PubMed Health⌕ Search

Biomedical subjects

J J Andreasen

Publications and source records attributed to J J Andreasen.

At least 19 recordsLinked to original sources
PubMed2000

Emergency coronary artery bypass surgery after failed percutaneous transluminal coronary angioplasty.

Coronary complications caused by percutaneous transluminal coronary angioplasty (PTCA) may necessitate emergency coronary artery bypass grafting (CABG). In 1994-1998, 132 patients (1.5% of the patients registered in the Danish PTCA registry) underwent CABG within 24 h because of angioplasty complications. We reviewed the files of 86 patients who had emergency operations within 6 h and found that 35% suffered from 1-vessel disease. Fifty-eight percent were taken directly to the operating room from the cardiovascular laboratory, and 13% were given preoperative cardiovascular resuscitation. The vessels most frequently injured were the right coronary artery and the left anterior descending branch (LAD). The patients received a mean of 2.4 coronary bypasses each. Forty-three percent of the patients with lesions of the left main coronary artery and/or the LAD received a vein graft to the LAD. A perioperative Q-wave myocardial infarction developed in 51% of the patients. The in-hospital mortality rate was 12%. These results are inferior to those obtained after elective surgery. Local cardiothoracic backup is vital when PTCA is performed in an unselected patient group.

Adult↗
PubMed1999

Intraluminal papaverine with pH 3 doubles blood flow in the internal mammary artery.

Seventy-five patients undergoing coronary artery bypass grafting were randomized to receive injections of papaverine solution or isotonic saline or no injection into the left internal mammary artery (LIMA) used as graft. Blood flow in the LIMA was measured twice-after dissection of the pedicle and before anastomosis to the coronary artery. Blood flow increased significantly in all three groups, but after papaverine injection it was twice as high as in the control groups, increasing by 285% (from 40 +/- 12 to 154 +/- 32 ml/min, p = < 0.0001). The pH of the papaverine solution was only 3, and we advise that surgeons check and correct pH in the papaverine solutions they use, in order to avoid endothelial damage to the LIMA. Based on these results we can recommend papaverine injection into the arterial graft only if the initial flow is low.

Adult↗
PubMed1998

Failure to detect Chlamydia pneumoniae in calcific and degenerative arteriosclerotic aortic valves excised during open heart surgery.

Chlamydia pneumoniae has been associated with atherosclerosis, although no causal association has been established. Employing culture and polymerase chain reaction in aortic valves with calcific and degenerative arteriosclerotic changes from 23 non-consecutive patients undergoing aortic valve replacement, C. pneumoniae was not detected in any of the valves. 19/22 patients had serological evidence of past infection with C. pneumoniae. Our findings do not provide supportive evidence for the hypothesis that C. pneumoniae is associated with calcific or degenerative arteriosclerotic aortic heart valve disease.

Adult↗
PubMed1997

[Chlamydia pneumoniae and atherosclerosis].

Several seroepidemiological studies have shown an association between chronic infection with Chlamydia pneumoniae and atherosclerosis of the coronary and carotid arteries as well as with acute myocardial infarction. Chlamydia-specific antibodies and circulating immune complexes are found more often in patients than in controls. The organism can often be shown in atherosclerotic plaques from coronary, carotid, iliac and femoral arteries as well as from the aorta, employing electron microscopy, immunocytochemical staining and the polymerase chain reaction, but is seldom demonstrated in arteries without atherosclerosis. Only one successful isolation by culture from an atherosclerotic coronary artery has been described. Whether there is any etiological or pathogenetic link between atherosclerosis and chronic infection with C. pneumoniae remains to be elucidated.

Antibodies, Bacterial↗
PubMed1997

Antibodies to cardiolipin may increase the risk of failure of peripheral vein bypasses.

