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Biomedical subjects

I Ihse

Publications and source records attributed to I Ihse.

At least 127 records · Page 7Linked to original sources
PubMed1989

Increased peritoneal permeability in acute experimental pancreatitis.

The peritoneal permeability to differently sized dextran molecules; Mw 4,000, 10,000, 20,000, and 40,000 was investigated in rats with bile-induced acute pancreatitis. Following intraperitoneal deposition, repeated blood samples for measurement of the different dextrans were collected. The results showed increased peritoneal permeability to molecules between 4,000-20,000 daltons in animals with pancreatitis, whereas there was no significant difference for molecules of 40,000 daltons compared to healthy control animals. Also, the passage of phospholipase A2 (Mw 14,000) over the peritoneal membrane was increased during pancreatitis. It is suggested that the transperitoneal route may be of pathophysiological importance in the development of the systemic components of severe acute pancreatitis.

Acute Disease↗
PubMed1989

Fat malabsorption in patients before and after total gastrectomy, studied by the triolein breath test.

The feasibility of using the triolein breath test to demonstrate fat malabsorption was evaluated in a prospective study of patients before and after total gastrectomy and Roux-en-Y reconstruction. Two of 11 patients had subnormal fat absorption before the operation, but 1 and 6 months after the operation 9 of 11 patients had subnormal fat absorption. Peak expiratory 14CO2 (median (range] at the three investigations was 3.9%/h (2.1-5.9%/h), 2.1%/h (1.4-4.5%/h), and 2.0%/h (1.2-6.0%/h), respectively. Patients who underwent a Nissen fundoplication were used as controls. They had normal fat absorption both before and after operation. Serum amylase was not appreciably affected by total gastrectomy and was similar to control values. In contrast, serum albumin decreased 1 month after gastrectomy and recovered after 6 months. In control patients pre- and post-operative albumin concentrations did not differ and were comparable to preoperative albumin values in the total gastrectomy group. The lowered fat absorption may be explained by duodenal bypass with decreased pancreatic stimulation, and it may in part explain the weight loss in patients operated on with total gastrectomy.

Aged↗
PubMed1989

Late sequelae of central pancreatic necrosis. Case report.

Three cases of complete central pancreatic atrophy following acute pancreatitis are described. The isolated pancreatic tail did not regress, but continued to secrete pancreatic juice through a chronic fistula or recurrent pseudocyst. To our knowledge this clinical entity has not previously attracted attention in the literature.

Acute Disease↗
PubMed1988

Proglumide treatment in bile-induced acute experimental pancreatitis.

Rats with acute experimental pancreatitis were treated with the cholecystokinin (CCK)-receptor antagonist proglumide. S-amylase was not affected by proglumide during the initial 4 h but was reduced after 72 h as compared to pre-pancreatitis values. The amylase levels in peritoneal fluid were lower in proglumide treated animals at 1, 2, 4 and 72 h after the induction of the pancreatitis, and amylase in pancreatic tissue was increased by proglumide after six but not 72 h. In spite of these biochemical changes, suggesting beneficial therapeutic effects by proglumide, survival rate was not improved when using a dose of 100 mg/kg every 8 h for 48 h and significantly reduced at a dose of 500 mg/kg every 8 h for 48 h. The results do not support proglumide as the sole treatment in acute pancreatitis.

Acute Disease↗
PubMed1988

Pancreatic atrophy follows bile-induced acute pancreatitis in the rat.

The late course of bile-induced acute experimental pancreatitis was studied in alcoholic and non-alcoholic rats. Addition of alcohol to the drinking water did, however, not influence any of the factors (see below) studied. Six hours after induction of pancreatitis the animals displayed a sixfold increase of S-amylase levels. The late mortality in the whole group of animals was 19% after 6 weeks and 71% after 12 weeks. Rats surviving 6 weeks had a marked reduction of pancreatic wet weight and of pancreatic protein, amylase, phospholipase A2, and S-glucose as compared with healthy controls. S-amylase was similar in all groups studied after 6 weeks. At light microscopy similar changes were seen after 6 and 12 weeks--that is, extensive atrophy of the exocrine pancreas with preserved islets of Langerhans. Only slight fibrosis and slight increase of inflammatory cells were seen, and no protein plugs were detected. The normal liver architecture was generally preserved, but pancreatic rats showed various degrees of bile duct proliferation. Although the morphologic findings do not correspond well with those seen in human chronic pancreatitis, we feel that they represent an integrated late phenomenon of the bile-induced pancreatitis per se, even though partial obstruction of the bile-pancreatic duct may be a co-factor.

Acute Disease↗
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

The value of preoperative imaging techniques in patients with chronic pancreatic pleural effusions.

Four patients with chronic pancreatitis and internal pancreatic fistulae to the left pleura are presented. ERCP was done in three of the patients and demonstrated the fistulae in all. In the forth patient CT gave valuable information. In patients with suspicion of internal pancreatico-pleural fistulae we recommend preoperative ERCP for demonstration of the internal demarcations of the ductal and fistula systems and CT for delineation of the external boundaries and relationships of the pathological lesions.

