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Biomedical subjects

U Haglund

Publications and source records attributed to U Haglund.

At least 145 records · Page 8Linked to original sources
PubMed1986

Neutropenia prevents decrease in strength of rat intestinal anastomosis: partial effect of oxygen free radical scavengers and allopurinol.

A marked decrease in strength, probably due to local collagenolysis, occurs early after surgery in tissues adjacent to an incisional wound. To examine the role of the neutrophils, antineutrophil serum (ANS) was given to rats before and after a standardized end-to-end ileoileal anastomosis. Preimmune serum (PIS) was given to control rats. The decrease in anastomotic breaking strength, amounting to 55% in the PIS group, did not occur in ANS-treated rats, in which there was a decrease by more than 95% in the number of circulating polymorphonuclear cells. The decrease in tissue strength seems to be partly from oxygen free radicals, since the free radical scavengers superoxygen dismutase (SOD) and catalase prevented approximately 50% of the decrease. The xanthine oxidase inhibitor, allopurinol, prevented approximately 30% of the decrease. This is consistent with oxygen free radicals being partly generated by the neutrophils and partly generated after conversion of tissue xanthine dehydrogenase to xanthine oxidase. In contrast to ANS, SOD and catalase were unable to fully prevent the decrease in breaking strength. Therefore some other factor in addition to oxygen free radicals should be involved. One such factor may be the release of collagenolytic proteinases, e.g., elastase and cathepsin G, from the neutrophils.

Allopurinol↗
PubMed1985

Villous adenomas in the duodenum.

Five patients with villous adenomas in the duodenum are described. In one patient malignant degeneration had occurred at the time of diagnosis. This patient was treated with a pancreaticoduodenal resection and is doing well 2 years postoperatively. The other four patients all had a duodenotomy and a local excision of the tumour. One patient had a recurrence with malignant degeneration within 1 year. The other three patients are doing well without signs of recurrence 1-4 years postoperatively. It is concluded that duodenal villous adenomas are potentially malignant. The strategy of surgical treatment is discussed.

Adenocarcinoma↗
PubMed1985

Early decrease in suture line breaking strength. The effect of proposed collagenase inhibition.

Rats were subjected to end-to-end intestinal anastomosis. Breaking strength with the sutures in place, i.e., suture-holding capacity, was measured in different groups immediately after suture and after 24 h. The synthetic kallikrein-plasmin inhibitor S-2441, the inhibitor of plasminogen activation tranexamic acid (Cyklokapron), and the metalloprotease inhibitor tiopronin (Thiola), were studied regarding their effect on breaking strength of the intestinal anastomoses. There was a marked decrease in breaking strength at 24 h in the controls. This decrease was diminished by all of the substances tested. Their effect was probably due to an inhibition of collagenase.

Animals↗
PubMed1985

Beneficial effect on intestinal anastomoses of S-2441, a synthetic kallikrein-kinin antagonist. Experimental studies in the rat.

The effects of two protease inhibitors on breaking strength of an intestinal anastomosis were studied. The inhibitors tested were aprotinin and S-2441, a synthetic triple-peptide kallikrein-kinin antagonist. Rats were subjected to an end-to-end anastomosis in the small intestine. The breaking strength, or suture-holding capacity, was measured immediately after suture and after 24 hours. The loss of mechanical strength found in untreated rats was substantially, but not fully, prevented by S-2441. Aprotinin in the dose given was not effective.

Animals↗
PubMed1985

Primary gastric lymphoma versus gastric cancer. An endoscopic and radiographic study of differential diagnostic possibilities.

Eighteen patients with primary gastric malignant lymphoma were compared retrospectively with an age- and sex-matched group of patients with gastric cancer. It was found that a correct preoperative diagnosis was established in 8 out of 18 lymphoma patients (44%). Of the remaining patients eight were preoperatively diagnosed as cancers and two as benign ulcers. Malignancy was not suggested by biopsy or cytology in a total of six lymphoma patients. There was no difference as regards the size of the gastric lesion between the groups. A diffuse involvement of the stomach was found only in lymphoma patients. Furthermore, lymphoma patients often showed superficial stellate ulcers and a sharp margin between the lesion and the normal mucosa. It is suggested that these findings should make the investigator aware of the possibility of a gastric lymphoma. When this diagnosis is considered, great importance should be attached to obtaining large biopsies which possibly allow a correct preoperative diagnosis more often.

Adult↗
PubMed1985

A technique for endoscopic balloon dilatation of pyloric stenoses.

A technique facilitating the endoscopic dilatation of pyloric stenoses due to peptic ulcer disease is described. By means of a Dormia basket placed in the 3rd part of the duodenum a guide wire is obtained with the aid of which the balloon catheter can be positioned. Four patients thus treated are described. Short-term follow-up has been uneventful.

Dilatation↗
PubMed1985

Plasma fibronectin in relation to surgical trauma.

