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Biomedical subjects

K Nygaard

Publications and source records attributed to K Nygaard.

At least 19 recordsLinked to original sources
PubMed1992

Bleomycin/cis-platin as neoadjuvant chemotherapy before radical radiotherapy in localized, inoperable carcinoma of the esophagus. A prospective randomized multicentre study: the second Scandinavian trial in esophageal cancer.

Survival and swallowing function were studied in a randomized trial of 97 patients with inoperable, localized esophageal carcinoma. Radical radiotherapy was given to 51 patients, while 46 patients had two courses of bleomycin/cisplatin before radiotherapy. The survival was 29% after one year, and 6% after 3 years in the radiotherapy group. The survival in the combined treatment group was 18 and 0%, respectively; p = 0.1895. The number of patients who could swallow any food increased from 6% before treatment to 38% after 3 months in the radiotherapy group, and from 0% to 23% in the combined group. No benefit was found by combining bleomycin/cisplatin with radiotherapy.

Aged↗
PubMed1992

Breath methane and colorectal cancer.

The association between colorectal cancer and breath methane is controversial. We compared a group of 59 patients with unresected colorectal cancer with a group of control subjects matched for age and sex. We also studied 43 of the cancer patients before and 3-6 months after resection. Sixty-three per cent of the patients with unresected carcinoma and 56% of the control subjects were methane excretors (NS). We found no significant change in methane excretion status after resection. Because recent colonic cleansing has been shown to influence methane production in the colon, 15 breath methane excretors were studied immediately before the start of cleansing, on the day of colonoscopy, and on the 7th day thereafter. Forty per cent became breath-methane-negative on the day of colonoscopy, but all 15 were excretors with a median of 60% of the precleansing concentration on the 7th day. The present study does not confirm an association between breath methane and colorectal cancer. It is unlikely that colonic cleansing procedures influenced the results of this study.

Adenocarcinoma↗
PubMed1992

Value of computed tomography in preoperative evaluation of resectability and staging in oesophageal carcinoma.

OBJECTIVE: To evaluate computed tomography (CT) as a method of staging patients with oesophageal carcinoma. DESIGN: Retrospective study. SETTING: Ullevaal Hospital, Oslo, Norway. SUBJECTS: 85 patients who presented with oesophageal carcinoma between February 1982 and December 1989. INTERVENTIONS: Assessment by CT was made in all patients. MAIN OUTCOME MEASURES: Correlation with findings at operation, and histological examination of operative specimens. RESULTS: From the findings at operation in the 46 patients who were operated on (resection, n = 39; exploration only, n = 7) the sensitivity, specificity, and accuracy of CT staging of the growth were 80%, 91%, and 88%, and when histological confirmation of infiltration was taken into consideration the figures were 25%, 84%, and 54%, respectively. The sensitivity, specificity, and accuracy of CT detection of lymph node metastases were 22%, 95%, and 55%. CONCLUSION: Staging of oesophageal cancer with CT before operation is useful in judging resectability, but the smaller tumours should be assessed with caution. CT is unreliable in the diagnosis of the depth of infiltration and the presence of lymph node metastases compared with histological examination.

Adenocarcinoma↗
PubMed1991

[Surgical treatment of gastroesophageal reflux. Evaluated by manometry and 24-hour pH monitoring of the esophagus].

From 1980 to 1989, 46 patients underwent surgery for pathological gastro-oesophageal reflux disease; 28 with Nissen technique, nine with Hill technique and nine with a modified Belsey technique. 11 patients (24%) experienced postoperative complications, 21% after Nissen, 33% after Hill and 22% after Belsey. Two of six patients suffered recurrence of their reflux symptoms after Belsey, three of six after Hill and two of 26 (8%) after Nissen. 85% experienced no reflux symptoms after Nissen fundoplication. 17 patients suffered from flatulence, three were not able to belch and two were not able to vomit. Median lower oesophageal sphincter pressure before Nissen fundoplication was 6.0 mmHg and length was 2.0 cm. After the operation the pressure increased to 10.0 mmHg and the length to 3.0 cm. Four patients underwent ambulatory 24-h oesophageal pH monitoring both preoperatively and postoperatively. The preoperative registration was pathological in all patients, but in three patients the postoperative pH was normal.

