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Biomedical subjects

H B Andersen

Publications and source records attributed to H B Andersen.

At least 19 recordsLinked to original sources
PubMed1999

Circadian intraocular pressure variation with beta-blockers.

PURPOSE: To investigate circadian intraocular pressure variation in patients treated with topical beta-blockers as monotherapy. METHOD: Circadian IOP curves were measured on 25 patients (47 eyes) treated with topical beta-blockers. IOP was recorded 4 times during the day and twice at night. All IOP measurements were taken using a non-contact tonometer. RESULTS: IOP at night was significantly higher than IOP during the day. Thirty-four percent exhibited an increase in IOP of more than 5 mmHg at night, and 15% exhibited an increase of 10-18 mmHg at night. The median range of circadian IOP variation was 7 mmHg. Determined separately by day, the range of IOP variation was 4 mmHg. CONCLUSION: Patients treated with beta-blockers as monotherapy may experience greater variations in IOP than can be detected by conventional daytime IOP measurements.

Administration, Topical↗
PubMed1996

Somatostatin reduces bile secretion and loss of bile constituents in patients with external biliary drainage.

The effect of 24-hours continuous somatostatin-14 infusion on the volume of the bile secretion and on the bile composition were studied in seven patients with malignant biliary obstruction who had transhepatic external biliary drainage. The bile acid composition was measured with high performance liquid chromatography (HPLC). Somatostatin infusion significantly reduced the daily bile loss from median 473 ml to 140 ml (41 per cent, p = 0.01) with a concomitant significant reduction in the daily molar loss of cholesterol, triglyceride, Na+, K+, Cl-, Ca+2 and Mg+2. The loss of chloride and sodium was reduced with median 50 mmol/day each (p = 0.01). The relative concentrations of the measured bile constituents did not change significantly, except for bile acids (p = 0.02): the concentration of glycochenodeoxycholic acid increased significantly (p = 0.04). The molar loss of taurocholic acid decreased significantly (p = 0.035), so the increased concentration of glycochenodeoxycholic acid resulted only in a marginally significant reduction in the total molar loss of bile aids (p = 0.051). Somatostatin is a potent inhibitor of bile secretion. The peptide may be used in severely bile depleted patients for reducing their serious electrolyte and acidity problems. Analysis of bile acid composition by HPLC is well suited for further investigations of the regulatory mechanisms of bile acid secretion.

Aged↗
PubMed1995

[Pancreaticoduodenectomy (Whipple's operation) for periampullary cancer].

This study evaluated the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients with periampullary adenocarcinoma. Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumour. The postoperative mortality rate after Whipple's operation was 8% (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15% (confidence limits, 5 to 25%). The five year survival rate for patients without tumour extension beyond the pancreas was 25% (confidence limits, 5 to 50%), and in patients with adenocarcinoma of the ampulla af Vater, 34% (confidence limits, 3 to 65%). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25% and a postoperative mortality rate of less than 5%.

Adenocarcinoma↗
PubMed1995

Sham feeding increases glucose tolerance by a mechanism independent of insulin secretion in normal subjects.

The effect of sham feeding on glucose metabolism was studied in eleven normal subjects. At random, one intravenous glucose tolerance test (25 g glucose/4 min) was preceded by 15 minutes of pure sham feeding (the sight and smell of a meal but not the taste) which continued for the first 15 minutes after the intravenous glucose load. Pancreatic polypeptide increased significantly during sham feeding and decreased significantly in response to the glucose injection. The glucose disappearance rate was significantly improved from 1.56 +/- 0.22 to 2.07 +/- 0.33 min-1 when the glucose tolerance test was preceded by sham feeding (p = 0.02). Incremental areas of plasma insulin, plasma C-peptide, and insulin secretion rates were not significantly influenced by sham feeding. We conclude that sham feeding by the sight and smell of food improves glucose tolerance in normal subjects without alteration in insulin secretion.

Adult↗
PubMed1994

[CT diagnosis of pancreatic or periampullary cancer].

Seventy-seven patients had abdominal computed tomography (CT) performed as part of the diagnostic work-up for suspicion of pancreatic cancer. The CT-images were reviewed by two radiologists who did not know the clinical course, the surgical procedure, or the final diagnosis. The positive predictive value of CT for the diagnosis of pancreatic or periampullary cancer was 92% (82-97%) and the negative predictive value 69% (41-89%). The 95% confidence limits of the positive predictive value of CT in staging the extent of periampullary cancer in 52 patients varied between 21-79% and 59-100%, with the lowest values in diagnosis of liver metastases. The confidence limits for the negative predictive values in staging varied between 17-56% and 67-94%, with the highest values concerning liver metastases. We conclude that CT cannot be used as the only diagnostic procedure for confirming or excluding the diagnosis of pancreatic or periampullary cancer, and that the staging of periampullary cancer by CT alone is too inaccurate for the evaluation of resectability.

