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Biomedical subjects

F Nilsson

Publications and source records attributed to F Nilsson.

At least 91 records · Page 5Linked to original sources
PubMed1988

Generation and isolation of cyanobacterial inside-out thylakoid vesicles.

A method has been designed to prepare inside-out thylakoid vesicles from a cyanobacterial species (Phormidium laminosum). Everted thylakoid vesicles could be generated by Yeda press treatment after induced membrane pairing. Membrane pairing was induced either by addition of high concentrations of Mg2+ ions or by lowering the pH of the fragmentation media. The inside-out vesicles were isolated by aqueous polymer two-phase partition. The membrane orientation was determined by proton translocation studies and freeze-fracture electron microscopy.

Cell Fractionation↗
PubMed1988

Torsion of a lung lobe: diagnosis and treatment.

Intraoperative lobar torsion occurred in 4 of about 2000 patients subjected to thoracotomy. Two of the patients died. Early diagnosis and proper management are of great importance to the outcome. Temporary deflation of the diseased lung by using double lumen endobronchial tube is a potential risk. Early progressive lobar opacity without signs of atelectasis on conventional chest radiograph is indicative of this serious complication. Computerized tomography and bronchoscopy are of diagnostic value. Exploratory thoracotomy must be performed without delay. The injured parenchyma should be sacrificed unless the diagnosis is obtained very early. When the injured lobe or lung is rotated back into normal position the airways may be flooded with serosanguinous fluid which promptly has to be removed. If an attempt is made to save the lobe or the lung, tracheostomy for frequent suction of the airways is indicated in order to prevent "spill-over" and dangerous postoperative hypoxia.

Adult↗
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↗
PubMed1988

A method for surgical exposure of intramyocardial coronary arteries for bypass grafting.

A method is described for locating deep stenotic intramyocardial coronary arteries. A metal probe is passed through the aortic wall into the coronary ostium and advanced to the stenosis, where the tip of the probe is palpated. The diseased artery is then dissected free and grafted distal to the obstructive lesion. The method was used in one patient whose heart was surrounded by a thick rind of fibrous scar tissue following two previous operations for coronary artery disease, and was highly successful when other methods had failed. The technique was also used in two patients undergoing both aortic valve replacement and coronary artery bypass grafting, in whom the stenotic arteries lay deep in the myocardium and were difficult to find. The described procedure is particularly useful in reoperations on a heart with a covering rind of fibrous scar tissue.

Aorta↗
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↗
PubMed1983

Bleeding as a complication to endoscopic biopsies from the gastric remnant after ulcer surgery.

Bleeding is a potential but rare complication after endoscopic biopsies of the gastric mucosa in non-operated patients. The resected stomach, however, seems to run an increased risk of this complication. In a retrospective study comprising 1843 consecutive biopsy examinations of the gastric remnant, 15 bleeding episodes were recorded (0.8%). The frequency of bleeding was 1.1% for the Billroth-II-resected stomach and 0.2% for the Billroth-I-resected stomach. In two patients the bleeding was excessive, requiring emergency surgery. Six other patients required blood transfusions. The observed frequency of bleeding was probably a minimal estimate, suggested by a 20% occult bleeding found in a small prospective study. When planning follow-up examination of patients who have had a gastrectomy, the risk of bleeding should be taken into account, and the patients should be appropriately informed and supervised.

Aged↗
PubMed1983

The role of the MA-sensitive leukocyte chemotaxis in rheumatoid arthritis. A randomized double-blind clinical trial of griseofulvin treatment.

Polymorphonuclear leukocyte (PMN) chemotaxis is thought to play an essential role in the pathogenesis of rheumatoid arthritis. PMN chemotaxis is in part sensitive to microtubule antagonists (MAs), e.g. colchicine. The antimycotic antibiotic griseofulvin inhibits the MA-sensitive PMN chemotaxis in vitro in concentrations far below those obtained in serum during antimycotic therapy. The role of the MA-sensitive chemotaxis in rheumatoid arthritis could thus be elucidated by a clinical trial of griseofulvin treatment. Griseofulvin (n = 20) was tested in a randomized double-blind study versus placebo (m = 19) during one year in patients with rheumatoid arthritis of mild-moderate activity. No beneficial effect of griseofulvin treatment was noted on clinical symptoms or laboratory parameters of rheumatoid arthritis. Moreover, the placebo-treated patients showed more improvement than the griseofulvin-treated patients. It is therefore suggested that the MA-sensitive chemotaxis plays a reparative role in the inflammatory lesions of rheumatoid arthritis.

Adult↗
PubMed1983

The early phase of meningococcal disease.

In a prospective case control study in Norway during the winter 1981-1982, 115 patients with systemic meningococcal disease were compared with 61 patient controls. Initially, skin bleedings, reduced general condition and consciousness, and body pain were seen more often, but irritability less often in meningococcal patients than in the patient controls. The meningococcal patients presented symptoms typical of infectious diseases in general. Symptoms that correlated with a poor prognosis of the meningococcal disease were reduced consciousness, cyanosis, and early diarrhea. The mean time interval from start of the meningococcal disease until admission to hospital was 34 hours. No deaths occurred when less than six hours elapsed before it was decided to admit the patient. All fatal cases were admitted by the first doctor who saw the meningococcal patient. Contact with the family doctor does not seem to have reduced the risk of death. To avoid unnecessary delays, access to hospitals should be facilitated, and efforts should be made to shorten the time interval before patients with relevant symptoms are seen by a doctor.

