Ureteral obstruction as a complication in aorto-iliac reconstructive surgery.

Two cases of ureteral obstruction secondary to aorto-iliac reconstruction with bifurcation aortic grafts are described. Twenty-eight cases have been called from the literature and analysed. There seem to exist two types of aetiology regarding this complication: development of heavy localized fibrosis, and mechanical compression owing to the ureter having been placed behind the graft.

Decreased fibrinolytic activity in vessels and ureters of rejecting human kidneys.

Plasminogen activator (PA) activity was determined with a histochemical fibrin slide technique in renal arteries, veins and ureters in 62 transplanted kidneys and again at transplantectomy in 12 transplants who later underwent irreversible rejection. At transplantation PA activity was the same whether the grafts later rejected or not. There was a significantly decreased PA activity in the vessels and ureters in rejected transplants.

Tissue blood flow and blood flow distribution after administration of dextran 70, dihydroergotamine and their combination. A study in dogs using the radioactive microsphere technique.

The radioactive microsphere technique was used to measure tissue blood flow after administration of dextran 70 and dihydroergotamine, both separate and in combination, in normotensive dogs. Dextran 70 increased cardiac, output and tissue blood flow to most organs. Unchanged blood flow after dextran 70 to CNS, liver (hepatic artery blood flow), adrenals, genitals, uterus and lungs (bronchial artery and arteriovenous shunts) was found.

Central haemodynamic effects of dextran 70, dihydroergotamine and their combination. A study in dogs.

In a study in dogs the central haemodynamic effects of dextran 70 and dihydroergotamine, both separated and combined, were evaluated. Dextran 70 gave an increased cardiac output, and peripheral resistance was reduced. The volume of blood flow in the femoral vein increased, pressure recordings being mainly unchanged.

Influence of operative trauma on factor XII and inhibitor of plasminogen activator.

A parallel decrease of factor (F) XII and a fibrinolytic inhibitor of plasminogen activation (PA inhibitor) was found in a series of 52 patients subjected to vascular surgery. It was at a maximum on days 2-4 postoperatively. The most extensive decrease was found in patients undergoing aortoiliac bypass operation.

Development of Xa inhibitor activity in relation to postoperative deep vein thrombosis (DVT).

65 patients, undergoing hip or elective general surgery, were tested for Xa inhibitor activity using a differential assay. Classification into minor and major deep vein thrombosis (DVT) was made. This study indicates that patients with repeatedly decreased Xa inhibitor activity during the first two days after trauma are highly disposed to develop postoperative DVT.

The pharmacokinetics of subcutaneous dihydroergotamine with and without a dextran 70 infusion.

The pharmacokinetics of subcutaneous dihydroergotamine (DHE) with or without dextran 70 infusion was evaluated in a single- and multiple-dose study in 30 patients. Radioimmunoassay was used to measure plasma DHE and the anthrone method to determine the dextran concentration. In the single-dose study no significant interaction between DHE and dextran was noted with respect to their plasma levels.

Comparison of the plasminogen activator activity of superficial hand and foot veins.

The plasminogen activator (PA) activity in superficial hand and foot veins was determined with a fibrin slide technique in 68 patients (46 with and 22 without thrombosis). The activity in the hand veins was identical to that of the foot veins in 57% of the patients and higher in 38%. There was a correlation between activity in hand and foot veins in patients with and without thrombosis.

Comparison between commercial heparin, low molecular weight heparin and pentosan polysulfate on hemostasis and platelets in vivo.

The effect of commercial heparin (MW 15000; 60 U/kg), low molecular weight heparin (MW 4500, 60 U/kg), sodium pentosan polysulfate (PZ-68) in doses of 0.5, 1, 2 and 5 mg/kg and 1 mg/kg combined with dextran 70 (0.5 g/kg) on microvascular hemostasis and platelet activity in vivo was investigated in the microcirculation of rabbit mesentery and ear chamber, respectively.

Lung complications after elective hip surgery.

A total of 350 patients undergoing elective hip surgery were retrospectively studied as regards pulmonary complications. The study is based on the findings of pre- and postoperative chest X-rays and of pulmonary perfusion scintigrams. Twenty-seven per cent of the patients had pulmonary complications of some kind.

Assessment of antithrombotic properties of sodium ibuprofen.

The effect of sodium ibuprofen on platelet activity in vivo and the lysability of ex vivo thrombi was investigated. The formation of a hemostatic platelet plug in the rabbit mesentery and platelet embolism as a response to a laser-induced injury in the ear chamber of rabbits were used as models for determining platelet activity. Ibuprofen at a dose of 25 mg/kg i.

After-exercise thermography and prediction of deep vein thrombosis.

A total of 112 patients participated in a prospective study of after-exercise thermography as a screening method for predicting risk of postoperative deep venous thrombosis. The fibrinogen-uptake test was used to detect thrombosis after elective surgery. The incidence of the complication showed no significant difference between patients who had had positive and those who had had negative thermograms.

Abdominal injury from sporting activities.

The frequency of abdominal injury is rising. In an analysis of 1,354 cases of closed abdominal trauma sustained during a 30-year period (1950-1979) in Skaraborg County, Sweden, a distinct increase was found in the numbers associated with sporting activities. The severity of the injuries caused by sports likewise showed an increase.

Prophylaxis of deep vein thrombosis in patients with fracture of the femoral neck: a prospective comparison between dextran and a sulphated polysaccharide.

A prospective and randomized study of 100 patients with fracture of the femoral neck was carried out. The aim was to compare the thromboembolic prophylactic effect of dextran 70 and a sulphated polysaccharide, PZ 68. Deep vein thrombosis was diagnosed using the 125I-fibrinogen test and phlebography, and pulmonary embolism with a perfusion and ventilation scan.

Oral contraceptives and venous thromboembolism.

In 58 patients with phlebographically diagnosed deep vein thrombosis during oral contraception the extension and localization of the thrombotic process was analysed in relation to the coagulation and fibrinolytic system 6 months after thrombosis. Left-sided thrombi dominated and the thrombi were more extensive and proximal on the left side. This left-sided dominance was more apparent with higher oestrogen content in the pills.

Venous insufficiency as a late complication after tibial fracture.

Thirty-eight patients were followed up 13 to 17 years after sustaining a fracture of the tibia. The aim was to establish the frequency of post-thrombotic venous insufficiency. All patients were examined clinically and with a modified ultrasound technique.