PubMed Health⌕ Search

Biomedical subjects

K Lindquist

Publications and source records attributed to K Lindquist.

35 records · Page 2Linked to original sources
PubMed1990

Different types of mucosal adaptation in the ileal reservoir after restorative proctocolectomy. A two-year follow-up study.

A histomorphologic study of the pelvic pouch mucosa during the first two years of function was performed in 11 consecutive patients treated for ulcerative colitis. Two types of mucosal adaptation were delineated. Type A response (5 patients) showed stable slight atrophy, normal numbers of goblet cells, and numerous sulphated mucin positive cells. The frequency of mitoses was higher than in the normal ileum. The degree of acute and chronic inflammation was low and decreasing or stable. Dysplasia was never seen. Type B response (5 patients) comprised progressive, finally severe atrophy accompanied by increasing degree of acute inflammation. The number of mitoses was higher than in type A response. In two patients the number of goblet cells was moderately/severely decreased and epithelial atypia or low grade dysplasia occurred repeatedly. The response was regarded as indeterminate in one patient. The determination of the types of mucosal adaptation may help in the planning of the follow-up of these patients.

Adaptation, Physiological↗
PubMed1990

Correlation between fluorescein flowmetry and laser Doppler flowmetry. A study in the intestine (ileoanal pouch) in man.

A study was undertaken to compare two new methods of capillary blood flow measurement, namely fluorescein flowmetry (FF) and laser Doppler flowmetry (LDF). The blood flow was measured in a pelvic pouch during its construction and in the completed ileoanal anastomosis in 12 patients. There was a high correlation between the two methods (correlation coefficient, 0.78) (p less than 0.01) when the blood flow was measured in the pelvic pouch. The correlation coefficient between the two methods for the difference between the blood flow in the pelvic pouch at the site of the planned anastomosis when the pouch resided in the abdomen and that in the completed ileoanal anastomosis was r = 0.99 (n = 12, p less than 0.001); the reduction amounted to 25% as measured by FF and 27% as measured by LDF (n = 12, p less than 0.01). All ileoanal anastomoses healed perfectly, the lowest FF and LDF values being 0.004 density units/sec and 0.3 V, respectively. The results indicate that either method can be considered for measuring capillary blood flow.

Adenomatous Polyposis Coli↗
PubMed1989

Qualitative assessment and morphometry in the study of the ileal reservoir after restorative proctocolectomy.

Little is known about the long-term effects on the reservoir mucosa in patients with ulcerative colitis and familial polyposis coli who undergo proctocolectomy with subsequent construction of ileal reservoir/pouch and ileoanal anastomosis. In these patients, questions regarding adaptation towards a more colon-like mucosa and/or development of (pre)malignant changes are of particular importance. With the aim of designing a method for reliable evaluation of the mucosa in the ileal pouch, biopsies from 10 patients were studied by semiquantitative assessment and morphometry. The findings were compared with those obtained from normal jejunum, ileum, and colon. The following parameters were found to be important: Villous surface density, quantity of goblet cells, number of mitoses, and the presence/absence of predominantly sulphated mucin+ goblet cells. The number of Paneth cells did not show significant changes. The villous surface density was determined by a cycloid test system applied to vertical sections. Semiquantitative assessment was a sufficiently precise method for the evaluation of the quantity of goblet cells. The counting of sulphated mucin+ goblet cells was not reproducible, instead a simple statement about the presence or absence of these cells was judged to be adequate. The number of mitoses and of Paneth cells were counted directly. During the first year of function the ileal pouch showed signs of adaptation towards a colon-like mucosa: Reduction of villous surface density, increased mitotic activity, and appearance of sulphated mucin+ goblet cells. The number of Paneth cells did not show significant changes. The amount of goblet cells was generally not increased, rather reduced in some patients.

Adult↗
PubMed1988

Alterations in ileoanal pouch technique, 1980 to 1987. Complications and functional outcome.

This study presents the results of 82 ileoanal pouch operations (57 S, 25 J) performed from 1980 to 1987. It also reports the development of the operative technique during these years. The functional outcome was evaluated in 66 patients followed for 2 to 84 months (mean, 23). The mean number of bowel movements per 24 hours was 5.0. Seventy-four percent of the patients had no leakage or staining and 82 percent had a deferral time of more than one hour. Nightly evacuations were significantly more common in men than in women. Leakage and short deferral time were significantly more common in patients over 40 years of age than in those under 25. Early experience with the S-pouch was encumbered by evacuation problems and ileoanal separations. Shortening of the efferent conduits and the muscle cuffs reduced these complications significantly. Postoperative continence was improved significantly after reduction of anal dilatation and preservation of the transitional zone. The length of bowel used for the double-loop reservoirs seemed to be of importance concerning frequency.

