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Biomedical subjects

J Wadström

Publications and source records attributed to J Wadström.

51 records · Page 3Linked to original sources
PubMed1990

Experience with the Hemasite device in haemodialysis and haemofiltration patients with vascular access problems.

Multiple vascular access failure is a frequent problem and we report our experience with 32 Hemasite devices implanted in 28 patients with end-stage renal disease. All of the patients were on maintenance haemodialysis or haemofiltration with a range of treatment of 1-17 years. Their mean age was 58 +/- 14 years (range 28-72 years). The main indication for using this device as an alternative vascular access was the presence of high-risk patients with a high incidence of previous access failure (1-8 accesses per patient). The majority of the patients were considered as high risk, due either to old age (more than 60 years) (60%) or to the presence of diabetes mellitus (29%). The results of 5 years' experience and follow-up showed that the Hemasite device could be successfully used as a secondary vascular access in high-risk patients who have problems of multiple access failures. The 1-year cumulative survival of the device (55%) was affected by complications such as thrombosis and infection (47% and 16%) which were noted mostly among patients with diabetes mellitus. These complications are the major ones endangering the longevity of the Hemasite implant and were important causes of implant loss (31% and 6% respectively). Being needleless and painless, the Hemasite was well-accepted by the patients and it functioned well, with adequate blood flow. We conclude that the Hemasite device is a valuable alternative when vascular access becomes a problem in haemodialysis patients.

Adult↗
PubMed1990

Effect of bleeding and hypervolaemic haemodilution on traumatic vasospasm in rabbits.

The effect of bleeding (20% of total blood volume) and of hypervolaemic haemodilution with dextran infusion (20% of total blood volume) on traumatic vasospasm was studied in the central ear arteries of 10 rabbits. The blood pressure dropped significantly after bleeding and the packed cell volume was significantly lower after dextran infusion. Neither treatment had any effect on the duration, intensity or severity of the vasospasm. The results suggest that moderate changes in blood volume do not influence traumatic vasospasm.

Animals↗
PubMed1990

The influence of body temperature on traumatic vasospasm.

The effect of hypothermia on traumatically induced vasospasm was studied in an in vivo model of the rabbit ear artery. Spasm was induced by standardized compression of a 3.2 mm segment of the artery for 3 s. The internal diameter was continuously measured with the aid of an operating microscope during transillumination of the artery. Measurements were begun before spasm induction and continued until the spasm was completely resolved. Spasm was first induced at normothermia and then after reduction of the body temperature by 1.0 degrees C and 1.75 degrees C. The spasm was evaluated in terms of its duration, intensity (% reduction of initial diameter) and severity (area under the curve where diameter was plotted against time). The results were compared with those in a control group which was kept normothermic. Reduction of the body temperature caused a significant increase in the duration of the spasm and increased its severity, but did not influence its intensity.

Animals↗
PubMed1990

Studies on traumatic vasospasm in the central ear artery of the rabbit.

An experimental model was developed for investigations of traumatically induced vasospasm (TVS) in the central ear artery (CEA) of the awake rabbit. Spasm was induced by a 3-second long pinch with a clip applying forceps exerting a standardized compression force between its claws. The vessel was transilluminated with cold light and inspected from above with an operating microscope equipped with a video camera. The internal diameter was continuously measured. TVS was assessed in terms of its duration, intensity (reduction of initial diameter) and severity (integrated change in diameter over time). The spasm lasted about 10-20 minutes and the inner diameter decreased to about 15-20% of the pretrauma values. The preparation was stable for at least 3 hours and repetitive pinches in different segments of the vessel caused reproducible spasms. TVS was more pronounced when the duration of trauma was prolonged and weakened when the same vessel segment was traumatized repeatedly. The nervous influence was studied after partial denervation of the ear, after partial denervation with additional nervous blockade, and after total denervation achieved by amputation and replantation of the ear. It was found that denervation had no influence on the TVS. Ice cooling was used to decrease the body temperature by 1.0 degree and 1.75 degree C. This caused a significant increase in duration and severity, but not in intensity of TVS. Bleeding by 20% of the total blood volume or hypervolaemic haemodilution with dextran infusion, 20% of total blood volume, did not affect the spasm. Blood flow of CEA was totally obstructed by ligation of the side branches along a 7 cm long segment and subsequent ligation of CEA distal to the segment. This resulted in decreased duration and severity of TVS. Topical application of 2 or 20% lidocaine or of 3% pentobarbital one minute after vessel trauma, when the vessel was maximally constricted, caused prompt resolution of the TVS. The rapid resolution was followed by drug-induced vasoconstriction to about 60% of the initial pre-spasm values. During this vasoconstriction the vessels were refractory to trauma. The results strongly suggest that TVS is a locally elicited phenomenon of vascular smooth muscle, and can be influenced by local application of lidocaine or pentobarbital.

