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Biomedical subjects

G Olaison

Publications and source records attributed to G Olaison.

63 records · Page 4Linked to original sources
PubMed1988

Increased phospholipase A2 activity of Ileal mucosa in Crohn's disease.

The activity of phospholipase A2 (EC 3.1.1.4) in endoscopic biopsy specimens of intestinal mucosa was compared in patients with Crohn's disease and controls without inflammatory bowel disease. In postresection Crohn patients there was significantly enhanced phospholipase A2 activity proximal to the anastomosis in the neoterminal ileum, whether or not the mucosa was inflamed at the time of biopsy. Highly elevated ileal phospholipase A2 activity had a predictive value for symptomatic relapse within 1 year after resection. Patients with concomitant Crohn's colitis, in whom the risk of ileal recurrence is particularly high, had greater ileal phospholipase A2 activity than noncolitis Crohn patients. Association thus was demonstrated between activity of phospholipase A2 in ileal mucosa and proneness to ileal inflammation in Crohn's disease.

Adult↗
PubMed1988

Endoscopic biliary drainage in malignant bile duct obstruction.

During a four-year period endoscopic biliary drainage (EBD)--preoperative in 25 and permanent in 45 patients--was successfully established without sphincterotomy in 70 out of 89 referred patients (79%) with malignant bile duct obstruction. 51 of the patients had internal stents and 19 external naso-biliary tubes. There was no procedure-related mortality or severe complications such as perforation or bleeding. One patient, however, got a moderate pancreatitis after stent drainage (1%). In the early drainage period (before operation or discharge) the cholangitis rate was 10%, and during the late period (after discharge) it rose to 27% of the patients. 68 of all 70 patients (94%) had a reduction in S-bilirubin concomitant with clinical improvement and 27 of the 45 patients (59%) with permanent drainage became unjaundiced. Recurrent or increasing jaundice occurred, however, in half the number of these patients (23/45) after an average of 89 days; twelve of them had a temporary regression of jaundice after exchange of stents in spite of advanced disease. The use of multiple stents did not reduce the risk of recurrent jaundice or of cholangitis. It is concluded that EBD inserted without sphincterotomy is a safe and efficient non-surgical alternative in the treatment of malignant bile duct obstruction.

Bilirubin↗
PubMed1987

Endoscopic removal of common bile duct stones without subsequent cholecystectomy.

Good results from endoscopic sphincterotomy (EST) for removing choledochal stones following cholecystectomy, have led to increasing use of the method when the gallbladder is in situ. The need for cholecystectomy after successful EST has been questioned. As cholecystectomy in elderly patients involves substantial risk, we routinely defer cholecystectomy in such patients while they remain asymptomatic. Experience of 40 cases is reported. Thirty-four were discharged without cholecystectomy and one underwent elective cholecystectomy at his own request. The remaining 33 patients were followed up for 6-53 (mean 21.5) months. Four died from causes unrelated to gallstone disease. Symptoms requiring cholecystectomy arose in two cases (6%). We found no problems due to refraining from routine elective cholecystectomy following EST for common bile duct stones. The rarity of later symptoms appears to justify a "wait and see" attitude to post-EST cholecystectomy.

Adult↗
PubMed1987

Decreased gastrointestinal absorption of peroral polyethyleneglycols (PEG 1000) in Crohn's disease. A sign of jejunal abnormality.

Gastrointestinal absorption of orally administered polyethyleneglycols in the 634-1294 dalton range (PEG 1000) was investigated in 44 patients with ileocaecal Crohn's disease and in 24 healthy controls. Absorption of PEG was inversely proportional to molecular weight in both groups. In the Crohn patients the absorption of all tested molecular weights of PEG was significantly less than in the controls. In Crohn's disease there was also less of selectivity of the mucosal barrier against the larger molecules. The state of the distal ileum--acutely inflamed, in remission or post-resection did not influence absorption. Decreased PEG absorption in ileocaecal Crohn's disease probably reflects an abnormality of jejunal mucosal permeability. The observations support the concept that Crohn's disease is a diffuse lesion, affecting the whole gastrointestinal tract. The nondependence of the abnormality on the severity of distal inflammatory changes or on previous resection suggests that abnormal jejunal permeability may be a primary expression of Crohn's disease.

