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K Kraglund

Publications and source records attributed to K Kraglund.

At least 19 recordsLinked to original sources
PubMed2004

Endothelium-dependent responses in small human mesenteric arteries.

The aim of the present study was to investigate the endothelial function in human mesenteric arteries with specific reference to defining the role of endothelium-derived nitric oxide (EDNO) and the endothelium-derived hyperpolarizing factor (EDHF). Isolated segments of small human mesenteric arteries (225-450 microm inner diameter) were mounted in organ baths for recording isometric tension. In arteries precontracted with U46619 (thromboxane A(2) analogue, 10(-7) M), endothelium-dependent relaxations were induced in a concentration-dependent manner by substance P and histamine. In normal Krebs solution the relaxations to substance P (10(-9) M) and histamine (10(-7) M) were not significantly affected by preincubation with N(omega)-nitro-L-arginine (L-NNA, 10(-4) M) or indomethacin (10(-5) M). When the preparations were exposed to a solution containing 60 mM KCl, stable contractions were induced, but relaxations could still be induced by substance P and histamine. When the arteries were further preincubated with L-NNA, the relaxations were almost abolished. A combination of apamin (3 x 10(-7) M) and charybdotoxin (10(-9) M) almost abolished relaxations in normal Krebs solution. It is concluded that isolated human mesenteric arteries respond to substance P and histamine with relaxations that are endothelium-dependent. Synthesis of both EDNO and EDHF seem important for these relaxations, whereas prostaglandins seem to be of minor importance.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1998

Lansoprazole and omeprazole in the prevention of relapse of reflux oesophagitis: a long-term comparative study.

BACKGROUND: Proton pump inhibitors are superior to H2-receptor antagonists in the prevention of relapse of oesophagitis, but few data directly compare the relative efficacies of lansoprazole and omeprazole in preventing oesophagitis relapse over a prolonged period. METHODS: Patients with healed Grade II, III or IV oesophagitis were treated with lansoprazole 30 mg o.d. or omeprazole 20 mg o.d. for 48 weeks. Endoscopy and symptom assessment were performed after 12. 24 and 48 weeks of treatment and an additional symptom assessment 36 weeks after starting treatment. RESULTS: Intention-to-treat analysis included 248 patients (lansoprazole n = 126, omeprazole n = 122). Comparison of time to endoscopic and/or symptomatic relapse revealed no difference between the treatments. There was no significant difference between treatments with respect to the proportion of patients in whom endoscopic and/or symptomatic relapse was reported (lansoprazole 12/126 (9.5%), omeprazole 11/122 (9.0%)). No difference between the treatments in either the number or severity of adverse events was reported. CONCLUSIONS: Continuous treatment with either lansoprazole 30 mg or omeprazole 20 mg is effective in preventing the relapse of oesophagitis over a 48-week period in a majority of patients. Both treatments exhibit a similar side-effect profile.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1996

[Results of ileoanal reservoir surgery].

We report our surgical, late complications and functional outcome of 157 consecutive restorative proctocolectomies with an ileoanal J pouch at the Department of Surgery L, Arhus City Hospital. Nine patients had familial adenomatous polyposis, while 148 patients were operated for ulcerative colitis. All patients had a protecting ileostomy. There was no mortality. Surgical complications after J pouch: Six patients were reoperated, five due to intra-abdominal bleeding, one for ileus. There was only one pelvic abscess, and it was drained percutaneously. There were no fistulae, no anastomotic leakage and no early pouch removal. Surgical complications after ileostomy closure: Eight patients were reoperated; two due to wound infections, five for ileus and one due to a wound rupture. Late Complications: Four pouches were removed, due to incontinence, difficult evacuation, chronic pouchitis or Crohn's disease. There were three late pouchovaginal fistulae more than one year after surgery. Five patients had surgery for ileus, one for an intra-abdominal abscess, one for a perianal fistula and eight for incisional hernia. Functional outcome: One year after pouch surgery more than 90% of patients were satisfied with the operation, 2.2% had regretted and 3.6% were in doubt. The functional result was satisfactory in the majority of the patients, but 21.1% had one or more night evacuations and 13.9% had variable degrees of incontinence.

