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Biomedical subjects

E Berglin

Publications and source records attributed to E Berglin.

At least 55 records · Page 3Linked to original sources
PubMed1988

The effect of insulin on the leg and splanchnic balance of glucose and gluconeogenic substrates after cardiac surgery.

The effect of insulin and glucose infusion on the leg and splanchnic balance of glucose and the gluconeogenic substrates lactate, pyruvate, alanine and glycerol was studied in 13 patients directly after cardiac surgery. Insulin was infused continuously at a rate of 1.0 Unit/kg/hr during 1 hour. Sixteen patients served as a control group and received no insulin and glucose infusion. A significant increase in arterial lactate concentration in both the control group (from 1.40 +/- 0.19 to 1.68 +/- 0.24 mmol/l p less than 0.01) and the insulin group (from 1.58 +/- 0.27 to 2.07 +/- 0.22 mmol/l, p less than 0.05) was observed. The arterial pyruvate concentration was significantly increased (from 0.075 +/- 0.019 to 0.105 +/- 0.021 mmol/l, p less than 0.01) and glycerol was significantly decreased (from 0.15 +/- 0.03 to 0.12 +/- 0.03 mmol/l, p less than 0.05) during the insulin and glucose infusion. The alanine concentration was unchanged in both groups. Insulin and glucose infusion was followed by an increased leg uptake of glucose (from 0.15 +/- 0.14 to 1.06 +/- 0.16 mmol/min/100 ml, p less than 0.05), and by a changed splanchnic glucose balance (from -8.2 +/- 2.8 to +4.0 +/- 1.2 mmol/kg/min, p less than 0.01). A net leg release and at the same time a net splanchnic uptake of all gluconeogenic substrates was observed. The insulin and glucose infusion did not significantly change either the splanchnic balance or the leg balance of the gluconeogenic substrates.

Aged↗
PubMed1987

Intravascular volumes and colloid dynamics in relation to fluid management in living related kidney donors and recipients.

This study examines our current perioperative fluid regimen in relation to body fluid compartments, intravascular volumes, and early kidney function in 17 kidney transplant recipients and their living related donors. Donors were given 0.5 g/kg of 10% dextran-40 during surgery and electrolyte solutions averaging 3032 ml/24 h. Recipients were randomized to receive albumin or dextran-40 infusions and given 0.5 g/kg during surgery. Electrolyte and 5% glucose infusions averaged 5580 ml/24 h, to match the urinary output. Total intravascular albumin (TIA) and total intravascular dextran (TID) were calculated from the plasma concentrations and plasma volume (PV). Mean preoperative PV in the donors was 44.5 ml/kg. The TIA loss of 0.37 g/kg was balanced by a TID of 0.27 g/kg, and PV increased to 46 and 49 ml/kg at 3 and 34 h after surgery, respectively. In recipients, the preoperative volume of extracellular water correlated linearly to the total body water and PV, as well as to the urine flow the first 24 h after transplantation. No difference was found in urine volume, serum creatinine, or PV expansion between recipient patients receiving albumin or dextran-40. Twelve patients with immediate urinary onset had blood volume (BV) and PV of more than 70 and 45 ml/kg, respectively, in sharp contrast to five patients with delayed urinary onset, who had lower BV and PV values. A fall in TIA of 0.9 g/kg at 3 h corresponded to a PV loss of 18 ml/kg and was only partially replaced by the 0.5 g/kg of intraoperative colloids.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Surgical treatment of the WPW-syndrome--experience in 30 initial cases.

Between May 1980 and February 1985, 30 patients were operated upon at Sahlgren's Hospital for life-threatening or disabling arrhythmias, caused by Kent's bundles. Two surgical methods were used. The outcome of surgery was fully satisfactory in 19 patients, whereas 4 patients continued to have arrhythmias after surgery. Six patients had a modified delta-wave in the ECG after surgery, but their arrhythmias could be controlled by antiarrhythmic medication. One patient died after surgery due to an undiagnosed cerebral tumor. There were 2 late deaths, between 6 and 12 months postoperatively; neither of these was caused by arrhythmias.

Adolescent↗
PubMed1985

Resectional operations and long-term results in carcinoma of the esophagus.

