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T Skau

Publications and source records attributed to T Skau.

34 records · Page 2Linked to original sources
PubMed1990

Host defence and bacterial growth in fosfomycin-treated peritonitis. Experimental observations in pigs.

An approximately steady state of bacterial density intraperitoneally has been observed in bacterial peritonitis. This state, which follows an initial (0-4 h) phase of rapid elimination of bacteria, was now studied in a model of porcine peritonitis. Twelve pigs were intra-abdominally infected with 10(10) CFU each of Escherichia coli and Bacteroides fragilis. Six of the pigs received no antibiotic and six were given two doses of fosfomycin (anti-aerobic), 1 g i.v., with the aim of disturbing possible equilibrium between rapid proliferation and destruction of the sensitive E. coli. Levels of fosfomycin up to 90 times the minimum inhibitory concentration (1 mg/l) were detected in the peritoneal exudate, but the antibiotic had no discernible effect on E. coli density or elimination pattern compared with B. fragilis in the same pig or with observations in controls. The results favoured the concept of slow-replicating E. coli and hence declining activity of the defence mechanisms a few hours after the induction of peritonitis.

Animals↗
PubMed1988

Isolated aneurysms of the iliac artery: what are the chances of rupture?

Sixteen patients with 22 isolated aneurysms of the common or external iliac artery were treated between 1974 and 1986. There were ten men and six women with a median age of 69 years. The aneurysm was discovered incidentally in seven patients; and in nine patients it was diagnosed upon rupture. A pulsating abdominal tumour was palpable in 12 patients seven of whom had a ruptured aneurysm. Common symptoms included urological and neurological problems and abdominal pain. Of the seven patients in whom the diagnosis was confirmed prior to rupture, three were operated upon successfully and four were not. Of the latter, two died within 3 months due to coexisting disease while two remain alive after one and 6 years. Of the nine patients with a ruptured aneurysm only four survived. The high risk of rupture justifies elective operation of an aneurysm of the iliac artery in the majority of cases.

Adult↗
PubMed1986

The kinetics of peritoneal clearance of Escherichia coli and Bacteroides fragilis and participating defense mechanisms.

In a study using pigs, we delineated the dynamic character and the interplay of defense mechanisms that operate in the peritoneal cavity and their effectiveness against Escherichia coli and Bacteroides fragilis. The bacteria were extensively cleared during the first three hours. The concentration of both organisms in the peritoneal fluid decreased by up to 300,000-fold, and the final concentration was a function of the inoculum given. Clearance efficiency did not differ between a bolus dose and prolonged bacterial administration. Peritoneal absorption was a major eliminating mechanism during the first three hours but was limited to bacterial concentrations exceeding approximately 10(9) colony-forming units per milliliter of peritoneal fluid. Intraperitoneal elimination started immediately and continued for approximately six hours. Thereafter, residual bacteria were not eliminated, even though the defense capacity was intact. Prolonged bacterial administration, however, protracted the period for active bacterial destruction.

Animals↗
PubMed1986

Bacterial clearance and granulocyte response in experimental peritonitis.

Clearance kinetics of Escherichia coli and Bacteroides fragilis from the peritoneal cavity and functional properties of peritoneal and blood polymorphonuclear leukocytes (PMNL) were studied in pigs. The bacteria, approximately 10(10) colony forming units (CFU) of each species, were intraperitoneally injected. Blood and peritoneal exudate were sampled regularly during 24 hr for bacterial quantification and PMNL analysis. The peritoneal concentration of both species fell rapidly in the first 3 hr and then stabilized. Approximately 10(2) CFU/ml remained after 24 hr. Chemotaxis, phagocytosis, and metabolic activation of the peritoneal PMNL showed little change. In some pigs a second bacterial dose was injected 6 hr after the first dose and gave an identical clearance pattern. Exhaustion of the local defence capacity thus was excluded as cause of the impaired bacterial elimination.

Animals↗
PubMed1986

Spontaneous peritonitis and rheumatoid arthritis--a case report.

An unusual case in which an adult patient with rheumatoid arthritis developed a fulminant spontaneous gram-positive bacterial peritonitis and underwent emergency laparotomy for this condition is presented. Spontaneous peritonitis in adult patients was previously seen only in patients with liver disease, nephrotic syndrome or systemic lupus erythematosus.

Arthritis, Rheumatoid↗
PubMed1985

Severity of illness in intra-abdominal infection. A comparison of two indexes.

The severity of illness in 58 surgical patients with high-grade intra-abdominal infection was measured with two methods, an acute physiology score and a septic severity score. Both methods are the summed weight of derangements in physiologic factors representing the function of the major organ systems of the body. Sixteen patients died (28%). Score values with both methods were significantly higher for nonsurvivors than for survivors. There was good interrelation between the methods, and the scores correlated better with mortality than did age, chronic disease, anatomy, or cause. Three risk levels were recognized, low, high, and intermediate, with respective mortality rates of less than 10%, greater than 80%, and approximately 45%. Three-fourths of the patients were assigned to the same risk group with both methods. The severity of illness in patients with intra-abdominal infection can suitably be measured with both methods.

Adolescent↗
PubMed1985

Microbiologic progression of post-traumatic peritonitis.

The natural course of post-traumatic peritonitis was studied in 17 pigs. Following a standardized missile wound to the abdomen the pigs were operated on and observed in continuous anesthesia for periods up to 3 days. Bacterial density was measured in peritoneal exudate, parietal peritoneum, laparotomy wound, and projectile entrance and exit wounds at this operation and also at relaparotomy, which terminated the experiments. The bacterial density showed significant perioperative fall, averaging X 1,905 in peritoneal exudate and X 40 in parietal peritoneum. From a low postoperative level (mean c. 10(2)/ml or /gm), bacterial density increased significantly in the observation period. In peritoneal exudate the increase was X 4,073 and in peritoneum X 2,630. In laparotomy and projectile entrance and exit wounds the corresponding figures were X 234, X 126, and X 15. The bacterial population's perioperative reduction and subsequent proliferation were interpreted as reflecting the host defense, which accordingly was limited in capacity and duration.

