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  • 1.
    Bergqvist, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Karacagil, Sadettin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Westman, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Paediatric arterial trauma1998In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 164, no 10, p. 723-731Article in journal (Refereed)
  • 2. Björck, M
    et al.
    Bergqvist, D
    Rasmussen, I
    Piehl, E
    Haglund, U
    An experimental porcine model of partial ischaemia of the distal colon.1997In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 163, no 11, p. 843-50Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Ischaemia of the colon is a major challenge in aortoiliac surgery. The aim was to establish an animal model of partial distal colonic ischaemia to study interventional strategies.

    DESIGN: Randomised experiment.

    SETTING: University Hospital. Department of Experimental Research.

    MATERIAL: 19 pigs.

    INTERVENTIONS: 11 Pigs were subjected to ischaemia consisting of total occlusion of the inferior mesenteric artery and partial occlusion of the superior mesenteric artery. Eight animals were sham controls. Dextran was given.

    MAIN OUTCOME MEASURES: Haemodynamic measurements, intramucosal pH-measurements (pHi) and histological grading.

    RESULTS: Both ischaemic animals and controls remained haemodynamically stable. It was possible to maintain stable ischaemia in the distal colon in the pHi-range of 6.9-7.1. There was histological mucosal damage of the distal colon in ischaemic animals but not in controls.

    CONCLUSIONS: The model could be of value when studying interventional strategies to reduce or reverse ischaemia.

  • 3.
    Karacagil, Sadettin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Narbani, A.
    Almgren, Bo
    Bowald, S.
    Bergqvist, David
    Modified vein cuff technique for distal polytetrafluoroethylene graft anastomoses: How we do it1995In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 161, no 1, p. 47-48Article in journal (Refereed)
  • 4.
    Ljungdahl, Mikael
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Eriksson, Lars-Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Nyman, Rickard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology, Radiology.
    Gustavsson, Sven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Arterial embolisation in management of massive bleeding from gastric and duodenal ulcers2002In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 168, no 7, p. 384-390Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: We have tried angiography and selective arterial embolisation as a complement or another option in patients with massive bleeding from peptic ulcers who were considered poor candidates for surgery.

    DESIGN: Prospective, descriptive study.

    SETTING: University hospital, Sweden.

    PATIENTS: Since 1998, 18 patients (11 women) with a median age of 78 years (range 53-94) had selective arterial embolisation for uncontrollable bleeding from peptic ulcers.

    INTERVENTION: Superselective angiographic catheterisation and embolisation of the arterial branch that was supplying the ulcer.

    MAIN OUTCOME MEASURES: The success rate of haemostasis and the overall outcome.

    RESULTS: 13 patients were treated after failed endoscopic treatment to stop bleeding or to control recurrent bleeding after initial arrest, while 5 patients were treated for recurrent bleeding after emergency operations for bleeding ulcers. Most of the ulcers were in the duodenum. The patients were haemodynamically unstable and had a median haemoglobin concentration of 72 g/L (50-98). Embolisation of the arterial branch that was supplying the ulcer was feasible in all patients. Permanent haemostasis was achieved in all but one patient, although two patients needed a second embolisation for recurrent bleeding. One patient had the bleeding controlled at an emergency operation, but eventually died of respiratory complications. There were no serious complications of embolisation.

    CONCLUSION: Angiographic embolisation may be an effective way to stop massive bleeding from gastroduodenal ulcers. Emergency operations in poor surgical candidates can therefore be avoided.

  • 5. Raab, Y
    et al.
    Rasmussen, I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Odenholt, I
    Påhlman, L
    Trimethoprim-sulphamethoxazole and metronidazole as prophylaxis in colorectal surgery: a study of bioavailability after an oral single dose.2001In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 167, no 1, p. 46-9Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate oral single dose prophylaxis in colorectal surgery.

    DESIGN: Prospective study.

    SETTING: University hospital, Sweden.

    SUBJECTS: 24 patients (13 women; 11 men; mean age 57 years, range 27-81) listed for elective colorectal operations.

    INTERVENTION: At 0630 on the day of the operation all patients were given an oral dose of trimethoprim-sulphamethoxazole (TMP 160 mg and SMZ 800 mg) and metronidazole (2 g). The serum concentrations of TMP and SMZ were analysed in venous samples taken at the start and end of each operation.

    RESULTS: The earliest operation started at 0830 and the last finished at 1700. The median (range) serum concentrations of TMP were 1.4 (0.7-2.6) mg/L (start) and 1.3 (1.0-2.8) mg/L (end), and of SMZ 35 (15-65) mg/L (start) and 33 mg (13-70) mg/L (end). The individual values were above or equal to the minimal inhibitory concentration (TMP 0.8 mg/L; SMZ 15.2 mg/L) for relevant gram-negative species.