OBJECTIVES: To assess the association between antibodies to cardiolipin and infrainguinal vein graft patency. MATERIALS AND METHODS: Plasma levels of antibodies to cardiolipin, haemostatic factors, lipids and the smoking marker carboxyhaemoglobin were determined preoperatively and 6 weeks postoperatively in 80 patients undergoing infrainguinal vein bypass surgery. Bypass patency was assessed by ankle blood pressure measurements and ultrasound duplex scanning at 1 week, 6 weeks, 3, 6, 9 and 12 months. A localised increase in the graft peak systolic velocity by a factor of 2.5 or more was considered to indicate a significant stenosis. RESULTS: Antibodies to cardiolipin were identified in seven (9%) patients preoperatively. In four of these seven patients the bypasses thrombosed within 3 months after surgery and another two developed stenoses. At 6 months the primary bypass patency, i.e. patency without stenosis, was 14% (95% confidence interval (CI) 0-33%) in patients with antibodies to cardiolipin, as opposed to 57% (95% CI 45-69%) in patients without these antibodies (log rank test: p = 0.03). Diabetes mellitus was also associated with a reduced 6 months primary bypass patency (38% (95% CI 16-60%) vs. 58% (95% CI 45-71%), p = 0.006). A Cox regression analysis showed that both the presence of antibodies to cardiolipin and diabetes independently contributed towards predicting the overall risk of bypass failure. CONCLUSION: Antibodies to cardiolipin were identified in 9% of patients undergoing infrainguinal vein bypass surgery and appeared to be associated with increased risk of bypass failure.

Aged↗
PubMed1997

The release of gastric inhibitory peptide, glucagon-like peptide-I, and insulin after oral glucose test in colectomized subjects.

BACKGROUND: The physiologic role of the colon as an endocrine organ is not clear. We therefore studied the enteroinsular axis in patients with ulcerative colitis after colectomy. METHODS: The subjects included 11 patients with a conventional ileostomy, 10 patients with an ileoanal reservoir, and 10 normal controls. The concentrations of glucose, insulin, gastric inhibitory peptide (GIP), and glucagon-like peptide-I (GLP-I) were measured in plasma during an oral glucose test. RESULTS: The peak level of glucose and peak levels and area under the curve (AUC) of insulin and GIP were higher in patients (P < 0.05). Neither the peak level nor the AUC of GLP-I differed between patients and controls, but time to peak level was four times longer in patients with an ileoanal reservoir (P < 0.05). CONCLUSION: Colectomy seems to affect the enteroinsular axis, leading to hyperinsulinemia and an impaired glucose tolerance. Moreover, patients with an ileoanal reservoir have a slower GLP-I response after intake of glucose.

Adult↗
PubMed1996

[Transmyocardial laser revascularization. A new possible method for treatment of ischemic heart disease].

Transmyocardial laser revascularization (TMR) using a CO2 laser or a holmium YAG laser represents a novel approach to treating coronary artery disease. Through a left thoracotomy, 15-30 transmural channels approximately 1 mm in diameter, are created with the laser through reperfusable areas of the left ventricular free wall of the beating heart. This allows blood to flow directly from the left ventricle into the myocardial vascular network. The epicardial holes seal within few minutes. More than 1000 patients have had TMR worldwide. Indications are not fully established. Preliminary results suggest that TMR may be of value either as an adjunct to coronary bypass surgery, or in patients in whom another invasive treatment is not an option. Results from randomized, controlled studies are not yet available.

Humans↗
PubMed1996

[Treatment of non-small-cell lung cancer and solitary adrenal gland metastasis].

A patient with non-small-cell lung cancer and a solitary adrenal metastasis was treated with right subsegmental pulmonary resection and right adrenalectomy. Four months later an upper right lobectomy was performed because of local recurrence. Forty-one months following the initial operation the patient is doing fine without signs or symptoms of recurrence. Adrenalectomy because of a solitary adrenal metastasis in patients with non-small-cell lung cancer may offer the opportunity of prolonged survival, when a radical thoracotomy can be performed.

Adrenal Gland Neoplasms↗
PubMed1994

[Appendicitis in pregnancy. Complications and treatment].

