.1 micronmol/l, respectively. Estimated from preoperative laboratory values there was no difference in liver function between the three groups. The conclusion drawn is that heme catabolism, increased by 50% in liver cirrhosis complicated by portal hypertension probably due to a slight decrease in erythrocyte survival, tends to normalize after subcutaneous transposition and subtotal resection of the spleen. After spleno-renal shunting, on the other hand, a further increase in heme catabolism is seen. And so the increase in serum bilirubin often seen after the latter type of surgery is mainly related to a raised bilirubin production and not to a further decrease in liver function.

Adult↗
PubMed1977

Staging laparotomy with splenectomy in Hodgkin's disease.

The series includes 91 patients with Hodgkin's disease who underwent a staging laparotomy with splenectomy during the years 1971-1976, in 82% of them as part of the initial evaluation before therapy. Positive abdominal lymph nodes were found in 29% of the patients, a positive spleen in 37%, and a positive liver in 10%. Follow-up of patients who lacked abdominal involvement at laparotomy indicate that sampling error was only of marginal importance. Evaluation of the therapeutic implications of the operation indicated that 41% of the patients benefited from the procedure; 31% by changing stage and 10% by changing radiation therapy port. Five patients had minor surgical complications. The mortality rate was nil.

Abdominal Neoplasms↗
PubMed1976

[Subcutaneous transposition of the spleen: an experimental and clinical study (author's transl)].

The growing scepticism about the use of portocaval anastomosis operations to prevent renewed bleeding of esophageal varices has led to the testing of new methods. This report describes subcutaneous transposition of the resected spleen in normal experimental animals with the Vena porta constricted with Ameroid rings and liver cirrhosis induced by DMNA. The report also covers 9 patients operated on from 1972 to 1973 with subcutaneous transposition of the spleen. A 77-year-old woman died postoperatively, one patient died after 2 years 4 months, and one had slight bleeding. All the other patients are alive 2-4 years after the operation, with no signs of renewed bleeding. The advantage of subcutaneous transposition of the spleen is that it eliminates hypersplenism.

Adult↗
PubMed1976

An attempt to create spleno-systemic anastomosis in the rat.

A selective diversion of the splenic venous flow into the systemic circulation was attempted in the rat. A combination of the subcutaneous splenic transposition and the ligation of the splenic vein as a two stage operation was carried out in 15 rats. A rich collateral system developed rapidly from the transposed spleen to the systemic circulation. Angiography, performed four weeks after the ligation, revealed that almost all of the injected contrast medium was diverted into the systemic circulation via those newly developed collaterals. The described method as an experimental model could be of value in the search for a spleno-hepatic axis.

Animals↗
PubMed1976

An attempt to induce portal hypertension and esophageal varices in the rat.

An attempt to induce portal hypertension using Ameroid constrictors and shunt operations is described. 1 week after the application of the Ameroid constrictor around the portal trunk, it was completely occluded and portal venous pressure was elevated to a level about twice of normal range. Angiographically, splenorenal collaterals and collaterals overbridging the Ameroid constrictor were observed in all examined rats. However, esophageal varices could not be found in any rat. In the second series of the experiment, an end-to-side cavoportal shunt was created before the application of the Ameroid constrictor. This operation model was devised to increase the portal venous flow. At the same time this operation should inhibit the development of splenorenal collaterals and as expected collaterals to the superior vena cava system developed instead. However, they were not located in the esophageal wall but retroperitoneally.

Animals↗
PubMed1976

The microscopical appearance of the subcutaneously transposed spleen.

The microscopical appearance of rat splenic tissue has been examined after subcutaneous transposition of the spleen and after portal vein ligation in rats subjected to splenic transposition. The histological picture was compared to that of control animals. Apart from congested red pulp and capsular fibrosis in the subcutaneous position did not seem to result in serious histological changes in the spleen. In three patients treated with subcutaneous transposition of resected spleen because of portal hypertension, histological needle biopsies from the splenic tissue were made postoperatively. Principally the same histological changes were found in the clinical as in the experimental material.

Adolescent↗
PubMed1975

Development of portsoystemic shunts after subcutaneous and extraperitoneal transposition of resected spleen.

After subcutaneous transposition of the spleen in rats a rapid development of portosystemic collaterals occurs. It is demonstrated that variations in types and extent of splenic resection and in location after transposition lead to differences in collateral development. It is shown that the hilus portion of the spleen is the most important part to preserve. Extraperitonealization leads to less collateral development than does transposition to the subcutis.

Animals↗