Acta chirurgica Scandinavica. Supplementum最新文献

{"title":"A new model to assess the haemorrhagic potential of various heparin preparations.","authors":"A Berstad,&nbsp;C J Bang,&nbsp;I Talstad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the gastric mucosa, haemostasis is hampered by the acidity and peptic activity of the gastric juice and by the fibrinolytic activity of plasmin. The hostile intragastric environment may be responsible for the unsecure haemostasis, with episodes of rebleeds often seen in gastroduodenal haemorrhage. Secondly, the haemostatic mechanisms of the gastric mucosa are largely independent of platelet aggregation and thus rely mainly on the coagulation system, making the gastric mucosa a unique model to test haemorrhagic effects of anticoagulants. Using a rat gastric chamber technique, we studied bleeding times from induced gastric mucosal lesions after intravenous administration of unfractionated and low molecular weight heparins. The bleeding times were dose-dependently prolonged by all heparins. With unfractionated heparin, significant prolongation of the bleeding times was seen already at a dose of 75 anti-Factor Xa U/kg, proving that the present model is more sensitive than previous models. The bleeding time per unit dose of both Kabi 2165 (p less than 0.05) and enoxaparin (p less than 0.001) was significantly less than that of unfractionated heparin.</p>","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"62-7"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13120762","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}

{"title":"The ideal operation for unilateral iliac occlusion. Should the asymptomatic iliac artery also be reconstructed?","authors":"J E Lorentzen,&nbsp;L Jørgensen,&nbsp;J J Johansen","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"555 ","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13297406","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}

{"title":"In situ or reversed vein bypass for lower limb revascularization?","authors":"F J Veith,&nbsp;K R Wengerter,&nbsp;S K Gupta","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"555 ","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13517030","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}

{"title":"Optimal methods to assess the deep venous system in the lower limb.","authors":"A N Nicolaides,&nbsp;D C Christopoulos","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"555 ","pages":"175-85"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13347769","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}

{"title":"Biochemical aspects of the pathogenesis of venous thrombosis.","authors":"J Felez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this review, an attempt has been made to present new data on the mechanisms that can be involved in DVT and to emphasize the role of the cell in these processes. It has been demonstrated that cells can mediate the relevant expression of tissue factor without cell disruption and that the fibrinolytic responses can also be modulated by the cells. It has also been demonstrated that the fibrinolytic system seems to be designed to work on the cell surface based upon (1) the existence of specific receptors, (2) the modulation of the expression of these receptors and (3) the comprehensive increase in plasmin generation by up-regulating, for example, the plasminogen receptors. It could also be worthwhile to attempt to explain some beneficial effects of drugs such as heparins by studying their action on these compartments. It is important to note that recently Rosenfeld et al. have described an increase in t-PA and u-PA binding to endothelium by pre-incubation of endothelial cells with unfractionated heparin. This work would be a first step in a very exciting and interesting new era in the prevention of venous thromboembolism.</p>","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"9-17"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13438430","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}

{"title":"How long after surgery does the risk of thromboembolism persist?","authors":"J H Scurr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many of the risk factors which occur immediately after major general surgical operations persist for several weeks, and therefore a study was undertaken to assess the incidence of deep vein thrombosis in the 6 week period following surgery. Fifty seven patients who had undergone major surgery were studied, most of whom received deep vein thrombosis prophylaxis in the form of graduated compression stocking and subcutaneous heparin. Only four patients did not receive prophylaxis. Patients were studied for 6 weeks using Doppler ultrasound. 125I-fibrinogen scanning, strain gauge plethysmography and venography. Thirteen of the 51 patients who had not developed a deep vein thrombosis at the time of discharge did so during the 6 week period. It was concluded that the risk factors may persist in many patients and that deep vein thrombosis prophylaxis should be continued for longer than the hospital stay.</p>","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"22-4"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13438493","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}