In order to establish guidelines for the management of a pregnancy that is complicated by acute appendicitis we carried out a retrospective review of 16 patients that had their appendix removed at the Department of Obstetrics and Gynaecology, Rigshospitalet, University of Copenhagen in the period 1974-1988. The diagnostic accuracy was 12/16 (75%). The signs and symptoms were classic. Uterine contractions may occur. There was one foetal death in a case complicated by an intraperitoneal abscess, and two patients delivered prematurely. Three patients had infectious complications, none of these patients were given prophylactic antibiotics. In all uncomplicated cases the pregnancy proceeded to term and the deliveries were normal. The pregnancy ought not to divert the surgeon's attention from performing prompt appendectomy once the diagnosis is suspected. Prophylactic antibiotics and tocolytic drugs should be used in all cases. Simultaneous caesarean section should be performed only on obstetric indications.

Appendectomy↗
PubMed1994

Secretion of glucagon-like peptide-1 and reactive hypoglycemia after partial gastrectomy.

Glucagon-like peptide-1 is a peptide hormone from the distal small intestine which stimulates insulin secretion and inhibits glucagon secretion and thereby lowers blood glucose. This hormone, therefore, could be involved in the pathogenesis of postprandial reactive hypoglycemia. We subjected 8 patients showing symptoms of early dumping after partial gastrectomy to an oral 100 g glucose load and measured blood glucose and plasma insulin, C-peptide, glucagon, enteroglucagon and GLP-1 concentrations for 3.5 h after ingestion. Ten matched controls were treated similarly. The patients had higher blood glucose concentrations for the initial 60 min, but lower values for the remaining test period with a nadir of 2.76 +/- 0.19 mmol/l at 146 +/- 17 min after glucose (controls: 3.36 +/- 0.21 mmol/l at 210 +/- 9 min). GLP-1 and enteroglucagon responses were grossly elevated in patients compared to controls and insulin and C-peptide levels were higher during the initial 60 min. Glucagon concentrations increased in patients and decreased in controls. When hypoglycemia occurred, GLP-1 levels were only moderately elevated and insulin and C-peptide levels were lower and glucagon levels higher in patients than in controls. Thus, mechanisms other than release of GLP-1 seem to be responsible for the observed changes in the concentrations of glucose and glucoregulatory hormones.

Administration, Oral↗
PubMed1992

[Microbiology related to anal abscess complicated with fistula formation].

The results of operative treatment of anal abscesses with reviewed retrospectively for a period of three years with the object of correlating the microbiological findings on culture from the abscess with the presence of a fistula. Patients who had not been controlled postoperatively were requested to attend for anal examination. Fistula were demonstrated in 27 out of 83 patients. No fistulae nor recurrences of abscesses were found in patients in whom only bacteria not derived from the intestine were cultured. Culture from an anal abscesses is thus of considerable prognostic value.

Abscess↗
PubMed1991

Human galanin: primary structure and identification of two molecular forms.

From acid/ethanol extracts of surgical specimens of human large intestine we isolated two peptides, in approximately equal amounts, that reacted with an antiserum against porcine galanin. By amino acid analysis, sequence analysis and mass spectrometry, the larger of the two peptides was found to consist of 30 amino acid residues, the sequence of which was identical to that of porcine galanin except for the following substitutions: Val16, Asn17, Asn26, Thr29 and Ser30. Unlike porcine galanin, the carboxy-terminus was not amidated. The smaller peptide corresponded to the first 19 amino acid residues counted from the N-terminus of the 30 residue peptide (again without amidation). The structural analysis was repeated on another batch of tissue with identical results. By HPLC analysis of extracts of specimens from a further 4 patients, the same peptides were identified. Thus, human galanin includes two peptides of 19 and 30 amino acids that share the sequence of the N-terminal 15 residues with other mammalian galanins, but exhibit characteristic differences in the remaining part of the molecules.

Amino Acid Sequence↗
PubMed1991

No signs of Campylobacter jejuni/coli-related antibodies in patients with active ankylosing spondylitis.

