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Biomedical subjects

S E Bergentz

Publications and source records attributed to S E Bergentz.

At least 19 recordsLinked to original sources
PubMed1979

Effect of dextran on factor VIII (antihemophilic factor) and platelet function.

Three different properties of factor VIII (antihemophilic globulin) were studied after infusion of 500 ml of six per cent Dextran 70 to healthy volunteers. This dose caused no change in the factor VIII coagulant activity while there was a significant but temporary decrease of factor VIII related antigen. The Ristocetin induced platelet aggregation analysed with native as well as with formalin-fixed platelets, also decreased significantly. The maximal decrease was found a few hours after the infusion. The decrease was seen only if Dextran was infused in vivo and not if Dextran was added to blood in vitro. The dysfunction of factor VIII caused by Dextran resembles that found in one variant of von Willebrand's disease. This finding probably explains the platelet function inhibiting properties of Dextran, and may be of significance for its antithrombotic effects.

Adolescent↗
PubMed1979

Surgery in von Willebrand's disease.

Fifty-eight major surgical procedures were performed in 38 patients with von Willebrand's disease (VWD), one of the most common of the inheritable hemorrhagic disorders. Specific treatment with fraction I-0, (AHF-Kabi) in addition to a fibrinolytic inhibitor, was given to all patients. The effect of the treatment was checked by measuring the Duke bleeding time and factor VIII:C level. A marked difference between hemophilia and VWD from a surgical point of view is demonstrated. While most of the surgery in hemophiliacs is performed for severe joint deformities, contractures and blood cysts, surgery in VWD is mostly general surgery, often necessitated by massive hemorrhages from mucous membranes.

Adolescent↗
PubMed1979

The effect of dextran on the platelet distribution and lysability of ex vivo thrombi in dogs.

Dextran infusion causes an increased lysability of ex vivo thrombi. This increased lysability is shown to be accompanied by a change in the distribution of 51Cr-labelled platelets. Rather than being localized to the head of the thrombus, after dextran infusion the platelets are found to be more evenly distributed. This change in platelet distribution is secondary to an effect of dextran on platelet function, probably via previously demonstrated impairment of the function of factor VIII. It is suggested that the increase in thrombus lysability is due to the change in platelet function.

Animals↗
PubMed1979

Unilateral renal artery stenosis and hypertension. II. Angiographic findings correlated with blood pressure response after surgery.

The findings at preoperative nephroangiography of 42 hypertensive patients with unilateral renal artery stenosis or occlusion were correlated with the blood pressure response following surgery and also with the preoperative renal vein renin activity ratio. A stenosis reducing luminal area by at least 90 per cent (or occlusion) and the presence of collateral circulation are considered to be highly suggestive of renovascular hypertension.

Adolescent↗
PubMed1979

Technique and complications in the surgical treatment of renovascular hypertension.

147 operations for renovascular hypertension were performed in 125 patients. 136 of the operations were vascular reconstructions. Aortorenal by-pass, using saphenous vein as a graft, was found to be a satisfactory technique. An aneurysmatic dilatation developed twice, which on both occasions was attributed to a stenosis proximal to the graft. Two failures also occurred among the 12 patients undergoing renal autotransplantation, both due to an illiac vein thrombosis, obstructing the renal vein. The majority of the six deaths were due to myocardial infarctions or uremia. They all occurred in the eldest patients (older than 59 years) and in patients suffering from complicating cardiac or renal disease. The results with regard to blood pressure were very good in fibrous dysplasia and in atherosclerosis affecting only one side. Operative treatment can therefore be recommended to these groups of patients even in relatively mild hypertension. The indication to operate should be restricted in elderly patients suffering from cardiac and renal complicating diseases, and in patients with bilateral atherosclerotic stenosis.

Adolescent↗
PubMed1979

Bilateral renal artery stenosis/occlusion and renovascular hypertension. Correlation of angiographic findings with blood pressure response after surgery.