Adenomatous Polyposis Coli↗
PubMed1995

Primary suture of anorectal abscess. A randomized study comparing treatment with clindamycin vs. clindamycin and Gentacoll.

UNLABELLED: Gentacoll (Schering-Plough A/S, DK-3520 Farum, Denmark) implant is a biologically absorbable collagen with gentamicin, which enables local use of gentamicin in an abscess cavity. PURPOSE: To increase healing rate in treatment of perianal abscess with primary suture, the effect of intraoperative parenteral clindamycin and Gentacoll was investigated against monotherapy with intraoperative clindamycin in a randomized study. METHODS: One hundred seven patients, 55 in the Gentacoll group and 52 in the control group, were enrolled in the study and followed for three months. RESULTS: Twelve patients (22 percent) in the Gentacoll group developed a new abscess and/or fistula. In the control group nine patients (17 percent) developed a recurrent abscess or a fistula. In both groups 43 patients had an uneventful course. The differences between the two groups were not significant. Of all 107 patients, 19.5 percent had recurrent disease in the follow-up period. Duration of hospitalization and reconvalescence were identical in both groups. One case of superficial thrombophlebitis was seen after clindamycin. No other adverse effects to either Gentacoll or clindamycin were seen. CONCLUSION: The study shows that Gentacoll is a safe preparation but is without value as a supplement to clindamycin in the treatment of acute perianal abscess with primary suture. The study has documented the value of this treatment under cover with a intraoperative dose of clindamycin.

Abscess↗
PubMed1992

Computer-aided analysis of gastrointestinal pressure recordings. Comparison with manual scoring.

The aim of the present study was to compare computer-based and visual/manual scoring of pressure recordings from the gastric antrum and duodenum. The computer system was based on three separate principles of recognition: moving average, tracking base line, and threshold filters. Computer scoring resulted in the detection of more contractions than visual/manual scoring, owing to inclusion of artefacts of duration and amplitude above the selected thresholds. Owing to its unreliability, visual/manual scoring led to inclusion of some contractions of below-borderline amplitude or duration. The median difference in the frequency of contractions was, however, 0 min-1. There was close agreement on amplitudes of contractions. As the differences between visual/manual analysis and computer-aided scoring by the present system are of an unimportant magnitude and as computer-based scoring is consistent, we conclude that computer-aided analysis is preferable to visual/manual analysis.

Duodenum↗
PubMed1992

The effects of omeprazole on interdigestive motility and early postprandial levels of gastrin and secretin.

Ten healthy men participated in a crossover study, and the experiments took place after 10 days of treatment (40 mg omeprazole every morning). Blood samples were drawn at fixed intervals during a complete migrating motor complex (MMC) cycle. The manometric pressure tube was removed after passage of the second duodenal phase III, and an omelet (1400 KJ) tagged with 99mTc was ingested, followed by 150 ml of water tagged with 111In-diethylenetriaminepentaacetic acid. Mean plasma gastrin (pmol/l) in phases I, II, and III in the omeprazole group was 18.8, 23.3, 19.9, respectively. The corresponding figures for the placebo group were 9.3, 9.6, 9.5, respectively. All mean values for the omeprazole group were significantly higher (p less than 0.01). Mean plasma gastrin in the omeprazole group was significantly higher in phase II than in phase I (p less than 0.05). Mean plasma secretin (pmol/l) in phases I, II, and III in the omeprazole group was 1.6, 1.4, 1.1, respectively. The corresponding figures for the placebo group were 2.0, 1.7, 2.2, respectively. Mean plasma secretin in the omeprazole group was significantly lower in phases I and III (p less than 0.05). The mean incremental integrated postprandial gastrin response (pmol.30 min/l) was significantly higher in the omeprazole group (475.0 versus 97.5) (p less than 0.05). The immediate postprandial mean value of secretin was significantly lower in the omeprazole group (p less than 0.05). We conclude that 40 mg omeprazole elicits i) a phase-related increase in fasting plasma gastrin, ii) a decrease in secretin in phases I and III, iii) an augmented meal-stimulated gastrin response, and iv) a secretin response characterized by a significantly lower mean in the immediate postprandial period.