Plasma concentrations of fibronectin, alpha 2-macroglobulin and orosomucoid were monitored immunochemically in 20 patients before, during and after surgery. At 2 h after the induction of anaesthesia fibronectin concentrations were lowered 31 +/- 6% (SEM) compared to values obtained 1-3 d preoperatively. However, the fibronectin concentration decreased 17 +/- 5% (SEM) compared to preoperative values at the beginning of surgery. Most of the decline was thus not caused by the operative trauma. The perioperative changes in fibronectin concentrations did not differ from those found in alpha 2-macroglobulin and, up to 2 h postoperatively, orosomucoid.

Fibronectins↗
PubMed1985

Gallstone disease following antrectomy and gastroduodenostomy with or without vagotomy.

The incidence and prevalence of gallstones has been documented in 289 consecutive patients with peptic ulcer disease, at the time of antrectomy and gastroduodenostomy (with or without truncal or selective vagotomy) and again during a 5-year follow-up period. By comparing the preoperative prevalence of gallstone disease in one age group with the prevalence 5 years after the gastric operation in another group of patients who were 5 years younger at the operation, the incidence of gallstone production due to the gastric operation could be calculated independent of the age factor. Within 5 years of the gastric operation, 18% of the patients who were normal at the time of operation produced gallstones. The incidence of new gallstones during the 5-year postgastrectomy follow-up was the same in men and women, and was increased by 7 to 15% in each age group of men. The incidence of new gallstones was 30% after truncal and 12% after selective vagotomy (p less than 0.05). Gallstone formation seems to be a sequel of Billroth I gastric resection. Truncal vagotomy in addition to the gastrectomy increases the risk of gallstone disease; patients with selective vagotomy and antrectomy had an incidence of postoperative gallstones which was the same as patients with antrectomy alone.

Adult↗
PubMed1985

Studies on the oxygen radical mechanism involved in the small intestinal reperfusion damage.

Characteristic mucosal lesions develop in the small intestine during ischaemia and hypotension. This tissue damage can be further aggravated in the immediate reperfusion phase, presumably secondary to the generation of oxygen free radicals which have been proposed to be generated in this situation through the hypoxanthine-xanthine oxidase system. This was further investigated in the cat small intestine using a standardized regional intestinal hypotension model in which the effects of allopurinol (a xanthine oxidase inhibitor) were compared to those of an exogenous supply of inosine. The grade of mucosal damage, the nucleotide levels, the concentrations of hypoxanthine, total and oxidized glutathione, and of conjugated dienes were measured in the intestinal tissue. The results indicate that oxygen radicals generated by xanthine oxidase are very important, but not the only significant factor in the small intestinal reperfusion damage.

Adenosine Diphosphate↗
PubMed1985

Gastric mucosal damage in sepsis--effects of pretreatment with a synthetic prostaglandin E1 analogue.

An experimental model was used which includes intragastric instillation of 80 mM HCl and 0.6 ml bile/kg followed by intravenous infusion of live E coli in cats for up to three hours. This procedure regularly induces gastric mucosal ulcerations. Mucosal blood flow was measured by microspheres before, early, and late in sepsis. Total gastric blood flow was recorded electromagnetically. Mucosal regeneration capacity as reflected by the RNA/DNA ratio was measured. Misoprostol (a PGE1 analogue) was infused iv (5 micrograms/kg X h) or given locally in the stomach (10 micrograms/kg) before bacteriemia. Misoprostol did not influence the haemodynamic response to bacteria. The gastric mucosal damage was assessed either as an index representative for the entire corpus-fundus region or as the number of areas with intact surface epithelium within the series. Misoprostol iv protected the mucosa from ulceration compared with untreated septic controls while misoprostol intragastrically significantly reduced the number of damaged areas only. Topical misoprostol increased total gastric and mucosal blood flows early in sepsis compared to iv or no pretreatment while no difference was seen during late sepsis. The protective effect of misoprostol was thus not dependent on increased gastric mucosal blood flow. Nor was it mediated through effects on mucosal nucleic acid concentrations or ratio.

Animals↗
PubMed1985

Influence of intraperitoneal Escherichia coli with septicemia on the healing of colonic anastomoses and skin wounds. An experimental study in the rat.

In rats a standardized left colonic resection was performed and colonic continuity restored by an end-to-end anastomosis in one layer. The rats were subjected to an LD50 septic challenge by intraperitoneal injection of live Escherichia coli pre- or postoperatively. Controls received saline in a corresponding manner. Groups of animals were sacrificed on the 3rd or 7th postoperative day. The breaking strengths of the anastomosis and of the skin wound were measured. The collagen content of the anastomotic segments was analyzed. There were no differences in anastomotic or skin wound strength between septic animals and controls. Collagen content was unaffected. Wound healing was not influenced by sepsis in this model.

Animals↗
PubMed1985

Peritonitis and septic shock--an evaluation of two experimental models in the rat.

Two different experimental models for inducing septic shock have been characterized. In one, septic shock was induced by intraperitoneal injection of live Escherichia coli bacteria. This resulted in a dose-dependent mortality. Those animals surviving the first 24 h are considered as permanent survivors. In the other models, septic shock and peritonitis was induced by ligation and needle punctures of the cecum. This resulted in a slower development of shock which was almost invariably lethal within 96 h. Arterial blood pressure remained within the normal range in both models for up to 3 h after inducing peritonitis. Then a rapid deterioration was noticed in animals injected with live E. coli. White blood cells and platelets in arterial blood were reduced compared to controls in both groups. This reduction was more pronounced in animals injected with live E. coli. Both models are considered as useful tools in further studies of the pathophysiology of peritonitis and septic shock.

