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Biomedical subjects

L Domellöf

Publications and source records attributed to L Domellöf.

At least 55 records · Page 3Linked to original sources

An unusual case of postoperative incarcerated diaphragmatic hernia.

A very unusual case of incarcerated afferent loop in a postoperative diaphragmatic hernia after a Billroth II operation and a subsequent thoraco-abdominal resection of a benign oesophago-cardial stricture is presented. Insufficient closure of the diaphragm combined with long loops after a gastro-jejunostomy seemed to be the predisposing factor to this unusual postoperative complication. The risk of rare cases of incarcerated diaphragmatic hernia should be considered after proximal gastric resection.

Female↗

The effect of an oral therapeutic single dose of doxycycline on subsequent monocyte phagocytosis in vitro.

Doxycycline has been reported to depress leukocyte functions. The effect of peroral administration of 400 mg doxycycline was evaluated after 24 hours in 18 healthy persons. No inhibitory effect on monocyte phagocytosis was found. There is no evidence that therapeutic concentrations of doxycycline depress leukocyte functions to a degree of clinical significance.

Administration, Oral↗

A randomized trial of oral 5-fluorouracil versus placebo as adjuvant therapy in colorectal cancer Dukes' B and C: results after 5 years observation time.

A double-blind randomized trial of daily oral 5-fluorouracil (5 mg kg-1 bodyweight) for 3 months versus placebo as adjuvant therapy to surgical treatment of colorectal cancer Dukes' B and C was conducted. In total 421 patients were randomized; 198 patients with Dukes' B, 159 with Dukes' C and 64 were referred to a limited resection group. The distribution of prognostic variables was similar in both groups indicating the absence of any bias and the efficacy of the randomization. Disease-free interval and survival time were analysed as end points. After 5 years of follow-up of all patients there was no significant difference between treatment or placebo group in the total material or the subgroups regarding either of the end points. There was no difference in localization of first recurrence between treated and control group. A high withdrawal of therapy was found in the 5-FU group (40 per cent) and in the placebo group (13 per cent).

Clinical Trials as Topic↗

The phagocytosis of yeast cells by blood monocytes. Effects of therapeutic concentrations of Vinca alkaloids.

The role of cytoplasmic microtubules in the phagocytosis of yeast cells by blood monocytes was studied by means of therapeutic concentrations of the Vinca alkaloids vincristine, vinblastine, and vindesine. Phagocytosis was measured in a monolayer of glass-adherent monocytes fed with fluorescein-labelled yeast cells. Phagocytosis was composed of two sequential processes, yeast cell adherence to the monocyte and yeast cell engulfment by the monocyte. Monocyte phagocytosis was significantly inhibited by the Vinca alkaloids, mainly due to inhibition of engulfment but probably also due to inhibition of adherence. Since the Vinca alkaloids are microtubule antagonists it is reasonable to assume that monocyte phagocytosis, both adherence and engulfment, are partially microtubule-dependent processes. It is suggested that Vinca alkaloid inhibition of monocyte phagocytosis is of value in the treatment of type II-III autoimmune disorders, such as idiopathic thrombocytopenic purpura and autoimmune haemolytic anaemia.

Adult↗

Nitrosamide-induced sarcomas in the gastric pylorus of hamsters. A histological and ultrastructural survey on the histogenesis.

A histological and ultrastructural survey on the histogenesis of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric sarcomas in hamsters was attempted. Within 3 months after the beginning of oral administration of MNNG, simple spindle cell proliferation in the submucosal zone of the pyloric region of the glandular stomach was evident. By 5-6 months, the cells had acquired a sarcomatous appearance. Ultrastructurally, the spindle cells in the early stage, were divided into 3 types, i.e., angiogenic cells, fibroblastic cells, and primitive mesenchymal cells. Similarly, those in the late-appearing sarcomatous tumors were also classified into different types of angiogenic, fibroblastic, histiocytic and miscellaneous cells. Among the cell population of the 2 major groups, angiogenic cells were the most predominant cell type. Some morphological transition appeared to occur between the corresponding cell types at the early and late stages. DNA content of cell nuclei of the representative forms of the nitrosamide-induced sarcomas was higher than that of early appearing spindle cells. Thus, the evidence suggests that the early appearing spindle cells are precursors for the gastric sarcomas.