Adult↗
PubMed1991

Short report: a double-blind placebo-controlled trial of omeprazole on characteristics of gastric emptying in healthy subjects.

The aim of the study was to investigate a possible effect of omeprazole on the characteristics of the gastric emptying of liquid and solid in healthy subjects. The study was performed as a double-blind crossover study and the gastric emptying studies were performed after 10 days of treatment with placebo or omeprazole 40 mg o.m. Omeprazole was without effect on the characteristics of liquid emptying or the lag phase of solid. It does, however, decrease the emptying rate of solid as the omeprazole group had a median half-time duration of the linear emptying period which had twice the duration of the corresponding figure in the placebo group.

Adult↗
PubMed1991

Radial analysis of duodenal motility recordings in humans.

To analyze radial variations in pressure recordings from the human duodenum, we used a catheter with six radially placed side holes with identical dynamic characteristics. Twenty-one hours of fasting pressure recordings were obtained in six volunteers. Computer-based cross-correlation analysis, event detection and counting, amplitude analysis, and concordance analysis were used for comparing the signals of the individual channels. Both the cross-correlation analysis and the counting of events showed radial asymmetry of contractile activity. This asymmetry was not related to any individual channel. The maximum difference between the individual channels was constantly between diametrically opposite spaced channels. The asymmetry was most pronounced during phase-I-like and phase-II-like activity of the migrating motility complex, whereas a much higher degree of cross-correlation and concordance was shown during phase-III-like activity. The results indicate that a greater in-depth analysis of pressure recordings from the small intestine--such as identification of individual events and differentiation between contractions and artefacts--requires that the recordings as a minimum comprise two diametrically placed side holes at each measurement level.

Adolescent↗
PubMed1990

Comparison of one dose versus three doses of prophylactic antibiotics, and the influence of blood transfusion, on infectious complications in acute and elective colorectal surgery.

In a randomized prospective controlled trial involving 311 patients undergoing acute or elective colorectal surgery, the efficacy and safety of two different single dose and one triple dose regimen of antibiotic prophylaxis, as well as the influence of blood transfusion on postoperative infectious complications, were studied. Postoperative infectious complications occurred in a total of 59 patients (19.0 per cent). There were no major differences between the three treatment groups. Thirty-four patients (10.9 per cent) developed abdominal wound infection, 17 patients (5.5 per cent) intra-abdominal abscess and 16 patients (5.1 per cent) anastomotic leakage. Of 202 patients (65.0 per cent) requiring blood transfusion during hospitalization 57 (28.2 per cent; 95 per cent confidence limits of 23-36 per cent) developed infectious complications, whereas two non-transfused patients (1.8 per cent; 95 per cent confidence limits of 0.2 to 6 per cent; P less than 0.001) developed infectious complications. It is concluded that one single dose of antibiotic prophylaxis in acute and elective colorectal surgery is as protective as a triple dose regimen. The development of infectious complications despite antibiotic prophylaxis is strongly related to blood transfusion.

Adolescent↗
PubMed1990

Variations in duodenal cross-sectional area during the interdigestive migrating motility complex.