Administration, Oral↗
PubMed1987

Endoscopic sphincterotomy in poor-risk patients.

During the period February 1981--February 1986 101 poor-risk patients with common bile duct stones were treated with EST (endoscopic sphincterotomy). 51 of the patients had no previous gallbladder surgery. The first year 7 complications occurred among 11 patients, including 3 deaths. The following four years we had a total of 8 complications among 90 patients, including 1 death. The complications consisted of: Bleeding needing transfusion (n = 5), pancreatitis (n = 5), cholangitis (n = 2), perforation (n = 2), impaction of the Dormia basket (n = 1). Fourty-five patients were discharged without cholecystectomy. Two patients later underwent elective cholecystectomy. Four patients developed symptoms requiring cholecystectomy. The remaining 39 patients have not required any further treatment for their gallstone disease. This study demonstrates that EST in experienced hands is a safe and effective method even in extremely poor-risk patients and that EST might be used as the sole treatment of common bile duct stones in this type of patients without previous cholecystectomy. The few complications are mostly mild and can be managed conservatively.

Adult↗
PubMed1986

Early and late results after antrectomy, selective vagotomy and Roux-en-Y reconstruction for severe peptic ulcer disease.

The Roux-en-Y gastrojejunostomy has become an increasingly used method for gastrointestinal tract reconstruction, and is advocated in the treatment of alkaline reflux gastritis. Since 1979 we have used selective vagotomy, antrectomy and Roux-en-Y reconstruction as the primary method in treating gastric ulcer and complicated duodenal ulcer in 25 patients. In a follow-up study we have evaluated the postoperative course and the long term results. All patients were operated on between 1979 and 1984. Nine patients had a gastric ulcer (GU), 11 a prepyloric ulcer (PPU) and 5 patients had a complicated duodenal ulcer (DU). The clinical results showed a grade Visick I in 48%, Visick II in 44%, Visick III in 4% and a grade Visick IV in 4%. There were no postoperative deaths, but other early complications occurred in 9 patients (36%). At follow-up, endoscopy showed signs of delayed emptying in 5 patients, but only 1 had corresponding symptoms. Mild to moderate symptoms of dumping were found in 1 patient. There was no case of severe diarrhea. The overall results were satisfactory, indicating that selective vagotomy and antrectomy with Roux-en-Y reconstruction is a valuable alternative as a primary method in the surgical treatment of severe peptic ulcer disease.

Adult↗
PubMedDate not supplied

Platelet-activating factor acetylhydrolase activity in intestinal mucosa and plasma of patients with Crohn's disease.

The activity of platelet-activating factor (PAF) acetylhydrolase in biopsy specimens of intestinal mucosa was compared in patients with Crohn's disease (n = 11) and controls (n = 6). In addition, PAF acetylhydrolase activity was determined in the plasma of Crohn patients (n = 30) and healthy subjects (n = 35). The activity of PAF acetylhydrolase in mucosal samples from the distal ileum was significantly lower in Crohn patients than in control patients (p < 0.02), whereas there was no difference in PAF acetylhydrolase activity of colonic or jejunal samples between Crohn patients and controls. The PAF acetylhydrolase activity in the plasma of Crohn patients was significantly decreased as compared to healthy subjects. Crohn patients with high disease activity (symptomatic index > 150) had a significantly lower PAF acetylhydrolase activity in plasma, as compared to patients in clinical remission (symptomatic index < 150; p < 0.02), and as compared to healthy subjects (p < 0.001). PAF acetylhydrolase activity in plasma increased within 4 months after bowel resection (p < 0.05). These findings indicate that the PAF acetylhydrolase activity is decreased in the ileal mucosa of patients with Crohn's disease and that PAF acetylhydrolase activity in plasma is inversely related to disease activity in Crohn's disease. The possibility that PAF acetylhydrolase is one factor of importance for protecting the intestinal mucosa against PAF-mediated inflammation is inferred.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