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Evaluation of propranolol for prevention of recurrent bleeding from esophageal varices between sclerotherapy sessions. 心得安预防硬化治疗期间食道静脉曲张复发性出血的疗效评价。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
L Lundell, R Leth, T Lind, H Lönroth, M Sjövall, L Olbe
{"title":"Evaluation of propranolol for prevention of recurrent bleeding from esophageal varices between sclerotherapy sessions.","authors":"L Lundell,&nbsp;R Leth,&nbsp;T Lind,&nbsp;H Lönroth,&nbsp;M Sjövall,&nbsp;L Olbe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Forty-one patients admitted with first episode of bleeding from esophageal varices were enrolled in a trial of the efficacy of oral propranolol to prevent rebleeding during the course of endoscopic sclerotherapy until obliteration. Single-blind randomization to sclerotherapy alone or with propranolol was used. At monthly endoscopy the varices were injected with 1% Aethoxysclerol until obliteration. If bleeding recurred, additional sclerotherapy was given. There was no intergroup difference in time to eradication of varices (8.1 vs. 7.7 months). The cumulative number of bleedings from varices and from distal esophageal ulcerations was identical in the two study groups. Five patients in the control group but only one in the propranolol group died of bleeding in the study period, a difference of only borderline significance (chi 2 = 4.08, df = 1). There were no specific side effects of propranolol. Thus propranolol did not significantly reduce the frequency of rebleeding until variceal obliteration, but could have had some influence on the gravity of rebleeding.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Vocal cord paralysis caused by a cyst in extraglandular thyroid tissue. Case report. 由甲状腺腺外组织囊肿引起的声带麻痹。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
M J Hippeläinen, H E Tulla, A V Seppä, E M Alhava
{"title":"Vocal cord paralysis caused by a cyst in extraglandular thyroid tissue. Case report.","authors":"M J Hippeläinen,&nbsp;H E Tulla,&nbsp;A V Seppä,&nbsp;E M Alhava","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 37-year-old woman presented with hoarseness two days after developing pain while undergoing physiotherapy for tension in her neck. Computed tomography showed a probably benign mass near to the left lobe of the thyroid, which was found at operation to be attached to the recurrent laryngeal nerve. The nerve was dissected free, the tumour removed, and the patient and her voice recovered fully. Histological examination confirmed a benign cyst in extraglandular thyroid tissue and the patient is well two years later.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endotoxin, epinephrine, glucagon, insulin and calcium ionophore A23187 modulation of pyruvate kinase activity in cultured rat hepatocytes. 内毒素、肾上腺素、胰高血糖素、胰岛素和钙离子载体A23187对培养大鼠肝细胞丙酮酸激酶活性的调节。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
J Alston-Smith, O Ljungqvist, P O Boija, J Ware, K N Ekdahl
{"title":"Endotoxin, epinephrine, glucagon, insulin and calcium ionophore A23187 modulation of pyruvate kinase activity in cultured rat hepatocytes.","authors":"J Alston-Smith,&nbsp;O Ljungqvist,&nbsp;P O Boija,&nbsp;J Ware,&nbsp;K N Ekdahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Altered glucose metabolism is one of the commonly observed sequelae of sepsis and septic shock. The present investigation was undertaken to determine the role of endotoxin (ET) upon hepatocyte glucoregulation, by measuring the activity of pyruvate kinase (PK), a key glycolytic enzyme. Hepatocytes were exposed to endotoxin concentrations known to occur in vivo during sepsis, i.e., from 1 X 10(-14) to 1 X 10(-8) g/ml. The alteration of the enzyme activities after addition of epinephrine, glucagon, insulin and calcium ionophore A23187 with and without ET preincubation were also examined. ET alone decreased the PK activity by 12% at all concentrations tested. The basal inhibition of the enzyme caused by epinephrine (-48%) was partially blocked by ET preincubation above 1 X 10(-10) g/ml. There were no ET-(glucagon, calcium ionophore, insulin) interaction. These in vitro results do not support pyruvate kinase as a site of hepatic enzyme regulation defect in endotoxaemia.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anal spinchter reconstruction. Surgical results and functional outcome. 肛门括约肌重建。手术结果和功能结果。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
P Luukkonen, H J Järvinen
