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Biomedical subjects

J Brunkwall

Publications and source records attributed to J Brunkwall.

85 records · Page 5Linked to original sources
PubMed1990

The effect of unfractionated and low-molecular-weight heparin on the release of prostacyclin from the arterial wall.

Heparin is widely used as an antithrombotic agent, but one reported complication is thrombocytopenia associated with platelet aggregation. The mechanism is not fully clear but heparin interference in the prostaglandin production has been proposed. To investigate if heparin interacts with the production of prostacyclin from the vessel wall, and if low-molecular-weight heparin differs from unfractionated heparin in this respect, excised rabbit aortas were studied in a perfusion model. The vessels were perfused ex vivo for 5 x 15 min and in the last period arachidonic acid was added. Unfragmented heparin (500 IU/kg body weight) or low-molecular-weight heparin (LMWH) (500 antifactor Xa units/kg body weight) were given either 15 min before harvesting the vessels or added directly to the perfusate. The stable degradation product for prostacyclin, 6-keto-PGF1 alpha was not altered by addition of these agents. It is concluded that heparin and LMWH per se do not interact with the prostacyclin system in normal rabbit aortas in the doses studied.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Solitary aneurysms of the iliac arterial system: an estimate of their frequency of occurrence.

Solitary iliac artery aneurysms are rare, and most reports have been presented as case reports. By combining autopsy records and operating records, a total of 13 cases were found: during a 15-year period (1971 to 1985), 42,010 of the inhabitants of Malmö died (population 230,000) and 35,265 (including 9014 forensic autopsies) underwent autopsy (84%). Solitary iliac artery aneurysms were found in seven (0.03%) of the 26,251 patients who underwent autopsy at the hospital; six of those had been asymptomatic and one was ruptured. Among the 9014 persons who underwent forensic medical autopsy, there were two with ruptured solitary iliac artery aneurysms. Four patients had clinically detected solitary iliac artery aneurysms, three of which were ruptured. All patients underwent surgery, and two of the three patients with ruptured solitary iliac artery aneurysms left the hospital well. The rupture rate of iliac aneurysm among those found at autopsy was one of seven (14%) and among those clinically detected three of four.

Adult↗
PubMed1988

The effects of omeprazole and cimetidine on duodenal ulcer healing and the relief of symptoms.

In a Swedish double-blind multicentre study, omeprazole (30 mg o.m.) was compared with the H2-receptor antagonist cimetidine (400 mg b.d.) in 152 patients. Clinical assessments and laboratory investigations were carried out at 2 and 4 weeks, and again at 6 weeks in unhealed patients. Endoscopy was performed at 2 weeks, and again at 4 and 6 weeks in unhealed patients. The patients in the two groups were well-matched prior to treatment. Omeprazole was superior to cimetidine in ulcer-healing rate after 2, 4 and 6 weeks. After 2 weeks of treatment, 66% of the omeprazole- and 45% of the cimetidine-treated patients were healed (P = 0.02), after 4 weeks 97 and 84% (P = 0.01), and after 6 weeks 100 and 92% (P = 0.02), respectively. There was a more pronounced improvement in the patients' symptoms in the omeprazole group after 2 weeks (P = 0.05). Both drugs were well-tolerated, but there was a high prevalence of patients with adverse events in the cimetidine group (51%, compared to 30% of the omeprazole group; P = 0.02). A total of 125 patients were followed for 6 months after healing. The patients were investigated by endoscopy after 6 months, or whenever symptoms occurred. There was no significant difference in the rate of relapse within 6 months between the two treatment groups: 54% relapsed in the omeprazole group and 52% in the cimetidine group. In conclusion, 30 mg of omeprazole, given once daily, is superior to 400 mg of cimetidine twice daily in duodenal ulcer healing; but ulcer relapse in the two groups appears to be equivalent.

Adolescent↗
PubMed1987

Prostacyclin and thromboxane release from the vessel wall--comparison between an incubation and a perfusion model.

Prostacyclin (measured as its stable degradation product 6-keto-PGF1 alpha) and thromboxane (measured as its stable degradation product TxB2) produced by the vascular wall were measured by radioimmunoassay (RIA). Four pieces from the rabbit aorta and four from the caval vein were used. One piece was incubated in Hank's balanced salt solution (HBSS), one piece with additional indomethacin, and the other pieces were mounted in a perfusion system so that only the endothelium was exposed to the buffer solution with or without indomethacin. There was a higher release in the piece incubated in the buffer than in the piece which was perfused, indicating that not only the endothelium releases prostacyclin and thromboxane from the vascular wall. The 6-keto-PGF1 alpha/TxB2 ratio was higher in the perfused than in the incubated samples suggesting that 6-keto-PGF1 alpha release is higher in the endothelium than in the other wall layers and/or that TxB2 production is higher in the outer layers than in the inner layers. No correlation was found between the release from the incubated vessel and from the perfused vessel. There was a higher release of 6-keto-PGF1 alpha from aortas than from caval veins, when incubated or perfused, whereas there was a tendency to a higher release of TxB2 from veins than aortas.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

Postoperative deep venous thrombosis after renal transplantation. Effects of cyclosporine.

