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Biomedical subjects

O Hansen

Publications and source records attributed to O Hansen.

At least 73 records · Page 4Linked to original sources
PubMed1996

Colorectal stapled anastomoses. Experiences and results.

PURPOSE: Stapled anastomoses are currently an established technique in colorectal surgery. Larger series about the use of circular staplers in rectal anastomoses within daily clinical routine are rare. METHODS: We evaluated the morbidity, clinical leakage rate, and mortality in an unselected population of a teaching hospital after elective, left-sided colorectal resections with stapled rectal anastomoses. In the course of our study, manually sewn rectal anastomoses were not performed. All anastomoses were tested intraoperatively by instillation of liquid. RESULTS: A total of 615 elective colorectal resections with stapled rectal anastomoses was performed by 18 surgeons from 1984 to 1993. A protective colostomy was created in 2.9 percent (n=16) of all patients. Clinical anastomotic leakage occurred in nine patients (1.5 percent). The mortality rate was 1 percent (n=6). CONCLUSION: Use of the stapling technique facilitates the performance of anastomoses, particularly in regions with difficult anatomy. The rate of local complications is low, and protective colostomy can thus be dispensed with in most cases

Aged↗
PubMed1996

[Late abscess after laparoscopic cholecystectomy caused by lost gallstones].

A possible intraoperative complication of laparoscopic cholecystectomy is opening of the gallbladder with subsequent loss of gallstones. We report on a 61-year-old woman who was hospitalised with an obscure subhepatic tumor. Intraoperatively an abscess was found that had been caused by lost gallstones following after laparoscopic cholecystectomy 3 years previously. There is a low incidence of late abscesses caused by loss of gallstones, but because of the long latency and unspecific symptoms there may be problems in diagnosis. Taking into consideration possible complications caused by intraoperative loss of gallstones, all concrements should be retrieved, even though there is no indication for changing to an open procedure.

Abdominal Abscess↗
PubMed1996

Repopulation in the SCCVII squamous cell carcinoma assessed by an in vivo-in vitro excision assay.

An in vivo-in vitro excision assay was used to study repopulation after a single dose of clamped irradiation (40 Gy) in the SCCVII tumour implanted in the foot of C3H/Km mice. The growth pattern of clonogenic cells was analysed by two different mathematical models: the logistic model and the Gompertz model. The logistic model described the data better than the Gompertz model. Accelerated repopulation was found when the regrowth rate after irradiation was compared to the growth rate at the time of treatment, and when it was compared to the growth rate in untreated tumours with a number of cells equivalent to the number that was found after irradiation. The clonogenic doubling time (cDT) was estimated at 15.1 h (95% c.i.: 14.2; 16.0) after irradiation, and 27.8 h (95% c.i.: 16.7; 43.5) in untreated controls of matching size. However, the estimate relies on the mathematical model chosen and on extrapolation below actually measured data. A small cDT points to shortening of the cell cycle time and recruitment of non-cycling clonogenic tumour cells to be the main mechanism behind the accelerated repopulation.

Animals↗
PubMed1996

Continuous vectorcardiographic changes in relation to scintigraphic signs of reperfusion in patients with acute myocardial infarction receiving thrombolytic therapy.

OBJECTIVES: Changes in the electrical activity of the heart reflecting the infarct process can be recorded by continuous vector-ECG, a method which is now clinically available for cardiac supervision. Shifts of the ST-segment and QRS-vector reflect ischaemia and necrosis of the myocardium. Continuous vector-ECG changes were evaluated against myocardial scintigraphy in 18 patients with acute myocardial infarction treated with streptokinase in order to study the impact of improved myocardial perfusion. DESIGN: Myocardial perfusion was analysed with 99Tcm-Sestamibi (Cardiolite, DuPont Scandinavia AB, Kista, Sweden) single photon emission computerized tomography (SPECT). Registrations were performed before and after thrombolysis in order to estimate the amount of myocardium with impaired perfusion initially (threatened myocardium) and the degree of perfusion improvement in this myocardial area. X, Y, Z vectors were registered continuously by Frank leads (Ortivus Medical, Täby, Sweden). QRS-vector difference, and the time to plateau phase and the ST-vector magnitude were used as a measurement of ischaemia and size of the myocardial infarction. RESULTS: In seven out of 11 patients treated within 3 h of onset of symptoms, an improvement in myocardial perfusion in the initially hypoperfused areas was achieved in contrast to none of the seven patients treated > 3 h after onset of pain (P < 0.05). In the whole patient material, there was a negative correlation between the time to plateau level for the QRS-vector and the improvement in myocardial perfusion (r = -0.53, P < 0.05). Among patients treated within 3 h, there was a negative correlation between the plateau level for the QRS-vector magnitude compared to the improvement in myocardial perfusion (r = -0.61, P < 0.05) and a negative correlation between the plateau level and the myocardial perfusion level after therapy (r = -0.69, P < 0.05). In these patients, there were also negative correlations between the maximal ST-vector magnitude and the myocardial perfusion both before and after thrombolysis (r = -0.81, P < 0.05 and r = -61, P < 0.05, respectively). CONCLUSION: Patients with marked improvement in myocardial perfusion indicating successful thrombolysis reach their plateau levels of the QRS-change faster and have lower total QRS-vector differences than patients without successful thrombolysis as reflected by myocardial scintigraphy. Patients with a high ST-vector magnitude have low perfusion levels both before and after therapy indicating a pronounced ischaemic damage of the myocardium. Thus, VCG-changes reflect impairment in myocardial perfusion during acute myocardial infarction.