{"title":"Bile secretion in man. The effects of somatostatin, vasoactive intestinal peptide and secretin.","authors":"B Nyberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 41 patients, operated upon for common bile duct stones, a temporary bile fistula was achieved by means of a T-tube and a Foley-catheter with an occludable balloon. To learn more about peptide control of bile secretion, 6-8 days after surgery, bile flow was studied before as well as during infusion of the three peptides somatostatin, vasoactive intestinal peptide and secretin. The findings, also presented in Figure 17, were: 1. During somatostatin infusion, bile secretion decreased by 30%, and bile lipid output was reduced by some 10%. The clearance of [14C]-erythritol decreased by 25%, indicating an effect on the bile acid-dependent canalicular bile secretion (Paper I). 2. Vasoactive intestinal peptide (VIP) increased bile secretion by 65%. The concentration of bile lipids decreased, whereas the output was uneffected. The bicarbonate concentration increased, and the concentrations of sodium and potassium were uneffected. [14C]-erythritol clearance was not influenced by VIP infusion. Thus, VIP stimulated bile secretion at the ductular level (Paper II). 3. VIP increased bile secretion by 60%, whereupon secretin increased it by another 70%. Neither of the two peptides effected bile acid output. Both VIP and secretin increased bicarbonate output, whereas only VIP increased the concentration. The clearance of [14C]-erythritol was uneffected by VIP infusion, but increased following secretin, as did the clearance of [14C]-mannitol. Thus, VIP stimulated bile secretion at the ductular level, whereas secretin seemed to stimulate bile secretion both at the ductular level and at the bile acid non-dependent canalicular level (Paper III). 4. Whereas VIP stimulated bile secretion, somatostatin decreased it by some 40%. Even when somatostatin was administered during VIP infusion, no reduction of the VIP-induced choleresis was seen. VIP increased both bicarbonate concentration and output, whereas somatostatin had the opposite effect. The concentration of chloride increased following VIP infusion, but decreased following somatostatin. The output of bile acids was not influenced by VIP infusion and decreased by somatostatin, whereas total lipid concentration increased during somatostatin infusion with a decrease when VIP was added. Thus, somatostatin acts on the bile acid-dependent canalicular bile secretion and also, to some extent, on the ductular secretion. The effects of the two peptides on bile secretion are independent of each other (Paper IV). 5. While fasting, 6-8 days after bile duct surgery, bile secretion averaged 290 microliters/min. Canalicular bile secretion, as measured by the clearance of [14C]-erythritol, constituted some 80% of total bile flow. Maximum de novo synthesis of bile acids was 8.7 mmol/24 h, implying a 8-9 fold stimulation due to interrupted enterohepatic circulation (Paper V). 6. No serious side effects from this method with temporary bile fistulas following bile duct surgery were found. Therefore, the method is recommended fo","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"557 ","pages":"1-40"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13140632","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}

{"title":"Prevention of post-operative thromboembolism in general surgery with enoxaparin: preliminary findings.","authors":"S Haas,&nbsp;C W Flosbach","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>On the basis of a global interim evaluation of 8738 patients in this large German multicentre trial, the efficacy and safety of enoxaparin were analysed in general surgical patients. Data from 194 hospitals were available for this interim evaluation. The general surgical procedures included abdominal, gynaecological (with the exception of mastectomy) and urological operations, lasting at least 30 min under general anaesthesia and/or spinal/peridural anaesthesia. All complications with an incidence greater than two per 1000 were documented, including: occurrence of thrombosis and pulmonary embolism, which, in cases of clinical signs, were confirmed by objective techniques; bleeding, blood loss and transfusion requirements; changes in platelet count, haematology and transaminases; adverse drug reactions. The incidence of pulmonary embolism in thromboembolic prophylaxis with enoxaparin 20 mg, once daily, in patients undergoing general surgery was found to be 0.26%. With respect to the incidence of fatal (0.03%) and non-fatal (0.23%) pulmonary embolism, this interim evaluation shows a superiority of enoxaparin in the prevention of thromboembolic complications when compared retrospectively with trials using unfractionated heparin. The safety and tolerance following administration of enoxaparin 20 mg, once daily, were shown to be excellent (low incidence of injection haematomas and bleeding, no drug-induced thrombocytopenia, and low incidence of adverse drug reactions).</p>","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"556 ","pages":"96-102"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13122158","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}

{"title":"Avoidance of renal and neurologic complications following thoracoabdominal aortic aneurysm repair.","authors":"L H Hollier,&nbsp;W M Moore","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"555 ","pages":"129-35"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13516399","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}

{"title":"Technical details in carotid endarterectomy.","authors":"R J Welten,&nbsp;B C Eikelboom","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7309,"journal":{"name":"Acta chirurgica Scandinavica. Supplementum","volume":"555 ","pages":"205-8"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13517025","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}