Biomedical subjects

P Kissmeyer-Nielsen

Publications and source records attributed to P Kissmeyer-Nielsen.

17 recordsLinked to original sources

PubMed1999

Perioperative growth hormone treatment and functional outcome after major abdominal surgery: a randomized, double-blind, controlled study.

OBJECTIVE: To evaluate short- and long-term effects of perioperative human growth hormone (hGH) treatment on physical performance and fatigue in younger patients undergoing a major abdominal operation in a normal postoperative regimen with oral nutrition. SUMMARY BACKGROUND DATA: Muscle wasting and functional impairment follow major abdominal surgery. METHODS: Twenty-four patients with ulcerative colitis undergoing ileoanal J-pouch surgery were randomized to hGH (12 IU/day) or placebo treatment from 2 days before to 7 days after surgery. Measurements were performed 2 days before and 10, 30, and 90 days after surgery. RESULTS: The total muscle strength of four limb muscle groups was reduced by 7.6% in the hGH group and by 17.1% in the placebo group at postoperative day 10 compared with baseline values. There was also a significant difference between treatment groups in total muscle strength at day 30, and at the 90-day follow-up total muscle strength was equal to baseline values in the hGH group, but still significantly 5.9% below in the placebo group. The work capacity decreased by approximately 20% at day 10 after surgery, with no significant difference between treatment groups. Both groups were equally fatigued at day 10 after surgery, but at day 30 and 90 the hGH patients were less fatigued than the placebo patients. During the treatment period, patients receiving hGH had reduced loss of limb lean tissue mass, and 3 months after surgery the hGH patients had regained more lean tissue mass than placebo patients. CONCLUSIONS: Perioperative hGH treatment of younger patients undergoing major abdominal surgery preserved limb lean tissue mass, increased postoperative muscular strength, and reduced long-term postoperative fatigue.

Adolescent↗

PubMed1998

Perioperative growth hormone treatment increases nitrogen and fluid balance and results in short-term and long-term conservation of lean tissue mass.

The surgical procedure for forming an ileoanal anastomosis with a J pouch (IAA) usually involves a temporary ileostomy; patients undergoing IAA surgery thus need to recover quickly because they return for ileostomy closure 3 mo later. We evaluated the effects of perioperative biosynthetic growth hormone (GH) treatment on short- and long-term changes in body composition and on nutritional intake. Patients with ulcerative colitis undergoing IAA surgery were randomly assigned to double-blind treatment with placebo (n=12) or 6 IU GH twice daily (n=12) from 2 d before to 7 d after the operation. Examinations were from 2 d before to 9 d after the operation and on days 30 and 90. Body composition was assessed with a dual-energy X-ray absorptiometry scanner. The 2 groups had similar nutritional intakes. On postoperative day 7, placebo-treated patients had lost 4.2 kg (95% CI: 3.0, 5.4) total tissue mass, 3.6 kg (2.1, 5.1) lean tissue mass, and 0.5 kg (-0.1, 1.2) fat mass. These reductions persisted 3 mo later. Compared with placebo, GH improved nitrogen balance, changes in lean tissue mass [gain of 4.0 kg (1.9, 6.0), P=0.001], and changes in total tissue mass [gain of 3.2 kg (1.6, 4.9), P=0.001], but increased the loss of fat mass [loss of 0.7 kg (0.0, 1.5), P=0.049] on postoperative day 7. Three months later, the placebo-treated patients had lost 2.4 kg (0.7, 4.2) more lean tissue mass than GH-treated patients (P=0.009), whereas changes in total tissue and fat mass were not significantly different. Hence, GH treatment enhanced the long-term regain of lean tissue mass.

Absorptiometry, Photon↗

PubMed1998

Differential changes in free and total insulin-like growth factor I after major, elective abdominal surgery: the possible role of insulin-like growth factor-binding protein-3 proteolysis.