{"title":"Anal spinchter reconstruction. Surgical results and functional outcome.","authors":"P Luukkonen,&nbsp;H J Järvinen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Direct repair of anal sphincter injuries was undertaken in seven patients, three men and four women. Obstetrical tears were the cause of injury in all the female patients; surgical trauma, road traffic accident, and sexual assault caused the injuries to the men. Temporary covering colostomies were fashioned for six patients either before, or at the time of, the repair. There were no major complications associated either with the repairs or with the colostomy closures. The degree of incontinence was reduced in all patients, but only two became completely continent after the operation. The change in anal sphincter pressures was not significant. Postanal repair was subsequently undertaken for one woman, but all the other patients were satisfied with their repairs. We conclude that direct sphincter repair should be the treatment of choice for patients with major injury to the anal sphinchter.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraabdominal abscess formation after major liver resection. 肝大部切除后腹内脓肿形成。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
R Andersson, A Saarela, K G Tranberg, S Bengmark
{"title":"Intraabdominal abscess formation after major liver resection.","authors":"R Andersson,&nbsp;A Saarela,&nbsp;K G Tranberg,&nbsp;S Bengmark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A series of 138 major liver resections undertaken between 1971 and 1987 were reviewed. Intrabdominal abscesses developed in 11 (8%) patients, a mean of 23 days (range 10-42) after operation and two died (mortality 18%). Eight developed after 63 right hepatectomies, two after 24 right lobectomies, one after 34 left hepatectomies and none after left lobectomies (17). Patients who developed intra-abdominal abscesses underwent significantly longer operations (mean (SEM) 400 (48) compared with 275 (21) min) (p less than 0.05) and had significantly more bleeding during the operation (7,600 (1,750) compared with 3,200 (430), p less than 0.01) than those who did not. The amounts recovered from the abdominal drains, both before and after the diagnosis, were comparatively greater in patients with abdominal abscesses. Antibiotic prophylaxis was given to 10 of 11 patients who did and 89 of 127 patients who did not, form abscesses. We conclude that the risk of intra-abdominal abscess formation after major liver resection is increased: when a large amount of liver tissue is removed (right hepatectomy or lobectomy); when there is a lot of intraoperative bleeding; and when the operation takes a long time. Antibiotic prophylaxis did not affect the risk of abscess formation this series.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electrostimulation of healing abdominal incisional hernias by low frequency, bipolar, symmetrical rectangular pulses. An experimental study. 低频双极对称矩形脉冲电刺激愈合腹部切口疝。一项实验性研究。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
A Franke, R Reding, D Tessmann
{"title":"Electrostimulation of healing abdominal incisional hernias by low frequency, bipolar, symmetrical rectangular pulses. An experimental study.","authors":"A Franke,&nbsp;R Reding,&nbsp;D Tessmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A total of 107 male Wistar rats had abdominal hernias repaired (3 weeks after they had been artificially induced) by a two layer closure of the abdominal wall--the Mayo technique. The wounds of 56 rats were subjected to constant stimulation by an electric flow field. An implanted stimulation unit provided a low frequency (0.87 Hz), bipolar, symmetrical rectangular pulsed current (+/- 25 microA). A control group were given units that did not transmit current. In 39 of the 51 animals in the control group the muscle margins of the abdominal scars separated by between 1 and 5 mm. The scars of the electrostimulated animals were distinguished histologically by early formation of fibroblasts and deposition of collagen and the rapid maturation and longitudinal alignment of the collagen fibres. 46 of 56 of these scars were not separated. This technique may have a clinical application as adjuvant treatment for relapses of incisional hernias.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13301879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs. 静脉输注钙逆转致死性柠檬酸中毒。猪的实验研究。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
C Vagianos, S Steen, P Masson, T Fåhraeus, T Sjöberg, J Kugelberg, J O Solem
