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Biomedical subjects

O O Rasmussen

Publications and source records attributed to O O Rasmussen.

At least 55 records · Page 3Linked to original sources
PubMed1991

Endosonography of the anal sphincter: findings in healthy volunteers.

Knowledge of the normal sonographic features of the anal canal is essential for the detection of anal carcinomas, anal sphincteric defects, or other anal abnormalities with endosonography. The anal sphincters consist of the circular smooth muscle fibers of the internal sphincter and the circular striated muscle fibers of the external sphincter together with the sling-shaped puborectalis muscle. Anal endosonography was performed in 14 healthy women with normal anophysiologic examinations. The procedure was performed during electromyographic registration in five. A radial 7-MHz probe and a multiplane 7-MHz probe were used, and transverse and longitudinal images were obtained. On transverse images, the internal anal sphincter was visualized as a circular hypoechoic band, which on longitudinal images was seen in continuity with the muscularis layer of the rectal wall. The external anal sphincter was seen as a thicker circular echogenic band just outside the internal sphincter. The puborectalis muscle sling, which is the medial part of the levator and muscle, was visualized in the upper anal canal and had the same echogenic appearance as the external sphincter. Our experience in volunteers provides information about the normal sonographic features of the anal canal as depicted on anal endosonography with high-frequency probes. The results suggest the procedure may be a useful diagnostic tool in detecting pathologic conditions in the anal canal.

Anal Canal↗
PubMed1991

Emergency haemorrhoidectomy compared with incision and banding for the treatment of acute strangulated haemorrhoids. A prospective randomised study.

OBJECTIVE: To find out if incision and banding was as effective as emergency haemorrhoidectomy in the treatment of strangulated haemorrhoids. DESIGN: Prospective randomised study. SETTING: Glostrup Hospital, Copenhagen, Denmark. SUBJECTS: 30 patients with uncomplicated acute strangulated haemorrhoids. INTERVENTIONS: Milligan-Morgan haemorrhoidectomy or incision, evacuation of blood clot, and application of elastic bands. MAIN OUTCOME MEASURE: Amount of analgesia required, length of stay in hospital, and incidence of complications. RESULTS: Patients treated by incision and banding required significantly less opioid analgesia and spent significantly fewer days in hospital than those treated by haemorrhoidectomy, but two of them required emergency haemorrhoidectomy because the bands had slipped. CONCLUSIONS: Incision and banding is a reasonable alternative to emergency haemorrhoidectomy provided that it is done correctly, but long term follow up is needed before a final conclusion can be drawn.

Acute Disease↗
PubMed1991

Assessment of the reliability of the symptoms and signs of acute appendicitis.

The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy.

Abdominal Pain↗
PubMed1990

Gracilis muscle transposition for faecal incontinence.

Transposition of the gracilis muscle for faecal incontinence was performed in 13 patients. Six gained satisfactory continence, four were improved, two did not benefit from the operation and one patient died from intercurrent disease before closure of a pre-existing colostomy. Anal manometry compared with a control group showed no alteration in resting and pressure at a median of 35 mmHg (range 5-63 mmHg), whereas maximum squeeze pressure increased from a median of 38 mmHg (range 5-79 mmHg) to 59 mmHg (range 10-143 mmHg) (P = 0.041) which was, however, significantly lower than 130 mmHg (range 81-236 mmHg) in the control group. All patients who benefited from the operation had an increase in maximum squeeze pressure. The ability to retain a viscous fluid in the rectum was measured in seven patients, four of whom had gained satisfactory continence and three of whom had improved continence. They were able to retain a median volume of 200 ml (range 50-225 ml) without leakage compared with 325 ml (range 250-400 ml) in the control group. These patients could retain the maximum amount of viscous fluid for 5-8 min, whereas all control subjects could do so for more than 15 min. It is concluded that, although gracilis transposition never results in normal continence, acceptable continence may be achieved in selected patients provided careful attention is paid to the technical details of the procedure and provided that systematic postoperative exercises are performed.

Adolescent↗
PubMed1990

A technique for the dynamic assessment of anal sphincter function.

A technique which renders continuous measurement of the cross-sectional area and pressure of the anal canal possible during distension and contraction of the anal sphincter has been developed. Electromyography of the external sphincter is measured simultaneously. With this technique a more detailed assessment of anal sphincter function is possible, including the opening and closing pressures of the sphincter at rest, anal compliance, anal hysteresis and the maximal closing pressure during squeeze. The results of in vitro measurements, measurements on 16 healthy subjects and 6 patients with faecal incontinence are presented.

Anal Canal↗
PubMed1990

[Anal incontinence--pathophysiology and treatment].

The prevalence of anal incontinence is probably far greater than has hitherto been admitted. As a result of the appearance, and the knowledge of new methods of treatment an increasing number of patients seek help for this, often socially crippling, condition. The pathophysiology, the methods of investigation, and the possibilities of treatment, chiefly based on the author's own studies, are described in this review article.

Adolescent↗
PubMed1989

[Diagnostic aids in acute appendicitis].