Aged↗
PubMed1996

Platinum-based cytotoxic therapy in basal cell carcinoma--a review of the literature.

Systemic cytotoxic therapy with platinum containing regimens has been reviewed in 53 patients with progressive disease of basal cell carcinoma. The overall response rate in 46 evaluable patients was 83% with complete remission obtained in 17 patients (37%), and partial remission in 21 patients (46%). Eight patients (17%) did not respond to platinum containing therapy. The median observation time was 26 months and the median time to progression 24 months. The median number of courses was 3 (range 2 to 12), and objective response was seen after median 2 courses (range 1 to 6). Platinum-based systemic chemotherapy, either alone or in combination with other therapeutic modalities, may be indicated as treatment of basal cell carcinoma when local therapy is inadequate, or in the rare cases with advanced lesions or metastatic disease.

Antineoplastic Agents↗
PubMed1996

Sustained-release metoclopramide plus methylprednisolone versus placebo plus methylprednisolone as antiemetic prophylaxis during non-cisplatin chemotherapy. A randomized double-blind cross-over trial.

In a randomized double-blind cross-over trial, sustained-release metoclopramide (S) plus methylprednisolone (M) was compared with placebo (P) plus methylprednisolone as antiemetic prophylaxis during two cycles of non-cisplatin chemotherapy. S was administered as 60 mg every 12 h commencing on the evening before chemotherapy up to total of 300 mg metoclopramide in 2.5 days. Evaluation of nausea and vomiting was done by self-assessment schemes and visual analog scales. Fifty patients were included and 36 fulfilled both cycles. Mild nausea and vomiting were experienced by 81% and 83% in the S + M and P + M groups, respectively, while 42% and 39% showed complete control of nausea and vomiting during the first day of treatment. Moderate-dose S did not add to the antiemetic efficacy of M in non-cisplatin chemotherapeutic regimens.

Adult↗
PubMed1996

[Maltose--an alternative in hypocaloric parenteral nutrition?].

OBJECTIVE: The carbohydrate balance and nutritive efficacy of a completed nutritional solution with maltose were compared to an isocaloric completed nutritional solution with glucose by means of a hypocaloric parenteral nutrition after colorectal resections. METHODS: Prospective, randomised, double blind phase II trial (study group: maltose; control group: glucose). The infusion rate of maltose amounted to 0.05g maltose/kg body-weight/hour and was given postoperatively over 5 days by an infusion pump. RESULTS: Plasma glucose concentrations were similar low in both groups; indeed in the study group a significant higher renal carbohydrate loss of 7.1% was found compared to the control group with 0.4% (p < 0.001). In the study group three patients showed renal carbohydrate losses over 10% without finding a risk factor for these high renal losses. The cumulative nitrogen balance amounted to -3g N in both groups (p > 0.1). The labile plasma proteins in the 2 groups revealed almost identical concentration courses. No essential surgical complications occurred; no clinical side effect or incompatibility of the maltose solution were observed. CONCLUSION: Postoperative hypocaloric nutrition with maltose is possibly nutritive and energetic sufficient under conditions of a clinical study. Indeed, the deviations of the carbohydrate balance show the problems of the low and individual different metabolic capacity of maltose. Thus general use in daily routine seems not favourable due to the necessary precise management (application by infusion pump, daily quantitative examination of renal carbohydrate losses).

Adult↗
PubMed1996

[Surgical treatment of diverticulitis of the large intestine--a plea for early elective resection].