Major surgery is accompanied by extensive proteolysis of insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3). Proteolysis of IGFBP-3 is generally believed to increase IGF bioavailability due to a diminished affinity of the IGFBP-3 fragments for IGFs. We have investigated 18 patients undergoing elective ileo-anal J-pouch surgery. Patients were randomized to treatment with GH (12 IU/day; n = 9) or placebo (n = 9) from 2 days before to 7 days after operation. Free IGF-I and IGF-II were measured by ultrafiltration of serum, and IGFBP-3 proteolytic activity was determined by a [125I]recombinant human IGFBP-3 degradation assay. In the GH-treated group, total IGF-I increased preoperatively by 99%. Postoperatively, total IGF-I decreased by 48% (placebo) and 52% (GH). Immunoassayable IGFBP-3 decreased by 27% (placebo) and 26% (GH). In the placebo-treated group, free IGF-I was unchanged throughout the study. In the GH-treated group, free IGF-I increased by 277% preoperatively and remained elevated after operation. IGFBP-3 proteolytic activity increased by 63-73% after operation. The relative elevations of free IGF-I levels despite decreased total IGF-I levels could thus relate to augmented IGFBP-3 proteolysis.

Adult↗

PubMed1997

[Injury pattern in a sports club with its own sports physician].

As the first Danish athletic association, TST-79 in 1995 appointed a permanent sports doctor for use by all its members. We publish the results of the first year. Seventeen percent of all handball players and 11% of all football players were seen in the consultation. The athletes were between 10 and 69 years old. Seventy-eight percent of the injured athletes could be diagnosed, instructed and, if necessary, treated after one consultation. Eight percent were sent for further examination at a hospital. Ultrasound examinations were necessary for establishing the diagnosis in 10% of the injured athletes. Some of the injuries were serious, and would probably not have been seen if the athletes did not have the possibility of consulting a sports doctor. This would increase the risk of chronic injury. It is suggested that a permanent arrangement with a sports doctor is an economically reasonable investment.

Adolescent↗

PubMed1996

Randomised comparison of leucocyte-depleted versus buffy-coat-poor blood transfusion and complications after colorectal surgery.

BACKGROUND: Allogeneic blood transfusion is associated with an increased frequency of postoperative infection. We studied whether such events can be avoided by the intraoperative and postoperative use of leucocyte-depleted blood. METHODS: 589 consecutive patients scheduled for elective colorectal surgery were randomised to receive buffy-coat poor (n = 299) or filtered leucocyte-depleted red-cells (n = 290) when transfusion was indicated. 260 patients actually received blood transfusion. Three patients were excluded from analysis. FINDINGS: The 142 patients randomised to and transfused with buffy-coat-poor blood had a significantly higher frequency of wound infections and intra-abdominal abscesses than the 155 patients who were allocated to this group but who were not transfused. (12 vs 1%, p < 0.0001) and (5 vs 0%, p = 0.005), respectively. Those receiving buffy-coat-poor blood also had a significantly higher frequency of wound infections and intra-abdominal abscesses than the 118 randomised to and receiving leucocyte-depleted blood (12 vs 0%, p < 0.0001) and (5 vs 0%, p = 0.017), respectively. Postoperative pneumonia occurred at a significantly higher rate in patients receiving buffy-coat-poor blood: 23 versus 3% in non-transfused patients (p < 0.0001), and 23 versus 3% in patients transfused with leucocyte-depleted blood (p < 0.001). The mortality rate between the groups was not statistically different. INTERPRETATION: Our data suggests that the association between allogeneic blood transfusion and postoperative infection is limited to allogeneic blood products that are not adequately depleted of immunosuppressive leucocytes. This undesirable effect can be reduced by leucocyte depletion with high-efficiency filters.

Aged↗

PubMed1996

Effect of insulin-like growth factor I (IGF-I) administration on the healing of colonic anastomoses in rats.

