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Biomedical subjects

K Nygaard

Publications and source records attributed to K Nygaard.

At least 91 records · Page 5Linked to original sources
PubMed1981

Pancreatic polypeptide secretion before and after gastric bypass surgery for morbid obesity.

Basal, meal-stimulated, and insulin-stimulated secretion of pancreatic polypeptide (PP) has been measured before and 3 and 12 months after gastric bypass surgery in 10 obese patients. The basal serum concentration of PP was significantly reduced after the operation. After a meal there was a significant increase in PP concentration both before and after operation. The early phase of meal-stimulated PP release was similar before and 12 months after surgery, but during the late phase the concentrations were 30% lower after the operation than preoperative values. Insulin-stimulated PP release was significantly reduced postoperatively. It is concluded that both basal and stimulated secretion of PP is significantly affected by gastric bypass surgery. The results indicate that the distal part of the stomach and the duodenum play no role in the early phase of meal-stimulated PP release and a minor role in the late phase of meal-stimulated PP release. The reduced basal level of PP and reduced PP response to insulin postoperatively indicate that gastric bypass surgery leads to impaired secretion of PP from the pancreas.

Adult↗
PubMed1981

Synthesis of sterols and proteins in liver biopsies from obese patients subjected to gastric or jejunoileal bypass operations.

Incorporation of 14C-acetate into digitonin-precipitable sterols and of 3H-leucine into proteins was examined in per- or post-operative liver biopsies from morbidly obese patients subjected to either gastric or jejunoileal bypass operations. Biopsies obtained from non-obese patients without liver disease served as controls. Incorporation of precursors into sterols and proteins in peroperative biopsies from obese patients (mean weight, 131 kg) did not differ from that of control subjects (mean weight, 64 kg). However, biopsies obtained from eight patients 11-53 months after jejunoileal bypass (mean weight loss, 32% of initial weight) showed an eightfold increased 14C incorporation into sterols, whereas incorporation of 3H-leucine into proteins did not differ from that of the control group. The results in postoperative biopsies (3-12 months) from 9 patients subjected to gastric bypass (mean weight loss, 25% of initial weight) did not differ significantly from those in 15 controls. The markedly stimulated biosynthesis of sterols in patients with jejunoileal bypass might reflect increased faecal excretion of cholesterol and bile acids, causing reduced feedback control mediated by bile acids and cholesterol.

Adolescent↗
PubMed1981

Intestinal and gastric bypass. Changes in intestinal microecology after surgical treatment of morbid obesity in man.

Jejunal bacterial flora, bile acid deconjugation, and breath hydrogen and methane excretion were studied in nine patients with end-to-side and nine patients with end-to-end jejunoileostomy and in eight patients with gastric bypass. Bacterial numbers did not differ significantly between healthy controls and any of the patient groups. Production of fermentation gases in anaerobic cultures supplemented with carbohydrates did not occur with jejunal secretions from healthy controls but was found in all intestinal bypass patients and half the gastric bypass patients. Bacterial bile acid deconjugation activity was significantly higher in end-to-side compared with end-to-end jejunoileostomy patients. In gastric bypass patients bile acid deconjugation was not significantly affected. Breath hydrogen after glucose ingestion was abnormal in six patients with end-to-side and three with end-to-end jejunoileostomy and in six of the patients subjected to gastric bypass. The highest values were found in the later group. Breath methane, which is found in one third of a healthy population, was absent in all 18 patients with intestinal bypass, and this may indicate that a change occurs even in the colonic microflora after this operation. Both intestinal and gastric bypass may change the small-bowel microflora, with the greatest changes occurring after end-to-side jejunoileostomy and the least changes after gastric bypass.

Adult↗
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↗
PubMed1978

Intestinal bypass. Experimental study on the influence of the excluded intestinal segment.

Five groups of operated rats with 10% of the small intestine in continuity were studied. In one group the animals were subjected to 90% resection of the small intestine, and in the other groups a 90% jejuno-ileal bypass was performed. In two of the latter groups different lengths of the excluded intestinal segment was resected. The bypassed segment was anastomosed to the colon in three of the groups and to the skin as an ileostomy in one group. There were no differences in haemoglobin concentration, liver function parameters or fat absorption between the five groups, but measurements of body weight seem to indicate that the bypassed intestinal segment exerts a general harmful effect on the rats. This effect is more pronounced when the excluded segment is long, and the effect seems to be the same whether it is connected to the colon or to the skin. The mechanism for this effect is not fully ascertained.

Animals↗
PubMed1978

The continent reservoir ileostomy: review of a collective series of thirty-six patients from three surgical departments.

A reservoir ileostomy was created in 36 patients. Three patients died from septic complications in the postoperative period, and one patient died from rectal carcinoma during the observation period. In six patients the reservoirs were removed during the observation period because of nipple-valve extrusion, nonspecific ileitis of the reservoir, or recurrence of Crohn's disease. Complications from the reservoir and its outlet were quite frequent and included fistula formation in eight patients, nipple-valve extrusion in 12 patients, nonspecific ileitis of the reservoir in five patients, and stenosis of the nipple in one patient. Malabsorption of vitamin B12 and fat due to a stagnant loop syndrome was found in four of seven patients examined for this. Fifteen patients underwent 25 reoperations for complications from the reservoir and its outlet. Twenty-six patients still have their reservoirs. Twenty-five of them are continent. They do not wear external appliances and they empty their reservoirs with a tube two to five times daily. One patient is incontinent due to an unrepaired nipple-valve extrusion.

Adolescent↗
PubMed1977

Crohn's disease. Recurrence after surgical treatment.

A series of 76 patients who have undergone surgical treatment for Crohn's disease is presented. In 14 of the patients surgery was performed for recurrence after previous resection. In total, 91 intestinal resections and one bypass--operation were carried out. Postoperative mortality comprised 4 patients (5.3%), and there were 4 late deaths. Sixty-six patients were followed up for periods ranging from 2 to 11 years, with a median of 4.0 years. Recurrence rates and reoperation rates were determined by actuarial analyses. The yearly recurrence rate seemed constant during the observation period, averaging 15.2%, and the cumulative recurrence rate was thus 77% after 9 years. The reoperation rate also seemed to be constant, and on the average 5.5% per year, and the cumulative reoperation per cent after 9 years was 45. There was no significant difference between cumulative recurrence rates after primary operations and after operations for recurrence. There was a significantly higher risk of relapse during the first year after non-radical excision of the diseased part of the gut than after radical excision. The majority of the patients were in good general condition at time of review; only 3 patients suffered from marked symptoms with reduced working capacity.

Adolescent↗