{"title":"Reversal of lethal citrate intoxication by intravenous infusion of calcium. An experimental study in pigs.","authors":"C Vagianos,&nbsp;S Steen,&nbsp;P Masson,&nbsp;T Fåhraeus,&nbsp;T Sjöberg,&nbsp;J Kugelberg,&nbsp;J O Solem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Intravenous infusions of 750 and 1000 ml 2.2% sodium citrate were given over a 60 min period to 17 pigs to study its effect on aortic pressure, electrocardiogram, ionised calcium, and citrate clearance. In group 1 (seven pigs) the animals did not receive calcium and the median survival time was 30 min (range 20-70 min). In groups 2 and 3 (five in each group) the pigs were treated with calcium chloride infusions (1 ml 10% calcium chloride to 10 ml citrate) and they all survived. In group 1 the ionised calcium concentrations in blood fell to values below 0.4 mmol/l, after which the blood pressure dropped abruptly. In the animals treated with calcium the mean ionised calcium concentration fell to 0.6 mmol/l, whereas total calcium increased to more than 7 mmol/l. The aortic pressure was consistently within normal values in the groups treated with calcium, but in the group that was not treated the blood pressure fell dramatically. There was no correlation between electrocardiographic changes and ionised calcium concentrations. In summary, calcium was an effective antidote to lethal citrate intoxication, and the only reliable method of determining the necessary dose of calcium was monitoring of ionised calcium concentrations.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of zinc deficiency on breaking strength of 3-week-old skin incisions in the rat. 缺锌对大鼠3周龄皮肤切口断裂强度的影响。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
M S Agren, L Franzén
{"title":"Influence of zinc deficiency on breaking strength of 3-week-old skin incisions in the rat.","authors":"M S Agren,&nbsp;L Franzén","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The effect of dietary zinc deficiency on the breaking strength of abdominal skin incisions was studied in rats 21 days postoperatively. Zinc deficiency was induced with a low-zinc diet (1.4 mg zinc/kg diet) 14 days preoperatively. Thereafter serum zinc was reduced by 60%, but the zinc concentration in unwounded skin and liver remained similar to that of pair-fed controls given a zinc-adequate diet (33 mg zinc/kg). The wound breaking strength (maximal load until wound disruption) was significantly lower in the zinc-deficient group (75% that of control wounds). The zinc concentration in wound tissue had decreased in the zinc-deficient group, but the wound hydroxyproline concentration was similar in the two groups. The results indicate that zinc is an important trace element during the early remodeling of scar tissue.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary closure or secondary granulation after excision of pilonidal sinus? 毛毛窦切除后的原发性闭合还是继发性肉芽肿?
Acta chirurgica Scandinavica Pub Date : 1990-10-01
H K al-Hassan, I M Francis, P Neglén
{"title":"Primary closure or secondary granulation after excision of pilonidal sinus?","authors":"H K al-Hassan,&nbsp;I M Francis,&nbsp;P Neglén","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two methods for treatment of chronic pilonidal disease were compared in a randomised trial of 100 patients with a mean follow-up of 29 months. Four patients were excluded from the excision and closure group, leaving 96 patients for analysis. Initial primary healing was significantly more frequent after excision and primary closure (45/46; 98%) compared with excision and healing by secondary granulation (36/50; 72%). The mean healing time was significantly shorter in the excision and closure group (10.3 days) compared to the excision and granulation group (13 weeks). There was, however, no significant difference between the two groups in cure rate after the first operation. The recurrence rate in the excision and granulation group was 12% and after primary closure 20%. The presence of stiff hair and anaerobic bacteria were related to the failure of primary healing, but not associated with recurrence. Although the cure rate was the same regardless which operation was done, the primary healing was quicker and the healing time and duration of sick-leave were shorter after primary closure. Excision with primary closure therefore seems to be the preferable method.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Malignant intestinal schwannoma. Case report. 恶性肠神经鞘瘤。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-10-01
D Hansen, A Pedersen, K M Pedersen
{"title":"Malignant intestinal schwannoma. Case report.","authors":"D Hansen,&nbsp;A Pedersen,&nbsp;K M Pedersen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Malignant schwannoma of the small intestine is rare and diagnosis often late. Histologic distinction from fibrosarcoma and leiomyosarcoma may require electron microscopy. The primary treatment is surgical. Close postoperative observation is recommended because of the tendency to recurrence. Remission after chemotherapy has been reported, but without controlled studies. The 5-year survival rate is unknown. Two cases are presented.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13415601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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