BACKGROUND: The gastrointestinal tract is highly responsive to the tropic effect of growth hormone (GH). GH stimulates the healing of colonic anastomoses either directly or through insulin-like growth factor I (IGF-I) since specific GH receptor as well as IGF-I receptor have been demonstrated in colon. AIM: To determine whether exogenous treatment with IGF-I could stimulate the healing of left colonic anastomoses in rats. METHODS: After colonic anastomotic operations adult rats were randomised to treatment with either IGF-I (500 mu g per day) or vehicle (controls). Anastomotic breaking strength and collagen deposition were determined at day after surgery. RESULTS: IGF-I treatment increased the anastomotic collagen content by 23% compared with controls. This resulted in a lower extensibility of the anastomosis (P < 0.05), whereas the anastomotic breaking strength did not differ between groups. The treatment resulted in a 3 fold increase in serum IGF-I of IGF-I treated rats, compared to controls. The postoperative body weight increased by 5% in the IGF-I rats from day 0 to day 3, while the control group had a weight loss of 2% in the same period (P < 0.001). CONCLUSION: Treatment of colon-operated rats with IGF-I increased the postoperative body weight and stimulates the collagen deposition of left colonic anastomoses, whereas the anastomotic strength may be unaffected by IGF-I treatment.

Anastomosis, Surgical↗

PubMed1996

The sportsman's hernia--fact or fiction?

This review is based on the results of 308 operations for unexplained, chronic groin pain suspected to be caused by an imminent, but not demonstrable, inguinal hernia: the 'sportsman's hernia' (SH). No differences in perioperative findings between cured and non-cured athletes were found. However, there was a remarkable difference between the various perioperative findings in the studies. It was characteristic that further clinical investigation of the noncured, operated athletes gave an alternative and treatable diagnosis in more than 80% of cases. Herniography was used consistently in the diagnostic process in all the studies on SH. However, in 49% of cases hernias were also demonstrated on the opposite, asymptomatic groin side. In conclusion, the final diagnosis (and treatment) often reflects the speciality of the doctor and the present literature does not supply proper evidence to the theory that SH constitutes a credible explanation for chronic groin pain.

Athletic Injuries↗

PubMed1996

Effects of longterm epidermal growth factor treatment on the normal rat colon.

BACKGROUND: Epidermal growth factor (EGF) exerts trophic effects on the mucosa of damaged and defunctioned colon, but the effects on the normal large bowel wall are not known. AIMS: To investigate the effect of systemic EGF treatment on growth and morphology of normal rat colon. METHODS: Rats were treated with subcutaneous biosynthetic EGF injections of 150 micrograms/kg/day for 28 days. The weight of the histological colonic wall layers and the luminal surface area were measured using quantitative morphometric analysis (stereology). The colon was subdivided into proximal and distal parts. RESULTS: EGF treatment increased the total colon wet weight by 23% compared with controls (p < 0.005). The weight increase occurred in the mucosal (33%) and the submucosal layers of the bowel wall (36%) and there was a 69% increase of the total luminal surface area (p = 0.001). In the proximal part of colon of EGF rats there was a 68% increase in mucosal weight (p < 0.005) accompanied by a 79% increase in the mucosal surface area compared with controls (p < 0.005), whereas submucosal and muscularis propria weights were identical. In distal colon, the mucosal weight increased 28% in the EGF group (p < 0.005), the mucosal surface area increased by 72% after treatment (p < 0.01). Furthermore there was a 34% increase in the weight of submucosa (p < 0.001) in the distal colon among EGF rats. CONCLUSIONS: Treatment of rats with EGF has a stimulating role on the mucosa and luminal surface area of the entire functioning colon and a trophic effect on the submucosa of the distal colon.

Animals↗

PubMed1995

Chronic systemic treatment with epidermal growth factor in the rat increases the mucosal surface of the small intestine.

We examined the effects of treatment with human recombinant epidermal growth factor (EGF) on the functioning small intestine in the rat. Male Wistar rats, 7-8 weeks old, were treated with EGF administered subcutaneously in doses of 0 (n = 7) or 150 micrograms/kg/day (n = 8) for 4 weeks. The histological composition and mucosal surface area of the perfusion-fixed small intestine was quantified with stereological principles. The length of the gut remained unchanged. The amount of tissue and surface area per length of gut (median (ranges)) were increased from 117 (101-131) mg/cm and 2.6 (2.1-3.5) cm2/cm in the controls to 146 (138-152) mg/cm and 3.5 (2.5-3.8) cm2/cm for the complete small intestine (both comparisons P < 0.02). The weight increase was due to mucosal growth in all parts of the intestine, whereas the surface area was only increased in proximal and middle parts. It is concluded that EGF treatment in rats increases the mucosal weight and surface area of the functioning small intestine.