Animals↗
PubMed1985

Acid secretion in isolated gastric glands from healthy subjects and ulcer patients.

Isolated human gastric glands provide an in vitro model that can yield significant information about the mechanisms regulating gastric acid secretion at the parietal cell level. Aminopyrine, a weak base that accumulates in acid compartments, has been used as an indirect probe of H+ secretion. By means of a microscale technique it was possible to isolate oxyntic glands from gastroscopic biopsy specimens and thereby enable studies of healthy subjects and non-operated ulcer patients. Histamine (5.4 X 10(-5) M) and db-cAMP (10(-3) M) both induced a pronounced response, whereas the response to carbachol (4.5 X 10(-6) M), although still statistically significant, was less potent. The response to stimuli was twice as high in duodenal ulcer patients as in normal individuals. In contrast, the response in patients with a gastric ulcer located either in the prepyloric region or at the minor curvature on the antrum-corpus border was of the same magnitude as in healthy subjects. Pentagastrin did not induce any response in isolated gastric glands from normal individuals. Gastric acid secretion in vitro, measured as aminopyrine accumulation, did not decrease with increasing age of the individuals.

Adult↗
PubMed1985

Histamine2-receptor antagonists in gastroduodenal ulcer haemorrhage.

This paper reviews randomised trials in which the effects of histamine2-receptor antagonists have been studied in gastroduodenal ulcer haemorrhage. There is a trend in these studies that histamine2-receptor antagonists may reduce the number of rebleedings, especially in elderly patients with gastric ulcers. A randomised trial comparing cimetidine and ranitidine in high risk patients with massive gastroduodenal haemorrhage is also presented. The total mortality in this study was 12%, 15% for gastric ulcer patients and 11% for duodenal ulcer patients. There was no difference in mortality, amount of blood transfusion required, rebleedings or need for emergency surgery between the two treatment models.

Aged↗
PubMed1985

Intestinal hemodynamic effects of dextran-induced hyperviscosity in the cat.

A hyperviscous state with red cell aggregation and increased plasma viscosity was induced in cats by intravenous infusion of high molecular weight dextran. A segment of the small intestine was isolated with intact vascular and nervous supply and placed in a plethysmograph for determination of the intestinal tissue volume and capillary filtration coefficient. The intestinal blood flow was measured by a drop recorder unit. Measurements of intestinal blood flow, flow resistance and capillary filtration coefficient were performed during normotension and regional hypotension before and after infusion of high molecular weight dextran. After infusion of high molecular weight dextran, there was a twofold increase of blood viscosity and a threefold increase of plasma viscosity. Erythrocyte sedimentation rate exceeded 100 mm/h. Intestinal blood flow decreased by 35% during normotension and by 45% during regional hypotension. Intestinal flow resistance increased by 45% during normotension and by 65% during hypotension. The capillary filtration coefficient was not affected by the dextran infusion. It is concluded that the intestinal hemodynamic effects of high molecular weight dextran are mainly dependent of the increased plasma viscosity and that the number of perfused capillaries is not reduced by obstructing red cell aggregates.

Animals↗
PubMed1985

Effect of high dose corticosteroids alone or combined with other drugs on survival in septic shock.

The effect of high dose corticosteroids on survival has been studied in a limited number of canine septic shock models which are reviewed in this presentation. Following injection of live bacteria neither methylprednisolone, nor gentamicin but a combination improved survival. Methylprednisolone increased survival following a slow but not a bolus infusion of endotoxin. In a recent study the effects of short term treatment with methylprednisolone, naloxone and ibuprofen were studied in endotoxin shock. All control animals died within 36 hours. Five of 9 dogs receiving the combination methylprednisolone, naloxone and ibuprofen were permanent survivors. The combined treatment with methylprednisolone and ibuprofen also increased survival. Dogs treated with methylprednisolone alone did not differ significantly from controls. It is concluded that methylprednisolone alone has no significant effect on survival in septic shock, but seems to be an important therapeutic factor to achieve increased survival.

Animals↗
PubMed1985

High doses of corticosteroids in the prevention of small intestinal mucosal damage in shock.

Experimental animals develop a characteristic mucosal damage in the small intestine following shock and hypotension. Similar lesions have also been described in man. The damage is caused by hypoxia and, in addition, proteolytic activities and generation of oxygen derived free radicals may be important. The small intestinal mucosal damage is associated with the development of cardiovascular collapse--hypotension induces mucosal lesions which, in turn aggravate the lesions. Among proposed mechanisms are portal invasion of bacteria and release of cardiotoxic material to the venous blood. Methylprednisolone in high doses (30 mg/kg) has been demonstrated to prevent or delay the development of mucosal lesions. This is probably not due to cardiovascular effects but rather to a stabilizing effect on cellular and subcellular membranes.

Adrenal Cortex Hormones↗