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Biomedical subjects

C Korsbäck

Publications and source records attributed to C Korsbäck.

At least 19 recordsLinked to original sources
PubMed1990

The effect of intravesically applied antibiotic solution in the prophylaxis of infectious complications of renal transplantation.

The effect of intravesically applied antibiotic solution in the prevention of infectious complications of renal transplantation was evaluated in a prospective, randomized study. The bladder was filled preoperatively with saline solution containing cephalotin in the test group, and with saline solution only in the controls. Both groups of patients received IV doses of cephamandole during, and once after, surgery. Two hundred consecutive patients were randomly allocated to the study groups. The overall incidence of urinary tract infection was 10.4% during the first 4 postoperative weeks; that of wound infections was 1.6% and of septicemia 3.3%. The addition of cephalotin to the bladder irrigation fluid did not have any effect on the overall incidence of infectious complications.

Administration, Intravesical↗
PubMed1989

Hyperimmune globulin therapy of clinical cytomegalovirus infection in renal allograft recipients.

Intravenous cytomegalovirus (CMV) hyperimmune globulin therapy was used in 24 episodes of proven CMV disease in 22 renal allograft recipients. All patients had fever up to 39-40 degrees C for at least 3 days. Many patients had thrombocytopenia, leukopenia, and/or elevation of serum transaminase levels. Five had pneumonitis. The diagnosis of CMV infection was confirmed by isolation of virus from urine or bronchoalveolar lavage fluid using a rapid culture method based on the demonstration of CMV early nuclear protein in cell culture monolayers and/or by the demonstration of CMV specific IgM antibodies. The hyperimmune globulin was given until fever disappeared. The infusions were well tolerated and no side effects were recorded. A clinical response defined as normalization of body temperature, occurred in 23/24 cases. One patient with septic fever and a fatal outcome had a superinfection with tuberculosis. Two other fatal complications were caused by invasive pulmonary aspergillosis and by multiple penetrating duodenal ulcers. Two reversible acute rejections and one recurrence of the original renal disease were recorded. 19/22 patients are alive, 18 with normal renal function. We conclude that hyperimmune globulin therapy is well tolerated and may help to control sever CMV infections in renal transplant recipients.

Aspergillosis↗
PubMed1988

Diagnosis of acute rejection in liver transplantation.

Eleven acute rejections were found in 9 patients with liver transplantation due to end-stage liver cirrhosis. The rejections were diagnosed with fine-needle aspiration biopsy (FNAB) giving the cellular picture of immunoactivation in the liver graft when compared to a simultaneous sample of peripheral blood. s-Alkaline phosphatase and s-bilirubin increased within 1 week after onset of rejection in 7 and 10 cases, respectively. s-Alanine amino-transferase and b-ammonium were of no value in the diagnosis of acute rejection. A core biopsy was obtained only in a case of severe liver damage, mainly to estimate the need for retransplantation. One year after grafting, 6 out of 7 cirrhotic patients are well, all with normal liver function. Two have died of sepsis. One patient died from pulmonary metastases of occult liver carcinoma 6 months after the transplantation. FNAB seems helpful in detecting early acute rejection and also excluding such an event in the liver graft.

Alkaline Phosphatase↗
PubMed1988

Fine-needle aspiration biopsy in the monitoring of liver allografts. I. Correlation between aspiration biopsy and core biopsy in experimental pig liver allografts.

We have used allogeneic pig liver transplants to investigate the structure of inflammation in acute liver allograft rejection. An inflammatory episode of acute cellular rejection was observed in 9/10 allografts in nonimmunosuppressed recipients, when monitored with simultaneous fine-needle aspiration biopsies (FNAB) and core needle biopsies (NB). The intensity of inflammation in FNAB was quantitated using the corrected increment method and correlated with NB findings. In FNAB, all inflammatory episodes were detected on the 4th day after transplantation with lymphoid blast and lymphocyte infiltration, later accompanied by monocytes and macrophages. Maximal intensity of inflammation was recorded in FNAB on day 14. In NB, histology demonstrated distinct inflammation in the portal area on day 4. The predominantly lymphocytic infiltration, also containing varying numbers of plasma cells, eosinophils, neutrophils and macrophages, reached its maximum 7-14 days after transplantation. With the indirect immunoperoxidase technique, lymphoid cell subpopulation analysis of FNAB demonstrated an increase of both T4 and T8 cells during rejection. The T4/T8 ratio was first low, and increased at the beginning of the episode, on day 4, but decreased again on days 7 and 14. The number of B cells in the graft was also elevated during rejection. The cellular changes in the corresponding blood specimens followed approximately the same lines, although the changes were less prominent. NB immunohistology, using immunoperoxidase and frozen sections, correlated well with FNAB results, and demonstrated a T4 predominance in the portal area on day 4 but a T8 predominance on days 7 and 14. In addition to lymphoid cells, macrophages/granulocytes were also frequent in the portal area and scattered in the parenchyma on days 7 and 14. An additional inflammatory cell component in liver allograft rejection, detectable only in the NB, was eosinophils in the portal area, recorded in maximum on day 14. Taken together, the inflammatory changes in the FNAB and NB were similar, and time-related changes of cellular infiltrate in FNAB and NB correlated closely.

