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Biomedical subjects

L O Nilsson

Publications and source records attributed to L O Nilsson.

36 records · Page 2Linked to original sources
PubMed1981

Quantitative recovery of contaminating bacteria at operation and the relation to postoperative infection in intestinal surgery.

In a prospective study of postoperative septic complications, young patients suffering mainly from inflammatory bowel disease were subjects to elective surgery. The bacterial concentration in the operative field was determined by an irrigation technique. When at least one of two irrigation fluids yielded greater than or equal to 50 CFU/ml of E. coli or S. aureus the risk of postoperative infection was highly increased (p less than 0.0001, Fisher's exact test).

Adolescent↗
PubMed1981

Continent ileostomy. An account of 314 patients.

Continent ileostomies were created in 314 patients between 1967-1979. Approximately 50% of the patients were provided with the continent ileostomy in connection with proctocolectomy and the others were converted from a conventional ileostomy to the continent ileostomy. In the majority of patients the indication for proctocolectomy was ulcerative colitis, but 51 patients with Crohn's disease were also included. There was 2.5% operative mortality overall, but when the material was divided into two groups operated upon during two consecutive time periods, no mortality was recorded in 152 patients operated upon during the latter period. The non-fatal complication rate had also decreased from 24% in the early series to 7% in the group operated upon during the latter period. Revisional surgery because of malfunction of the nipple valve has consecutively decreased with the present technique for construction of the nipple from 54% in the original series to 6%. At the follow up, 94% of the patients were continent and never used ileostomy appliances.

Adolescent↗
PubMed1980

Morphological and histochemical changes in the mucosa of the continent ileostomy reservoir 6--10 years after its construction.

Morphological and histochemical changes in the mucosa of the continent ileostomy reservoir were studied in 13 patients who had been provided with a continent ileostomy reservoir 6--10 years before the investigation. Biopsy specimens were taken for evaluation of basal morphology, morphometry, and enzyme histochemical analyses. The villi were predominantly finger-like, but the villus height was reduced compared with normal. The crypt layer and the number of cells in each crypt were increased. The number of mitoses was normal or slightly subnormal. In comparison with biopsies taken 1 year after construction of the reservoir, there was an increase in villus height and mucosal volume and a decrease in the number of mitoses, whereas the number of cells per crypt was unchanged. The surface to volume ratio decreased progressively during the 6- to 10-year period. This decrease was partly caused by an increase of the mucosal volume. The epithelial cell layer was intact, and no changes were seen in the microvillus layer. No alarming changes in terms of dysplasia, fibrosis, or progressive atrophy were found. Histochemical investigation showed a high enzymatic activity in the epithelial cells as concerns both the oxidative metabolism and the secretory function.

Acid Phosphatase↗
PubMed1980

New water absorption and mucosal morphometry of ileal reservoirs and of ileal segments transposed to the colon in the cat.

New water absorption and changes in villous height were studied in ileal reservoirs and in ileal segments transposed to the colon in the cat. A continuous perfusion technique was used to estimate net water absorption. The villous height was reduced both in ileal reservoirs and in the transposed segments compared with normal ileum. The serosal area of the reservoir was significantly increased compared with the initial segment used in construction of the reservoir. The reservoir showed a reduced net water absorption rate per unit serosal area compared with a control segment, but when the absorption of the whole reservoir was compared with that of a control segment of the same initial length, there was no significant change. In the transposed segments no significant change in net water absorption could be revealed. Data from both series of experiments showed a positive correlation between net water absorption per unit serosal area and villous height. Blood flow registration in ileal segments transposed to the colon showed a blood flow of the same magnitude in the transposed segment as in the control segment.

Acid-Base Equilibrium↗
PubMed1980

Construction of a stable nipple valve for the continent ileostomy.

Construction of the continent ileostomy has been beset by a high incidence of late complications due to malfunction of the nipple valve. A modification of the technique for the construction of the valve was developed in animal experiments and tried out with success in clinical tests. The operation technique is described and preliminary clinical results reported.

Animals↗
PubMed1979

Absorption studies in patients six to 10 years after construction of ileostomy reservoirs.

