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Biomedical subjects

B Holmström

Publications and source records attributed to B Holmström.

At least 55 records · Page 3Linked to original sources
PubMed1991

The effect of yoga on puborectalis paradox.

Nine patients with severe defaecation difficulties primarily considered to be due to puborectalis dysfunction (puborectalis paradox), verified by electromyography (EMG) of the striated anal sphincter muscles, were offered training in Yogic techniques of relaxation and muscle control in order to change the activity of the pelvic floor muscles during attempted defaecation. Five patients completed the training program of 20 2-hour sessions and were re-examined clinically and with EMG. One patient regained a normal EMG pattern but none of the patients improved clinically.

Adult↗
PubMed1991

Is paradoxical sphincter reaction provoked by needle electrode electromyography?

In 10 patients with emptying disturbances, the anal sphincter reaction was investigated clinically and by electromyography with needle and wire electrodes to elucidate whether pain during the investigation could provoke the paradoxical sphincter reaction. In eight of the patients, the paradoxical reaction was easily felt at digital examination. Two patients complained of pain during the needle electrode recording; none complained during the wire electrode investigation. Nevertheless, all 10 patients had paradoxical sphincter reaction independent of the electrode used at electromyography. With careful clinical investigation, most cases of paradoxical sphincter reaction can be diagnosed. When this is inconclusive, the diagnosis should be confirmed by electromyography, preferably by the wire technique.

Adult↗
PubMed1990

Slow transit chronic constipation (Arbuthnot Lane's disease). An immunohistochemical study of neuropeptide-containing nerves in resected specimens from the large bowel.

Seven patients (6 women, 1 man) with severe idiopathic chronic constipation, who underwent surgery with subtotal colectomy and ileorectal anastomosis, were investigated for the occurrence and density of nerve fibres, immunoreactive to different neuropeptides in the mucosa, submucosa, ganglia and smooth muscle in fresh specimens from the colon ascendens, the colon transversum and the colon descendens-sigmoideum. The following substances were studied: enkephalin, substance P, somatostatin, neuropeptide Y, vasoactive intestinal polypeptide, calcitonin gene-related peptide, bombesin, motilin, tyrosine hydroxylase, dynorphin and galanin. Nerve fibres immunoreactive to CGRP occurred in large numbers in the myenteric ganglia of the patients with severe idiopathic chronic constipation, whereas in the myenteric ganglia of the control cases they only occurred in low numbers. In two patients there was no detectable motilin immunoreactivity and in one patient only sparse in the mucosa and the smooth muscle. The other neuropeptides investigated occurred in the density and distribution previously reported in the normal gut. With the present technique there were indications that patients with severe idiopathic chronic constipation have a significant difference in the occurrence of immunoreactive nerve fibres to CGRP and motilin compared to control patients.

Adult↗
PubMed1990

Slow transit of the colon associated with severe constipation after the Ripstein operation. A clinical and physiologic study.

Eighteen patients with severe constipation after undergoing the Ripstein operation for rectal prolapse (n = 11) or internal rectal procidentia (n = 7) were studied with defecography, anorectal manometry, electromyography of the external anal sphincter and the puborectalis muscle, colonic transit time, and blood tests. Thirteen patients had slow-transit constipation. None showed a completely normal pattern in the parameters studied. The authors emphasize the importance of careful preoperative investigation to identify the patients who have associated colorectal disturbances together with their rectal prolapse or internal rectal procidentia.

Adult↗
PubMed1990

A combined electromyographic and cineradiologic investigation in patients with defecation disorders.

Records from 20 patients on whom defecography and electromyography were performed simultaneously because of defecation disorders were analyzed. According to the electromyographic investigation, the patients could be divided into three main groups: 1) normal sphincter reaction; 2) paradoxical sphincter reaction; and 3) combined reaction. Group A was characterized by a marked reduction of muscular activity during emptying and a pronounced closing reflex after emptying. This was followed by return of normal tonic activity. Patients in group B had no relaxation of the sphincters during emptying but a pronounced increased activity in the external sphincter and the puborectalis muscle. They also had severe emptying difficulties at defecography. No closing reflex was seen. In group C the electrical activity in the sphincters increased during moderate straining and when emptying was complete a clear closing reflex was seen. In this study, a dynamic visualization of the defecation together with a registration of electromyographic activity in the striated anal sphincters was performed. It was shown that patients with paradoxical sphincter reaction were lacking a closing reflex after emptying was complete. This has not been reported previously and is important evidence for the paradoxical defecation pattern. It was also shown that the patients with rectoceles had paradoxical sphincter reaction.