PURPOSE: Diverticulitis of the colon is observed more and more frequently in highly developed countries. The spontaneous course of the disease is not predictably; an exact definition of risk factors for perforated diverticulitis is missing. Therefore the decision for the conservative therapy or for an early elective resection is subject of a controversial discussion. The results of an offensive surgical concept, aiming at an early elective resection for definite therapy of diverticulitis have been analysed in a retrospective study. RESULTS: From 1980-1995 337 patients were operated due to diverticular disease (rate of resection: 98.8%). In spite of the increase of cases with severe complicated diverticulitis from 36.2% (1980-1985) to 45.8% (1991-1995; p = 0.05) the incidence of protective colostomies decreased from 18.8% in the first six years to 0.6% (n = 1) in the last 4 1/2 years (p < 0.001). After elective resection general complications occurred in 30.1% (n = 101), local complications in 17.0% (n = 57). The clinical anastomotic leakage rate was 2.1% (n = 7). During the study the morbidity rate decreased significantly (p < 0.005). Especially the incidence of nosocomial infections was reduced from 37.7% (1980-1985) to 14.8% (1991-1995); severe local complications (anastomotic leakage, bowel obstruction, peritonitis, hemorrhage, abscess) were reduced from 10.1% (1980-1985) to 3.2% (1991-1995). The mortality rate was 1.2% (n = 4). CONCLUSION: By consistent early elective resection of diverticulitis together with a standardized surgical management a definitive treatment of diverticulitis with a high and safe standard is possible. Already after the first severe attack of the disease, which leads to hospitalization, the early elective resection allows the definite cure for diverticular disease analogous to cholecystectomy or appendectomy, avoiding the life threatening complications.

Aged↗
PubMed1996

Incidence of nursing sickness and biochemical observations in lactating mink with and without dietary salt supplementation.

The impact of dietary sodium on the incidence of nursing sickness in mink dams and on the average litter biomass of 28 and 42 day old kits was studied. One group (n = 115 including 12 barren females) was given a standard feed mixture with a natural content of 0.53 g NaCl/MJ and another group (n = 115 including 8 barren females) was given the same feed mixture supplemented with NaCl to a final content of 1.00 g/MJ. The average dam weight at weaning was significantly lower (P < 0.001) and the incidence of nursing sickness during the last part of the lactation period 3 times higher in the nonsupplemented group. The average litter biomass at weaning did not differ between the 2 experimental groups. A number of biochemical markers of preclinical nursing sickness, e.g. plasma aldosterone and osmolality, Na+ and Cl concentrations in plasma and urine, were studied during the last part of the lactation period and at weaning in 20 dams of the nonsupplemented group, in 10 dams of the salt supplemented group and, for comparison, in 5 + 5 barren females on the day corresponding to day 34 after parturition in nursing mink. The nonsupplemented group had significantly lower concentrations of sodium and chloride in plasma and urine and a significantly higher concentration of plasma aldosterone as compared to the salt supplemented group. Distinct signs of relative salt deficiency and preclinical nursing sickness thus characterized the nonsupplemented group throughout this period, while more blurred hints of electrolyte imbalances were noticed in the sodium chloride supplemented group at weaning. A beneficial effect of salt supplementation on the incidence of nursing sickness was shown; however, it remains unclear whether salt deficiency can cause nursing sickness or whether salt acts as an appetite stimulant preventing inanition and the development of the disorder.

Aldosterone↗
PubMed1996

Failure of loop diuretics to induce nursing sickness in mink at weaning.

Nursing sickness in mink is thought to be precipitated by inadequate salt intake, whether this is due to inadequate salt levels in the diet or inadequate total dietary intake. To test this hypothesis, lactating females raising large litters were given 2 daily intramuscular injections of the loop diuretic furosemide (Lasix, 4 + 4 mg/kg/day) for 2.5 d during the normal weaning period 6 wk after parturition or served as untreated controls. Following the same protocol, barren mink (i.e. unsuccessfully mated females) were treated similarly. Dams were carefully inspected for clinical signs of nursing sickness during and after the treatment. Urinary osmolality and concentrations of sodium, potassium, chloride, creatinine and carbamide (urea) were measured prior to treatment (day 1) and on day 3, immediately before and 4 h after the final diuretic treatment. Plasma concentrations of aldosterone and cortisol were determined by radioimmunassay 4 h after the last injection with furosemide on day 3. Biochemical changes in urine (a low osmolality, low concentrations of carbamide and creatinine, and extremely low sodium concentrations) and in plasma (aldosteronism) similar to those found in nursing sickness were elicited in the nursing dams. Nevertheless, none of the dams developed overt clinical signs of nursing sickness. It is concluded that the biochemical signs of volume and salt depletion associated with nursing sickness are sequelae rather than etiological factors of this disorder.

Aldosterone↗