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Biomedical subjects

K Nygaard

Publications and source records attributed to K Nygaard.

At least 73 records · Page 4Linked to original sources

Crohn's disease. Results of excisional surgery in 133 patients.

Of a series of 133 patients treated surgically for Crohn's disease during the years 1962-78, 21 had recurrence after previous operations in other hospitals. In addition, 40 of the patients underwent altogether 52 reoperations for recurrent disease; hence the total number of operations was 185. Five patients died in the postoperative period (2.7%). There were five late deaths related to Crohn's disease. The annual recurrence rate after all operations performed was rather constant, averaging 13.1%, and the cumulative recurrence rate after 10 years was 76.1%. The annual rate of reoperation tended to decline, with a cumulative reoperation rate of 35.8% after 10 years. The recurrence rate was not significantly different after primary operations and operations for recurrent disease. There was a higher risk of relapse during the first 2 years after non-radical excision of diseased gut than after radical excision. At follow-up examination in 108 patients most were in good general condition. Only eight patients had severe, disabling symptoms with reduced working capacity.

Adolescent↗

Intestinal bypass. Bacteriological studies from different parts of the small intestine in rats.

Forty-five rats were divided into four groups according to type of operation: 1) end-to-side jejunoileal bypass (ES), 10 rats; 2) end-to-end jejunoileal bypass (EE), 10 rats; 3) jejunoileal resection (R), 10 rats; and 4) no operation, 15 rats. The luminal contents from the proximal jejunum and distal ileum, in groups 1 and 2 also from the proximal and distal part of the excluded small intestine, were examined bacteriologically 5-11 months after operation. The total number of aerobic and anaerobic microbes in the jejunum was equal in all groups. The number of aerobic bacteria in the ileum was significantly higher in the ES group than in the R and U groups. The number of bacteria capable of producing gas in glucose-supplemented media was increased both in the jejunum and ileum after ES bypass. Enterobacteriaceae and Bacteroides were commonly present in the ileum after both types of bypass but were not cultured in jejunal contents. The proximal part of the excluded intestinal segment in groups 1 and 2 contained very low numbers of microbes, whereas the flora of its distal part was similar to that of the ileum in continuity in group 1. Thus, the most marked changes of the intestinal flora occurred after ES bypass in the region of the anastomosis and distal to this.

Animals↗

Late changes following single dose roentgen irradiation of rat small intestine.

In female Wistar rats a 10 cm long exteriorized mid small intestinal segment was roentgen irradiated with 17, 19, 21 and 23 Gy as single exposures. Animals were killed in groups of 3 at intervals of 6 weeks from 2 to 50 weeks following irradiation. Irradiation injury was assessed using 8 macroscopic and histopathologic parameters, and an injury score for each animal was calculated. The parameters used were divided in 2 subgroups, early and late alterations, showing different types of development. The score for the early alterations decreased from 2 to 20 weeks following irradiation and then remained constant. The late alterations increased and seemed to stabilize about 8 weeks following irradiation. After the initial 20 weeks there was no progression of irradiation injury.

Animals↗

Effects of dose fractionation on late roentgen radiation damage of rat small intestine.

In female Wistar rats a 10 cm long exteriorized mid small intestinal segment was roentgen irradiated. Nominal standard radiation doses were 17 and 19 Gy, given as a single exposure and in 2 and 3 fractions with intervals of 48 hours. Animals were killed and examined in groups of 3 every 6 weeks from 8 to 44 weeks following irradiation. Macroscopic and histopathologic parameters of irradiation injury were used to calculate an injury score for each animal. In the 2 fractions group both mortality and irradiation injury score were higher than in the single exposure and 3 fractions groups. The difference was due in particular to persisting mucosal ulcerations and epithelial atypia. Adenocarcinoma of the irradiated intestine was found in 4 animals.

Adenocarcinoma↗

Large-bowel carcinomas with different ploidy, related to secretory component, IgA, and CEA in epithelium and plasma.