Adult↗
PubMed1989

Voluntary relaxation of the external anal sphincter.

In this study five volunteers with special training in anal sphincter exercise (Scandinavian Yoga School) managed voluntarily to reduce anal pressure. The mean reduction of anal pressure was 20 mm Hg. In one of the subjects, this was shown by manometry during low spinal anesthesia and electromyography to be caused by relaxation of the external anal sphincter.

Anal Canal↗
PubMed1988

Recovery of the internal anal sphincter following rectopexy: a possible explanation for continence improvement.

Twenty-one patients suffering from rectal prolapse (n = 15) or internal rectal procidentia (n = 6) were investigated clinically and by anorectal manometry prior to and six months following retopexy. Rectal prolapse was associated with incontinence in 67% (10/15) of the patients preoperatively. The moderately or severely incontinent patients had lower than normal maximum anal resting pressures (MAP) and those with severe incontinence also had lower than normal maximum squeeze pressure (MSP). Postoperatively only 20% (3/15) of the patients remained incontinent and none of them suffered severe incontinence. MAP values increased significantly indicating that improvement of the function of the internal anal sphincter may be one of the factors contributing to better continence. Rectal sensibility was impaired in patients with rectal prolapse as compared to 15 controls. There was no postoperative change. Patients with internal rectal procidentia had normal MAP and MSP and no postoperative change could be demonstrated.

Adult↗
PubMed1988

Evacuation difficulties and other characteristics of rectal function associated with procidentia and the Ripstein operation.

Twenty-one patients with rectal prolapse (N = 15) or internal rectal procidentia (N = 6) were investigated clinically and by anorectal manometry prior to and six months following rectopexy. Symptoms such as urgency, rectal pain, blood, and mucous discharge were markedly relieved by the operation. Rectal evacuation and number of bowel motions seemed to be unaffected. Rectal volume, sensibility, and compliance did not change following surgery. Rectal sensibility was reduced in these patients compared with 15 controls, but there was no difference in rectal volume or rectal compliance.

Adult↗
PubMed1987

Endocrine cells in the human colorectal mucosa: immunocytochemical observations on patients with prolapse or internal procidentia of the rectum.

We have examined the occurrence and distribution of endocrine cells storing serotonin and the regulatory peptides somatostatin, glicentin, peptide YY in rectal mucosa on 16 patients with prolapse or intussusception of the rectum. There were no significant differences compared with normal rectal mucosa. Our results do not support the assumption that these endocrine cells of the rectum are involved in the pathophysiology of rectal prolapse.

APUD Cells↗
PubMed1987

'Tegaderm' dressings prevent recolonization of chlorhexidine-treated skin.

'Tegaderm', a semi-permeable, self-adhesive dressing made of polyurethane film, applied to intact upper arm skin in Intensive Care Unit (ICU) patients reduced the aerobic skin flora compared to adjacent exposed skin sites. We also applied 'Tegaderm' to skin disinfected with chlorhexidine; the aerobic skin flora remained unchanged at a low level for 5 days.

Adult↗
PubMed1986

Results of the Ripstein operation in the treatment of rectal prolapse and internal rectal procidentia.

Over 15 years 108 patients with either rectal prolapse or internal rectal procidentia were treated by the Ripstein operation. Postoperative evaluation was possible in 97 patients (mean observation time, 6.9 years). The mortality rate was 2.8 percent, and surgical complications occurred in an additional 3.7 percent. The recurrence rate was 4.1 percent. Preoperative and postoperative functional analysis was possible in 92 patients. The proportion of continent patients increased from 33 percent preoperatively to 72 percent postoperatively. Defecation difficulties increased from 27 percent to 43 percent following surgery, and were a major cause of dissatisfaction.