Animals↗
PubMed1988

Fine-needle aspiration biopsy in the monitoring of liver allografts. II. Applications to human liver allografts.

Serial fine-needle aspiration biopsies (FNAB) were used for clinical monitoring of human liver allografts. Nine liver allograft recipients were monitored with FNAB at 1-3 day intervals. No complications were recorded. All patients underwent at least 1 inflammatory episode of acute rejection; altogether 11 episodes, all reversible, were recorded. The inflammatory infiltrate consisted mainly of lymphoid cells, including lymphoid blasts, with minor involvement of monocytes, monoblasts, and macrophages. Further analysis of lymphoid cell subpopulations by immunoperoxidase techniques demonstrated an increase of T cells during rejection, both the CD4 (T4) and CD8 (T8) subsets were increased. A slight increase of B cells in the graft was also seen. The CD4/CD8 (T4/T8) ratio was first low, peaked at the onset, and decreased toward the end of the episode. No clear correlations to the intragraft cellular events were recorded in corresponding blood specimens. However, an episode of eosinophilia was seen in the blood at the beginning of rejection, correlating with fever in the recipient. Degenerative changes in the parenchymal cells and bile droplets in the hepatocytes, indicating cholestasis and hepatocyte damage, were seen during all episodes of rejection, and these changes persisted even 10 days after the inflammation had subsided. The FNAB-findings correlated well with biochemical laboratory parameters, but the diagnosis of rejection could be established by the FNAB already 1-5 days earlier than elevated serum values indicated liver dysfunction.

Alkaline Phosphatase↗
PubMed1987

Ventilation through a mini-tracheostomy. An experimental study in pigs.

The purpose of the study was to evaluate the function of mini-tracheostomy as a means of emergency ventilation. Piglets were manually ventilated with a revivator through a mini-tracheostomy tube. In five out of seven experiments good oxygenation was upheld but hypercarbia could not be avoided. If the insertion opening in the trachea was too big, ventilation was not possible. The mini-tracheostomy tube can be used in an emergency situation for oxygenation. However, training is recommended.

Animals↗
PubMed1984

Small bowel and liver gas tensions during intravenous vasopressin infusion and 60% oxygen ventilation.

Vasopressin has been found to significantly decrease tissue pO2 in the gastrointestinal tract and the liver. The aim of this study was to find out whether 60% oxygen ventilation could prevent the tissue hypoxia. Vasopressin was infused i.v. in ten piglets for 60 min. During the first 30 min they were ventilated by room air and for the following 30 min by 60% oxygen, which did not alter the intestinal tissue pO2, but liver pO2 increased to the normal level. The plasma lactate was significantly decreased by 60% oxygen ventilation. The findings in this experimental study suggest that 60% oxygen ventilation is indicated in the clinical use of vasopressin infusion.

Animals↗
PubMed1984

Fine-needle aspiration cytology of liver allografts in the pig.

We have analyzed the inflammatory changes in pig liver allografts and autografts by fine needle aspiration biopsy (FNAB) and correlated the cytological findings with transplant histology and changes in recipient blood. In nonimmunosuppressed piglets (n = 9) the inflammatory episode of rejection occurred promptly, peaked on days 4-7, and thereafter subsided in cases in which the graft was accepted (n = 6). The early inflammatory infiltrate consisted of all major types of inflammatory leukocytes, including T lymphoblasts, B plasmablasts, and plasma cells, lymphocytes and monocytes; macrophages dominated the late inflammatory lesion of irreversible rejection. In piglets that died of rejection (n = 3), the inflammation peaked earlier and the total amount of inflammation, including the frequency of blast cells and mononuclear phagocytes, was higher. These differences were, however, statistically insignificant and not predictive for irreversible rejection. In sham-operated autograft recipients (n = 5) no inflammation was recorded in the graft. Application of cyclosporine (n = 5), significantly suppressed the total inflammation (P = 0.02 and 0.06 on days 4 and 7, respectively) and delayed the peak; in addition, both the blastogenic component (P = 0.08 on day 4) and the mononuclear phagocyte component (P = 0.03 on day 7) were clearly suppressed. These inflammatory changes, recorded by the FNAB, had a close correlation with biopsy histology. On the other hand, determinations of S-ASAT, S-ALAT, and S-AFOS was not correlated with the episodes of rejection, and no characteristic changes were seen in blood cytology during the rejection episodes either.

Animals↗
PubMed1984

Small bowel and liver tissue pO2 and pCO2 during hypovolaemic shock and intravenous vasopressin infusion.

Ten piglets were bled to a mean BP of 60 mm Hg, after which vasopressin was infused for 30 minutes (2.75 mU/kg/min.). Twenty minutes after completion of the vasopressin infusion, the shed blood was retransfused. Small bowel and liver tissue pO2 and pCO2 were continuously monitored. Systemic arterial and portal blood gas analyses and plasma lactate were studied every 30 minutes. Tissue pO2 in both the small bowel and the liver decreased significantly during hypovolaemic shock; a further non-significant decline was noted during vasopressin infusion. Small bowel pCO2 increased, but liver pCO2 remained unchanged. Plasma lactate increased significantly during hypovolaemia, and vasopressin caused a further increase to a level three times the rest period level. These findings indicate that vasopressin infused during hypovolaemia may increase the risk of hypoxic intestinal lesions and impair liver function.

Animals↗