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Biomedical subjects

P Stentoft

Publications and source records attributed to P Stentoft.

14 recordsLinked to original sources
PubMed1999

[Lung volume reduction surgery. A new surgical therapeutic possibility for patients with emphysema].

Lung volume reduction surgery is a new surgical procedure for treatment of patients with pulmonary emphysema. At the operation the most peripheral parts of the lung are resected. Only 15-20% of the patients admitted for lung volume reduction surgery are suitable for operation. The preliminary results have demonstrated improvement in lung function in the majority of the patients. Most of the reports comprise small numbers of patients and have a short time of observation. The longest reported period of observation for a larger number of patients is 24 months and shows a continuing improvement in lung function, dyspnoea and six minute walk test. Because of the high incidence of emphysema, lung volume reduction is a procedure that could reach large extension in the future. However, better definition of criteria of inclusion and better evaluation of the operative procedures are needed.

Aged↗
PubMed1997

[Coronary bypass surgery at the Rigshospitalet 1993-1995. Results after 1.000 consecutive operations].

During 1993-95 1000 consecutive patients were admitted for coronary bypass surgery. The total 30-day mortality of 1.9% was 0.9% for elective cases, 0.8% for reoperations and 0.2% for urgent cases. Perioperative myocardial infarction occurred in 44 patients of whom 25% had infarction at the start of the operation. Respiratory insufficiency occurred in 1.4% of the patients, 3.6% developed renal insufficiency and 1.8% had neurological defects postoperatively. Reoperation for bleeding occurred in 6%, and 0.2% developed sternal or mediastinal infection. This study demonstrates that the results of coronary bypass surgery at Rigshospitalet, Copenhagen are fully comparable to similar results in our neighbouring countries. The results can probably be further improved by more intensive treatment of perioperative ischaemia, especially in reoperations and urgent cases.

Adult↗
PubMed1997

Re-mediastinoscopy in the assessment of resectability of lung cancer.

OBJECTIVE: Thirty-one patients underwent re-mediastinoscopy in the diagnostic assessment of lung cancer. The reason for a repeat mediastinoscopy was either a negative result at the first operation in spite of CT indication of enlarged nodes or an incomplete first mediastinoscopy. METHODS: All patients underwent a conventional mediastinoscopy. RESULTS: In 22 patients with enlarged mediastinal lymph nodes at computed tomography, 10 had a positive lymph node histology at re-mediastinoscopy, while 12 were negative. In 9 patients with no enlarged mediastinal nodes at CT scan, but incomplete biopsies at the first mediastinoscopy, 1 patient had lymph node metastases. The median duration from the first to the second mediastinoscopy was 43 days. No major complications occurred. The staging of the patients was greatly affected by the re-mediastinoscopy. Of 31 patients judged as operable according to the initial mediastinoscopy only 60% were found to be operable following the second mediastinoscopy. CONCLUSION: This study has demonstrated the value of re-mediastinoscopy in assessment of resectability of lung cancer.

Adult↗
PubMed1997

Direct bronchial artery revascularization and en bloc double lung transplantation--surgical techniques and early outcome.

BACKGROUND: Lung transplantation including direct bronchial artery revascularization (BAR) has produced promising early results in small clinical series. METHODS: In Copenhagen primary en bloc double lung transplantation with BAR, with the left mammary artery used as conduit, has been performed in 47 patients from 1992 to the end of 1995. After introduction of the bloc into the recipient, the mammary-to-bronchial artery anastomosis is performed as the first anastomosis, allowing perfect exposure and early reperfusion. Internal mammary-bronchial artery arteriography has been performed routinely after operation. RESULTS: Bronchoscopic examination performed in all patients documented normal airway healing in 42, disturbed in two, and complicated in three. Arteriography performed in 42 patients demonstrated complete BAR in 25, incomplete in 15, and failed BAR in 2. Failed BAR was associated with complicated airway healing. The 1- and 2-year survival rate (Kaplan-Meyer) is 83%. Eleven patients have died, only one within 30 days. The total incidence of bronchiolitis obliterans syndrome at 3 years (with Kaplan-Meier technique) is 33%. Successful BAR has also been performed with an adjusted technique in a limited number of heart-lung and single lung transplantations. Our total experience of BAR in any type of lung transplantation includes 65 patients with an arteriographic BAR success rate of 94% (50 of 53 examined patients). CONCLUSIONS: Experience has improved the surgical technique and has made BAR reliable and safe, be it double lung, single lung, or heart-lung transplantation. Early results are good, but only follow-up will show if long-term results after lung transplantation will be improved by BAR. Already today, en bloc double lung transplantation with BAR is a viable alternative to sequential bilateral lung transplantation.

Anastomosis, Surgical↗
PubMed1992

Omeprazole in the long-term treatment of severe gastro-oesophageal reflux disease in patients with systemic sclerosis.