The absorption of fat, bile salts, and vitamin B12 was studied in 14 proctocolectomised patients six to 10 years after construction of a continent ileostomy. All patients were in excellent health and displayed no signs of malnutrition. Schilling test disclosed subnormal absorption of vitamin B12 in one patient and borderline values in five. Faecal loss of bile acid was increased in 12 patients and fat malabsorption occurred in two. Except for slightly pathological liver tests in two patients, routine laboratory tests, including plasma concentration of vitamin B12 and folic acid, were normal. There were no signs of sodium or potassium depletion.

Adult↗
PubMed1979

Faecal excretion of intravenously injected 14C-cholic acid in patients with conventional ileostomy and in patients with continent ileostomy reservoir.

Bile salt absorption, as determined by the faecal excretion in i.v. injected 14C-cholic acid (FBS) was studied in 13 ileostomy patients before and after conversion to Kock's continent ileostomy reservoir. The result was compared with that obtained in 8 ileostomy patients in whom about 50 cm of the terminal ileum has also been removed. As compared with 16 healthy controls, FBS was moderately increased in the conventional ileostomy patients, but still within normal limits. After conversion to ileostomy reservoir all patients had pathological FBS, although less severe than in the ileostomy patients with ileal resection. Bacterial contamination probably contributes more than the structural mucosal changes to the bile malabsorption in the pouch, whereas reduced mucosal surface and short small-intestinal transit time are the main causes of malabsorption in ileostomy patients in whom an appreciable amount of the terminal ileum has been resected.

Adult↗
PubMed1976

Surgical treatment of perforations of the sigmoid colon.

Previous reports show evidence that perforation of the sigmoid colon with diffuse peritonitis, when conventionally treated (i.e. by suture, drainage, and proximal defunctioning colostomy) is associated with a high mortality. Recent investigations, however, indicate that the mortality can be lowered considerably if acute resection or exteriorization of the affected segment of the bowel is performed. Fifteen patients with perforated lesions in the sigmoid colon associated with diffuse peritonitis were treated with drainage and right transverse colostomy during the 10-year period 1963-72 with five deaths. In comparison, during the last years, ten patients with perforation and diffuse peritonitis were treated with acute resection or exteriorization of the affected segment of the bowel without any mortality. Though the two patient series are not completely comparable, the results imply that removal or exteriorization of the affected bowel is to be preferred in the surgical treatment of most perforated lesions in the sigmoid colon, even if the perforation is associated with diffuse peritonitis.

Adult↗
PubMedDate not supplied

Sexual adjustment in ileostomy patients before and after conversion to continent ileostomy.

Questionnaires were sent to 48 ileostomy patients to evaluate the effects on sexual life of an ileostomate before and after conversion to a continent ileostomy. Forty-two patients (88 per cent) returned their questionnaires. Ninety-eight per cent of the patients had sometimes felt embarrassed, uncertain or inhibited by the conventional stoma, whereas only 24 per cent had these reactions after conversion to a continent ileostomy. About 80 per cent of the patients thought that the conventional ileostomy disturbed their sexual life because of the risk of leakage, odor, noise or such inhibitory influence to the continent ileostomy. Four men (31 per cent) and 15 women (52 per cent) reported that their sexual activity was reduced or absent when they had their conventional ileostomy. After conversion to a continent ileostomy all but one man and one woman considered their sexual activity to be normal. One-third of the patients claimed that the partner was embarrassed by the conventional ileostomy, but no partner admitted a negative reaction towards the continent ileostomy. Conversion to a continent ileostomy improved the quality of sexual life in about 85 per cent of both men and women.

Adult↗
PubMedDate not supplied

Gastroduodenal and ileal polyps in patients treated surgically for familial polyposis coli with proctocolectomy and continent ileostomy.

Eighteen patients, who previously had been treated surgically for familial polyposis coli with proctocolectomy and a continent ileostomy were re-investigated with endoscopy and X-ray for gastric, duodenal and ileal polyps. Gastric and/or duodenal polyps were found in 6 patients and ileal polyps in 2. Altogether upper GI-polyps were found in 7 patients (39%). Most polyps were true adenomas. In one patient with large gastric adenomas, the severe dysplasia called for a gastric resection. It is obvious that familial polyposis may affect the whole gastro-intestinal tract, therefore necessitating regular surveillance of the upper GI-canal as well as the colon and rectum in patients with this hereditary affliction.

Adenomatous Polyposis Coli↗