In a previous study of unilateral renal artery stenosis the angiograms of patients with a favourable blood pressure response after surgery were found to be characterized by a reduction of renal arterial lumen greater than or equal to 90% and/or renal collateral circulation. Ancillary features were post-stenotic dilatation and a reduction of kidney length greater than or equal to 1 cm (Andersson; Andersson, Bergentz, Dymling, Ericsson, Hansson & Hökfelt). This report deals with 32 patients with bilateral renal artery stenosis who were followed 6--54 months after operation. The preoperative angiograms were analysed retrospectively without knowledge of the blood pressure response. In patients with bilateral fibromuscular dysplasia a good correlation was found between the above-mentioned criteria and a favourable blood pressure respone. In patients with bilateral arteriosclerotic stenosis no correlation was found. It was concluded that renal angiography constitutes a valuable predictive test in bilateral non-arteriosclerotic stenosis. In the presence of bilateral arteriosclerotic stenosis the selection of patients for surgery should be based on other parameters such as kidney function, age and general vascular status of the patient.

Adult↗
PubMed1978

Combination of fibromuscular hyperplasia, renal aplasia, hypoplasia or dysplasia and otosclerosis occurring in the same individual or the same family.

We have found 3 reports of fibromuscular hyperplasia (FMH) of the renal arteries with hypertension occurring in 2 siblings as well as a few instances of renal agenesis and unilateral renal aplasia occurring in the same family. In this paper we report on FMH of the renal arteries in 2 women, one giving birth to a child with renal agenesis, the other to a child with a focally dysplastic hypoplasia of the kidneys. A third family is reported, heavily loaded with hypertension and otosclerosis, in which 2 siblings with FMH and otosclerosis were found. Another 4 patients without known heredity for hypertension, but with FMH combined with renal or urinary tract anomalies, are also reported. The findings are discussed, particularly in relation to the findings in a large material of chronic non-obstructive pyelonephritis, where in those with well maintained renal function, hypertension below the age of 40 was found predominantly in females with a positive family history of hypertension and signs highly suggestive of infected hypoplasia or dysplasia of the kidney.

Abnormalities, Multiple↗
PubMed1978

Role of platelets and lymphocytes for the hemodynamic effects of rapidly injected antilymphocyte globulin.

Xenogenic antilymphocyte globulin (ALG) given as a rapid intravenous injection into dogs caused a significant decrease in arterial blood pressure and oxygenation as well as an increase in portal pressure. At the same time, there was an almost complete elimination of lymphocytes and an extensive but almost completely reversible thrombocytopenia. Lymphocytopenia induced by a previous injection of ALG was found to eliminate completely the circulatory response to a second injection of ALG in spite of the fact that an extensive thrombocytopenia was induced. Extensive thrombocytopenia induced by injection of an antiplatelet globulin was also found to prevent completely the hemodynamic effects of ALG although as many lymphocytes were eliminated as in the intact dogs. Thus both platelets and lymphocytes are necessary to trigger the circulatory response induced by ALG.

Anaphylaxis↗
PubMed1978

[Surgery in haemophilic patients (author's transl)].

This paper deals with a total of 108 major surgical procedures in haemophilic patients of type A or type B, performed during the last 20 years. The principles of adequate substitution therapy are described, as well as the indications for surgery and the surgical technique. The importance of prolonged postoperative substitution therapy to avoid late haemorrhage and haematoma formation, is stressed. By combining substitution therapy with immuno-suppresive measures, it is also possible to operate on patients with inhibitors against factor VIII or IX. It is concluded that major surgery can be carried out even in severe haemophilia without significantly increased risk.

Age Factors↗
PubMed1977

Surgery of hemophiliacs--20 years' experience.

Seventy-seven hemophilic patients of type A or type B were subjected to a total of 108 major surgical procedures mainly in the field of general surgery, orthopedic surgery, or neurosurgery. The principles for the substitution therapy in the different types of procedures and different types of hemophilic diseases are described, as well as the indications for surgery and the surgical technique. The importance of prolonged substitution therapy postoperatively to avoid late hematoma, particularly in patients with severe hemophilia undergoing major surgery, is stressed. With this type of management there has been no increased intraoperative hemorrhage, and very few cases of late hematoma formation. By combining the substitution therapy with immunosuppression, it has been possible to operate also on patients with inhibitors against factor VIII or IX. The rate of complications, particularly the incidence of hepatitis, has been low with the type of substitution given in this series of patients. It is concluded that major surgery can be carried out even in severe hemophilia without significantly increased risk. The handling of the substitution therapy, and the surgical judgment and technique, offers however, special problems, necessitating centralization of elective cases.

Adolescent↗