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Biomedical subjects

Egil Johnson

Publications and source records attributed to Egil Johnson.

At least 19 recordsLinked to original sources
PubMed2006

Polymorphisms of the XRCC1, XRCC3 and XPD genes and risk of colorectal adenoma and carcinoma, in a Norwegian cohort: a case control study.

BACKGROUND: Genetic polymorphisms in DNA repair genes may influence individual variation in DNA repair capacity, which may be associated with risk of developing cancer. For colorectal cancer the importance of mutations in mismatch repair genes has been extensively documented. Less is known about other DNA repair pathways in colorectal carcinogenesis. In this study we have focused on the XRCC1, XRCC3 and XPD genes, involved in base excision repair, homologous recombinational repair and nucleotide excision repair, respectively. METHODS: We used a case-control study design (157 carcinomas, 983 adenomas and 399 controls) to test the association between five polymorphisms in these DNA repair genes (XRCC1 Arg194Trp, Arg280His, Arg399Gln, XRCC3 Thr241Met and XPD Lys751Gln), and risk of colorectal adenomas and carcinomas in a Norwegian cohort. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated by binary logistic regression model adjusting for age, gender, cigarette smoking and alcohol consumption. RESULTS: The XRCC1 280His allele was associated with an increased risk of adenomas (OR 2.30, 95% CI 1.19-4.46). The XRCC1 399Gln allele was associated with a reduction of risk of high-risk adenomas (OR 0.62, 95% CI 0.41-0.96). Carriers of the variant XPD 751Gln allele had an increased risk of low-risk adenomas (OR 1.40, 95% CI 1.03-1.89), while no association was found with risk of carcinomas. CONCLUSION: Our results suggest an increased risk for advanced colorectal neoplasia in individuals with the XRCC1 Arg280His polymorphism and a reduced risk associated with the XRCC1 Arg399Gln polymorphism. Interestingly, individuals with the XPD Lys751Gln polymorphism had an increased risk of low-risk adenomas. This may suggest a role in regression of adenomas.

Adenoma↗
PubMed2006

Survival and complications after insertion of self-expandable metal stents for malignant oesophageal stenosis.

OBJECTIVE: To report on survival and complications after insertion of self-expandable stents in patients with malignant oesophageal stenosis. MATERIAL AND METHODS: Data were gathered retrospectively from the medical records of 92 consecutive patients in the period 1994-2003. The study comprised 68 men and 24 women (median age 72 years, range 46-93 years) with stenosis from cancer of the oesophagus (n=61), the gastric cardia (n=26) and the lung (n=5), located mainly above (n=4) or below (n=62) the carina, or at the gastro-oesophageal junction (n=26). One uncovered stent and six different covered stents were used. RESULTS: Median and mean survival times after stenting (n=92) were 83 (range 4-1102) and 125 days, respectively. Thirty-day mortality was 19% (n=17), and 7% (n=6) survived more than one year. Survival was neither significantly influenced by division of the patients into diagnostic subgroups nor by comparison of the three most frequently used stents. One, two, three and four stents were received by 76, 11, 4 and 1 patient(s), respectively. There was no stent-related mortality, and complications were bleeding 1 (1%), stent migration 7 (8%), recurrent stenosis 8 (9%) from both tumour overgrowth (n=8) and tumour ingrowth (n=2) when using uncovered stents. Thirteen (14%) patients were re-stented because of recurrent stenosis (n=8) including fistula formation to the left main bronchus (n=2) and stent migration (n=5). CONCLUSIONS: Use of self-expandable stents in patients with inoperable malignant oesophageal stenosis carried few complications and resulted in relatively long survival in comparison with similar studies.

Aged↗
PubMed2006

Long-term outcome after intestinal resection for Crohn's disease.