A probe for measurement of intestinal cross-sectional area (CA) was used to elucidate variations of human gut CA during the interdigestive migrating motility complex (MMC). A balloon was inflated by saline at a pressure of 1 kPa, and variations of balloon CA (BCSA) were measured by means of the field-gradient principle. Duodenal phasic activity was measured by perfused side holes proximal to, distal to, and inside the balloon. In vitro characterization of probe performance showed that static measurement of BCSA was very accurate regardless of the configuration of the balloon. However, during dynamic measurements, BCSA was valid only for slow variations in BCSA due to resistance in the evacuation and inflation system. Eight duodenal MMCs were recorded. BCSA increased consistently from the start of phase I to the end of phase II from 72 (45-100) to 136 (87-154) mm2. During late phase II, a large BCSA increase was recorded. A positive correlation between the phasic activity level in phases I and II of MMC and maximal BCSA in duodenum was demonstrated (proximal P less than 0.01; distal P less than 0.05). BCSA during phase III was small but could not be estimated accurately because steady-state conditions were not obtained. The large BCSA in late phase II suggests a relaxation of the duodenal wall secondary to a decrease in smooth muscle tone. The results add evidence to previous findings of a low-resistance or large-capacitance situation in late phase II, observed as a large pancreaticobiliary excretion into the duodenum and an increased flow of duodenal contents.

Adult↗
PubMed1990

Identification of the pylorus from the intraluminal pH profile. Validation of the method by comparing it with transpyloric potential difference and pressure profile.

In contrast to the steady low intragastric pH, the pH in the proximal duodenum shows wide, rapid, and frequent fluctuations. This change in pH pattern may be used to localize the pylorus and thereby ensure reproducible measurements of duodenal pH at a known and reproducible distance from the pylorus. To validate this method of localizing the pylorus, simultaneous measurements were performed of the transpyloric pH and potential difference (PD) profile and of the pH and pressure profile in 10 normal subjects. pH-metry and PD-metry localized the pylorus within the same 1.5 cm in 82% of 104 5-min periods, and pH-metry and manometry localized the pylorus within the same 5 cm in 72% of 77 10-min periods. This agreement and accuracy seem satisfactory for most studies of intraluminal pH in the duodenum and make reliable long-term ambulatory recording of duodenal pH possible without serial roentgenogram controls.

Adult↗
PubMed1989

Effects of general anaesthesia with halothane on antroduodenal motility, pH and gastric emptying rate in man.

Antroduodenal motility, pH and gastric emptying rate were measured in 11 patients undergoing orthopaedic or plastic surgery with general anaesthesia. Motility was measured by manometry and gastric emptying rate by the rate of paracetamol absorption. During anaesthesia, gastric emptying was delayed in eight patients. General anaesthesia with halothane reduced the duration of the interdigestive motility complex (P less than 0.01), mainly by a shortening of phase II (P less than 0.01) which correlated with the inhaled concentrations of halothane (P less than 0.01). Anaesthesia impeded the occurrence of antral contractions during phase II (P less than 0.01); the frequency of contractions was unchanged during anaesthesia, but decreased during the recovery period (P less than 0.01). The amplitudes of antral contractions diminished with anaesthesia (P less than 0.01), but increased after operation. The frequency of contractions in the duodenum was unchanged during phase II and reduced during phase III (P less than 0.01). Gastric pH increased during and after operation (P less than 0.01). General anaesthesia with halothane affects gastroduodenal motility especially during phase II, increases gastric pH and delays gastric emptying rate.

Adult↗
PubMed1989

Antroduodenal motility, pH and gastric emptying during balanced anaesthesia: comparison of pethidine and fentanyl.

In a randomized study of 22 patients, antroduodenal motility, pH and gastric emptying rate were measured during barbiturate anaesthesia with pethidine or fentanyl. Motility was measured by manometry and gastric emptying rate by the paracetamol absorption test. Anaesthesia reduced the duration of the interdigestive motility complexes with both analgesics (P less than 0.001), mainly by a shortening of phase II (P less than 0.01). The duration of phase II and III were shorter with pethidine, and pethidine reduced both the frequency and amplitudes of antral contractions during phase II (P less than 0.01). Fentanyl affected only the amplitudes. The phase III variables assessed were unchanged, apart from a decrease in the velocity of propagation of the motility complexes with pethidine (P less than 0.01). The gastric pH increased in both groups during and after operation (P less than 0.01). Gastric emptying rate was normal in 82% with fentanyl and in 60% with pethidine. Motility in the recovery period approached, but did not reach, preoperative values. Balanced anaesthesia with pethidine and fentanyl seem to have minor influence on gastroduodenal motility and gastric emptying rate.