Adolescent↗
PubMed1991

Mucosal surface area of a reversed intestinal segment in rats.

Only scarce knowledge exists of morphologic changes after antiperistaltic reversal of the small intestine. Previous animal models using a reversed segment of the small intestine after massive intestinal resection have been mostly concerned with assessing absorption. A rat model was therefore developed for the purpose of studying mucosal surface area in the small intestine after reversal of an intestinal segment. A reversal of 10 cm, representing a length of about 10%, was found suitable for the investigation. Marked dilatation of the reversed segment occurred. A pronounced increase in mucosal surface area caused by mucosal hyperplasia was observed. The mucosal surface area in an anastomosed, but not reversed, segment also increased markedly compared with a group undergoing no operation, although less than in the reversed segment. We conclude that a reversed intestinal segment will increase mucosal surface area in an optimal length used for this purpose. This increase is possibly caused by prolonged exposure to intestinal chyme.

Animals↗
PubMed1991

Perforated appendicitis with generalized peritonitis. Prospective, randomized evaluation of closed postoperative peritoneal lavage.

The therapeutic value of closed postoperative peritoneal lavage in perforated appendicitis with generalized peritonitis was assessed in a prospective, randomized study. In all patients the peritoneal cavity was irrigated peroperatively, and all received systemic ampicillin and tinidazole. The patients were randomly allocated to management with (n = 39) or without (n = 44) closed peritoneal lavage. Postoperative infection developed in ten patients of the lavage group and in four controls. The infection was intra-abdominal in one of the former and two of the latter cases. No intergroup difference was statistically significant. The lavage procedure had to be prematurely discontinued in ten cases. Closed postoperative peritoneal lavage is expensive and seems to involve a risk of complications. No clinical benefit could be attributed to the lavage in this series, in which the risk of overlooking therapeutic advantages was calculated as maximally 2.5%.

Adolescent↗
PubMed1989

[The polyposis project].

A research project initiated in 1978 comprised establishment of a national polyposis registry, a genetic linkage study using classical and DNA markers, an in vitro study of fibroblasts for transformation parameters and chromosome instability, and a comparative study of DNA-RFLPs in cancer and constitutional tissue. The linkage study (to be reported elsewhere) confirmed the recently reported close linkage between the polyposis gene locus APC and D5S71. No in vitro test for the presence of the APC gene has been confirmed or revealed, but we detected increased chromosomal instability on a statistical basis and also recorded abnormal DNA-repair. As per 1. January 1988 the prevalence of adenomatosis of colon and rectum in Norway was 1/43,500. Among patients born in the period 1931-1950 the incidence at birth of developing the disease is 1/20,000 and the mutation rate is 1/72,000 per gamete per generation. In Norway new mutants in healthy families will comprise 1/3-1/2 of all new cases in the coming two decades, or one of 36,000 births.

Adenomatous Polyposis Coli↗
PubMed1989

Antibiotic prophylaxis in colorectal surgery. Combined doxycycline-tinidazole vs. doxycycline alone.

Single-dose doxycycline was compared with single-dose doxycycline + tinidazole in regard to prevention of septic complications after colorectal surgery, taking into account the type and level of surgery--right or left hemicolectomy, rectal operations and others. The study was performed as a prospective double-blind trial, with randomization in blocks. In colorectal surgery as a whole the combination was found to be more effective than doxycycline alone. When the four surgical blocks were separately considered, however, the difference between the two regimens was found to be mainly due to rectal operations, following which the incidence of abdominal and of perineal wound infections was significantly lower with the combined regimen than with doxycycline alone. The subgroups composed of right-sided or left-sided hemicolectomy or other operations were too small to permit definite conclusions.

Adolescent↗
PubMed1986

Pancreatic duct occlusion in the rat: report and assessment of a new technique.