OBJECTIVE: To assess the need for intestinal repeat resection for recurrence of Crohn's disease in patients observed for more than 20 years after the first resection. MATERIAL AND METHODS: Data were gathered retrospectively from the medical records of 53 (28 F) consecutive patients with Crohn's disease from May 1954 to December 2002. Median age at first intestinal resection was 24.5 (range 13-65) years, and median observation time thereafter was 26.5 (20.1-48.6) years. Disease location and behaviour were defined according to the Vienna classification. RESULTS: The 53 patients had an average 2.7 and a median 2 intestinal resections. Out of 144 intestinal resections (77.1%) 111 were performed during the first three operations; no alterations in distribution of ileal, ileocolic and colic resections were found. From the first to the third operation there was an increase in penetrating disease from 15% to 39% (p=0.046) concomitant with a decrease in stricturing disease from 72% to 44% (p=0.048) of the patients. There was also a corresponding decrease in ileocolic disease from 45% to 5% (p=0.003) and a tendency towards an increase in ileal disease from 38% to 67%. One patient died (1.8%) from rectosigmoid perforation after the third resectional operation. Six patients needed reoperation (11.3%) for ileus, anastomotic bleeding, rectosigmoidal perforation and abdominal pain. Thirty-four patients (64.2%) needed intestinal repeat resection (median 8.3 years) during 25.3 years after the first repeat resection. CONCLUSIONS: This study indicates a diminution of Crohn's disease activity with time, as demonstrated by no need for intestinal repeat resection more than 25 years after the first resection.

Adolescent↗
PubMed2006

An extract of the mushroom Agaricus blazei Murill protects against lethal septicemia in a mouse model of fecal peritonitis.

Bacterial septicemia is frequently occurring during gastroenterological surgery. Because of increasing problems in hospitals with bacteria developing multiresistance against antibiotics, prophylactic treatment using immunomodulators is interesting. We have examined the putatively anti-infective immunomodulatory action of the edible mushroom, Agaricus blazei Murill (AbM), in an experimental peritonitis model in BALB/c mice. The mice were orally given an extract of AbM or phosphate-buffered saline 1 day before the induction of peritonitis with various concentrations of feces from the mice. The state of septicemia, as measured by the number of colony-forming units of bacteria in blood, and the survival rate of the animals were compared between the groups. Mice that were orally treated with AbM extract before bacterial challenge showed significantly lower levels of septicemia and improved survival rates. Our findings suggest that the AbM extract, when given prophylactically, may improve health. Further studies are needed on humans when considering whether AbM could be used as an alternative treatment modality for patients at risk of contracting serious bacterial peritonitis.

Agaricus↗
PubMed2005

GPX Pro198Leu and OGG1 Ser326Cys polymorphisms and risk of development of colorectal adenomas and colorectal cancer.

Little is known about genetic risk factors for colorectal cancer. We assessed the association between polymorphisms in two genes involved in DNA repair of oxidative stress, GPX and OGG1, and risk of colorectal carcinoma or adenomas. We studied 166 cases with adenocarcinoma, 974 with adenomas and 397 controls recruited from the Norwegian cohort NORCCAP. No associations were found between the polymorphism GPX Pro198Leu and risk of colorectal adenomas or carcinomas. Carriers of the variant allele OGG1 Ser326Cys polymorphism had a lowered risk of colorectal cancer, OR=0.56 (95% confidence interval 0.33-0.95), while no association were found with risk of adenomas. This indicates that a low repair capacity of oxidative DNA damage may not be a risk factor for development of colorectal adenomas or carcinoma.

Adenocarcinoma↗
PubMed2005

[Inguinal and femoral hernia repair in Norway 1990-2003].

BACKGROUND: The purpose of this study was to chart changes in surgical treatment of inguinal or femoral hernia in Norway from 1990-91 to 1999-2003. METHODS: Data were compiled from the Norwegian Patient Registry based on procedure coding for inguinal and femoral hernia repair. RESULTS: The annual number of femoral hernia repair procedures was constant throughout the study period. From 1990-91 to 2003, the mean age dropped from 66 for both sexes to 63 among men and 62 among women. The female-to-male ratio was constant at 2/1. Emergency admittances went down from 56% to 43% and mean hospitalisation was down from five to four days. The use of mesh repairs increased from 3% (1990-91) to 37% (2003). Incidence rates for inguinal hernia repair increased throughout the period, from 1.8 to 2.3 per 10,000 women and from 20.6 to 32.1 per 10,000 men. Mean age was as down from 63 (both sexes) to 59 among men and 57 among women. The female-to-male ratio remained constant at 1/12. Emergency admittances dropped from 13% to 6%. Mean days of hospitalisation fell from 4 in 1990-91 to 1 in 2003. Two out of three inguinal hernia repairs were done ambulatory in the last year of the study period. The use of mesh repairs increased from 1% in 1990-91 to 78% in 2003. Laparoscopic procedures were rarely used (2% in 2003). INTERPRETATION: In 2003, the majority of inguinal hernia repairs were performed as day surgery with open mesh techniques, in line with European guidelines.