The 5 year survival rate after resectional operations for carcinoma of the esophagus is still very low. Many factors have been identified as contributing to these poor long-term results. The main factor found in this study, comprising 102 patients undergoing resection out of 125 patients operated upon during a 10 year period, was nonradical resection. The main cause of nonradical resection was invasion of the tumor into the mediastinum, which was observed in 80% of the patients. In 43 of the 102 patients undergoing resection, the penetration of the carcinoma into the tissue surrounding the esophagus was observed only histologically. Thirty-three of the 38 hospital survivors in this group died within 2 years of the operation of recurrence of carcinoma. Fourteen of 17 survivors after resectional operations in whom the tumor growth was still limited to the esophagus were alive from 2 to 9 years (mean 6 years) after the operation, without evidence of recurrence.

Adult↗
PubMed1984

Haemodynamic effects of a single large dose of insulin in open heart surgery.

The haemodynamic effects of a single dose of 0.35, 1.5 or 7.5 IU fast acting insulin X kg bw-1 were studied in 24 patients undergoing aortocoronary bypass grafting. No inotropic drugs were used. Blood glucose was measured using a continuous blood glucose monitoring system, and was kept at the preinsulin level by administration of a 40% glucose solution. Injection of 0.35 or 1.5 IU X kg bw-1 of insulin did not have significant haemodynamic effects. Injection of 7.5 IU X kg bw-1 of insulin resulted in significant changes in cardiac index (+20.8%) and in total peripheral resistance (-13.9%) within 2 min. After 10 min a reduction of 16.8% was found in the diastolic pulmonary artery pressure. These haemodynamic effects occurred before glucose had been infused. The arterial pressure and the heart rate were unaffected. It is concluded that the injection of 7.5 IU X kg bw-1 of insulin results in an increase in cardiac index in patients who have undergone open heart surgery. The effects are not primarily related to stimulation of glycolysis.

Adult↗
PubMed1984

Clinical experience of blood transfusion in renal transplantation.

A positive effect on survival of renal grafts of pretransplant blood transfusions have been reported from several centers. The aim of this study was to study if the described graft-protecting effect of blood transfusion was present in the Gothenburg material of transplanted patients, and if this effect could be achieved by deliberately transfusing previously non-transfused patients with two units of leukocyte-reduced blood. The effect on graft survival (GS) of the number and timing of transfusions to recipients, transfusions to the cadaveric donors, HLA-A, B matching, lymphocytotoxic antibodies and pretransplant hemodialysis was also studied. The study includes 844 recipients of primary renal grafts from living related and cadaveric donors (LRD, CD) and 70 patients waiting for transplantation. In the retrospective part of the study the GS of previously transfused and non-transfused non-transfused patients was compared. In the prospective part of the study a protocol with two deliberate transfusions (DT) to previously non-transfused patients was introduced. The GS of the DT group was compared to that for patients transfused for strictly medical reasons (MT) and non-transfused patients (NT). Survival of patients and grafts was calculated according to the life table method. In the retrospective part of study one year GS in LRD transplantation was 86.6% for transfused and 38.4% for non-transfused patients (P less than 0.01). In the first period one year GS in CD transplantation was 62.1% for transfused and 35.1% for non-transfused patients (P less than 0.01). The corresponding figures in the second period were 68.1% and 39.5%, respectively (P less than 0.001). In transfused recipients receiving kidneys from transfused and non-transfused cadaveric donors, the GS was 76.3% and 55.4%, respectively (P less than 0.05). In the prospective part of study the one year GS after LRD transplantation was 85.0% in both the DT and MT groups. In CD transplantation the one year GS was 73.4% and 75.7% of the DT and MT groups, respectively. The GS of each of these two groups was significantly better than that of 20.8% for the NT group (P less than 0.01). Lymphocytotoxic antibodies were detected in 5.0% of the DT group and 23.0% of the MT group (P less than 0.001). Foreign HLA-B series antigens had a negative influence on GS in the first period of the retrospective CD study. Later, no influence on GS was noted of HLA-A, B matching. Hemodialysis prior to transplantation did not influence GS.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1983

Aortic cross-clamping for more than 2 hours in open-heart surgery. Early results in 87 patients.

Myocardial protection with cold cardioplegia has made it possible to prolong the time of aortic cross-clamping during open-heart surgery. Myocardial ischemia for up to 120 minutes is considered acceptable under these conditions. Eighty-seven patients operated upon for various heart lesions with cardiopulmonary bypass and aortic cross-clamping for more than 2 hours (mean time 146 minutes) were reviewed. Myocardial protection was achieved with cold cardioplegia, in some cases with additional topical cooling of the heart. Ten patients died and 77 were discharged from the hospital. Perioperative and early postoperative deaths could not be correlated to aortic cross-clamping time or the method of myocardial protection. Aortic cross-clamping can be safely performed for a period far longer than 2 hours with myocardial preservation by cold cardioplegia.