Acute appendicitis is usually diagnosed solely on clinical grounds. This results in a 15-30% incidence of unnecessary laparotomies and contributes to a perforation rate of 20-35%. The accuracies of eleven diagnostic aids for appendicitis are reviewed. The white blood cell count and straight x-ray of the abdomen are very unreliable. Four other methods, viz leucocyte scintigraphy, peritoneal lavage, barium swallow and scoring systems have not yet been sufficiently investigated. CT scanning may be useful in difficult cases. Four methods have a proven value and are recommended: Ultrasound scanning, computer assessment, laparoscopy and barium enema. Each of the latter are better than clinical assessment alone and can reduce both negative laparotomy rates and the incidence of appendicular perforation. Unaided clinical diagnosis of acute appendicitis is no longer acceptable.

Acute Disease↗
PubMed1989

Aids in the diagnosis of acute appendicitis.

Methods used to improve the accuracy of diagnosis of acute appendicitis are reviewed. Laparoscopy, barium enema, ultrasonography and computer assistance have all been shown to improve accuracy, but no one method is of proven superiority. Such diagnostic aids or intensive in-hospital observation must be used to reduce the 15-30 per cent negative laparotomy rate when acute appendicitis is suspected, without increasing the incidence of appendiceal perforation.

Acute Disease↗
PubMed1989

Conservative management of Bowen's disease of the anus.

Bowen's disease of the anus is usually treated by wide local excision including macroscopic normal areas if random biopsies show dysplasia. Skin grafting will often be necessary, since areas of microscopic dysplasia may be found at a considerable distance from the gross affected site. In this study of 11 patients with Bowen's disease of the anus we report the results of a more conservative approach. All patients were treated by local excision of the gross affected areas only, and none of the patients required skin grafting. Seven patients were followed for a median of 34 months without macroscopic recurrence, including 3 patients with histologically proven dysplasia in the resection margins. Two patients, one with and one without dysplasia in the resection margins, developed recurrence within a year. One patient with an area of invasive carcinoma was first treated by local excision, but required an abdominoperineal excision 3 months later. One patient lost to follow-up had invasive carcinoma after 3 years. It is concluded that a conservative surgical approach in Bowen's disease of the anus is justified, provided the patients are followed closely.

Adult↗
PubMed1988

Recurrent unexplained haematuria and risk of urological cancer. A follow-up study.

To evaluate the risk of urological cancer in patients with unexplained haematuria, 93 patients, who had undergone complete urological examination and who were classified as having unexplained haematuria, were followed. Mean age was 46 years, range 16-84 years. Seventy-seven patients had gross haematuria and 16 patients had microscopic haematuria. Mean follow-up time was 62 months (range 6-360 months). Urological neoplasms were found in 7 of 38 patients (18%; 95% confidence limits 8-34%) with recurrent haematuria after primary urological examination, and in 1 of 36 patients (3%; 95% confidence limits 0.07-14%) without additional haematuria after primary examination. Regular urological examination of patients with recurrent unexplained haematuria is justified. In patients without additional incidents of haematuria after primary urological examination the risk of urological cancer is not significantly increased.

Adolescent↗
PubMed1986

Molecular forms of gastrin in antrum and duodenum after parietal cell vagotomy.

We examined whether parietal cell vagotomy (PCV) changed the distribution between the different molecular forms of gastrin. Serum, antrum, and duodenum from PCV patients, unoperated duodenal ulcer (DU) patients and control subjects were studied. PCV was followed by a twofold increase in the serum gastrin concentration, while the distribution between small and large gastrins were unaffected. However, sulfation of antral gastrins was reduced from 45 percent in unoperated DU patients to 34 percent in PCV patients (p less than 0.01). We conclude that gastrin sulfation is diminished after PCV. Diminished sulfation seems to be correlated to hypergastrinaemia of antral origin and not to specific diseases.

Adult↗
PubMed1985

S-100 protein in malignant mesotheliomas.

Recently, the presence of S-100 protein has been described in a few tissues that are not of neuro-ectodermal origin. Here we report the presence of S-100 protein in epithelial and biphasic malignant mesotheliomas and one of seven reactively proliferating mesothelial lesions. Sarcomatous malignant mesotheliomas, six of seven reactive mesothelial lesions and normal mesothelium were without S-100 protein. The presence of S-100 protein in mesothelial cells may indicate intense proliferation.

Humans↗
PubMed1984

Influence of atenolol and nifedipine on digoxin-induced inotropism in humans.

Short term effect of digoxin on left ventricular performance was studied in six healthy volunteers before and during atenolol or nifedipine administration. Left ventricular function was evaluated by systolic time intervals and echocardiography. No changes in left ventricular end diastolic or systolic dimensions occurred throughout the study, indicating unchanged ventricular pre- and afterload. Thus, changes in the systolic time intervals must be attributed to changes in cardiac contractility. Changes in the pre-ejection period index (PEPI) obtained from the systolic time intervals were used as a measure of digoxin-induced inotropism. A concentration-response relationship between plasma digoxin level and changes in PEPI was revealed when digoxin was given alone. Atenolol did not influence the digoxin-induced inotropism at a given serum digoxin level. During nifedipine administration no inotropic effect of digoxin could be demonstrated. Thus, it is concluded that nifedipine attenuates digoxin-induced inotropism, while atenolol seems without this effect. These results are in accordance with previous experiments and reflect the different pharmacological sites of action of beta-adrenoceptor antagonists and calcium channel blocking agents. Plasma digoxin concentration, renal digoxin clearance and creatinine clearance did not change during atenolol or nifedipine.

Adult↗