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Biomedical subjects

G Jurell

Publications and source records attributed to G Jurell.

35 records · Page 2Linked to original sources
PubMed1987

Reconstruction in the head and neck regions with free radial forearm flaps and split-rib bone grafts.

Fifty patients with wound defects in the head and neck region underwent reconstruction with the free radial forearm flap. Mandible defects in 17 patients were reconstructed by split-rib bone grafts. Radiotherapy was administered to 44 patients preoperatively. The free flap was successful in 49 patients, and there was one case of partial flap necrosis. The free flap is soft, thin, and movable. The split-rib bone graft was successful in 15 patients, and there was one case of partial graft necrosis and one case of complete necrosis. Postoperative complications were decreased by 50 percent when compared with the complication rate when split ribs were covered by forehead flaps, deltopectoral flaps, or oral mucosa. Finally, the functional and cosmetic results were excellent.

Bone Transplantation↗
PubMed1986

Adrenergic nerves and the delay phenomenon.

The present study indicates that adrenergic nerves can in part explain the delay phenomenon. Data presented suggest that degeneration in release of norepinephrine might be deleterious to critical parts of a skin flap. This could be avoided by performing a delay procedure, as no release of norepinephrine will occur after the second operation.

Adenosine Triphosphate↗
PubMed1985

Laser Doppler surveillance of the circulation of free flaps and replanted digits.

In a series of 40 clinical free flaps and replantations the laser doppler technique has been used successfully for postoperative surveillance of circulation. A uniform flow pattern was obtained from all uncomplicated cases contrasting to the flow pattern seen in cases with thrombotic complication. The laser doppler continuously records flow of the microcirculation and is able to monitor blood flow in all types of free tissue transfer presently used as well as replantations. The laser doppler has effectively diagnosed two arterial thromboses with a characteristic flow pattern. It can distinguish venous from arterial occlusion. It can record flow in skin flaps which are difficult to judge clinically and in buried flaps, where no clinical observations are possible. The laser doppler should be used in conjunction with routine clinical observations.

Adolescent↗
PubMed1985

Bacteria in the female breast.

Subclinical infection may play a role in capsular formation around silicone breast implants. To assess the possibility of antibiotic prophylaxis for prevention of capsular formation, knowledge of bacteria present in the female breast tissue and the resistance pattern of these bacteria is needed. Samples were taken from 25 patients (49 breasts) peroperatively during reduction mammaplasty with an impression pad method. The samples were placed in agar plates and incubated both aerobically and anaerobically. In more than 90% of the samples bacteria were found. The species of bacteria found were mainly Staphylococcus epidermidis and propionibacteria. These bacteria were sensitive to penicillin G and/or isoxapenicillin. It remains to be shown that prophylactic antibiotic treatment will decrease capsular formation following augmentation mammaplasty.

Adolescent↗
PubMed1984

Accidental burns with domestic fire-lighting fluid.

The use of methyl alcohol (methanol) as an igniting fluid is very dangerous. Nineteen patients (17 males and 2 females), burned while using this fluid for lighting barbecues or filling lamps and stoves, have recently been treated at the Burn Unit at the Karolinska Hospital. A mean of 23% body surface was involved and many of the burns were deep dermal or full thickness. Ninety percent of the patients had facial burns. Hospital stay averaged 23 days with 2.2 operations. It seems that previous alarms ( Nordstr öm & Nyl én, 1975) remain unheeded by both manufacturers and consumers. The public must be warned about the dangers associated with the use of methanol. Briquettes as solid fuel for barbecues and safer ignition fluids ought to be popularized .

Accidents, Home↗
PubMed1983

On the mechanism by which antiadrenergic drugs increase survival of critical skin flaps.

In order to asses the possibility that degeneration release of noradrenaline influences the survival of critical skin flaps, we studied the effect of various antiadrenergic drugs on skin-flap levels of noradrenaline, ATP, and cyclic AMP. Reserpine treatment depleted the skin flaps of noradrenaline and counteracted the fall in ATP and the cyclic AMP accumulation. Guanethidine had similar but less pronounced effects. Propranolol did not affect noradrenaline levels or depletion rate, but reduced the metabolic stimulation, as assessed by cyclic AMP levels in the flap. Phentolamine had no effect on basal noradrenaline levels, but tended to accelerate its disappearance and reduce lactate accumulation, a measure of hypoxia. All these drugs are known to increase skin-flap survival. It is suggested that they do so by, respectively, depleting the flap of its content of noradrenaline prior to operation or preventing the vasoconstriction and metabolic stimulation caused by released noradrenaline.