    CONCLUSION: Oral TMP/SMZ in the morning gives satisfactory serum concentrations independently of when the operation is done during the day. The regimen is simple and has the potential for being an effective alternative to intravenous prophylaxis.

  • 6. Rasmussen, I
    et al.
    Lundgren, E
    Osterberg, J
    Arvidsson, D
    Haglund, U
    Spilled gallstones: a complication of laparoscopic cholecystectomy.1997In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 163, no 2, p. 147-50Article in journal (Refereed)
  • 7. Rasmussen, I
    et al.
    Rane, A
    Haglund, U
    Hepatic oxygen consumption and cytochrome P450 activity in experimental faecal peritonitis.1993In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 159, no 4, p. 201-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study hepatic oxygen consumption and cytochrome P450 activity in pigs with septic shock induced by faecal peritonitis.

    DESIGN: Controlled experimental study.

    ANIMALS: 12 pigs weighing 19-27 kg.

    INTERVENTION: The animals were divided into a control group (n = 6) and a peritonitis group (n = 6). Peritonitis was induced by intraperitoneal instillation of a standard amount of autologous faeces. The animals were then observed for 300 minutes. Liver biopsy specimens were taken at 0 and 300 minutes.

    MAIN OUTCOME MEASURES: Hepatic oxygen delivery (DO2) and consumption (VO2). Cytochrome P450 activity was studied by measuring O- and N-demethylation of codeine at 0 and 300 minutes.

    RESULTS: Hepatic DO2 was reduced, whereas VO2 was increased during sepsis. There were no significant changes in the N- and O-demethylation of codeine.

    CONCLUSIONS: Hepatic VO2 did increase during sepsis, possibly because of the increased metabolic demand. Cytochrome P450 activity was unaffected by the septic challenge.

  • 8.
    Rasmussen, Ib
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Berggren, U
    Arvidsson, D
    Ljungdahl, M
    Haglund, U
    Effects of pneumoperitoneum on splanchnic hemodynamics: an experimental study in pigs.1995In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 161, no 11, p. 819-26Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the effects on splanchnic haemodynamics of pneumoperitoneum induced by carbon dioxide insufflation.

    DESIGN: Controlled experimental study.

    ANIMALS: 11 Pigs weighing 19-30 kg.

    INTERVENTION: The animals were divided into a control group (n = 4) and a experimental group (n = 7). Experimental animals were subjected to stepwise increasing intra-abdominal pressure from 0 mm Hg to 25 mm Hg by carbon dioxide insufflation.

    MAIN OUTCOME MEASURES: Portal venous blood flow, portal venous blood pressure, portal/hepatic vascular resistance, and gastrointestinal vascular resistance.

    RESULTS: At 25 mm Hg portal venous blood flow was reduced (66% of baseline), and portal venous blood pressure and portal/hepatic vascular resistance were increased (360% and 650% of baseline, respectively). The increase in gastrointestinal vascular resistance was less pronounced.

    CONCLUSIONS: Increased intra-abdominal pressure caused significant changes in the splanchnic haemodynamics. The risk was greater if the intra-abdominal pressure exceeded 15 mm Hg.

  • 9.
    Wollert, Staffan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Antonsson, J.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Lundberg, C.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Rasmussen, Ib Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Haglund, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Intestinal mucosal injury during porcine faecal peritonitis1995In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 161, no 10, p. 741-50Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the incidence of intestinal mucosal injury during faecal peritonitis in pigs, the relation of such lesions to haemodynamic variables, intramucosal pH (pHi), and endothelial adherence of polymorphonuclear leucocytes (PMNs). DESIGN: Experimental laboratory study. SETTING: University department of surgery, Sweden. SUBJECTS: 57 Juvenile pigs. INTERVENTIONS: Pigs had faecal peritonitis induced (n = 39) or a sham procedure (n = 18). In addition, 15 animals were pretreated with the monoclonal CD18 receptor antibody IB4 before induction of peritonitis with the aim of preventing tissue accumulation of PMNs. MAIN OUTCOME MEASURES: Development of mucosal lesions and correlation with haemodynamic variables. RESULTS: 17/18 (94%) of control animals had normal mucosa. The incidence of mucosal lesions in animals with faecal peritonitis was 56%. Animals with severe mucosal injury (grade 4-5) had significantly lower mean arterial pressure, cardiac index, and pHi during the last hour of the experiment compared with animals without mucosal lesions. Pretreatment with IB4 did not prevent the development of intestinal mucosal injuries. Intramucosal pH decreased during sepsis and was not affected by IB4. CONCLUSIONS: Severe intestinal mucosal injury is associated with arterial hypotension, low cardiac index, and low pH. Neither the mucosal injury nor the reduction in pHi seen during porcine faecal peritonitis seemed to be leucocyte-related phenomena.

1 - 9 of 9
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