Adolescent↗
PubMed2005

[Surgery and stenting for oesophageal cancer].

BACKGROUND: The purpose of this study was to evaluate the results of surgery and stenting for operable and inoperable oesophageal cancer. MATERIAL AND METHODS: Retrospective patient materials with resection (n = 65, 1983-2002) or stenting (n = 59, 1994-2003) for primary oesophageal cancer. RESULTS: Mortality after surgery was 11% and 15% of the patients were re-operated. 36 (55%) had complications such as respiratory failure (n = 33), anastomotic dehiscence/perforation (n = 4), chylothorax (n = 1), haemorrhage (n = 3), wound rupture (n = 1), septicaemia (n = 2), arrhythmia (n = 4) and wound infection (n = 5). Median survival after surgery was 11 months. Survival after three years was 17%, after five years 8%. The stent procedure was without mortality but haemorrhage (n = 1) and stent dislocation (n = 2) occurred. 8 patients (14%) were re-stented for tumour stenosis (n = 6), fistula (n = 2) and dislocation (n = 1). Median survival after stenting was 78 days. Survival after 30 days was 80%, after one year 7%. INTERPRETATION: Resectable oesophageal cancer should be operated in fit patients, as survival is improved and some patients can be cured. Stenting is the main option in inoperable patients.

Adenocarcinoma↗
PubMed2005

An extract of the medicinal mushroom Agaricus blazei Murill differentially stimulates production of pro-inflammatory cytokines in human monocytes and human vein endothelial cells in vitro.

An extract of the edible mushroom Agaricus blazei Murill (AbM) has known antitumor and anti-infection properties, probably mainly by stimulating mononuclear phagocytes of the native immune system. The aim of this work was to study the effect of AbM on the production by human monocytes and human umbilical vein endothelial cells (EC) of pro-inflammatory cytokines (IL-1beta, IL-6, IL-8, TNFalpha), the anti-inflammatory/T regulatory cytokine IL-10 and the pro-Th1 cytokine IL-12. AbM, in concentrations from 1-15%, induced a considerable and dose-dependent increase in production of IL-8, IL-6, TNFalpha and IL-1beta in monocyte cultures. The biosynthesis reached a plateau at a concentration of 10% of AbM, and was most pronounced for the three former cytokines. AbM did also dose-dependently stimulate EC production of IL-8,I L-6 and TNFalpha, but at lower levels compared with the monocytes. AbM did neither induce synthesis of cytokines IL-10 nor IL-12 in monocytes or EC. Our results demonstrate the differential effect of AbM stimulation on the magnitude of pro-inflammatory cytokines produced by monocytes and EC.

Agaricus↗
PubMed2004

[A 25-year old woman with abdominal pain and respiratory failure].

BACKGROUND: About 25% of patients with acute pancreatitis progress into severe pancreatitis with local and systemic complications. Local complications include oedema, necrosis, haemorrhage, infections, abscesses and pseudocysts. Systemic complications frequently involve the lungs and the kidneys in addition to cardiovascular dysfunction with hypotension and shock. Multi-organ failure is caused by a systemic inflammatory response commonly seen in necrotising pancreatitis, a severe condition with high mortality (about 30%). Similar pathogenesis is seen in sepsis or severe burns. METHODS: We report a young woman with acute pancreatitis and have used available literature to discuss the clinical picture and the pathogenesis, with an emphasis on the systemic complications. RESULTS AND INTERPRETATION: Systemic complications like multi-organ failure are frequently reported in acute severe pancreatitis characterised by pancreatic oedema and necrosis. Our patient had abdominal pain and mild pancreatitis without radiological manifestations. She developed systemic complications with respiratory failure not previously reported in mild pancreatitis. Early identification of systemic complications in acute pancreatitis is important in order to start treatment and reduce the risk of a fatal outcome.

Abdominal Pain↗
PubMed2004

[Cholecystectomy in Norway 1990-2002].

