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Biomedical subjects

M Osnes

Publications and source records attributed to M Osnes.

At least 37 records · Page 2Linked to original sources
PubMed1978

Comparison of juice obtained during duodenal aspiration and cannulation of the main pancreatic duct after stimulation with exogenous secretin in man.

The exocrine pancreatic secretion obtained by endoscopic cannulation was compared with that obtained by a conventional duodenal tube after exogenous secretin. The flow rate, bicarbonate output, and amylase output in response to secretin was larger during duodenal aspiration than when collecting during endoscopic cannulation. The majority of samples collected from the duodenum contained bile, whereas those from the pancreatic duct were, with few exceptions, colourless. In all patients the bicarbonate concentration was lower in the duodenal aspirate than in the pancreatic juice. In 5 of the 7 patients, however, the concentration of amylase was higher in the duodenal aspirate than in juice collected by endoscopic cannulation. In these patients the quantitative difference found could not therefore solely be explained by non-quantitative collection of juice from the pancreatic duct and/or contamination of bile, intestinal juice, and gastric juice in the duodenum. Augmentation of the response to secretin by the presence of bile and pancreatic juice in the duodenum and inhibition by the endoscopic cannulation of the pancreatic duct are discussed as alternative explanations.

Adult↗
PubMed1977

Mucosal changes in the gastric stump 20-25 years after partial gastrectomy.

Out of 421 patients who had partial gastrectomy 20-25 years ago for gastric or duodenal ulcer, 108 were examined by endoscopy with multiple biopsy. In no case were the endoscopic appearances of the mucosae interpreted as malignant, though in 2 patients the clinical history suggest malignant disease. Histological examination revealed infiltrating carcinoma in 4 patients, 3 of whom had intramucosal carcinoma only. 3 further patients had severe dysplasia (carcinoma-in-situ). Only 1 patient had a near-normal mucosa close to the anastomosis; in the remainder the gastric remnant showed various degress of dysplasia, metaplasia, or chronic atrophic gastritis. In the patients with carcinoma only 28 (12%) of the 226 biopsy specimens revealed the malignant lesion. Patients who have had partial gastrectomy for benign lesions are at high risk of gastric-stump carcinoma. If, 20 years after operation, they have an endoscopy with multiple biopsy, stump carcinoma may be detected early when the prognosis after operation is probably good.

Adult↗
PubMed1977

Juxtaminorpapillary diverticulum associated with chronic pancreatitis.

A 69-years-old male with a juxtaminorpapillary diverticulum of Santorini in the duodenum and chronic pancreatitis is described. The patient had suffered from attacks of epigastric pain during the last 35 years. At recent admission to hospital he had also an elevated urinary amylase activity and a juxtaminorpapillary diverticulum, demonstrated by duodenoscopy and X-ray examination after administration of a contrast medium. Endoscopic retrograde cholangio-pancreatography (ERCP) showed changes of the pancreatic duct system compatible with chronic pancreatitis, a diagnosis which was confirmed by explorative laparotomy.

Aged↗
PubMed1977

Early gastric carcinoma in patients with a Billroth II partial gastrectomy.

In a consecutive series of 830 routine gastroscopies a total of 43 patients was found with gastric carcinomas, Thirteen of these were patients with a previous Billroth-II operation for ulcer disease. Early cancers were found in ten patients (23%), and four of these ten (3 men, 1 woman, aged 49 to 76 years), had been operated on 20-33 years previosuly with a Billroth II partial gastrectomy. All patients had symptoms indicating gastro-intestinal disease. We conclude that a high number of gastric stump carcinomas may be detected at an early stage, and that endoscopy of the whole gastric stump, with multiple biopsies and brush cytology from the entire gastro-jejunal anastomosis, is of crucial importance in detecting such carcinomas.

Adenocarcinoma↗
PubMed1977

Endoscopic choledochoduodenostomy for choledocholithiasis through choledochoduodenal fistula.

A new endoscopic method for treatment of choledocholithiasis in patients with choledochoduodenal fistula is described. In 2 patients with common bile duct stones a choledochoduodenostomy was performed by means of a diathermy snare. In both patients the calculi passed into the duodenum within some days. No complications occurred. It is concluded that the described technique may be helpful when surgery is contraindicated and when endoscopic papillotomy is difficult to perform.

Aged↗
PubMed1977

Juxtapapillary duodenal diverticula and abnormalities by endoscopic retrograde cholangio-pancreatography (ERCP).

In a consecutive series of 174 patients the biliary and pancreatic ducts were demonstrated by endoscopic retrograde cholangio-pancreatography (ERCP). In 84 patients with normal duct systems, juxtapapillary diverticula were found in 5 patients (6%). In 90 cases with ductal abnormalities due to biliary concrements, dilated common bile duct and pancreatitis, diverticula were found in 35 patients (39%). In patients with abnormalities in both duct systems, diverticula were found in 52%, and in patients with changes in one duct system diverticula were found in 33%. The difference in occurrence of diverticula in patients with normal duct systems and pathological duct systems was statistically significant (p less than 0.02). The findings indicate a correlation between juxtapapillary diverticula and pathological changes due to biliary concrements, dilated common bile duct without concrements and pancreatitis.

Biliary Tract Diseases↗
PubMed1977

A comparison of a new non-ionic (metrizamide) and a dissociable (metrizoate) contrast medium in endoscopic retrograde pancreatography (ERP).

Endoscopic retrograde pancreatography (ERP) was performed on 12 patients with a non-ionic contrast medium (metrizamide) and a traditional dissociable medium (metrizoate). All patients were examined with both media at an interval of one week. The study was based on double blind and a cross-over randomization. There was a significantly lower rise in serum amylase 2 (p = 0.05), 4 (p = 0.04), and 6 hours (p = 0.03) after the examination using the non-ionic contrast medium than after using a dissociable one. The pain during contrast filling of the pancreas was significantly lower (p = 0.015) when using metrizamide than when using metrizoate. All, except one patient, preferred the examination with the non-ionic contrast medium (p = 0.0002). A positive correlation was found between pain and degree of pancreatic filling when using the dissociable medium (r = 0.77). Such a correlation could not be detected following the non-ionic contrast medium (r = 0.009). There was a positive correlation between rise in serum amylase and degree of pancreatic filling with both contrast media. The coefficient of correlation was lower after metrizamide (r = 0.21) than after metrizoate (r = 0.56). It is concluded that a non-ionic contrast medium in this study was better tolerated than a dissociable medium, and that metrizamide was more suitable for endoscopic retrograde pancreatography than the traditional hypertonic contrast medium.

Adult↗
PubMed1977

Endoscopic papillotomy (EPT) with removal of common bile duct stones.

Endoscopic papillotomy with removal of common bile duct stones was successfully performed in 14 patients. In 11 patients stones were found after cholecystectomy. In the remaining 3 patients there was a high operative risk. No serious complications occurred. Consequently the removal of choledocholithiasis by endoscopic papillotomy is an alternative to traditional treatment.

Adult↗