The bile salt-stimulated lipase in human milk is an evolutionary newcomer derived from a non-milk protein.
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Animals↗
Biomedical subjects
L Domellöf
Publications and source records attributed to L Domellöf.
Microflora and deconjugation of bile acids in alkaline reflux after partial gastrectomy.
It has been postulated that reflux of bile into the stomach promotes gastric carcinogenesis. Bile-stained aspirates from 50 asymptomatic patients, partially gastrectomized more than 10 years earlier, were examined bacteriologically and with regard to conjugated and deconjugated bile acids. Endoscopic biopsies showed atrophic gastritis in all patients, cancer in two and severe dysplasia in another two. pH in the reflux aspirates was 7.3 +/- 0.4 (mean +/- standard deviation). Bacterial cultures were positive in all patients studied. Fecal type flora, mostly E. coli, klebsiella and Clostridium perfringens, was found in 85% of the patients. Total bile acids were found to be 2.6 +/- 2.0 mg/ml, 23% of which were deconjugated. Deoxycholic acid, known to promote carcinogenesis in animals, amounted to 27% of total bile acids and deconjugated deoxycholic acid was 5% of total bile acids. The mostly anaerobic microflora and the presence of mainly free secondary and primary bile acids may contribute to the high incidence of cancer in the gastric remnant observed after Billroth I or II operations.
Bile↗
Influence of cancer chemotherapy treatment on the reticuloendothelial system in the rat.
The phagocytic function of the reticuloendothelial system (RES) in the rat has been studied after the administration of cyclophosphamide, 5-fluorouracil or a combination of these drugs and vincristine. No impairment in the elimination of 125I-labelled microaggregated human serum albumin was found. A significant reduction in relative and total spleen weight was not paralleled by a decreased splenic uptake of the RES test substance per gram tissue. A significant increase in the relative weight of the lungs was paralleled by a significant increase in the uptake of test substance on a per gram basis. No correr. A general reduction in the cell population of the haematopoietic system has to be assumed. If this reduction is more pronounced in subpopulations of T lymphocytes (suppressor T cells) has to be further tested.
Animals↗
Fiberendoscopic intramural lesion of the oesophagus.
Iatrogenous oesophageal lesions are rare complications since the introduction of fiber instruments. A recent case is presented of an intramural lesion of the oesophagus in a 33-year-old woman subjected to fiberendoscopy. Etiology, diagnostic and therapeutic measures are discussed. When oesophageal disease is suspected and instruments with side optic are to be used it is advisable to check the oesophagus with a forward viewing fiberscope or contrast X-ray first. Even when a slight resistance is noticed on insertion of the instrument, a perforation must be suspected and the patient subjected to diagnostic and therapeutic measures without delay.
Adult↗
Staging laparotomy for Hodgkin's disease.
Splenectomy was performed in patients with Hodgkin's disease in a prospective study at the University Hospital of Umeå 1973-1978. Fifty-nine subjects were included and the laparotomy was made as a part of the pre-treatment investigation. The result of the surgical exploration was compared to other investigations, e.g., lymphangiography or cavography. The operation morbidity was 5% (3/59). The clinical stage was changed in 15/58 (26%). Fourteen upstaged and one downstaged. The macroscopical evaluation was poorly correlated to the histological involvement. It is concluded that if the staging procedure is performed by specialized surgeons the morbidity is low. No adverse effects have yet been observed after splenectomy. The staging laparotomy and splenectomy is considered superior to nonsurgical staging procedures from both treatment and cost benefit point of view.
Adolescent↗
Alpha-hydroxylation of N-nitrosopyrrolidine and N'-nitrosonornicotine by human liver microsomes.
The environmental carcinogens N-nitrosopyrrolidine (NPYR) and N'-nitrosonornicotine (NNN) were incubated with human liver microsomes to test for the presence of enzymes catalyzing alpha-hydroxylation, which is likely to be an activation mechanism for these compounds. Both nitrosamines underwent alpha-hydroxylation; rates were higher for NPYR than for NNN, as observed in rats. The results indicate that both NPYR and NNN can be metabolically activated by human liver microsomes.
Humans↗
Gastric carcinoma promoted by alkaline reflux gastritis -- with special reference to bile and other surfactants as promoters of postoperative gastric cancer.
For reasons that are not known, the incidence of stomach cancer is declining in most countries. In contrast, cancer of the gastric remnant after partial gastrectomy for peptic ulcer disease seems to be increasing. "Stump cancer" has been claimed to be a separate disease entity and has recently been mentioned as an iatrogenic cancer. Alkaline bile reflux, dietary surfactants and maybe the abuse of tobacco are postulated as promoting or initiating agents, in causing malignant transformation of the operated as well as non-operated stomach. Variations in gastric pH, microflora and emptying rate may be of importance in the carcinogenic process. The decline in cancer incidence in the non-operated stomach has mainly been restricted to the intestinal type of cancer. Thus, it is important to note that stump cancer often is of the diffuse type. Different target cells and/or modes of carcinogen exposure may be of etiological importance in these histologically and clinically separate neoplastic diseases.
Animals↗
The effect of combination chemotherapy on neutrophil function in cancer patients.
The effect of adjuvant and palliative combination chemotherapy (Vincristine, MeCCNU, 5-Fluorouracil) on neutrophil function was studied in 18 patients prior to and during the anticancer treatment. Neutrophil responsiveness was assessed by leukocyte chemotaxis and chemiluminescence. No impairment could be observed in the circulating phagocyte function in either of the 2 groups before or in connection with short or long-term treatment.
