Optimal cyclosporine plasma levels decline with time of therapy.

To avoid nephrotoxicity and hepatotoxicity the CsA-PL should be kept at less than 500 ng/mL during the first month after transplantation and less than 200 ng/mL after four months. After ten months most patients in this study had a CsA-PL of less than 150 ng/mL and many had levels of less than 50 ng/mL with an apparently good immunosuppressive effect. Rejections showed no correlation with high or low CsA-PL.

Deterioration in glucose metabolism in pancreatic transplant recipients after conversion from azathioprine to cyclosporine.

Six recipients of combined pancreas and kidney transplants displayed a deterioration in glucose tolerance when the immunosuppressive therapy was changed from azathioprine-prednisolone to cyclosporine-prednisolone. Because at the same time the plasma C-peptide level increased it seems that insulin resistance, rather than reduced insulin secretion, caused the impairment in glucose tolerance. The condition was found to be reversible.

Circulatory effects of VIP in anesthetized man.

VIP was given intravenously over 1 min at the doses 0.1 and 0.2 micrograms X kg X min-1 to twenty-one anesthetized patients undergoing abdominal surgery.

A case of haemobilia following percutaneous liver biopsy treated by selective arterial embolization.

A case is reported of severe hemobilia following a percutaneous liver biopsy. Hepatic ultrasound and computed tomography showed evidence of blood in the bile ducts and gall bladder. A selective arteriography revealed extravasation of blood in the liver.

The effect of cimetidine on liver blood flow in anesthetized man.

In eight patients subjected to abdominal surgery, the effect of intravenous cimetidine (Tagamet) on hepatic arterial blood flow and portal blood flow was studied, utilizing electromagnetic blood flowmetry. Following cimetidine an increase in hepatic arterial blood flow concomitant with a decrease in mean arterial pressure were detected. Calculated hepatic artery vascular resistance was therefore significantly decreased by 28% after 2 min and 17% after 10 min.

Peritoneovenous shunting for intractable ascites.

Ten patients with intractable ascites were treated with the LeVeen peritoneovenous shunt. Of these, three died perioperatively. Three patients with malignant ascites died within 2-3 months, but with good shunt function.

Effect of carotid endarterectomy on the antihypertensive properties of the carotid sinus reflex.

In eight patients subjected to carotid reconstructive surgery, the reflex effect on systemic pressure of an increase in carotid sinus transmural pressure was studied, before and two months after endarterectomy. The increase in carotid sinus transmural pressure was obtained by applying subatmospheric pressure to the neck. It was found that the closed loop gain of the carotid sinus reflex, calculated as the ratio of change in systemic pressure to change in carotid sinus transmural pressure, was 0.

The effect of somatostatin on blood flow through coronary bypass grafts in anesthetized man.

The effect of intravenous somatostatin on blood flow through coronary bypass grafts was studied in 12 patients subjected to aorto-coronary bypass surgery. Aorto-coronary bypass blood flow was determined by means of electromagnetic blood flowmetry. No change was observed in the bypass blood flow, either during or after intravenous somatostatin at doses of 100 microgram/h and 250 microgram/h.

Basic training in general surgery at a university clinic in Sweden. A comparison with formal training programs.

In Sweden there is no formal training program during the basic surgical training for residents. The operative work-loads of residents were analyzed on a weighted basis with operations converted into hernia equivalents (HE). This made a comparison with other countries possible.

Accidental drainage of ovarian cyst into superior vena cava.

A case of pulmonary edema and anuria with fatal outcome after insertion of a LeVeen peritoneovenous shunt is reported. It was proved at autopsy that the shunt was draining a voluminous ovarian cystic carcinoma into the superior vena cava. Abdominal ultrasound scanning is recommended in patients selected for shunt surgery to avoid this complication.

Effect of carotid endarterectomy on baroreflex sensitivity in man. Intraoperative studies.

In six patients subjected to carotid reconstructive surgery, the reflex effect on systemic pressure of unilateral carotid artery occlusion was studied before and after endarterectomy. Before endarterectomy, carotid occlusion lowered carotid sinus pressure by 45 mmHg evoking a reflex increase in systemic pressure of 12 mmHg. After endarterectomy the corresponding values were 34 mmHg and 19 mmHg.

Rational treatment of hypotension after carotid endarterectomy by carotid sinus nerve blockade.

Intraarterial blood pressure was monitored continuously for the first 24 postoperative hours in twenty consecutive patients subjected to carotid endarterectomy. Ten patients developed postoperative hypotension not attributable to hypovolaemia, depressant drugs, myocardial impairment or arrythmias. The postoperative hypotension was readily reversed by local blockade of the sinus nerve on the operated side.

Internal carotid artery blood flow during the Valsalva manoeuvre in man.

In five patients subjected to reconstructive surgery of the internal carotid artery (ICA), postoperative measurements of the ICA blood flow during the Valsalva manoeuvre were obtained by means of an implanted electromagnetic flow probe. ICA blood flow varied rapidly and parallel to the changes in calculated cerebral perfusion pressure during the Valsalva manoeuvre. At the end of the manoeuvre there was no overshoot in arterial pressure, indicating poor baroreceptor function in these patients.

Effect of somatostatin on regional splanchnic blood flows in man. Angiographic studies.

The effect of somatostatin (1 microgram/kg b.w. i.

The effects of changes in the carotid sinus baroreceptor activity on splanchnic blood flow in anesthetized man.

In 9 patients being subjected to abdominal surgery, electromagnetic blood flow measurements were obtained from the hepatic, mesenteric and iliac beds while the carotid sinus baroreceptors were stimulated by carotid sinus massage. Carotid sinus stimulation produced an average maximum decrease in mean arterial pressure of 21%. Hepatic and mesenteric blood flows decreased by 15% and calculated vascular resistances were not significantly changed in these vascular beds.