Abdominal Injuries↗
PubMed1984

Intra-operative irrigation of the peritoneal cavity with ampicillin in experimental posttraumatic peritonitis.

Penetrating abdominal wounds with injury to the intestines were inflicted on 24 anaesthetized pigs. The injured gut was resected. During this operation the peritoneal cavity in 9 pigs was irrigated with 3 litres of antibiotic solution (ampicillin 2 g/l). In 15 pigs the irrigation was done with 3 litres of saline solution only. During the postoperative observation period the animals were in continuous anaesthesia. Absorption of ampicillin, reduction of the peritoneal bacterial flora and emergence of resistant strains were evaluated. Ampicillin was rapidly absorbed to the systemic circulation, with an average peak concentration of 42.4 +/- 1.7 mg/l. The average half-life of the drug in serum was 54 +/- 4 min. The average density of the total aerobic flora decreased during the operation from 10(4.74) CFU/ml peritoneal exudate fo 10(1.20) CFU/ml, but increased to 10(5.16) CFU/ml during the posttraumatic observation period. Total anaerobic counts changed to similar extent. The results were not significantly different from the values in the saline-irrigation group. Ampicillin irrigation led to a significant increase of resistant strains, from 25% before irrigation to 97% at the end of the observation period.

Abdominal Injuries↗
PubMed1983

Epithelioid sarcoma in the hand.

An illustrative case of epithelioid sarcoma in the hand of a young man, causing considerable diagnostic problems, is presented. Epithelioid sarcoma is a malignant lesion, first described by Enzinger in 1970. Although epithelioid sarcoma is the third commonest soft tissue sarcoma in the upper extremity (Bryan, 1974) it still causes confusion in differential diagnosis, both to the surgeon and to the pathologist. Because of its deceptively harmless appearance during the initial period and its clinical and microscopical similarity to an inflammatory process, it is often mistaken for a benign lesion. The purpose of our paper is to draw attention to this rare malignant tumour. This case illustrates a course similar to those described previously. (Enzinger, 1970: Santiago, 1972).

Adolescent↗
PubMed1983

Elimination patterns of Escherichia coli and bacteroides fragilis from the peritoneal cavity. Studies with experimental peritonitis in pigs.

An animal model for study of bacterial elimination from the peritoneal cavity is presented. Using Escherichia coli and Bacteroides fragilis as infecting agents, two elimination patterns emerged. The patterns were related to the surface properties of the micro-organisms. The concentration of both species was greatly reduced within 2 to 4 hours after peritoneal contamination with 10(10) CFU. The elimination of B. fragilis was contemporaneous with mobilization of granulocytes into the peritoneal cavity, and was probably attributable to bactericidal action of the granulocytes. Most of the E. coli inoculum, however, was cleared before the granulocyte mobilization. Cell-free peritoneal fluid was found to have a bactericidal effect against a rough strain of E. coli, but not against a smooth strain, as demonstrated in vitro. This effect was inhibited by pretreatment of the peritoneal fluid with EDTA, EGTA or heat, which suggested that the alternate pathway of the complement system was involved. In vivo the rough strain of E. coli was rapidly eliminated, while elimination of the smooth strain followed the B. fragilis pattern. It is concluded that bacterial surface properties are important in bacterial peritonitis.

Animals↗
PubMedDate not supplied

Effect of buflomedil on cell metabolism in ischemic muscle.

The effect of Buflomedil on cell metabolism in ischemic muscle was studied in pigs. Six pigs received Buflomedil 6 mg per kg intravenously 30 minutes prior to induction of total leg ischemia, whereas 6 control animals were not premedicated. Arterial and venous blood samples and muscle specimens from the ischemic leg were collected prior to ischemia, after 5 hours of ischemia, and after 10 minutes and 30 minutes of reperfusion of the leg, and analysed for metabolic parameters. Similar decreases in local venous pH and PO2 indicated comparable and severe leg ischemia in both groups. Similar increases in venous and arterial concentrations of potassium and creatine kinase indicated a comparable degree of cell damage in the two groups. The ischemic muscle specimens in the Buflomedil group contained significantly higher phosphocreatine (PC) levels (p less than 0.01) and significantly lower lactate levels (p less than 0.01) than did the control group, whereas ATP levels were comparable in the two groups. We conclude that Buflomedil reduces PC-conversion, glucolytic activity and energy demands of the ischemic cell.

Adenosine Triphosphate↗
PubMedDate not supplied

Digital subtraction angiography versus standard contrast arteriography in evaluation of peripheral vascular disease.

Fifteen patients with lower limb ischemic disease were preoperatively assessed with both intravenous or intra-arterial digital subtraction angiography (DSA), and standard contrast angiography (SCA). The images were reviewed and the operative strategies, based on the clinical data and each of SCA and DSA, were compared. SCA provided more information than DSA in two patients, one of which had an incomplete DSA investigation. DSA provided more information than SCA in three patients. The distal crural vessels were better visualized with DSA in one patient, and popliteal lesions were demonstrated as being more severe using DSA than with SCA in two patients. The level of the distal anastomosis of the proposed bypass was lowered to below the knee as a result of DSA in these two patients. We conclude that comparable information is obtained using SCA or DSA, and that DSA, in particular the intraarterial technique, is a satisfactory alternative to SCA in preoperative evaluation of patients with lower limb ischemic disease.

Aged↗