Adenosine Triphosphate↗
PubMed1981

Early changes in ATP and cyclic AMP levels in experimental critical skin flaps.

A cranially based pedicle skin flap, 2 cm wide and 7 cm long, was prepared in the midline of the rat dorsum. The contents of ATP and cyclic AMP were determined in the proximal, middle and distal parts of the flap. The basal level of ATP was 1.3 +/- 0.1 nmol/g dry weight. Following the operation the level of ATP fell rapidly. The fall was more marked in those parts of the flap that eventually do not survive. During the first 12 h the level of cyclic AMP fell at least as rapidly. However, thereafter the cyclic AMP level remained constant or even increased while the ATP showed a further decrease. It is suggested that the rapid fall in ATP may be used to assess the eventual survival of skin flap. The results are also compatible with the opinion that a period of metabolic stimulation in the skin flap starts 12--18 h after operation, i.e. at the time when the adrenergic nerves in the flap degenerate.

Adenosine Triphosphate↗
PubMed1981

Degeneration release of noradrenaline in skin flaps in rats.

To study if noradrenaline released from degenerating sympathetic nerves may contribute to metabolic stimulation and low blood flow in an experimental skin flap, we have determined noradrenaline levels in such skin flaps. Attempts to use radioenzymatic methodology for the determination of noradrenaline in rat skin extracts were unsuccessful due to interference with the assay. High performance liquid chromatography with electrochemical detection was, however, found to give accurate estimates of rat skin noradrenaline contents. Rat skin contained approximately 2.7 nmol (455 ng) noradrenaline per gram dry weight. Extensive depletion of skin flap noradrenaline, occurring mainly between 6 and 24 h postoperatively, was found. At 48 h nearly all sympathetic nerves in the skin flaps had degenerated as evidenced by noradrenaline levels of 0.13 nmol/g. The degeneration of sympathetic nerve endings appears to proceed from the sides towards the middle of the flap, indicating a segmental distribution of the nerves. Noradrenaline released from degenerating sympathetic nerves may adversely affect the survival of critical skin flaps by causing vasoconstriction and metabolic stimulation.

Animals↗
PubMed1979

Effect of dipyridamole on the survival of experimental critical skin flaps.

The effect of dipyridamole (Persantin) on the survival of experimental skin flaps was studied. In controls 39% of the skin flap area survived. Intraperitoneal injection of dipyridamole 4 mg/kg twice daily starting four hours preoperatively increased the surviving area with 18%. This increase is statistically significant (p less than 0.05). The improved survival could be due to the vasodilatory action of the drug and/or proliferation of small bloodvessels induced by the drug.

Animals↗
PubMed1976

Increased survival of experimental skin flaps in rats following treatment with antiadrenergic drugs.

The effect upon the survival of skin flaps of several drugs which affect the adrenergic system was studied in rats. In control animals 41% of the skin flaps had survived seven days after the operation. Reserpine (1 mg/kg) injected intraperitoneally (i.p.) three days and one day before the flap operation increased the surviving flap area by 75% (p less than 0.001) as compared to control rats injected with saline. I.p. injection of guanethidine (5 mg/kg) or bretylium (10 mg/kg) every 12 hours, starting 24 hours before surgery and continued for 5 consecutive days, also increased the surviving flap area (19 and 33% respectively p less than 0.001). The surviving flap area was unchanged when desipramine (5 mg/kg) was injected in the same way and was decreased by 15% (p less than 0.05) following i.p. injection of the MAO inhibitor pheniprazine (5 mg/kg). Treatment with alpha-methyl-p-tyrosine (75 mg/kg), i.p. 30 min before surgery or 6-hydroxydopamine (50 mg/kg) i.v. 24 hours prior to surgery also increased the flap survival (56 and 49% increase in surviving flap area, respectively, p less than 0.001). The results demonstrated that the survival of skin flaps increased when the function of the adrenergic nervous system was inhibited. Enhanced sympathetic nervous activity slightly reduced or did not affect skin flap survival.

Adrenergic Agents↗
PubMed1975

Effect of phentolamine and propranolol on the survival of experimental skin flaps.

The effect of phentolamine and/or propranolol (alpha- and beta-receptor blocking compounds respectively) on the survival of skin flaps was studied in rats. Phentolamine and/or propranolol were injected intraperitoneally every 12 hours, starting one day before the flap operation, and continued for 5 consecutive days. One week after the operation the survival of the flaps was judged. Systemic treatment with either compound alone or in combination resulted in statistically significant increased survival of the flaps. The results demonstrate that both alpha- and beta-adrenergic receptors influence the survival of skin flaps in rats.

Animals↗