Adolescent↗
PubMed1987

Cuff abscesses and ileoanal anastomotic separations in pelvic pouch surgery. An analysis of possible etiologic factors.

In many reports, mucosal proctectomy and ileoanal anastomosis has been reported as a procedure afflicted with a considerably high frequency of cuff abscesses and ileoanal anastomotic separations. In order to find the predisposing factors the charts of 20 early pouch patients were reviewed; ten of these patients had these complications and ten constituted a control group. There were two striking findings about the complication group: a tendency toward more severe rectal gross inflammation and troublesome mucosectomy, and consistently very long, greater than or equal to 7 cm, acute angulated, efferent conduits, and severe evacuation difficulties. Reconstruction of the pouch, with shortening of the efferent limb, was necessary for definite cure in all but one patient. The cuff abscess seemed to be either a descending infection, or an infection ascending from a disrupted anastomosis, a rupture provoked by a long, kinked efferent conduit. After introduction of the S-pouch with short spout and the J-pouch, this feared complication did not appear.

Abscess↗
PubMed1987

Douglas Houghton.

Explore the source record for details and available documents.

History, Modern 1601-↗
PubMed1986

Proximal gastric vagotomy and segmental gastrectomy in duodenal ulcer disease--a preliminary report.

The clinical and acid secretory results of 3 patients operated upon with proximal gastric vagotomy associated with a segmental gastrectomy for duodenal ulcer are presented. The outcome of surgery was favourable with cure of the ulcer disease, without dumping, diarrhoea or retention symptoms. The maximal acid output was reduced by 82% and the basal acid output by 62%. However, one patient developed a nonfatal anastomotic leak postoperatively and was reoperated upon. As this might be due to inadequate blood supply following proximal gastric vagotomy we plan to study the microcirculation in this area before proceeding with this combined procedure.

Duodenal Ulcer↗
PubMed1985

A reconstructive operation on malfunctioning S-shaped pelvic reservoirs.

Patients with triple-loop pelvic reservoirs have often suffered from evacuation problems, clinically shown as the need for intubation, frequent stooling, leakage or ileoanal disruptions. In a recent study, the authors have shown that malposition of the reservoir and presence of a long, kinked, efferent limb constitute the main causes of these problems. A corrective operation consequently was designed in order to improve pouch topography. The pouch and its efferent conduit were completely mobilized and the efferent limb was shortened considerably. The reservoir then was placed in close proximity to the anus and the ileoanal anastomosis was reestablished. This operation now has been performed in seven patients who were considered "failures" and the results are gratifying. Six of these patients now have efficient evacuation and four are completely without leakage. Comparison of pre- and postoperative clinical and radiologic variables confirm the strong correlation between reservoir topography and clinical outcome.

Adult↗
PubMed1985

The mucosal blood flow in pelvic pouches in man. A methodologic study of fluorescein flowmetry.

Fluorescein flowmetry implies the measurement of capillary blood flow, expressed as an index between the maximum fluorescence after the first circulatory passage of sodium fluorescein (NaF) and the rise time, defined as the time interval between ten and 90 percent of the maximum fluorescence. A mathematic model based on fluorescein flowmetry was deduced to distinguish a mucosal and muscular blood flow in an intact (unopened) intestine during surgery in man. The hypothesis was that if, at a certain point in time, there is a fixed relationship between the seromuscular fluorescence and the mucosal maximum fluorescence, obtained during the first circulatory passage of NaF, and if the rise times were equal, then a mucosal blood flow could be calculated based on the seromuscular fluorescence. The model was tested in intestinal anastomoses on 16 patients. A fixed relationship between the numeric value of the mucosal maximum fluorescence and the seromuscular fluorescence was found. After five minutes, the ratio was 1:1 and the correlation coefficient at its highest (0.97). It was also found that the rise times were practically identical (r = 0.92). The validity of the model was then tested by comparing it with fluorescein flowmetry, and the correlation coefficient was 0.85. The model was therefore accepted and named indirect mucosal fluorescein flowmetry. Indirect mucosal fluorescein flowmetry was applied to measure blood flow in pelvic pouches in 14 patients, and fluorescein flowmetry in the ileoanal anastomoses in eight patients. The mucosal blood flow in the reservoir, compared with the normal intestine, was reduced to 58 percent if the ileocolic artery or distal branches of the mesenteric artery were ligated, and to 88 percent if the vessels were left intact (P less than 0.05). In the ileoanal anastomosis the mucosal blood flow was reduced to 23 percent compared with the normal intestine (P less than 0.01). The results suggest that stretching and compressing the mesentery might be critical for circulation in the ileoanal anastomoses.

