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O Broström

Publications and source records attributed to O Broström.

29 records · Page 2Linked to original sources
PubMed1987

Flow cytometric DNA analysis in longstanding ulcerative colitis: a method of prediction of dysplasia and carcinoma development?

During a prospective study lasting 3.5 years flow cytometric DNA analysis was evaluated as a possible predictor of dysplastic and malignant lesions in longstanding ulcerative colitis. Fifty three patients with total ulcerative colitis (mean disease duration of 22 years) were regularly colonoscoped. Biopsies of colonic mucosa were analysed by flow cytometric technique and were also assessed histologically. Findings of abnormal DNA pattern (aneuploidy) were compared with findings of dysplasia. Five patients (9%) had aneuploidy, four of those at repeated colonoscopies. Four of those patients also had various degrees of dysplasia. In one patient aneuploidy preceded the finding of dysplasia and in another aneuploidy preceded a well differentiated adenocarcinoma, grade Dukes' A subsequently found at surgery. Four additional patients had dysplasia, all in connection with macroscopic lesions, but were diploid. It is suggested that flow cytometric DNA analysis in long standing ulcerative colitis may be helpful in addition to histopathology in the detection of potential malignancy in ulcerative colitis.

Adult↗
PubMed1987

Prevalence of inflammatory bowel disease among relatives of patients with ulcerative colitis.

The familial occurrence of inflammatory bowel disease (IBD) was investigated among 963 patients with ulcerative colitis (UC) diagnosed in 1955-1979 in Stockholm County. For 76 patients who had a relative with IBD a pedigree was drawn. The diagnoses of the diseased relatives were verified. There was a general prevalence of 7.9% for IBD among relatives. In 80% one relative was affected, in most cases a first-degree relative with UC. Sibship was the commonest relationship. No concordance for UC was found among three pairs of monozygotic twins. The prevalence of UC in first-degree relatives was 15 times higher than in non-relatives. The age of onset was significantly lower among patients with a family history for UC; they also had a higher incidence of total colitis. The prevalence of Crohn's disease in first-degree relatives of patients with UC was almost 3.5 times higher than in non-relatives.

Adolescent↗
PubMed1987

Prognosis and mortality of ulcerative colitis in Stockholm County, 1955-1979.

All 1274 patients in Stockholm County who were diagnosed as having ulcerative colitis during the 25-year period 1955-79 were followed up and studied with regard to prognosis and mortality. There were 109 deaths recorded--41 caused by ulcerative colitis and 68 from other causes. The cumulative survival probability (computed by life-table methods) was worse than expected. For males it was approximately 80% at 20 years, to be compared with the approximately 97% expected in the background population. For females the corresponding figures were approximately 85% and 98%, respectively. The excess death risk increased with increasing age and was more commonly due to unrelated causes than to ulcerative colitis as such. In patients with total colitis at onset the death risk was greater than for other patients during the first years of disease. Thereafter the prognosis was, if anything, better than in other cases. There was no major change in postoperative mortality or general mortality pattern during the 25 years of observation.

Adolescent↗
PubMed1987

The risk of colorectal cancer in ulcerative colitis. An epidemiologic study.

Patients with a definite diagnosis of ulcerative colitis in Stockholm County during the 35-year period 1945-79 were identified and followed up with regard to the development of cancer of the colon. We found 25 patients who had developed 31 cancers. In 24 of 25 cases this occurred in patients with total colitis. The cumulative risk of developing cancer for patients with total colitis at follow-up study was calculated by means of life-table methods. It was 13% at 25 years (SD +/- 4.2%) among patients diagnosed in 1945-79, compared with the 1.9% expected in a population matched for age and sex. Among patients diagnosed in 1955-79 the risk was approximately 5% at 20 years (SD +/- 3.0%), compared with 1.4% for the background population. The cancer risk for all patients with colitis was higher but not significantly higher than that of the general population. The outcome of patients who developed cancer was dependent on histologic staging (Dukes's) at surgery but not on age at cancer diagnosis.

Adult↗
PubMed1986

Cancer surveillance of patients with longstanding ulcerative colitis: a clinical, endoscopical, and histological study.

An eight year endoscopical and histological cancer surveillance programme comprising 71 patients with ulcerative colitis is presented. Forty one patients had total colitis and 30 substantial colitis. Mean duration of the disease was 19.7 years (range 9-46 years). An average of 2.6 colonoscopies per patient in the total colitis group were carried out, and at least two biopsies were taken at 10 locations in the colon. In the total colitis group, seven had either low (four), or high grade dysplasia (two), or Dukes' A cancer (one). In the group with substantial colitis two patients with low grade dysplasia were found. Dysplasia or cancer leading to operation was found above the rectum in four of five operated patients, all having had total colitis for 25 to 44 years. The dysplasia and cancer findings at the colonoscopy preceding surgery corresponded well with the surgical specimens. In three operated patients a sequence of dysplasia development was recorded. With the exception of long duration and dysplasia, nothing in the clinical course distinguished the operated cases. Using this surveillance programme prophylactic colectomy can be limited to patients in a high risk group developing dysplasia. The risk of missing a cancer before it becomes incurable seems to be low.