Immunofluorescence staining for carcinoembryonic antigen (CEA), secretory component (SC), and epithelial IgA was evaluated semiquantitatively in 85 large-bowel carcinomas in relation to degree of tumour differentiation, Dukes' stage, and plasma CEA level. The tumours were divided into a near-diploid (ND, 28) and an aneuploid group (AN, 57) by means of flow-cytometric DNA measurements. Expression of SC and IgA in neoplastic epithelium was positively related to differentiation in both groups. The AN tumours scored significantly higher for CEA than the ND ones, but the staining was apparently unrelated to differentiation or Dukes' stage. CEA expression in the transitional mucosa adjacent to ND tumours was negatively correlated with tumour differentiation, whereas epithelial IgA and SC in this zone showed a substantially higher positive correlation with tumour differentiation, and a somewhat stronger negative correlation with Dukes' stage in the ND than in the AN group. Plasma CEA levels were significantly related to Dukes' stage, only in patients with AN tumours, and only in this group were positively correlated with estimates of total tumour CEA for Dukes' stages A and B. For Dukes' stages C and D (disseminated tumours), moreover, the plasma CEA levels were found to be significantly higher in the AN group. These findings indicate that the DNA profile of large-bowel carcinomas is related both to the way neoplastic cells influence the activity of the transitional mucosa and their capacity for expression and release of epithelial products. AN tumours thus seem to be more active as "secretors" of CEA than ND ones.

Adenocarcinoma↗

A single dose tinidazole and doxycycline prophylaxis in elective surgery of colon and rectum. A prospective controlled clinical multicenter study.

Antimicrobial prophylaxis with agents active against aerobic and anaerobic micro-organisms leads to a significant reduction of infectious complications following colorectal surgery. A single dose (1600 mg) of tinidazole (a nitroimidazole derivate) and doxycycline (400 mg) will provide serum and tissue values well above minimum inhibitory concentration (MIC) values for more than 24 hours. To reduce the unwanted side effects and cost of prolonged antimicrobial prophylaxis, a prospective controlled clinical multicenter study comparing the effect of a single dose before operation of tinidazole and doxycycline to five days of prophylaxis before operation in 234 patients undergoing elective colorectal surgery was undertaken. Six patients given a single dose of prophylaxis before operation (n = 118) developed infectious complication (5.1%). Prolongation of prophylaxis before operation for four days after operation (n = 116) did not lead to any further reduction of infectious complications. A single dose of tinidazole and doxycycline before operation is a simple and effective prophylaxis against infectious complications following elective colorectal surgery.

Adolescent↗

Gastrin secretion before and after gastric bypass surgery for morbid obesity.

Fasting, meal-stimulated, and insulin-hypoglycemia-stimulated serum gastrin levels were measured before and 3 and 12 months after gastric bypass surgery in nine obese patients. The basal gastrin concentration was unaffected by the operation. After a meal both serum gastrin and blood glucose levels were significantly increased before the operation (p less than 0.002), whereas there was no significant gastrin release in response to food 3 and 12 months after the operation. Insulin hypoglycemia did not elicit any gastrin response either before or after gastric bypass surgery, even though considerable hypoglycemia was obtained. It is concluded that this lack of gastrin release after food and insulin hypoglycemia postoperatively may in part explain the rare development of peptic ulcer in patients after extensive gastric exclusion.

Eating↗

Elective surgery for ulcerative colitis: colectomy in 158 patients.

Chronic ulcerative colitis was treated by elective colectomy in 158 patients. Proctocolectomy and ileostomy was performed in 140 patients and colectomy and ileorectal anastomosis (CIRA) in 18 patients. The operative mortality was 2.5%, and postoperative complications, mostly infections, occurred in 38%. Within a 2-year postoperative period another 1.9% of the patients died, and late complications occurred in 18%. Colorectal carcinoma was present at the time of colectomy in 5.1% and developed some years later in another two patients primarily operated on with CIRA. Half of the cancer patients died of malignancy. Most extracolic complications, present in 25% of patients before colectomy, regressed or disappeared after operation. Half of the patients operated on with CIRA needed to have their rectum removed within a few years because of cancer or proctitis, and few of the rest had lasting relief of symptoms.

Adolescent↗