Animals↗

Observer variability in upper gastrointestinal fiber endoscopy.

The reliability of esophagogastroduodenoscopy (EGD) was evaluated in 71 patients. The study was designed as a comparison between the separate protocols written by two endoscopists at each EGD. The results showed an over-all disagreement of 32% between observers. When the results were correlated with endoscopical experience, a significantly higher proportion of false-negative results was found among endoscopists with experience of less than 500 EGDs compared with a more experienced group of investigators. No difference was found between residents in training (less than or equal to 200 EGDs) and those with intermediate experience (200-500 EGDs). The implications with regard to repeated training programs and authorization of endoscopists are discussed.

Adolescent↗

Effects of long-term combination chemotherapy on the reticuloendothelial system.

The phagocytic and metabolic functions of the reticuloendothelial system (RES) were studied in 20 postoperative cancer patients undergoing long-term combination chemotherapy. Each course included vincristine, methyl-CCNU (day 1) and 5-fluorouracil (days 1-5) every sixth week. The RES-test was performed prior to each course, using 125I-labeled microaggregated human serum albumin. Total leukocytes, mononuclear cells and platelets were monitored before, during and after each treatment. A significant, initial impairment of the catabolic function of the RES was found (2P = 0.006). A similar, nonsignificant trend was observed in the phagocytic function. The normalization may mirror the large metabolic capacity of the RES. This is further demonstrated by the fact that splenectomized (N = 9) and nonsplenectomized patients did not differ. A significant decrease was also found in total leukocytes and mononuclear cells (2P less than 0.001). Combination chemotherapy induced a similar myelosuppression in both groups, but did not further reduce the mobile RES in asplenic individuals.

Adult↗

Adherence and phagocytosis of yeast cells by blood monocytes. Effects in vitro of a therapeutic doxycycline concentration.

The effect of a therapeutic doxycyline concentration on yeast-cell phagocytosis by blood monocytes was studied in vitro by means of a fluoresence assay. This method allows discrimination between monocyte-adherent yeast cells and ingested yeast cells. The adhesive and phagocytic capacity of 50 monocytes was measured in 16 healthy donors. Yeast-cell adherence was not influenced by doxycycline. In contrast, a slight depression of phagocytosis by doxycycline was suggested. The median difference between doxycyclin-treated and control monocytes was 30% (p = 0.07). It is reasonable to assume that a possible inhibitory effect of doxycycline on monocyte phagocytosis is negligible in healthy individuals. However, a clinically significant effect cannot be excluded in severely immuno-compromised patients.

Doxycycline↗

Prevalence of gallstones in Finland: an autopsy study in the Helsinki area.

The prevalence of gallstones in Helsinki (Uusimaa county) was determined in an autopsy sample consisting of 1102 males and 768 females. The crude prevalence of gallstone disease in men was 15.3%, as compared with 34.5% in women. The age-adjusted rates for men and women were 8.7% and 15.9%, respectively. The prevalence of gallstone disease appears to be significantly lower in Finland than in Sweden. However, cholecystectomy rates appear to be higher in Finland than in reports from Sweden and Norway. No significant association with neoplastic disease was found.

Adult↗

Bleeding as a complication to endoscopic biopsies from the gastric remnant after ulcer surgery.

Bleeding is a potential but rare complication after endoscopic biopsies of the gastric mucosa in non-operated patients. The resected stomach, however, seems to run an increased risk of this complication. In a retrospective study comprising 1843 consecutive biopsy examinations of the gastric remnant, 15 bleeding episodes were recorded (0.8%). The frequency of bleeding was 1.1% for the Billroth-II-resected stomach and 0.2% for the Billroth-I-resected stomach. In two patients the bleeding was excessive, requiring emergency surgery. Six other patients required blood transfusions. The observed frequency of bleeding was probably a minimal estimate, suggested by a 20% occult bleeding found in a small prospective study. When planning follow-up examination of patients who have had a gastrectomy, the risk of bleeding should be taken into account, and the patients should be appropriately informed and supervised.