Animals↗

PubMed1995

[Iliopsoas tendinitis in athletes. Diagnosis and treatment].

Iliopsoas tendinitis is a common injury in sport. Despite of this there are only a few articles in the literature that deal with these injuries. The changes in the inflamed tendons and muscles have been difficult to determine objectively. The modernization of ultrasound devices has improved the methods of examination and made it possible to diagnose objective changes in the tendons and muscles. Recommendations for the treatment of acute and chronic iliopsoas tendinitis are given.

Adult↗

PubMed1995

Transmural trophic effect of short chain fatty acid infusions on atrophic, defunctioned rat colon.

PURPOSE: This study was designed to investigate and quantify trophic alterations in the defunctioned, atrophic rat colon after short chain fatty acid (SCFA) treatment was administered in a clinically relevant way. METHODS: Diverting colostomy with exclusion of distal colon was performed on adult female rats (58), and treatment was started four weeks later. Enemas of either a SCFA solution of sodium-acetate, sodium-propionate and sodium-butyrate (concentration, 780 mM), or isotonic saline (placebo) were instilled through the anus into the defunctioned colon. This was done twice daily for 7 or 14 days before death. RESULTS: After SCFA instillation for 14 days, the colonic wet weight was 18 percent higher compared with placebo (P < 0.01), and there was a similarly significant difference in dry weight (P < 0.05). Using stereologic assessment to determine the histologic composition of defunctioned colon, we found significant increases among SCFA-treated rats in the weight of the mucose (P < 0.05), the submucosa (P < 0.05), and the muscularis propria (P < 0.05) and a 30 percent increase in the mucosal surface area compared with placebo-treated in the mucosal surface area compared with placebo-treated rats (P < 0.05). Measurements of breaking strength and hydroxyproline content showed no differences between treatment groups. CONCLUSIONS: SCFA enemas have a transmural trophic effect and preserve mucosal surface area of defunctioned and atrophic colon in rats.

Acetates↗

PubMed1995

Impaired wound healing but unaltered colonic healing with increasing age: an experimental study in rats.

Age-related differences in the healing of left colonic anastomoses and abdominal incisional wounds were compared between young and old rats. Immediately after surgery the anastomotic strength (suture-binding capacity) was 67% higher in old rats corresponding to a 107% higher collagen content per unit length of left colon compared to young rats. After 2 and 4 days of healing there was no difference in the breaking strength of the anastomoses between young and old rats, although the increase in collagen content of the anastomosed segment was 100% in the young rats and only 35% in the old rats from day 2 to day 4. The healing of the abdominal incisional wounds was, however, impaired in old rats compared to young rats, since the tensile strength and the energy absorption on the 4th postoperative day was 67 and 57% lower, respectively. In conclusion, old rats have impaired skin healing, whereas colonic healing is not affected by age.

Aging↗

PubMed1995

Trophic effects of biosynthetic growth hormone on normal and defunctioned left colon in rats.

BACKGROUND: In rats with diverting colostomies the effects of growth hormone can be differentiated from the actions of fecal passage. METHODS: After sham operation or diverting colostomy rats were treated with biosynthetic growth hormone (b-hGH) for 4 weeks. RESULTS: In defunctioned colon of b-hGH-treated rats there were increases in mucosal surface area and the weight of mucosa and muscularis propria compared with the atrophic colon of saline-treated rats. The breaking strength of defunctioned colon rings was greater and the defatted dry weight and hydroxyproline content of these specimens were also increased. In intact colon b-hGH stimulated luminal surface area, the weight of mucosal and submucosal layers, and the hydroxyproline content compared with controls. The breaking strength was highest in specimens from saline-treated rats. CONCLUSIONS: B-hGH has a growth-promoting role throughout the whole thickness of the colonic wall in rats also in the absence of fecal passage.

Animals↗

PubMed1994

Diverting colostomy induces mucosal and muscular atrophy in rat distal colon.