Capillaries↗
PubMed1985

Poly(ADP-ribose) and the recovery from damage in Chinese hamster cells due to 5-bromodeoxyuridine photolysis.

Exposure of Chinese hamster cells to near-u.v. light, following the uniform incorporation of 5-bromodeoxyuridine (BrdUrd) into their DNA, resulted in cell killing that was close to exponential. An inhibitor of poly(ADP-ribose) synthesis, 3-aminobenzamide (3-ABA), enhanced the cytotoxic effect of this treatment when present for 2 h at 20 mM after light exposure. The dose modifying factor was 1.4. Under conditions that resulted in a sigmoidal survival curve (a 30 min BrdUrd pulse in S phase, followed 90 min later by light exposure) the effect of 3-ABA was to remove the shoulder of the survival curve with very little change in its final slope. Using various inhibitors of ADP-ribosyl transferase (ADPRT) the enhanced cell killing was found to correlate with the inhibitors' relative potency. Cellular NAD+, the substrate for poly(ADP-ribose) synthesis, was rapidly depleted after exposure. This depletion was largely prevented by 3-ABA; the activity of ADPRT increased with the fluence of near-u.v. light; and the concentration of cellular NAD+ decreased with exposure. ADPRT activity was maximal immediately after exposure to near u.v. light and then decayed to pre-exposure levels within 30 min (37 degrees C). The enhanced cytotoxicity of BrdUrd + near-u.v. light, when followed by 3-ABA treatment, disappeared at a rate similar to that of the decay in ADPRT activity. We conclude from these results that poly(ADP-ribose) synthesis is important for the recovery from BrdUrd photolysis damage in DNA. Because this damage and its repair are relatively specific (e.g. compared to ionizing radiation) and relatively easy to manipulate, it could serve as a model system for the study of the role of poly(ADP-ribose) in the repair of DNA damage.

Animals↗
PubMed1984

The topography of ileoanal reservoirs in relation to evacuation patterns and clinical functions.

The clinical outcome following ileoanal pouch operations vary greatly. To understand the underlying mechanism 15 S-shaped reservoirs and one J-shaped were studied by defecography (evacuation pouchography). Efficient evacuation was noticed when the reservoir was placed deep in the pelvis with the outlet of the pouch on a level with the 5th sacral vertebra or coccyx, and when the efferent limb was short (less than or equal to 7 cm) and straight. When the pouch was placed higher up in the pelvis and when the efferent limb was long and angulated, evacuation was impaired. Patients with efficient evacuation all had excellent clinical functions with few (less than or equal to bowel movements in 24 hours and no leakage, but when the evacuation was impaired there was a tendency towards more frequent stooling and leakage.

Adult↗
PubMed1968

Enzymes of the lung. I. Detection of esterase with a new cytochemical method.

The esterases of rabbit lung have been investigated from two viewpoints, the cytochemical and the biochemical. To accomplish this objective, we designed and synthesized a series of ester substrates which provide both a cytochemical indicator of the location of the enzyme and a means of following the enzymatic activity in tissue homogenates and subfractions. The substrates are p-nitrophenylthiol esters which yield, upon hydrolysis, carboxylic acid and p-nitrothiophenol. The latter can react with aurous ions to give an electron-opaque deposit; in addition, the strong absorption of p-nitrothiophenol at 410 mmicro permits continuous kinetic measurements. Thus, it is possible to correlate the intracellular site of action and the biochemical behavior of the esterases. The new substrates are the thiol analogues of the p-nitrophenyl esters frequently employed as esterase substrates. The rates of hydrolysis of the two series of esters are compared in vitro. During tissue fractionation, most of the esterase activity sediments with a particulate fraction. The effects of a number of common esterase inhibitors, such as diisopropyl phosphorofluoridate and eserine sulfate, are examined, and the effects of enzyme concentration and heat inactivation are shown with the use of the partially purified preparations. The cytochemical work shows that the esterase activity is most prominent in the lamellar bodies of the giant alveolar (type II, septal, or granular pneumatocyte) cells of the lung and to a lesser extent in squamous (type I, or membranous pneumatocyte) epithelial and endothelial cells. In both the cytochemical and biochemical studies, the enzymes are inhibited by diisopropyl phosphorofluoridate and phenyl methylsulfonyl fluoride but are insensitive to eserine sulfate.

Animals↗