Aged↗

Cholelithiasis, cholecystectomy, and cancer: a case-control study in Sweden.

To study the relationship between gallstone disease (cholelithiasis and cholecystectomy) and cancer, a case-control study was performed in two Swedish hospitals comparing the prevalence of gallstone disease discovered at necropsy in 1422 subjects who died of cancer and 1205 subjects who did not die of cancer. Gallstone disease was more prevalent in the group of 131 women less than 50 yr of age who died of various cancers: odds ratio = 2.2, p less than 0.01. When the analysis was restricted to 89 younger women who died of cancers that have been suggested to be related to diet (breast, reproductive system, gastrointestinal), the results became more significant: odds ratio = 3.3, p less than 0.001. No such relationship was detected in older women or in men of any age. It seems likely that gallstone disease and several common cancers in younger Swedish women share similar epidemiologic and perhaps metabolic features.

Adult↗

Effect of bile acid gavage or vagotomy and pyloroplasty on gastrointestinal carcinogenesis.

Possible promotion of MNNG-induced gastrointestinal carcinogenicity was evaluated in male Wistar rats exposed to unconjugated bile acid given as gavage or as obtained through truncal vagotomy plus pyloroplasty. No significant difference was found compared with the relevant control groups. Even though gastroduodenal erosions were found more frequently in the bile acid gavage and MNNG groups than in MNNG-treated controls, secondary deconjugated bile acids apparently did not reach optimal promoting concentrations. In contrast to partial gastrectomy, vagotomy and pyloroplasty does not increase the tumor yield in the rat.

Adenocarcinoma↗

Gentamicin treatment in severe surgical infections--serum levels, interactions, toxicity and efficacy.

A retrospective and a prospective group of 38 and 20 patients respectively were studied with regard to bacterial strains, clinical effect, toxic side effects and serum concentration of gentamicin in severe surgical infections. A high degree of therapeutic efficacy evaluated as cure or improvement was noted (68 and 75% in the two groups). The serum levels were especially closely checked in the prospective study to keep the gentamicin concentration within the therapeutic range but below toxic levels. This aim was achieved in most cases probably explaining the relatively low incidence of side effects (nephrotoxicity 4 and fungal infection 11 patients). The hazards of gentamicin interactions with drugs like furosemide, penicillins or cephalosporins are discussed.

Adult↗

Enhancing effect of vagotomy and pyloroplasty on gastro-intestinal carcinogenesis induced by nitrosamide in hamsters.

The possible promoting effect of vagotomy and pyloroplasty on N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced carcinogenesis in the gastrointestinal (GI) tract was studied in Syrian golden hamsters on high fat diet (10% corn oil). After truncal vagotomy and pyloroplasty or sham operation, 50 micrograms/ml of MNNG was given for 4 months in drinking water. Similarly operated or non-operated animals without carcinogen administration served as controls. Spindle cell sarcomas were frequently seen in the MNNG-treated hamsters as well as spindle cell proliferation. After vagotomy and pyloroplasty, a small number of hamsters also developed adenocarcinomas and rosette-forming neurogenic tumors. The tumor development in the glandular stomach or small intestine was significantly increased after truncal vagotomy and pyloroplasty. The data suggest that this operation has an enhancing effect on the MNNG carcinogenesis in the hamster.

Adenocarcinoma↗

Splenectomy after blunt abdominal trauma. A retrospective study of 413 children.

Splenectomies performed in children aged 0-14 during the period 1968-1977 have been reviewed. In 413 cases traumatic rupture of the spleen had occurred. The trauma causing the rupture, preoperative examinations, operative findings and complications have been studied. Most frequently traffic accidents had caused the splenic rupture. Many ruptures were not bleeding at the time of operation. Consequently surgical repair saving the spleen had been possible in several cases. Splenectomized children have a significant increased risk of overwhelming sepsis. In this retrospective material 10 children (2.4%) developed sepsis within eight years. Five of these cases had a fatal outcome. The need for a more conservative attitude in children with splenic rupture is emphasized.

Abdominal Injuries↗