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Biomedical subjects

L E Gelin

Publications and source records attributed to L E Gelin.

At least 19 recordsLinked to original sources
PubMed1980

Septic shock.

Explore the source record for details and available documents.

Animals↗
PubMed1980

Active treatment of uremia in the city of Göteborg 1966-1977.

137 patients were actively treated because of chronic uremia, during 1966 to 1977 in the city of Göteborg. One year patient survival increased from 51% (1966 to 1968) to 81% (1975 to 1977). Peritoneal dialysis decreased as the initial mode of treatment, and only 3% of the patients started dialysis treatment with this mode of therapy in the last 3-year period. Mean age of the actively treated patients was 44 years. A decreasing mean age of the actively treated patients was found towards the end of the period, reflecting more liberal criteria for accepting young patients with different systemic diseases. If the initial mode of treatment was dialysis, 1-year patient survival in the last 3-year period was 77%.

Adult↗
PubMed1980

Pretreatment with blood transfusions in primary kidney transplantation.

Since 1977 a deliberate pretransplant transfusion protocol consisting of two units of leucocyte poor blood given minimum 6 weeks prior to transplantation was applied to earlier not transfused recipients of primary renal transplants in Gothenburg. Graft loss due to rejection at 6 months was 17% and 8% in cadaver and one shared HLA-haplotype living donor recipients, respectively. These results were very much superior to those earlier obtained in not transfused recipients in this centre. The risk of presensitization seemed low.

Blood Transfusion↗
PubMed1980

Steroids and rejection treatment in the Gothenburg transplant programme.

Our experience from the Gothenburg material indicates that the graft prognosis is highly dependent on pretransplant blood transfusions, to a lesser degree on avoidance of two mismatches for the HLA-B-locus and, not the least, on the use of methylprednisolone antirejection therapy. It seems that a rather moderate dosage of methylprednisolone allows us to prolong and repeat the courses according to individual needs, and this may be the main reason for the significantly improved graft function at one year. The experiences gained and the lessons learned from the transplant programme in Gothenburg have resulted in 70% of the uraemic patients in the Gothenburg region being alive with functioning renal transplants.

Antilymphocyte Serum↗
PubMed1980

Outcome of repeated renal regrafting.

Fifteen patients underwent renal transplantation 4 and in one case 5 times. 7/15 grafts (47%) survived more than one year. The one year graft loss due to rejection was 40%. Seven patients are currently alive -- five with excellent graft function and optimal rehabilitation. Two patients are back and well on dialysis. Standard operation technique worked well in all cases. In our opinion repeated renal regrafting is a well worthwhile procedure.

Adult↗
PubMed1980

Skeletal muscle microcirculation and oxygenation in experimental intestinal shock: A study on the efficacy of different plasma substitutes.

Shock was induced in 60 dogs by exteriorization of the small intestine for three hours. The relative effectiveness of various hemodiluting agents on the microcirculation was measured as skeletal muscle capillary blood flow (QXe) and capillary permeability (P) surface area (S) for plasma (PSp), as calculated from the clearances of two locally injected isotopes, 133 Xenon and 131 Iodide. Skeletal muscle oxygen tension (Pm(2) was measured with a tissue PO2 electrode. During shock QZe decreased to 26%, PSp to 31% of the initial values, and PmO2 dropped from 51 to 18 mmHg. The degree of recovery from shock was assessed after reposition of the intestine and the infusion of different plasma substitutes (albumin, dextran 40, dextran 70, gelatin, ACD-plasma, and Ringer's acetate). Return of the intestine to the abdominal cavity did not in itself improve the shock condition. Dextran 40 and dextran 70 infusion increased QXe, PSp, and PmO2 to or above control levels, PSp to 60%, and QXe to 40% of the control values. Ringer's acetate gelatin, and ACD-plasma did not improve QXe but increased PSq to 62-67% of control values. Albumin and dextran increased PmO2 significantly in relation to no-fluid infusion. Only dextran 40 and dextran 70 increased both QXe and PSp significantly in relation to no -fluid infusion.

Anesthesia↗
PubMed1979

Oxygen consumption and recovery from surgical shock in rats: a comparison of the efficacy of different plasma substitutes.

Shock was induced in 537 rats by exteriorization of the intestines and occlusion of the superior mesenteric circulation for 1 hour. After 1 hour of this intestinal ischemia shock, oxygen consumption (VO2) decreased to half of the preexperimental values. When no infusion was given, the survival rate at 24 hours was 22%; this was correlated with the degree of restoration of VO2 at 1 hour after shock. VO2 and survival rate improved with infusion of albumin, dextran 40, and dextran 40, and dextran 70. With increasing doses of colloids, both VO2 and survival rate increased; the optimal effect was at the dose of 2 g/kg body weight. When no other therapy was given, colloids at concentrations of 3.5 or 6% solutions had a better effect on survival than the 10% solution. Colloids were more effective than Ringer's acetate when the latter was given in the same volume and up to three times the volume of the colloids.

Animals↗
PubMed1979

Successful kidney transplantation in a man with Dacron "trouser" prosthesis.

The case history of a male patient, 62 years old, in preterminal uremia at transplantation with a cadaveric kidney is described. Twelve years before the transplantation he was operated on because of an aortic aneurysm where the abdominal aorta and both iliac arteries were substituted with a Dacron prosthesis. The kidney was anastomosed to this vessel substitute and functioned excellently for more than five years and the patient was completely rehabilitated.

Aorta, Abdominal↗
PubMed1979

The general and local response to injury related to complement activation.

Injury can activate the complement system as well in vivo as in vitro. This activation might contribute to some of the phenomena seen after large injuries. Such general effects as fall in blood pressure, impaired ability to oxygenate blood and local effects such as accumulation of granulocytes and oedema formation might be influenced by complement activity. The in vitro experiments indicated an alternative pathway activation of whole complement by injured tissue or endotoxin.

Animals↗
PubMed1979

Hemodilution and oxygen transport to tissue in shock.

Shock was induced in sixty dogs by laparotomy, splenectomy and exteriorization of the small intestine for three hours. Resuscitation following different plasma substitutes was assessed by measuring hemodynamic parameters (mean arterial blood pressure, plasma volume, oxygen consumption, cardiac output and hematocrit). To justify a comparison, the colloids (albumin, ACD-plasma, dextran 40, dextran 70, gelatine) were given at the same concentration and dose (3.5 % solutions in saline at a dose of 1.5 g/kg or 43 ml/kg). Ringer's acetate was given in a three times larger volume (129 ml/kg). After reposition of the intestine, the infusion was given over a 20 minute period. During shock hemoconcentration developed, increasing from 50 to 59 % in hematocrit; mean arterial blood pressure dropped from 144 to 95 mm Hg; plasma volume decreased to 67 %; total body oxygen consumption decreased to 59 % and cardiac output to 21 % of initial values. Reposition of the intestine did not in itself improve these values. Ringer's acetate was effective up to about 30 minutes after infusion but did not differ from no infusion at four hours. Gelatine and ACD-Plasma had a similar effect up to two hours. Albumin, dextran 40 and dextran 70 increased and maintained plasma volume and oxygen consumption at preexperimental levels for up to at least four hours. It is concluded that a single infusion of albumin, dextran 40 or dextran 70 is superior to ACD-plasma gelatine or Ringer's acetate in restoring and maintaining oxygen consumption and hemodynamic functions, when given in comparable doses and volumes.

Animals↗