Adult↗
PubMed1983

Transfused cadaver kidney donors and graft survival.

A retrospective study of blood transfusion to the cadaveric kidney donor and graft survival in 129 primary transplantations between 1973 and 1981 in a single center is presented. Only transfusions given while the donor had the fatal disease were considered. Among 109 earlier transfused recipients graft survival calculated according to actuarial methods was significantly higher in 55 patients who received kidneys from transfused donors than in 54 patients who received kidneys from donors who had not been transfused (P less than 0.05). We conclude that transfusion to the cadaveric kidney donor positively affected graft survival in recipients who had been transfused.

Adolescent↗
PubMed1982

Polytetrafluoroethylene and anodized aluminum surfaces in an extracorporeal circuit: scanning electron microscopic study.

Tubes with polytetrafluoroethylene (PTFE) or anodized aluminum surfaces were inserted in an extracorporeal circuit which was connected to mongrel dogs. The tubes were removed at regular intervals during the perfusions and their inner surfaces were examined by scanning electron microscopy. The anodized aluminum tubes were covered with platelets, fibrin, and other blood elements in a thick layer. In contrast, the PTFE tubes were mainly uncovered.

Aluminum↗
PubMed1981

Haemostatic clot formation at anastomosis of synthetic venous graft in defibrinogenated dogs: a scanning electron microscopic study.

A segment of the inferior vena cava was replaced by an expanded polytetrafluoroethylene graft in 13 dogs. Five of them served as a control group, while the other 8 were moderately or severely defibrinogenated with subcutaneous batroxobin. Plasma fibrinogen decreased to extremely low values throughout the experiment in the defibrinogenated dogs except in the moderately treated group in which it temporarily rose to 0.72-0.87 g/l on the first postoperative day. Scanning electron microscopic observations of the haemostatic clot formed at the anastomoses of the graft revealed no significant morphological differences in platelet adhesion and/or aggregation between the three groups. These findings confirmed that platelets play a key role in primary haemostasis during defibrinogenation. The fibrin network was slightly diminished and only short fibrin filaments could be seen in the moderately and severely defibrinogenated groups respectively. These differences in composition of the clots are discussed in relation to their haemostatic capacity.

Animals↗
PubMed1981

Intrapleural instillation of streptokinase. Effects on systemic fibrinolysis.

Ten consecutive patients aged 25 to 75 with postoperative empyema or hemothorax conventionally treated with drainage without sufficient effect were given intrapleural instillations of streptokinase (Kabikinase, 250,000 IE) for 4 hours). The effects on systemic fibrinolysis were studied. Venous blood samples for determination of fibrinolytic activity on fibrin plates, plasminogen, alpha 2-antiplasmin, alpha 2-macroglobulin, fibrinogen, fibrin(ogen) degradation products (FDP) and thrombin time were taken before instillation, after instillation and then after 24 hours. Preinstillation values were compared to the values 4 and 24 hours after instillation with Student's paired t-test. There were no differences in fibrinolytic activity, alpha 2-macroglobulin and thrombin time. There was a slight increase in plasminogen, alpha 2-antiplasmin and fibrinogen, probably due to an acute phase reaction. Fibrin degradation products showed an increase with border line significance. These changes are not consistent with generalized fibrinolysis, and it is concluded that intrapleural instillations of streptokinase can be given safely in the early posttraumatic or postoperative period.

Adult↗
PubMed1981

Pseudoendothelium formation in expanded polytetrafluoroethylene grafts implanted in the inferior vena cava of normal and defibrinogenated dogs.

The outgrowth of endothelial cells in an expanded polytetrafluoroethylene graft implanted in the canine inferior vena cava was studied by scanning electron microscopy. The adjacent endothelial cells of the vena cava started to invade the anastomotic area three days after the implantation and reached approximately the central part of the 2-cm-long graft after 21 days. There was no obvious difference in the process of endothelialization between the control group and the moderately defibrinogenated group, in which the fibrinogen concentration was at most 0.72-0.87 gm/L. A slight delay in the outgrowth of endothelial cells was noted within the first seven days in the severely defibrinogenated group, in which the fibrinogen concentration was below 0.40 gm/L. After 70 days, all grafts were completely covered by endothelial cells. The structural difference of the mural thrombus resulting from reduced fibrin formation might be a major factor influencing the endothelium formation.

Animals↗