[Acute abdomen calls for considerable care resources. Analysis of 3727 in-patients in the county of Stockholm during the first quarter of 1995]. / Akut buksjukdom kräver stora vårdresurser. Analys av 3,727 inlagda patienter första kvartalet 1995 i Stockholms län.

A total of 3,727 in-patients with acute abdominal symptoms were identified during the first quarter of 1995 at the surgical clinics of the nine hospitals with emergency departments in the county of Stockholm. The diagnoses were: non-specific abdominal pain 24%; cholecystitis 9%; appendicitis 8%; bowel obstruction 7%; intra-abdominal malignancy, diseases of the urinary tract and peptic ulcer 6% each; gastrointestinal hemorrhage, diverticulitis of the colon and pancreatitis 5% each; other diseases as a cause of abdominal symptoms, 19%. 1,601 operations were performed of which 47% were endoscopic procedures. The mean duration of hospital stay was 4.8 days. The length of stay increased significantly with age. The age-related relative frequency of hospitalization due to acute abdominal pain was also dramatically higher in the elderly cohorts. These facts and the prognosis of an 18% increase of inhabitants 50 years of age or older until 2010 in Greater Stockholm signal an increased need of hospital resources for this large group of patients in the coming years.

Clinical effects of monoclonal antibody 17-1A combined with granulocyte/macrophage-colony-stimulating factor and interleukin-2 for treatment of patients with advanced colorectal carcinoma.

Granulocyte/macrophage-colony-stimulating factor (GM-CSF) has previously been indicated to enhance the therapeutic effect of the anti-colorectal carcinoma mAb17-1A as well as to augment in vivo immune effector functions. In vitro interleukin-2 (IL-2) augmented GM-CSF-induced antibody-dependent cellular cytotoxicity, a mechanism considered to be of significance for the therapeutic effect of mAb. A treatment regimen was elaborated that combined mAb17-1A (400 mg at day 3 of a 10-day treatment cycle) with the simultaneous administration of GM-CSF (250 microgram/m(2) once daily) and IL-2 (2.4 x 10(6) U/m(2) twice daily) for 10 days. The treatment cycle was repeated once a month. Twenty patients with advanced colorectal carcinoma were included in the study. One patient obtained a partial remission and 2 patients stable disease for 7 and 4 months respectively. The median survival time from the start of mAb therapy was 8 months. Owing to allergic reactions, the planned mAb17-1A dose had to be reduced by repeated infusions. At the fourth treatment cycle only 25% received the planned mAb dose. In 3 patients the GM-CSF and IL-2 dose was reduced because of side-effects. The subjective tolerability of the treatment was considered good or acceptable in more than 80% of the patients. The increment in white blood cell subsets induced by the cytokines decreased by increasing number of courses. This particular regimen did not augment the therapeutic effect of mAb17-1A anticipated from in vitro data but rather hampered the clinical effect of the antibody. The reason for this is not clear but a possibility might be the induction of immune suppression in vivo resulting from an impaired human anti-(mouse Ab) and anti-idiotypic antibody response as well as antibody-dependent cellular cytotoxicity, on the basis of a comparison of mAb17-1A/GM-CSF/IL-2- and mAb17-1A/GM-CSF-treated patients.

Preventing warm ischemia with a polyurethane bag during renal transplantation.

We have developed a technique that reduces the rewarm time during renal transplant vascular anastomoses by supporting the kidney in a slush-filled sterile polyurethane bag. There were no complications related to the use of this technique.

Effects of lipolytic and antilipolytic agents on glucose transport in human fat cells.

The effects of lipolytic and antilipolytic agents on glucose transport and glycerol production in isolated human fat cells was investigated. Insulin and various adenylate cyclase inhibitors caused a dose-dependent stimulation of 3-O-methyl glucose transport. The maximum effects were 245 per cent and 100 per cent, respectively. The lipolytic agents isoprenaline, forskolin and dibutyryl cyclic AMP also caused dose-dependent stimulation of 3-O-methyl glucose transport, the maximum effect being about 100 per cent. Enprofylline counteracted the 3-O-methyl glucose transport-stimulating effect of both the lipolytic and antilipolytic agents but altered only the effect of antilipolytic agents on glycerol production. Enprofylline alone had no effect on 3-O-methyl glucose transport activity but stimulated glycerol production. It is on 3-O-methyl glucose transport activity but stimulated glycerol production. It is concluded that stimulation as well as inhibition of lipolysis at different steps in the lipolytic system is associated with acceleration of glucose transport in human fat cell which does not seem dependent upon the lipolysis rate.