BACKGROUND: The purpose of this study was to investigate cholecystectomy incidence and laparoscopy rates in Norway (1990-2002). METHODS: Data were compiled from the Norwegian Patient Registry based on codes for cholecystectomy. RESULTS: From 1990 to 2000-02, age-adjusted incidence rate (per 10,000 inhabitants) for cholecystectomy increased from 2.9 to 4.1 for men and from 7.0 to 11.8 for women. Incidence rates varied between counties. The proportion undergoing laparoscopic surgery increased from 1% in 1990 to 89% in 2000-02. Over the same period the length of postoperative inpatient stay decreased from 7.3 days to 3.3 days. 94% of electively admitted patients were operated by laparoscopic technique in 2000-02. Among patients admitted on an emergency basis, women below 50 were more often operated by laparoscopic technique than older women and men. CONCLUSION: Substantial changes in the treatment of gallstone disease occurred in Norway over the period 1990 -2002. Increased incidence rates for cholecystectomy and reduced length of postoperative inpatient stay were observed after the introduction of cholecystectomy by laparoscopic technique.

Adult↗
PubMed2004

[Pain and rehabilitation after inguinal hernia repair in adult male patients].

BACKGROUND: Increased awareness of post-hernia repair pain motivated a study of pain and rehabilitation after day surgery. MATERIAL AND METHODS: Forty male patients were prospectively randomized to conventional (McVay) or open mesh repair. Self-assessment of postoperative pain was based on a four-step verbal scale. Patients and the physicians conducting the study were blinded to the surgical method. Clinical follow-up was performed twice, after four weeks and median 21 months. RESULTS: The open mesh technique generated less pain during the first postoperative week. Chronic light to moderate pain occurred in 20% of patients irrespective of surgical method. A sick leave of one to three weeks was sufficient in 20 out of 27 patients. INTERPRETATION: The study showed no clinical advantage of a tension-free method in terms of rehabilitation and post-hernia repair after the first postoperative week. Because of the relatively high incidence of late treatment-related pain, non-symptomatic adult patients should not be referred for inguinal hernia surgery. The primary sick leave period should not exceed three weeks.

Adult↗
PubMed2004

[Internal rectal invagination treated with rectopexy and sigmoid resection].

BACKGROUND: Internal rectal intussusception, usually occurring in women, causes constipation and incomplete evacuation of stool. MATERIALS AND METHODS: Twenty-one women and one man (median age 48) were operated with suture rectopexy and sigmoid resection. The patients were examined with anoscopy and defecography, and symptomatic outcome, patients' satisfaction and morbidity were evaluated. Outcome was based mainly on the validated KESS score for constipation. RESULTS: There was a significant reduction in all ten symptoms. Faecal incontinence improved in the two afflicted patients after operation. The number of patients with constipation was reduced from 20 to 8 (p < 0.01); none became constipated. Mean (95 % CI) colonic transit times in ten constipated patients was reduced from 5.3 (4.1-6.4) to 4.0 (2.6-5.4) days (p = 0.08); seven of these patients had a reduction of transit time as well as constipation score. INTERPRETATION: Rectopexy with sigmoid resection improved symptoms, including constipation and feeling of incomplete rectal emptying.

Adult↗
PubMed2003

[Surgical treatment of anal fissure].

BACKGROUND: Anal fissure is very painful; surgery is warranted when medical treatment fails. MATERIAL AND METHOD: We present a retrospective study of 34 patients (median age 42; 19-63) treated by subcutaneous lateral internal sphincterotomy (n = 27) and anal dilatation (n = 7) from 1992 to 2002, carried out by a questionnaire on pain, anal incontinence, and treatment result. RESULTS: There were no complications or treatment for recurrence of anal fissure. Median pain score before surgery was 7.3 on a scale from 0 (no pain) to 10 (worst imaginable pain), median 73 months (4-124) after surgery the median score was 0 (0-5) (p = 0.00). For sphincterotomy (n = 27), the median score was 7.8 before surgery and 0 (0-5) after (p = 0.00), for anal dilatation 6 (3-10) before surgery and 2 (0-2) (p = 0.01) after. All patients had reduced pain scores after surgery but their incontinence scores remained unchanged. Two patients (7%) who had previously been dilated or irradiated developed faecal incontinence after sphincterotomy. More patients became asymptomatic after sphincterotomy (n = 18; 67%) than after anal dilatation (n = 4; 57%). INTERPRETATION: Compared to anal dilatation, sphincterotomy offers better pain relief for anal fissure. Doing a shorter sphincterotomy corresponding to length of the fissure reduces the risk of anal incontinence.