Anesthesia↗
PubMed1989

Antroduodenal motility and gastric emptying. Gastroduodenal motility and pH following ingestion of paracetamol.

The influence of paracetamol on antroduodenal motility and gastric pH was studied in 11 healthy subjects and the relationship between gastroduodenal motility and gastric emptying rate time, tmax, to peak concentration of serum paracetamol, Cmax, was evaluated. The incidence of antral phase III activity and the duration of phase III was diminished with paracetamol (P less than 0.05). The other motility parameters assessed were unchanged. Three patterns of motility and absorption were observed. One group (n = 5) were fast absorbers with a tmax of 1 h and a motility pattern characterized by antral activity, a high motility index and a short duration of phase II (33-60 min); the phase IIIs were complete except in one case. The second group (n = 4) had tmax at 1.5 h and their phase II motility was characterized by a longer duration (80-133 min) (P less than 0.05), by antral activity, and by a high motility index; their phase IIIs were all incomplete. The last group (n = 2) were slow absorbers: Cmax was not reached in the investigation period, no antral contractions were seen, and the motility index was low. The area under the serum-concentration curve of paracetamol differed between the groups at 90 and 180 min (P less than 0.01).

Acetaminophen↗
PubMed1989

The effect of a new selective alpha 2-adrenoreceptor antagonist, idazoxan, and the agonist, clonidine, on fasting antroduodenal motility in healthy volunteers.

Studies were carried out on 16 healthy male volunteers to investigate whether intravenous administration of the alpha 2-adrenoreceptor antagonist, idazoxan, could affect fasting antroduodenal motility with and without administration of the agonist, clonidine. Contractile activity was recorded using an oral tube with perfused side holes positioned in the stomach and duodenum. Clonidine decreased antral contractile activity, an effect that idazoxan did not restore. Idazoxan alone did not affect antral motility. In the duodenum, clonidine decreased the number of contractions significantly and idazoxan restored them. Idazoxan alone did not increase duodenal motility but clonidine induced phase-III activity within the first 15 min after administration. The observations indicate that regulation of antroduodenal motility is influenced by alpha 2-adrenoreceptor drugs. Idazoxan may have potential as a motility restoring drug, for example, in postoperative ileus.

Adolescent↗
PubMed1989

A double-blind placebo-controlled trial of omeprazole on characteristics of the migrating motor complex in healthy volunteers.

The aim of the study was to investigate a possible effect of omeprazole on the characteristics of the migrating motor complex. The study was performed as a double-blind crossover study and the pressure recordings were performed after 3 days of treatment with placebo or omeprazole 40 mg o.m. The calculations were based on 5 h of recording in each subject and in both investigations. There were two characteristics in the omeprazole group which were significantly different from placebo. Firstly, duodenal phase III was more often accompanied by an antral phase III and secondly, the duration of duodenal phase III was increased. The results suggest that the rapid cleaning mechanism, represented by phase III activity, is more pronounced after omeprazole treatment, possibly arising from its antisecretory effect.

Adult↗
PubMed1989

Consistency in manual scoring analysis of gastrointestinal pressure recordings.

The aim of the present study was to evaluate the consistency in visual scoring and whether this could be the basis for computer analysis using pattern recognition techniques. We studied the consistency of visual scoring of pressure tracings from the upper gastrointestinal tract with regard to pressure wave identification. The aim was to make such an identification the golden standard for computerized analysis of pressure waves. Pressure recordings containing different phases of contraction activity were evaluated by five trained observers. The inter- and intra-observer agreement was highest in periods with high contraction activity (phase III), both of which were better than 90%. In periods with low contraction activity (phases I and II) this agreement was as low as 49%. The results indicate that forming a learning set for pattern recognition should only be based on visual scoring during phase-III activity.

Adult↗