Twenty-five patients with systemic sclerosis and severe gastro-oesophageal reflux disease were treated with 20-80 mg omeprazole daily for up to 5 years. Efficacy of treatment was assessed by symptom score, by endoscopic and histopathological surveillance of the oesophageal and gastric mucosa, and by laboratory screening including serum gastrin concentration. Statistically significant relief of symptoms and healing of oesophagitis confirmed the efficacy of this treatment. However, complete healing of oesophagitis was not achieved in half of the patients due to residual gastro-oesophageal acid reflux. Repeated adjustments of the maintenance dose of omeprazole may be needed for this group of patients. From the safety point-of-view, nothing was observed to discourage the long-term use of omeprazole in this group of patients.

Adult↗
PubMed1989

The progress of oesophageal involvement in progressive systemic sclerosis during D-penicillamine treatment.

In 21 patients with initial signs of progressive systemic sclerosis, oesophageal motility was monitored manometrically from the start of D-penicillamine treatment and over a period of up to 5 years. Urinary excretion of the collagen-specific amino acids hydroxyproline and hydroxylysine, and of proline was used as a guideline for monitoring the bioavailability of D-penicillamine. D-penicillamine therapy was found to be unable to arrest the progress of oesophageal involvement. A downward trend over time--statistically significant at p = 0.03, p = 0.02, and p less than 0.005--was found for lower oesophageal sphincter pressure, peristaltic wave pressure in the distal third, and peristaltic wave pressure in the middle third of the oesophagus, respectively.

Esophagitis↗
PubMed1989

Inability to elicit vagal responses from the acid-infused esophagus of pigs.

Acid application in the esophagus and esophageal distension were undertaken in pigs. One group (n = 9) had operatively induced esophagitis. The other group (n = 7) was normal. We found no discrepancy between the groups neither in inspiratory pressure nor in expiratory PCO2 nor in plasma concentrations of pancreatic polypeptide. The results indicate inability to elicit vagal responses from the acid-infused esophagus of pigs.

Animals↗
PubMed1987

Esophageal manometry and pH-probe monitoring in the evaluation of gastroesophageal reflux in patients with progressive systemic sclerosis.

Fifty-five patients with progressive systemic sclerosis (PSS) were evaluated with esophageal manometry, 12-h pH-probe monitoring in esophagus, and registration of symptoms of gastroesophageal reflux (GER). Thirty-nine patients had symptoms suggestive of GER. The 12-h pH-monitoring showed pathologic GER in 30 patients. We found that 33% of the patients with symptoms did not have pathologic GER, and 25% of the patients without symptoms had pathologic GER. Characteristic changes of impaired motility in the esophagus were found in 46 patients. When combining esophageal manometry, reflux measurement, and symptoms of GER, we found a positive correlation in 60% of patients with reduced peristalsis in the lower two-thirds of the esophagus and GER. We therefore recommend sensitive esophageal pH-monitoring in all PSS patients to ensure treatment of patients with pathologic GER.

Adult↗
PubMed1986

Long-term ranitidine in progressive systemic sclerosis (scleroderma) with gastroesophageal reflux.

Eighteen patients with progressive systemic sclerosis and symptomatic gastroesophageal reflux were studied for 20 weeks. All patients were initially treated with ranitidine for a 6-week period. From the 7th week the patients were randomized to further treatment with either ranitidine or placebo. Heartburn and dysphagia, the endoscopic appearance of the esophageal mucosa, the esophageal motility, and gastroesophageal reflux were assessed during the study. The efficacy of ranitidine was maintained during the 20-week period. A shift to placebo was recognized by the patients almost immediately and caused heartburn and esophageal mucosal inflammation to increase significantly.

Adult↗
PubMed1986

Flushing and plasma substance P concentration during infusion of synthetic substance P in normal man.

Six normal subjects received synthetic substance P intravenously in successively increasing doses of 0.5, 1.0, 2.0, 4.0, and 8.0 pmol X kg-1 X min-1. Each dose was given for 20 min. Concentrations of substance P in plasma and infusions were measured radioimmunochemically. The incremental plasma concentration of substance P correlated linearly to the dose infused. Metabolic clearance rate was 0.361 X kg-1 X min-1, and the half-life of exogenous substance P 1.6 min. Lacrimation and sustained flushing were elicited at plasma concentrations above normal range. Transient flushing in spite of continued infusion was seen at 'physiological' levels. Pulse rate and blood pressure did not change significantly.

Adult↗
PubMed1983

Value of the 30-minute adrenocorticotropin (ACTH) test in demonstrating hypothalamic-pituitary-adrenocortical insufficiency after acute ACTH deprivation.

Adrenocortical responsiveness to corticotropin was reestablished by daily administration of 1 mg ACTH depot for 4 days in seven patients with secondary adrenocortical insufficiency. Peak plasma cortisol concentrations during a 30-min ACTH test performed 2 days after stopping injection of ACTH depot increased in all seven subjects (they were normal in five subjects) compared to the initial subnormal responses. Repeated short ACTH tests 5, 8, and 12 days after the last administration of ACTH depot showed a gradual decrease in plasma cortisol responses. When tested 8 days after the last ACTH depot injection was given all seven patients again had a subnormal response to ACTH. Thus, acute ACTH deprivation leads to an impaired adrenocortical response at a short ACTH test within 8-12 days.

Adrenal Cortex↗