Adult↗
PubMed1982

The aerobic and anaerobic microflora of the gastric remnant more than 15 years after Billroth II resection.

The bacteriology of the gastric remnant contents was examined in 150 patients 15-20 years after Billroth II resection for duodenal ulcer disease. Samples of gastric contents were aspirated through a gastroscope, and aerobic and anaerobic microflora were cultured and analyzed semiquantitatively. All patients but one had bacterial growth, with a mean number of 6.8 strains per remnant. One third of the bacterial strains were anaerobic, and many of them had their normal habitat in the colon. The role played by bacteria of the gastric remnant in the etiology of mucosal pathology and gastric remnant disease is discussed.

Adult↗
PubMed1982

Insulin sensitivity and glucose uptake in the course of surgical treatment for valvular aortic stenosis.

The dose-response relationship between plasma insulin and systemic glucose uptake was studied before, one hour after and 6 months after valvular surgery in 11 patients with valvular aortic stenosis. The immediate effect of valvular surgery was a dramatic rightward shift of the dose-response curve and a decrease in glucose uptake at peak insulin activity. From a comparison between the preoperative and the 6-month postoperative dose-response curves it is concluded that the patients had adapted metabolically to the preoperative haemodynamic situation with increased insulin sensitivity.

Aortic Valve Stenosis↗
PubMed1981

Survival and emergency surgery in upper gastrointestinal bleeding.

The outcome in terms of survival and frequency of emergency surgical intervention for all patients with upper gastrointestinal bleeding during a two-year period was evaluated. During the period early oesophago-gastro-duodenoscopy was recommended as a routine procedure. A total of 277 patients were hospitalized with upper gastrointestinal bleeding and in 206 patients endoscopy was performed. The point of time for endoscopy did not affect the diagnostic yield. If variceal bleeders were excluded the total mortality was 7.1%. The operative frequency was low, 11%. The postoperative mortality was 45.2%. The postoperative morality occurred among patients over 60 years and the mortality during conservative treatment was obviously difficult to avoid. The benefit of endoscopy was expressed as a low operation frequency without negative effects on the total mortality.

Adult↗
PubMed1981

Parietal cell vagotomy and truncal vagotomy as treatment of duodenal ulcer. A prospective randomized trial.

In a prospective randomized trial parietal cell vagotomy (PCV) was compared with truncal vagotomy with drainage (TV) in the treatment of duodenal ulcer. The material consists of 106 patients, 50 TV and 56 PCV. Basal and maximal acid output (BAO, MAO) were measured preoperatively, 6 weeks and 12 months postoperatively. The clinical results were judged from a modified Visick grading system 1-6 years postoperatively. BAO 6 weeks after PCV was reduced with 60% in average and 12 months postoperatively with 45%. After TV the BAO was reduced with 53% 6 weeks postoperatively and 34% 12 months postoperatively. MAO was reduced with 47% 6 weeks after PCV and with 31% 12 months postoperatively. After TV the reduction of MAO was 50% and 44%, respectively. After PCV 62% of the patients were insulin positive at the first postoperative examination and 78% one year later. After TV 46% of the patients had a positive insulin test at the first postoperative examination and 50% one year later. In the PCV group 9 patients (16%) have got recurrences during the 1-6 years observation time, in the TV group there were 4 recurrences (8%). In the PCV group 24% of the patients with pyloric or prepyloric ulcer got recurrences and 13% of the patients with duodenal ulcer. In the TV group the number of recurrences was 13% and 6%, respectively. At the modified Visick classification 71% of the patients in the PCV group were graded as I and II, 4% as III and 25% graded as IV. After TV 83% of the patients were graded as I and II, 4% as III and 13% graded as IV. The results from this study do not allow us to recommend PCV before TV and it should be seriously questioned if it shall at all be performed on prepyloric ulcers.

Adult↗
PubMed1981

Endoscopy in the management of gastric ulcer disease.

The influence of endoscopy on the management of gastric ulcer disease during a three-year period was reviewed. A total of 265 endoscopies on 120 gastric ulcer patients were performed. 145 of these endoscopies were controls of ulcers primarily diagnosed as benign. At these controls 4 carcinomas were detected, all invasive. In all these cases the endoscopist had a suspicion of malignancy at the first endoscopy, although it was not verified histologically. This emphasizes the importance of the macroscopic appearance of the ulcer and of appropriately taken biopsies. All gastric cancers during the same period were reviewed, only 3.4% were classified as early. They were all diagnosed at the first endoscopy. There was a significant decrease in the number of operations on suspicion of malignancy compared with earlier periods when endoscopy was not a routine procedure.

Adult↗