Adult↗
PubMed2003

[Appendicitis and appendectomy in Norway 1990-2001].

BACKGROUND: The purpose of this study was to examine the incidence of appendicitis and appendectomy in Norway from 1990 to 2001. METHODS: Data were compiled from the Norwegian Patient Registry based on ICD-9 and ICD-10 codes for appendicitis and appendectomy. Re-admissions after appendectomy were selected based on institution and allocation numbers for hospitalisation. RESULTS: Age-adjusted incidence rates for appendectomy were 117 per 100 000 for men and 116 per 100 000 for women. Incidence rates were highest among patients aged 10-29. Diagnostic accuracy increased from 81% to 86% in men and from 60% to 71% in women over the study period. Perforation ratio increased from 12% to 21% in men and from 9% to 17% in women. Appendectomy by laparoscopic technique increased during 1998 to 2001 from 5% to 10% of cases for men and from 9% to 15% of cases for women. The proportion of laparoscopic appendectomy was considerably higher in two counties (50% and 28% in 2000-2001). Length of hospital stay was shorter after laparoscopy (median two days) than after open surgery (median three days), with no difference in the rate of re-admission of 4%. INTERPRETATION: Diagnostic accuracy and perforation ratio increased over the 1990s. Patients operated upon with laparoscopic technique had shorter hospital stays and the same re-admission rate compared to patients undergoing conventional surgery. Though the proportion of appendectomies done by laparoscopy doubled from 1998 to 2001, the procedure is not in commonly use in Norway.

Adolescent↗
PubMed2003

[Secondary anterior sphincteroplasty for anal incontinence after delivery].

BACKGROUND: The prevalence of anal sphincter rupture at vaginal delivery is from 0.5 to 2.5 %. More than 50 % of these patients may need a secondary anterior sphincteroplasty because of anal incontinence. MATERIALS AND METHODS: We present prospective series of 29 women (median age 45 years) operated with an overlapping anterior sphincteroplasty from 1996 to 2001. The patients were examined with anal ultrasonography (n = 23), manometry (n = 19) and neurophysiologically (n = 13), and divided into group 1 (n = 19) with anal sphincter rupture and group 2 (n = 10) with sphincter rupture as well as pudendal neuropathy. All patients (n = 29) were examined with the Cleveland Clinic incontinence score before and median eight (2-64) months after operation. RESULTS: Median incontinence score before and after operation was 11.0 (0-22) versus 5.0 (0-16) (p = 0.002) for group 1; 18.0 (15-24) versus 15.5 (11-24) (p = 0.034) for group 2. There was also a significant difference between the groups concerning incontinence scores both preoperatively (p = 0.045) and postoperatively (p = 0.028). An improvement of continence was seen in 15 (79 %) of the patients in group 1 compared to 4 patients (40 %) in group 2. In group 1 a significant increase of median resting and squeeze pressures was seen. INTERPRETATION: Anterior sphincteroplasty improves anal continence considerably in patients with isolated sphincter rupture. However, patients with evidence of pudendal neuropathy must be informed that they should expect only a minor improvement in continence after operation.

Adult↗
PubMed2003

HUVEC take up opsonized zymosan particles and secrete cytokines IL-6 and IL-8 in vitro.

Uptake of zymosan A particles by human umbilical vein endothelial cells (HUVEC) and its effect on cellular cytokine and oxygen radical production was examined. HUVEC took up more serum-opsonized than -unopsonized zymosan as demonstrated by flow cytometry with fluorescence-labeled particles. The former uptake was inhibited in the presence of anti-C3c antibodies and thus complement-mediated. It probably occurred via CR1 (CD35), although participation of other receptors cannot be ruled out. Scanning electron microscopy indicated that HUVEC with fully internalized zymosan particles were damaged. Prolonged incubation of both serum-opsonized and -unopsonized zymosan particles with HUVEC induced increased secretion of the proinflammatory cytokines IL-6 and IL-8 to the cell culture supernatants, but had no effect on production of oxygen radicals. The results confirm previous reports that EC can internalize yeast and other pathogens and points to complement as a mechanism of uptake, but illustrates that the cells may be damaged in the process. Moreover, EC may participate in the anti-infection defense effort by secreting proinflammatory and chemotactic cytokines in response to the contact with pathogens.

CD11b Antigen↗