Adult↗
Association of hyperthyroidism with idiopathic thrombocytopenic purpura and haemolytic anaemia.
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Adrenal Cortex Hormones↗
Carcinoembryonic antigen (CEA) in the gastric mucosa after partial gastrectomy.
Carcinoembryonic antigen (CEA) was studied by the three-layer bridge immunoperoxidase technique in gastric biopsy specimens taken from 49 patients, 13--20 years after partial gastrectomy. Routine histological examination revealed various degrees of chronic atrophic gastritis in all patients. A positive CEA reaction was found in 6 out of 9 with malignant or premalignant mucosal changes and in 4 out of 40 without these changes. In two cases of carcinoma the biopsies revealed a positive CEA reaction. In 4 patients with carcinoma diagnosed 1--2 years after the first examination the initial nonmalignant biopsies were CEA-positive in one case. All biopsies from mucosa with severe dysplasia and adenomatous polyps were CEA-positive. Four patients without malignant or premalignant changes in the gastric mucosa had CEA-positive biopsies. No carcinoma has been found in these patients at re-examinations after 1 year. The results indicate that the occurrence of immunohistochemically detectable CEA may be associated with malignant transformation of the gastric mucosa. The value of this method in screening patients at increased risk of gastric carcinoma will be further explored.
Adolescent↗
[Gastritis and cancer--surgical aspects].
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Aged↗
Angiography of the testicular artery as a diagnostic aid in boys with nonpalpable testis.
Selective angiography of the testicular artery was performed in 12 boys (age 3-14 yr) with nonpalpable testis. The angiographic, operative, and microscopic findings are described. True aplasia was diagnosed in seven patients. In three patients previously operated upon, the second exploration was facilitated by angiography. This method might be a valuable diagnostic aid in selected cases previously operated for gonadal disorders or inadequately explored for cryptorchism in order to avoid more extensive surgical exploration.
Adolescent↗
The effect of combination chemotherapy on the reticuloendothelial system in man.
The effect of adjuvant combination chemotherapy (vincristine, CCNU/MeCCNU, 5-fluorouracil) on the phagocytic and catabolic properties of the reticuloendothelial system (RES) was studied in 4 patients before and during the anticancer treatment. The results indicate a transient impairment of both these functions, more prolonged with regard to phagocytosis. No significant changes were noted in the mobile macrophage system. This suggests that chemotherapy induces a depression especially of the stationary macrophage populations in the liver, spleen and bone-marrow.
Aged↗
The development of mucosal changes after gastric surgery for ulcer disease.
The development of morphological changes in the body mucosa after partial gastrectomy for ulcer disease according to Billroth I and II was studied early (within 3 years) and late (10-24 years) postoperatively with gastroscopy and forceps biopsies. The morphological findings in the body mucosa of the operation specimens and biopsies from the stomas were compared. The effect of time, ulcer disease, operation procedure, sex, and age was studied. In duodenal ulcer patients, with significantly less pronounced inflammatory mucosal changes in the operation specimen, partial gastrectomy caused acute and chronic gastritis to the same degree as seen in gastric ulcer patients within 3 years postoperatively. Duodenal ulcer patients also developed mucosal atrophy, cystic dilatation of the gastric glands, and intestinal metaplasia by time to an extent not significantly different from what was found in gastric ulcer patients. No correlation could be found between the mucosal changes and factors like age, sex, or operation procedure. Mucosal atrophy, chronic gastritis, and intestinal metaplasia are regarded as possible features of malignant transformation. If this concept is true, our findings may explain why stump carcinoma is frequently reported with the same incidence independent of preoperative ulcer disease or anastomotic procedure.
Acute Disease↗
Gastric polyps and precancerous mucosal changes after partial gastrectomy.
Gastric polyps are considered to be rare. However, at endoscopy the prevalence of gastric polyps after partial gastrectomy was found to be 8.9% (30/336 patients) compared with 4.9% (20/407) in a clinical control material with a comparable age and sex distribution. Four patients with precancerous mucosal alterations were found in the operated group. Repeated endoscopic check-ups have at present been performed in 57.4% of these patients. In our experience the diagnostic accuracy with regard to malignancy is not entirely satisfactory. Histological examination of the surgical specimen from one of the 4 patients with precancerous changes showed a macroscopically invisible early carcinoma. Follow-up examinations (within 4 years) have in 5 out of 26 cases with sessile polyps disclosed carcinoma in 3 cases and precancerous changes or adenoma in another 2 cases. Careful re-examination of all patients with precancerous changes and gastric polyps is recommended.
Adenoma↗
[Current progress in cancer therapy].
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Animals↗
Leakage from T tube tracts as determined by contrast radiology.
The continuity of the T tube tract on removal of the drain was studied by fluoroscopic examination in 51 patients. Leakage was found in 25 cases (abdominal cavity 7, wound drain 6, local cavity 11, combined abdominal and wound drain leakage 1). No correlation was found between the incidence of pyrexia or pain and the presence of leakage. These complications, noted in 10 patients, are probably explained by bacterial contamination of the bile in combination with the trauma caused by extraction of the tube.
Adult↗
The risk for gastric carcinoma after partial gastrectomy.
To study whether gastric resection implies a greater risk for gastric carcinoma than what is expected in a nonoperated population, 676 patients who underwent Billroth I and II resection from ten to twenty years ago were reexamined by gastroscopy. Fourteen patients with carcinomas were found. Statistical evidence shows that male patients resected for benign ulcer disease more than eleven years previously constitute a risk group.
Adult↗