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Biomedical subjects

J Malmstrom

Publications and source records attributed to J Malmstrom.

8 recordsLinked to original sources
PubMed1977

Effect of truncal vagotomy on gastroduodenal content of gastrin.

The vagal influence on gastroduodenal content of gastrin was studied in duodenal ulcer patients. Endoscopic biopsies were assayed for total concentrations of gastrin, and fractionated for measurements of gastrin components before and after total vagotomy. Antral concentration was 17-0 +/- 2-0 mug gastrin/g mucosa (mean +/- s.e.m.) in 52 unoperated patients compared with 25-2 +/- 3-2 mug in 32 vagotomized patients. In 14 patients studied before and 3 months after vagotomy antral content was almost doubled (10-9 +/- 2-3 and 20-4 +/- 2-9 mug respectively). In the duodenal bulb the concentration was 2-4 +/- 0.3 mug in 37 unoperated patients and 2-2 +/- 0.4 mug in 19 vagotomized patients. In 6 patients in whom measurements were made throughout the duodenum, gastrin concentrations were slightly but significantly lower 3 months after vagotomy. Fractionations of pooled homogenates on Sephadex G-50 showed that gastrin component III (gastrin-17) made up 95 per cent of the antral gastrins before and after operation. In the duodenum component III constituted more than half of the gastrins preoperatively, but only one-third postoperatively. The total amount of gastroduodenal gastrin was considerably increased by vagotomy, and it is well established that in serum the gastrin concentration is also higher postoperatively. The most likely implication of these findings is that in man the vagus, directly or indirectly, suppresses gastrin production.

Duodenal Ulcer↗
PubMed1977

Central hemodynamics in acute gastrointestinal bleeding.

In 15 patients with acute gastrointestinal bleeding, central hemodynamics were monitored by means of a flow directed thermodilution catheter. Also, the systemic blood pressure, heart rate, blood volume and oxygen saturation in arterial and mixed venous blood were measured. In patients without cardiac insufficiency, the pulmonary artery mean pressure was found to be the hemodynamic parameter giving the most clear and constant evidence of hypovolemia. In patients with left ventricular failure and hypovolemia, the pulmonary artery pressures revealed cardiac insufficiency, and the central venous pressure indicated the degree of hypovolemia. The method has proved useful in observing patients with acute gastrointestinal hemorrhage complicated by cardiac disease, cirrhosis of the liver or the frailty of old age.

Acute Disease↗
PubMed1976

Experiences with the Linton-Nachlas and the Sengstaken-Blakemore tubes for bleeding esophageal varices.

A controlled clinical trial was begun to compare the effectiveness of the Sengstaken-Blakemore tube with that of the Linton-Nachlas tube in the emergency treatment of bleeding esophageal varices. The investigation was prematurely terminated after two lethal complications with the Linton-Nachlas tube. At that time, 28 patients with 42 bleeding episodes were included. Twenty-seven were treated with the Sengstaken-Blakemore tube, with bleeding being controlled in 20; 15 were treated with the Linton-Nachlas tube, with bleeding being controlled in six. No significant statistical difference was found between the two tubes, 0.05 less than p less than 0.1, but the results encourage the use of Sengstaken-Blakemore tube in preference to the Linton-Nachlas tube, except in patients with a hiatal hernia or bleeding from fundic varices.

Adult↗
PubMed1975

Tumours of the thymic region. Symptomatology, diagnosis, treatment, and prognosis.

Fifty-three patients operated on between 1952 and 1971 were originally diagnosed as having thymoma. Re-examination of the material shows that only half of these tumours were true thymomas. The rest were classified as malignant lymphomas, primary and secondary carcinomas, and a few haemangiomas. Half of the patients had symptoms at the time of diagnosis. However, in half of the asymptomatic cases the tumours had penetrated the capsule. Decisive in prognosis are the macroscopic findings around the capsule. Of 33 patients with infiltration of the capsule, 30 had died at the time of investigation. Twenty-five patients died within two years of operation, Twenty-five patients had thymomas, of which 14 were well defined. Twelve patients with thymomas suffered from myasthenia gravis. The treatment of choice of thymoma is total excision, if necessary enbloc, and if there is penetration of the capsule, radiotherapy should be given. None of the patients with a well-defined thymoma had died from their tumour while only two patients with infiltrating thymomas are still alive, Of eight patients with Hodgkin's disease located in the thymus, six had penetration of the capsule, and of these only one patient is still alive. Two patients with well-defined tumours are both alive. The treatment of localized Hodgkin's disease is excision and irradiation. The prognosis for patients with other malignant tumours was bad, the mean time of survival being less than six months.

Adolescent↗
PubMed1975

Effect of histamine on immunoreactive gastrin in gastric juice and in serum.

Due to recent reports claiming that gastrin is present in the gastric juice, the method for gastrin determination has been evaluated. Separate experiments showed that gastrin added to gastric juice disappears rapidly if the juice is not boiled or neutralized. A total of 82 patients with various abdominal disorders were examined. No or only a trace amount of gastrin was found in untreated, boiled, or boiled and neutralized gastric juice in every patient, including three patients with achlorhydria. Histamine injection (0.04 mg. per kilogram, subcutaneously) did not influence this and was without effect upon serum gastrin concentrations of nine duodenal ulcer patients. Because gastrin apparently is degraded rapidly by gastric juice, this study does not necessarily disprove that gastrin is secreted into the stomach. However, the virtual absence of gastrin in all specimens examined, including some collected directly upon boiling water bath during continuous gastric aspiration lends no support to this speculation. Because gastrin does not survive even a short exposure to gastric juice without degradation, we suggest that earlier reports on the presence of gastrin within the stomach are questionable.

Achlorhydria↗