The progress of adaptive changes in the left colon after diverting colostomy was studied in rats using stereological techniques. Standardised segments of left colon proximal and distal to the colostomy was examined after 0, 1, 2, 4, or 12 weeks. In excluded colon the mucosal weight was reduced by 37% (p < 0.01) and the luminal surface area by 47% (p < 0.01) after four weeks and reached a steady state at this point of time, as no further reduction was seen from 4 to 12 weeks. The number of proliferating crypt cells was determined immunohistochemically after in vivo labelling with bromodeoxyuridine and was compared with the total number of colonocytes. Total bowel rest leads to a reduction in the number of proliferating epithelial cells and not to a reduced average life span. The weight of the muscularis propria decreased by 32% after four weeks (p < 0.01) and by 48% after 12 weeks (p < 0.001), whereas the weight of the submucosa was unchanged. No adaptive changes were found in segments proximal to the colostomy. These results show that the wall composition of defunctioned colon in rats is radically changed resulting from a mucosal and muscular atrophy, and from a reduction in luminal surface area.

Animals↗

PubMed1994

Growth hormone treatment of rats with chronic diverting colostomy. Differential response on proximal functioning and distal atrophic colon.

Diversion of colon from the fecal stream leads to profound intestinal atrophy. After diverting colostomy for 4 weeks, female rats were treated with biosynthetic human growth hormone (b-hGH; 2.0 mg.kg-1 body wt.day-1) in order to investigate whether b-hGH could reverse atrophic changes in distal colon, with special reference to changes in morphometric composition, collagen content and biomechanical properties. Biosynthetic hGH treatment for 28 days stimulated growth of the muscularis propria of the defunctioned, atrophic colon (p < 0.05), whereas the mucosal atrophy was unaffected by the treatment. In colon proximal to the colostomy, however, b-hGH increased the colonic wet weight (p < 0.01), defatted dry weight (p < 0.005) and the collagen content (p < 0.05). Morphometric analysis showed that the growth increase was localized to the mucosa and the muscularis propria. In conclusion, fecal diversion alters the response of b-hGH treatment and indicates that the trophic effect of growth hormone on colonic mucosa is dependent on fecal bulk passage, whereas the trophic effect on muscularis propria is fully retained when colon is deprived of luminal nutrients.

Animals↗

PubMed1993

[Lateral ligament ruptures of the ankle joint in young athletes].

Treatment of lateral ligament rupture of the ankle has previously been primarily surgical. Immobilisation in a plaster cast has recently become more usual, and gradually this treatment is partially being replaced by immobilisation in adhesive elastic bandage. Operation of younger, athletic patients with large ruptures is, however, still recommended. It is inexpedient to operate these patients. They will be delayed for several weeks in their return to sport.

Adult↗

PubMed1993

Decrease in collagenous proteins and mechanical strength of distal colon after diverting colostomy in rats.

The effects of a diverting colostomy on weight, collagen content, and biomechanical strength of the left colon was investigated in rats. Female rats received either a diverting colostomy or a sham-operation and were killed randomly 1, 2, 4, or 12 weeks after surgery. The dry weight and hydroxyproline content of excluded colon decreased by 37% (P < 0.001, confidence limits (CL) = 21-53%) and 25% (P < 0.001, CL = 18-31%), respectively, after 4 weeks, and by 52% (P < 0.001, CL = 38-66%) and 40% (P < 0.001, CL = 27-53%), respectively, after 12 weeks compared to sham-operated rats. The breaking strength of the defunctioned colon decreased by 21% (P < 0.05, CL = 2-40%) after 4 weeks and by 25% after 12 weeks (P < 0.05, CL = 4-46%). The tensile strength of defunctioned colon (load per unit collagen) was reduced by 19% after 4 weeks (P < 0.05, CL = 6-32%). Proximal to the colostomy site we found no differences in the hydroxyproline content or biomechanical strength. In conclusion, defunctioning of the left colon in rats leads to deterioration in the biomechanical properties caused by a lesser content and a decreased quality in the collagen of the left colon.

Animals↗