Animals↗
PubMed1990

Closure of the abdominal wall; how and why? Clinical review.

Closure of the abdomen after surgery has been performed in a multitude of fashions and the literature is flooded with differently tailored studies of this matter. In this paper the available literature in the field has been reviewed with special emphasis on the advantages and disadvantages of continuous or interrupted, mass or layered closure, and on the choice of monofilament or multifilament, resorbable or non-resorbable suture material. After weighing up all the aspects, the authors recommend that the abdomen should be closed with a continuous mass closure technique, using a monofilament suture. No firm conclusion can be drawn from the literature as to whether resorbable or non-resorbable suture should be chosen.

Humans↗
PubMed1986

Anatomical variations of the semilunar notch in elbow dislocations.

The anatomical relations of the semilunar notch of the ulna were studied in radiographs, taken in a strict lateral view, from 100 patients with elbow dislocations. The results were compared with those from a control group of 150 patients without dislocation or other radiographic pathology. We found that the coronoid process and an angle (a) formed between the axis of the ulna and a line going through the tip of the coronoid process and the tip of the olecranon were significantly smaller than those in the control group (P = 0.02). The central angle of the semilunar notch was significantly larger in the dislocation group than in the control group (P = 0.009). The smaller angle (a) and larger central angle in the dislocation group are a result of a lower coronoid process, but they are also due to the prominent tip of the olecranon. The results suggest that the dislocation mechanism is partly a hyperextension, with the tip of the olecranon as the pivot point.

Disease Susceptibility↗
PubMed1985

Serum half life of prostatic acid phosphatase.

Traumatic manipulation of the prostate can cause elevated prostatic acid phosphatase (PAP) values. To avoid falsely elevated PAP values after prostatic trauma we studied the serum half life of PAP and the time taken to return to preoperative levels in patients undergoing transurethral resection (TUR-P). Although we observed a broad variation in peak PAP values the half life of PAP is fairly constant at about 1.1-2.6 h. Preoperative values were reached within 30 h. We conclude that PAP determinations can safely be carried out 30 h after prostatic trauma without any risk of falsely elevated PAP values.

Acid Phosphatase↗
PubMed1984

Elevation of serum prostatic acid phosphatase levels after prostatic massage.

The effect of prostatic massage on the serum prostatic acid phosphatase (PAP) levels determined by radioimmunoassay (RIA) was studied in 29 patients with benign prostatic hyperplasia (BPH) and 7 patients with prostatic carcinoma (CA). Among the BPH patients, 77 per cent (P less than 0.001) showed an increase in post-massage PAP levels but only 3 (10%) showed an increase to more normal levels.

Acid Phosphatase↗
PubMed1983

Role of spleen in immune response to polyvalent pneumococcal vaccine.

The immune response of lymphocytes to subcutaneously administered pneumococcal vaccine was studied in five patients without spleens and in five healthy subjects. Seven days after immunisation circulating B cells synthesising IgG antipneumococcal capsular polysaccharides (anti-PCP) appeared in both groups. Twenty one days after vaccination this B cell population had disappeared and a B cell subset which secreted IgM and IgG anti-PCP in the presence of pokeweed mitogen was detected in the normal but not in the splenectomised subjects. In the splenectomised group polyclonal IgM synthesis induced by pokeweed mitogen was defective. It was concluded that the early events of the immune response to PCP may be mediated by lymph nodes but that, later, the spleen acquires a central role in producing lymphocyte subsets capable of synthesising specific antibodies and that this might explain the increased sensitivity of splenectomised subjects to pneumococcal infection.

Adult↗