In this prospective study the frequency of deep venous thrombosis during the first three weeks after renal transplantation was determined using a combination of strain gauge plethysmography and thermography for objective diagnosis. Ninety-seven consecutive patients were studied, 30 patients having juvenile diabetes mellitus. As immunosuppression cyclosporine and low-dose steroids were used. The series was compared with a similar group of 83 patients, 33 having juvenile diabetes mellitus treated with azathioprine and high-dose steroids as immunosuppression, in which the diagnosis of deep venous thrombosis was made with an identical technique. The overall frequency of thrombosis was 9.3% in the cyclosporine-treated group, which is a significant reduction in comparison with the azathioprine group (24.1%). It is concluded that the combination of cyclosporine and low-dose steroids does not increase the frequency of deep venous thrombosis in comparison with azathioprine and high-dose steroids in renal transplanted patients.

Adolescent↗
PubMed1985

Cholescintiscan or infusion cholecystography in acute cholecystitis. A prospective study.

Two methods of diagnosing acute cholecystitis--cholescintigraphy and infusion cholecystography--were compared in a prospective study of 105 patients. Sensitivity and specificity were very high (96-99% and 91%, respectively), without difference between the two methods. Infusion cholecystography gave transient rise in liver enzyme levels in more than half of the patients. Cholescintigraphy gave no side effects. Cholescintiscan could be performed at moderately elevated bilirubin levels. It also gave information concerning liver malignancy in four patients. On these grounds, cholescintigraphy is the preferable of the two methods.

Acute Disease↗
PubMedDate not supplied

Options for treatment of persistent aneurysm perfusion after endovascular repair.

Persistent aneurysm perfusion represents failure of endovascular repair. The leak may occur around either end of the prosthesis or through a collateral route. Most cases can be treated by endovascular means. Stents can be rotated, the prosthesis can be lengthened at either end, and collateral pathways can be occluded, all without recourse to open repair. This report describes the management of persistent aneurysm perfusion in five patients from a total experience of 32 cases of endovascular aneurysm repair.

Aneurysm↗
PubMedDate not supplied

Pulsatility index determination by flowmeter measurement: a new indicator for vascular resistance?

BACKGROUND: Peripheral resistance (R) is measured by flow (Q) and a pressure difference (P1-P2), where R equals (P1-P2)/Q. The pulsatility index (PI) has been used to assess peripheral vascular resistance by measuring flow velocities. Alternatively, PI can be expressed by the ratio of the flow volume amplitude and mean flow volume which both are quantified by a flowmeter. While reflected flow due to a distally located stenosis will considerably influence PI, this parameter theoretically could provide a good estimation of resistance. The appropriateness of this presumption has not been evaluated in this setting though, why the correlation of PI in flow recordings was examined by comparing PI with the true R using the stenosis of the internal carotid artery (ICA) as a clinical model. METHODS: The volume flow in the ICA was measured by a transit-time flowmeter in 400 patients undergoing carotid endarteriectomy. The pressure in the common carotid artery (CCA) proximal to and in the ICA distal to the stenosis was determined by direct puncture allowing the calculation of a pressure gradient (PG) and R in analogy to Ohm's law. R and PI were then correlated using Spearman's correlation. RESULTS: The blood flow in the ICA ranged from 2 to 478 ml/min with a median value of 165. The median PG was 14 mm Hg (0 to 88). Median R was 0.08 mm Hg x min / ml (0-26.5). PI varied between 0.8 and 114.1 with a mean of 1.9. Since a concentration of R and PI values in the lower ranges was observed, a logarithmic transformation was performed. Log PI showed only weak correlation to log R (r = 0.426, p < 0.0001). CONCLUSIONS: Log PI was intermediately correlated to log R in carotid artery stenosis, with a low discriminating power in the lower ranges due to the close distribution of measurements. Further studies are required to clarify the role of PI in hemodynamic questions and its general usefulness in other fields of vascular surgery like in peripheral bypass surgery.

Adult↗
PubMedDate not supplied

Dextran and release of prostacyclin from ex vivo perfused rabbit arteries and veins.

The effects of dextran on the haemostatic system lead to prolongation of the bleeding time. To observe if the coating of endothelial cells by dextran influences the release of prostacyclin from the vessel walls in response to ex vivo perfusion, dextran 70 (1 g/kg b.w.) was given i.v. 15 min or 4 hours before excision of caval vein and aorta in rabbits, or was added to the perfusate. Vascular segments were perfused for 5 x 15 min, with the perfusate changed after each period and with arachidonic acid added on the last occasion. Prostacyclin was measured as its stable degradation product 6-keto-PGF1 alpha by radioimmunoassay. Arteries released more prostacyclin than did veins (p less than 0.01). Dextran given in vivo or ex vivo had no influence on release of prostacyclin from the walls of perfused arteries or veins. The anti-haemostatic properties of dextran 70, 1 g/kg b.w., thus do not seem to be mediated by prostacyclin release from vessel walls.

6-Ketoprostaglandin F1 alpha↗