Adult↗
PubMed1987

Intestinal obstruction with strangulation of the small bowel.

The records of 128 patients operated on for adhesive complete mechanical obstruction of the small intestine were retrospectively reviewed. The gut proved to be strangulated in 53 cases, irreversibly in 16 and reversibly in 37, while 75 patients had simple obstruction (12, 29 and 59%). Continuous abdominal pain was more common in strangulation than in simple obstruction and leukocytosis was most common in irreversible strangulation (both differences significant). But no preoperative clinical parameter was specific for strangulation obstruction. Preoperative hospital stay greater than 25 hours was significantly more common in irreversible strangulation obstruction than in the other groups. Strangulation was preoperatively recognized in only 25% of the cases. The overall mortality rate was 5.5%, but with no statistical intergroup difference, possibly because so few patients died. The study showed that strangulation usually is unrecognized preoperatively, and that early operation is essential for obstruction due to intestinal strangulation. Early surgery is therefore indicated in most cases clinically diagnosed as intestinal obstruction.

Adolescent↗
PubMed1986

Influence of peritoneal lavage on objective prognostic signs in acute pancreatitis.

In 39 patients with severe attacks of acute pancreatitis, a longitudinal study was done with respect to the influence of peritoneal lavage on objective prognostic signs (WBC, blood-glucose, serum-calcium, hematocrit, serum-creatinine, arterial pO2, base deficit); amylase activities in peritoneal fluid, serum, and urine; serum-hemoglobin, serum-Na, serum-K, and plasma-insulin. In addition to standard care in the ICU, half of the patients (N = 19) were randomly treated with peritoneal lavage. Peritoneal lavage did not influence overall mortality (13%), incidence of major complications (36%), or hospital stay (23 +/- 7 days). None of the prognostic signs was significantly influenced by lavage. Amylase concentration in peritoneal fluid was significantly reduced in the lavaged group after 6 hours compared to 24 hours in controls. Serum and urinary amylase decreased 12 hours earlier in the lavaged group, indicating an efficiency of the lavage procedure per se. Still, this study did not reveal any beneficial clinical effects of peritoneal lavage in acute pancreatitis.

Acute Disease↗
PubMed1986

Radiolabelled colloid uptake distribution and pulmonary contents and localization of lysosomal enzymes in cholestatic rats.

Studies of the activity uptake of radiolabelled 99mTc2S7 colloid in different tissues showed a moderately increased uptake in the lung 1 week and a greatly increased uptake 3 weeks after permanent bile duct occlusion. Three weeks after bile duct occlusion the activity uptake was also slightly increased in the spleen and moderately reduced in the liver. In pulmonary tissue of cholestatic rats, the levels of alkaline and acid phosphatase, beta-glucuronidase, and beta-hexosaminidase were determined after 6 weeks. The pulmonary contents of beta-glucuronidase was increased tenfold, and that of beta-hexosaminidase was increased fourfold in cholestasis. Histochemical investigation showed that the lysosomal enzymes were located in the macrophages, which in cholestasis were abundant in alveolar walls and inside alveoli. Macrophages were also frequently seen to engorge pulmonary veins.

Animals↗
PubMed1986

Influence of bile duct occlusion on plasma insulin responses to glucose in rats.

The plasma insulin and glucose responses to intravenous glucose administration were studied in rats after 1, 3, and 6 weeks of bile duct occlusion. One week after the occlusion the first-phase plasma insulin response to glucose was clearly reduced, whereas the late-phase response was increased. Despite a relative hypoglycemia, a clearly increased glucose-induced elevation of plasma insulin was noted after 3 weeks' bile flow obstruction, at which time the median 15-min plasma insulin response to glucose was 38 microU/ml in duct-occluded rats and 7 microU/ml in control rats (p less than 0.001). At the same time an increased glucose elimination rate of 3.59%/min in duct-occluded rats and 3.08%/min in control rats (median values; p less than 0.05) was observed. Available evidence suggests that the effect on the insulin response may be induced by the trypsin-sensitive branch of the 'enteroinsular axis'.

Animals↗
PubMed1986

Tissue content and localization of lysosomal enzymes in cholestatic rats.

Levels of the lysosomal enzymes beta-glucuronidase and beta-hexosaminidase were determined in tissues from rats at 1-7 weeks after permanent bile duct occlusion (28 animals) and sham operation (16 animals). With increasing duration of bile duct occlusion, increasing levels were found in the liver and spleen, whereas levels were unaffected in the pancreas, kidneys, brain, muscle, and skin. Histochemical investigation showed that the lysosomal enzymes accumulated in the hepatocytes and in the increasing numbers of reticuloendothelial cells of the liver and spleen during cholestasis. No significant accumulation of lysosomal enzymes was seen in the pancreas. In preparations of isolated hepatocytes and non-parenchymal cells increased specific activity of lysosomal enzymes in cholestasis appeared in both cellular fractions. It is assumed that the serum increase of lysosomal enzymes in late cholestasis is partly due to a release from activated macrophages in the liver and spleen.

Animals↗