Twenty-two patients with active ankylosing spondylitis were investigated to assess the levels of specific serum IgG, IgA and IgM titres against Campylobacter jejuni/coli before and during treatment with sulfasalazine. An enzyme-linked immunosorbent assay was used, and the results were compared with the antibody levels in 300 healthy blood donors. Three patients had elevated levels of serum anti-Campylobacter-IgA before treatment, and a two-fold decrease in the antibody titre was observed during treatment. Three patients had elevated anti-Campylobacter-IgG titres before treatment. One of these patients also had elevated anti-Campylobacter-IgA and IgM titres. Elevated IgM titres were not seen in any other patient. The results do not support the hypothesis that C. jejuni/coli plays an important role in the pathogenesis of active AS.

Adult↗
PubMed1991

Massive hematuria due to iliac artery-ureteral fistula. Case report.

Massive hematuria in a 73-year-old man, who 17 years previously had undergone aorto-iliac-femoral thrombendarterectomy, was found to originate from an iliac artery-ureteral fistula due to a false aneurysm. Fistula formation should be kept in mind when investigating such hematuria in patients with a history of vascular surgery in the iliac segment.

Aged↗
PubMed1990

[Appendicitis in pregnancy].

The incidence, symptoms, clinical and paraclinical findings, and complications of appendicitis during pregnancy is reviewed. The symptoms and signs do not differ from those in non-pregnant women with the disease. Uterine contractions may occur. The pregnancy ought not to divert the clinicians attention from the disease which is complicated by a considerable foetal mortality, premature labour and abortion. These complications are especially connected with perforated appendicitis. The perforation frequency is related to the delay prior to operation. Immediate appendectomy is recommended as soon as the disease is suspected, making use of prophylactic tocolytic therapy. Antibiotics should be administered according to the usual recommendations. Abdominal delivery should be reserved for obstetric indications only.

Abortion, Spontaneous↗
PubMed1989

[Socio-medical consequences of patients with Bechterew's disease in Denmark].

During the period 1972-1985, 179 patients with Bechterew's disease replied to a questionnaire based on the age at commencement of the disease, treatment and the patient's experience of this and the working capacity related to the duration of the disease inter alii. The distribution of patients who were capable of working was constant regardless of the duration of the disease. 40% were completely fit for work, 35% partially fit for work and 25% were unfit for work. 63% sought alternative forms of treatment which were without clinical effect. Regular training and employment of non-steroid, anti-inflammatory agents resulted in clinical improvement. During the latest five years of the period of investigation, a tendency was observed for reduction in the delay in establishing the diagnosis. Despite early onset and varying clinical course, the prognosis in patients with Bechterew's disease is good.

Adult↗
PubMed1989

[Antibacterial treatment of Campylobacter pylori-associated gastritis and peptic ulcer].

On the basis of possible etiological or pathogenetic significance of Campylobacter pylori for the development, maintenane og recurrence of gastritis and peptic ulceration, a review based on the literature is presented for the sensitivity of the bacteria in vitro and in vivo to antibiotics and preparations employed in the medicinal treatment of gastritis and peptic ulceration. The bacterium is sensitive in vitro to a long series of antibiotics and all of the anti-ulcer agents have, similarly, antibacterial activity in vitro, but, apart from bismuth, only in high concentrations. Among the anti-ulcer agents, only bismuth and, similarly, amoxycillin are capable of eliminating the bacteria from the stomach and this is associated with healing of any gastritis present. Recurrence of infection is observed in more than 50% of the patients after the conclusion of treatment regardless of whether this was antibiotic or bismuth treatment. High in vitro activity of a substance is not synonymous with in vivo activity. A correlation was demonstrated between recurrence of duodenal ulcer and recurrent/persistent infection with Campylobacter pylori. The optimal antibacterial therapeutic strategy is not established and, similarly, no generally accepted indication for specific antimicrobial treatment of Campylobacter pylori associated gastritis or peptic ulceration exists.

Anti-Bacterial Agents↗