Adult↗
PubMed1986

Ulcerative colitis in Stockholm County--a study of epidemiology, prognosis, mortality and cancer risk with special reference to a surveillance program.

The epidemiology of ulcerative colitis (UC) in Stockholm County 1955-79 was investigated. There were 1274 cases. The proportion of patients with proctitis, left-sided and total extent of disease remained constant over the study period. The incidence increased over the first 20 years followed by a plateau. The peak incidence in relation to age increased slightly but remained in the third and fourth decade through the study period. The incidence in men over 40 years of age increased markedly towards the end of the study. There were 109 deaths at follow-up (Dec. 1981) among those having the UC diagnosis between 1955-1979. Twentysix out of 41 patients who died due to UC did so postoperatively. The mortality pattern among those 68 patients who had causes of death unrelated to UC was similar to the expected. There was a decrease in cumulative survival probability compared with the expected, in particular in those with total colitis. This was also seen when only deaths unrelated to UC were included suggesting an increased sensitivity to the ordinary disease spectrum in UC patients. Between 1945-1979 there were 1339 patients who had UC diagnosed. Twentyfive of those had developed colon cancer (24 with total colitis) at follow-up (Dec. 1981). Eighteen were dead at follow-up, the survival time being in direct relation to the Dukes' grading at cancer diagnosis irrespective of age. The cumulative cancer risk at 25 years duration (total colitis patients only) was 13% (SD 4%) compared to the expected 1,9%. In a selected group of 71 patients followed for cancer surveillance during the period 1974-82 nine patients developed at least low grade dysplasia including one Dukes' A carcinoma. The dysplasia or cancer leading to operation was found above the rectum in four of five operated patients, all having total colitis with a duration ranging between 25-44 years.

Adolescent↗
PubMed1985

Incidence of ulcerative colitis in Stockholm County 1955-1979.

The epidemiology of ulcerative colitis in Stockholm County over a 25-year period, 1955-79, was investigated. Only definite cases in accordance with specified acceptance criteria were included. There were 1274 cases--681 males and 593 females. The proportion of patients with proctitis, left-sided, and total extent of disease of diagnosis remained constant over the study period, as did the time interval between onset of symptoms and definite diagnosis. The peak incidence in relation to age increased slightly but remained in the 3rd and 4th decade through the study period. The incidence in men over 40 years old increased markedly towards the end of the study.

Adolescent↗
PubMed1983

The role of cancer surveillance in long term prognosis of ulcerative colitis.

The cancer risk in patients with extensive colitis has increased. It seems to be of a moderate degree in the long-term perspective when looking at it in epidemiological terms and studies. All methods of selecting patients for cancer prophylactic surgery have their merits and disadvantages. The decision could be made only on the duration and extent of the disease. Then there is a risk of an unnecessary surgery including post-operative mortality and morbidity. By including histological and endoscopical findings in the decision one increases the precision of selection but one runs the risk of missing carcinoma which may develop in occasional patients. Hopefully in the future additional methods will increase our means of selection as an important part of the long-term management for these patients.

Biopsy↗
PubMed1982

Neutrophil functions during total parenteral nutrition and Intralipid infusion.

Total parenteral nutrition (TPN) has been associated with an increased incidence of infection. To assess the hypothesis that TPN, and in particular one of its constituents, the rat emulsion Intralipid, might impair host defense, we investigated in vitro migration, bactericidal functions, and chemiluminescence of the neutrophil granulocyte in four patients with Crohn's disease, given TPN for up to 12 wk. No abnormal values were found during TPN, but both before and after, impaired migration was noted. Further, 10 volunteers were given 10% Intralipid (85 ml/h), and in blood samples obtained 2 h after discontinuation of the infusion, enhancements were recorded for migration stimulated with serum and the maximal chemiluminescence response (p less than 0.05, respectively). Thus, neither during TPN nor infusions of Intralipid were impairments of neutrophil migration or bactericidal functions noted, and it is suggested that other factors than effects on neutrophils must be sought to explain susceptibility to infection during TPN.

Adult↗
PubMed1979

Tranexamic acid in massive haemorrhage from the upper gastrointestinal tract: a double-blind study.

In a double-blind trial of tranexamic acid in massive upper gastrointestinal haemorrhage, 76 patients were treated with the active drug and 73 patients with placebo. The doses were 1 g intravenously six times daily for a maximum of 3 days, followed by 1.5 g orally four times daily for a maximum of 4 days. The treatment group and the placebo group were comparable with respect to mean age, diagnoses and laboratory tests but differed slightly with respect to sex and alcohol consumption. The transfusion requirement in the treatment group was less than in the placebo group during the first days after admission, the difference being significant on the second day after admission. Ten patients in the treatment group and 18 patients in the placebo group were operated on. Eleven patients in the treatment group and 12 patients in the placebo group died. In the tranexamic-acid-treated group fewer operations were performed and significantly less blood was needed. It therefore seems highly likely that tranexamic acid has a beneficial effect, although small.

Aged↗