Adult↗
PubMed1986

Increased anal resting pressure following the Ripstein operation. A contribution to continence?

To investigate the physiology of improvement in continence following the Ripstein operation for procidentia, preoperative and postoperative anorectal manometry was performed on 11 patients. The mean maximum anal resting pressure increased from 39 to 55 mm Hg (P = 0.01). This probably reflects improved function of the internal anal sphincter, which might contribute to better continence by increasing the closing capacity of the anal canal.

Anal Canal↗
PubMed1983

Metabolic effects of four intravenous nutritional regimens after elective surgery. I. Clinical data and biochemistry.

Biochemical variables have been determined in 28 patients before and after resection of carcinoma of colon or rectum. A synthetic oral diet was given for four days before operation, (0.1 gN.kg/day and 165 kJ.kg/day) and four isocaloric intravenous regimens with different amounts and proportions of amino acids were given for six days after operation. During the preoperative diet the serum urea, glucose, urate, inorganic phosphate and cholesterol concentration decreased while those of triglyceride, iron and alanine amino-transferase increased. After operation the serum triglyceride, protein, albumin, iron, TIBC and urate concentrations decreased. The serum calcium fell in all groups receiving amino acids after operation while magnesium increased in all groups except the one receiving the highest amount of amino acids. The urea concentration decreased when no amino acids were given but increased when amino acids were administered whereas the reverse situation occurred with cholesterol. The highest increase in glucose level was observed when the highest amount of amino acids were given.

Journal Article↗
PubMed1983

Metabolic effects of four intravenous nutritional regimens in patients undergoing elective surgery II.--Muscle amino acids and energy-rich phosphates.

Muscle amino acids and energy-rich phosphates have been determined in 28 patients before and after resection of a carcinoma of colon or rectum. Before operation the patients received a synthetic diet (Vivasorb for four days and postoperatively four different intravenous regimens with different amounts and proportions of amino acids were given for six days, the energy intake being the same for all groups. When compared with age-matched healthy controls the patients showed only slight increases in phenylalanine and isoleucine concentration in muscle and plasma with elevated plasma glutamate during the four days prior to the operation. Vivasorb treatment increased the concentration of alanine, glycine and methionine in both muscle and plasma while increases of threonine and histidine were seen only in muscle. Decreased concentrations of valine were found in muscle and plasma, while lysine and leucine decreased only in plasma. As an effect of operation, but independent of the nutritional regimen, muscle asparagine increased and muscle glutamine and glutamate decreased in all groups. The unique pattern of amino acid changes in postoperative trauma was confirmed in the present investigation but few differences in amino acid concentrations could be related to the various nutritional intakes. Alterations in the individual amino acid concentrations were not influenced by the intake of amino acids and seemed to have little relationship to the composition of any solution infused. Prior to operation there were low levels of ATP in muscle possibly due to immobilisation and chronic semistarvation but no changes in the energy rich phosphates could be attributed to trauma or nutrition. The content of muscle glycogen increased as a result of the Vivasorb supply indicating that the preoperative carbohydrate administration promotes muscle glycogen synthesis and postoperatively muscle glycogen was reduced significantly indicating enhanced glycogenolysis in the postoperative state. This finding emphasizes the importance of providing the patients with ample amount of glucose before and after surgery.

Journal Article↗
PubMed1981

Ileal Crohn tissue and concomitant flora inoculated into germfree rats.

During the last decade, the presence of a transmissible agent in Crohn's disease has been disputed. Some authors have observed granulomatous changes in laboratory animals inoculated with Crohn tissue, while others have failed to do so. The reason for these differences in results might inter alia be the susceptibility of the recipient animals and/or the handling of the Crohn tissue. In the present study germfree rats, which are known ot be highly susceptible to microbial agents, were inoculated with ileal Crohn tissue with adjacent content. The Crohn tissue was handled in a way securing the least possible influence of oxygen on the anaerobic part of the flora. The animals were exsanguinated after 35 weeks. Specimens from the gastrointestinal tract and related organs were removed and examined histologically. In all 264 specimens from inoculated rats and 144 from untreated controls were examined. None of the inoculated germfree rats showed any patho-anatomical changes or other features related to Crohn's disease.

Adult↗