Temporary reduction of the exocrine pancreatic secretion may be desirable in various experimental models. In the rat this can be achieved by obstructing the connection between the pancreas and the duodenum. A new, simple technique of pancreatic duct occlusion using metal hemostatic clips is described. The reduction of secretion produced by the procedure was assessed by measuring duodenal protein, amylase, and trypsin during stimulation with cholecystokinin. Stimulated duodenal amylase activity 1 and 4 weeks following duct occlusion was reduced by approximately 80% compared with sham-operated controls, whereas proteolytic activity was reduced by 96 and 60%, respectively. The magnitude and duration of pancreatic insufficiency achieved by this technique is equivalent to that achieved with more complicated methods.

Amylases↗
PubMed1979

Repair of hiatus hernia by an abdominal semi-fundoplication technique.

The results of an anti-reflux operation are reviewed. The procedure is similar to the Belsey Mark IV operation, a semi-fundoplication, but performed via an abdominal approach. Forty-five patients were operated upon between 1971 and 1977, 41 had a sliding hernia and 4 a para-oesophageal hernia. Two patients died during the observation period. The follow-up of the remaining 43 patients includes clinical, radiological and manometric examinations. The length of follow-up averaged 35 months (7--70 months). There were 6 anatomic recurrences or persisting sliding hernia and one recurrence of paraoesophageal hernia. Three of the patients with recurrence had been subjected to parietal cell vagotomy and hernia repair, and one was a primary technical failure with persisting hernia. In 32 technically successful repairs of sliding hernia performed as a primary procedure without concomitant PCV, there was one recurrence. Subjectively, 93% (40/43) of the patients considered the operative result excellent or good. Manometric studies showed a significant rise in the lower oesophageal sphincter pressure, from a median value of 6.5 mmHg preoperatively to 12.5 mmHg postoperatively (p less than 0.05) (median value in normal controls, 15.3 mmHg).

Abdomen↗
PubMed1978

Pulmonary complications after bleomycin, irradiation and surgery for esophageal cancer.

Eight patients with epidermoid carcinoma of the esophagus were given radiotherapy of 3000 rads and 120 mg of bleomycin. Esophageal resection was performed five to six weeks later. Four of these patients died within six weeks, three from respiratory failure, and one from complications secondary to an anastomotic fistula. Of the remaining four patients, three showed varying degrees of pulmonary infiltration for several weeks. Interstitial pneumonitis was demonstrated in all the fatal cases. Four patients given the same irradiation and bleomycin doses were only subjected to exploratory surgery. They had no postoperative pulmonary complications. Ten patients given the same irradiation and bleomycin treatment without surgery also showed no pulmonary complications. Sixteen patients received higher doses of radiotherapy and bleomycin. Seven of these developed lung infiltrations terminating fatally in four. The likely mechanism of the observed postoperative pulmonary complications is that the preoperative treatment sensitized the lungs, while the subsequent surgical trauma triggered a reaction in the lungs leading to respiratory failure.

Aged↗
PubMed1978

Small-bowel adaptation after colectomy in rats.

Colectomy with ileoproctostomy or ileostomy was performed in rats. The animals were killed at different time intervals after operation. In histological sections from the small intestine the total crypt cell number and vinblastine-arrested mitoses were counted, and the villus height was measured; these parameters were compared with the corresponding ones in unoperated controls and in rats subjected to ileal transection. After ileoproctostomy the rats remained in good condition, whereas ileostomy was followed by weight loss, debility and a great mortality. After ileoproctostomy, ileostomy and ileal transection there was an increased number of mitoses in the crypts during the 28 days' observation period, indicating an increased rate of cell proliferation. Increased villus height was observed after ileoproctostomy as well as after ileostomy. The mucosal hyperplasia may play a role for the increase in water and salt absorption capacity after colectomy. Probably, however, the hyperplasia of the small-intestinal mucosa cannot fully compensate for the loss of the colon in rats. Preservation of the absorptive function of the rectum, as in ileoproctostomy, is necessary for adequate water and salt absorption.

Adaptation, Physiological↗