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Biomedical subjects

C T Bergren

Publications and source records attributed to C T Bergren.

9 recordsLinked to original sources
PubMed1988

Improved survival using oxygen free radical scavengers in the presence of ischemic bowel anastomosis.

A rat model was developed to determine the efficacy of oxygen free radical scavenger compounds in improving small bowel anastomotic healing in ischemia. 50 Sprague-Dawley rats underwent laparotomy and were divided into groups: I. sham operation; II. ischemia produced by ligation of mesenteric vessels along 3-5 cm of bowel; III. bowel transection and anastomosis; IV. ligation of vessels with bowel transection and anastomosis; V. ligation of vessels, bowel transection and IV administration of superoxide dismutase (SOD) (5000 U/kg) prior to anastomosis. All surviving animals were sacrificed after 2 weeks. Anastomotic tensile strength and histology were evaluated. Percent survival and the average length of survival for all groups is seen in the table below. (table: see text) A significant decrease in survival was present with the anastomotic group and the ischemic anastomotic group when compared with controls. An improved survival similar to ischemia alone was present in SOD group. No significant difference was noted between SOD and control groups. The results of this study indicate an improved survival rate and length of survival similar to controls in animals undergoing ischemic and penetrating injury to the bowel with the use of oxygen free radical scavenger compounds prior to anastomosis.

Anastomosis, Surgical↗
PubMed1987

Intravenous pyelogram results in association with renal pathology and therapy in trauma patients.

The charts of 127 consecutive patients who sustained renal trauma between December 1977 and January 1984 were reviewed in order to relate the results of intravenous pyelogram (IVP) to the magnitude of renal pathology. Eighty-eight cases resulted from blunt trauma and 39 cases had penetrating injuries. There were 34 gunshot wounds and five stab wounds. An IVP was performed in 116 patients. All cases of blunt trauma with an IVP reported as normal had no renal pathology greater than contusion. Intravenous pyelogram results in penetrating injuries had a 75% false negative rate. Findings of nonvisualization or extravasation were significant for fractures, perforation, or pedicle injuries in all trauma. Eight of the patients with nonpenetrating wounds and 37 of the patients with penetrating injury underwent exploratory laparotomy. Sixteen nephrectomies were performed for a nephrectomy rate of 12.6% of the total series. This nephrectomy rate is comparable to similar studies which are reviewed.

Accidental Falls↗
PubMed1987

Liver preservation techniques for transplantation.

The development of optimal methods for preservation is important for the advancement of liver transplantation. This study compares hypothermic storage (HS) and hypothermic pulsatile perfusion (HPP) with various solutions, using an isolated normothermic perfusion model (LIPM). Canine livers were removed from mongrel dogs without warm ischemia and flushed with either heparinized Ringer's lactate (control and HPP-preserved groups) or the solution used for hypothermic storage (TP-V or modified Collins). The type of preservation and solution for each of the experimental groups was as follows: group I (n = 7), no preservation, fresh; group II (n = 7), 24-h HS with TP-V (a hyperosmolar colloid solution containing sucrose, dextrose, and ATP-MgCl2); group III (n = 7), 24-h HS with modified Collins (C-2), an intracellular crystalloid solution; group IV (n = 5), 24-h HP with TP-V; group V (n = 6), 24-h HPP with Belzer solution, containing ATP-MgCl2; group VI (n = 3), 24-h HPP with albumin. After the preservation period, livers were placed on HPP at 37 degrees C with albumin-mannitol solution for 3-h testing in an LIPM. Perfusate samples were taken at 1-h intervals to assess liver function. LDH, SGOT, alkaline phosphatase, lactic acid, LAP, GGT, pO2, pCO2, pH, osmolarity, AMP, ADP, and ATP were studied. Histologic studies were performed, as were representative HIDA scans. Using the LIPM, livers preserved by HS and HPP with TP-V solution appeared to be superior to those preserved with modified Collins, Belzer, and albumin solutions. In these non-TP-V groups, the greatest cellular and organ damage was observed. TP-V HPP appeared to give the best overall liver functional response and histologic results and is recommended as the preferred method for 24-h liver preservation.

Animals↗
PubMed1987

Effect of cyclosporine on fresh and preserved orthotopic small bowel allografts.

Twenty-three unrelated mongrel dogs underwent successful transplantation of the entire small intestine in the orthotopic location. Four groups of unrelated mongrel dogs were studied. Group I (n = 6) animals served as controls and received no immunosuppression. Survival of 5.3 +/- 3.8 days (M +/- SD) was noted. Poor survival (7.2 +/- 7.9 days; M +/- SD) was also seen in Group II (n = 6) dogs receiving immunosuppression with azathioprine post-operatively. Animals in Group III (n = 6) were treated with cyclosporine, until death or sacrifice at 40 days, and demonstrated a prolonged survival of (17.5 +/- 13.7 days; M +/- SD). All animals in Groups I, II and III were immediately transplanted with fresh bowel from the donor animal. Small bowel allografts in Group IV (n = 5) animals were stored for 24 hours in hypothermic TP-V (a hypersomolar colloid solution containing ATP-MgC1(2)) prior to transplantation. These animals received the same amount of cyclosporine as those in Group III, and similar survival was noted (16.4 +/- 12.9 days; M +/- SD) (p greater than 0.1). These results indicate that transplanted animals who were treated with cyclosporine post-operatively, and for successive days thereafter (Groups III and IV), achieved prolonged but not uniformly indefinite graft survival. Most importantly, similar survival among these two groups was evident, whether or not the allograft was fresh, or preserved for 24 hours in hypothermic storage with TP-V prior to transplantation.

Animals↗
PubMedDate not supplied

The thermodilution technique for measuring resting energy expenditure does not agree with indirect calorimetry for the critically ill patient.

BACKGROUND: The complications associated with overfeeding critically ill patients are well documented. Indirect calorimetry is touted as the gold standard for measuring resting energy expenditure (REE). Unfortunately, the device is expensive, and many centers do not have this technology. The thermodilution technique for measuring cardiac output and calculating REE using the Fick equation has been reported to be an acceptable alternative. This study compared these techniques in a critically ill population. METHODS: Forty consecutive patients with indwelling Swan-Ganz catheters in the surgical intensive care unit were prospectively studied while under the consultative care of the nutrition support service. REE was determined in all patients by both techniques within a 2-hour period. An error of 5% (approximately+/-100 kcal/d) between the two methods was deemed acceptable for clinical use. RESULTS: Mean values for REE were 1928+/-558 vs 1898+/-518 kcal/d for the indirect calorimetry and thermodilution methods, respectively, and were not significantly different. However, there was great variation between the two techniques for the majority of patients such that REE determinations did not agree (t = 6.8; p < .0005). In 70% of the patients, REE determinations differed by > or =20% and in 10% of the patients by 50%. Additionally, the greater the difference between the two methods, the more the thermodilution method tended to overestimate REE. CONCLUSIONS: When compared with indirect calorimetry in a critically ill population, the thermodilution method demonstrated an intersubject variability that is unacceptable for clinical use.

Adolescent↗