Adolescent↗
PubMed1994

Evidence for an abnormal postprandial response to a high-fat meal in women predisposed to obesity.

The present study was undertaken to investigate fat metabolism after a high-fat meal [50 energy percent (E%) fat] in formerly obese subjects with a familial history of obesity. Twelve normal-weight postobese women (PO) and 12 closely matched controls were given the test meal after a 2-day carbohydrate-rich weight-maintenance diet (58 E% carbohydrate). Whereas the thermic effect of the meals was similar in the two groups, postprandial fat oxidation was 2.5 times more suppressed in PO compared with controls (P < 0.05). A similarly enhanced suppression of arterialized plasma concentrations of nonesterified fatty acids was seen postprandially in PO (P < 0.05), possibly due to a more marked suppression of epinephrine and a reduced glucagon response in PO than in controls. Moreover, the postprandial plasma triglyceride response was attenuated and only amounted to 43% of that in controls (P < 0.05). This may be explained by a more pronounced increase in gastric inhibitory polypeptide in PO, giving rise to a higher adipose tissue lipoprotein lipase activity. No other differences were found in plasma substrates and hormones or in subjective appetite scores. In conclusion, a metabolic and hormonal pattern favoring lipid storage was observed in postobese subjects after a high-fat meal.

Adult↗
PubMed1994

Radioimmunoassay of plasma neuropeptide Y using HPLC for separation of related peptides and fragments.

The aim of the present study was to characterize the basal level of plasma neuropeptide Y (NPY) in man using HPLC for separation of related peptides and fragments and furthermore to determine to what extent plasma NPY and/or PYY increased in response to food intake and exercise. Peptides and fragments were separated on a Pharmacia LKB Superdex 75 HR 10/30 column and measured by radioimmunoassay. Two commercially available antibodies were used. One antibody did not crossreact with plasma PYY, whereas the other antibody detected both NPY and PYY, although with slightly different reactivities. Normal subjects were examined in the basal state, after food intake and at the end of a 20 min period of heavy exercise. HPLC data indicated that basal values of plasma NPY were low and not greater than 2.5 pmol l-1. During food intake there was a marked increase in plasma PYY, whereas plasma NPY did not change. Expectedly, we observed an increase in plasma NPY at the end of a period of heavy exercise, whereas plasma PYY remained unchanged. It is concluded that the basal level of plasma NPY is considerably lower than reported in most studies in the literature. HPLC or similar methods should be used to characterize NPY-like immunoreactivities in further studies of plasma NPY during physiological and pathophysiological conditions.

Adult↗
PubMed1994

Pancreaticoduodenectomy for periampullary adenocarcinoma.

BACKGROUND: This study evaluates the indications for and effects of pancreaticoduodenectomy (102 patients) or total pancreatectomy (15 patients) with extensive lymph node dissection performed upon 117 patients for treatment of periampullary adenocarcinoma. STUDY DESIGN: Presenting symptoms and postoperative morbidity and mortality rates were recorded. Cumulative survival rates were evaluated in relation to origin, size, and staging of tumor. Postoperative follow-up of clinical symptoms was done after one year. RESULTS: The postoperative mortality rate after Whipple's operation was 8 percent (eight patients). The median survival period was 1.1 year and the overall five year survival rate was 15 percent (confidence limits, 5 to 25 percent). The five year survival rate for patients without tumor extension beyond the pancreas was 25 percent (confidence limits, 5 to 50 percent), and in patients with adenocarcinoma of the ampulla of Vater, 34 percent (confidence limits, 3 to 65 percent). The median survival rate in patients with adenocarcinoma of the ampulla of Vater was 3.3 years, which was significantly longer than in the other patients. Fifty-nine patients with distant spread could be divided into 14 patients with para-aortic lymph node metastases who had a significantly shorter survival period than 45 patients without para-aortic lymph node metastases (p = 0.004). Most patients surviving more than one year were doing well, although 60 percent needed exocrine pancreatic substitution therapy. CONCLUSIONS: Resection of periampullary carcinoma provides a better palliation and survival rate than nonoperative biliary drainage or bypass operation. An improved preoperative verification of para-aortic metastases could restrict resection to patients with a prognostic five year survival rate of more than 25 percent and a postoperative mortality rate of less than 5 percent.

Adenocarcinoma↗
PubMed1993

[Preoperative or postoperative local anesthesia. Effect on postoperative pain treatment].

A randomized, double-blind trial was conducted to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 ml) on postoperative pain. Thirty-seven patients scheduled for elective inguinal herniotomy participated. The demand for additional postoperative analgesics occurred earlier in those who received lidocaine infiltration after incision (165 min) than in those who received preincisional lidocaine (225 min), p < 0.05). The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (p < 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method for postoperative analgesia than postincisional infiltration.

Adolescent↗
PubMed1993

Pancreatic beta-cell function and glucose metabolism in human segmental pancreas and kidney transplantation.

beta-Cell function and glucose metabolism were studied in eight insulin-dependent diabetic recipients of combined segmental pancreas and kidney transplant with peripheral insulin delivery (Px), in eight nondiabetic kidney-transplant individuals (Kx), and in eight normal subjects (Ns) after three consecutive mixed meals. All subjects had normal fasting plasma glucose, but increased basal levels of C-peptide were demonstrated in the transplant groups (P < 0.05 relative to Ns). Postprandial hyperglycemia was increased 14% in Kx and 32% in Px (P < 0.05), whereas compared with Ns postprandial C-peptide levels were increased three- and twofold, respectively, in Kx and Px (P < 0.05). Compared with Ns basal insulin secretion rate (combined model) was increased 2-fold in Kx and 1.4-fold in Px (P < 0.05). Maximal insulin secretion rate was reduced 25% in Px compared with Kx (P < 0.05) but not different from that of Ns (P NS). Also, maximal insulin secretion rate occurred later in Px than in controls (Tmax: Px 50 min, Kx 30 min, and Ns 32 min; P < 0.05). The total integrated insulin secretion was increased 1.4-fold in Px compared with Ns (P < 0.05) but decreased 1.4-fold compared with Kx (P < 0.05). Fasting and postprandial proinsulin-to-C-peptide molar ratios were inappropriately increased in Px compared with Kx and Ns. Basal hepatic glucose production was increased 43% in Px and 33% in Kx compared with Ns (P < 0.05). Postprandial total systemic glucose appearance was similar in all three groups, whereas peripheral glucose disposal was 15% reduced in Px (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

CT for assessment of pancreatic and periampullary cancer.

Over a period of 2 years, 77 patients, strongly suspected of having pancreatic cancer, had abdominal CT as part of the diagnostic work-up. The CT images were reviewed by 2 radiologists who did not know the clinical course, the surgical procedure, or the final diagnosis. The positive predictive value of CT for the diagnosis of pancreatic cancer was 92% (82-97%) and the negative predictive value 69% (41-89%). The 95% confidence limits of the positive predictive value of CT in staging the extent of periampullary cancer in 52 patients varied between 21 to 79% and 59 to 100%, with the lowest values in diagnosis of liver metastases. The confidence limits for the negative predictive values in staging varied between 17 to 56% and 67 to 94%, with the highest values concerning liver metastases. We conclude that CT cannot be used as the only diagnostic procedure for confirming or excluding the diagnosis of pancreatic or periampullary cancer, and that the staging of periampullary cancer by CT alone is too inaccurate for the evaluation of resectability.

Adenocarcinoma↗
PubMed1992

Piroxicam spares buprenorphine after total joint replacement. Controlled study of pain treatment in 81 patients.

In a blinded, placebo-controlled study, the nonsteroidal antiinflammatory drug piroxicam, in combination with the partial morphine agonist/antagonist buprenorphine, was compared with buprenorphine alone for analgesic effect and side-effects in a 10-day period following total replacement of the hip or knee. 117 patients entered and 81 completed the study. The patients receiving piroxicam consumed less buprenorphine. There were no differences concerning side-effects between the two treatment groups, apart from a tendency towards less nausea after the third postoperative day in the group receiving piroxicam.

Buprenorphine↗
PubMed1992

Sham-feeding decreases cardiac output in normal subjects.

The cardiovascular effect of sham-feeding was measured in seven healthy non-obese human subjects by the Fick principle using the carbon dioxide rebreathing method. The subjects were resting in the sitting position and were exposed to the sight and smell but not the taste of a breakfast meal. Cardiac output decreased significantly from a mean value of 4.0 1 min-1 to 3.5 1 min-1 during sham-feeding (Friedman, P = 0.004). The cardiac output returned to basal values in all seven subjects when the sensory stimulus was removed. The decrease in cardiac output was due to a decreased stroke volume, whereas heart rate and blood pressure did not change. The mechanism of the decrease in cardiac output during sham-feeding remains to be established.

Adult↗
PubMed1992

A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain.

We conducted a randomized, double-blind trial to compare the efficacy of preincisional and postincisional wound infiltration with 1% lidocaine (40 mL) on the postoperative pain of 37 patients scheduled for elective inguinal herniotomy. The demand for additional postoperative analgesics occurred earlier in those who received lidocaine infiltration after incision (165 min) than in those who received preincisional lidocaine (225 min, P less than 0.05). The preincisional lidocaine infiltration group also had fewer patients requiring supplemental analgesics (58%) than the postincisional group (94%) (P less than 0.05). We conclude that preincisional infiltration of the surgical wound with lidocaine is a more effective method of providing postoperative analgesia than is postincisional infiltration.

Adolescent↗