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Biomedical subjects

P Thommesen

Publications and source records attributed to P Thommesen.

At least 19 recordsLinked to original sources
PubMed1992

Diagnosis of esophageal motor disorders: a prospective study comparing barium swallow, food barium mixture, and continuous swallows with manometry.

Radiography and manometry of the esophagus were compared in 77 patients consecutively referred for manometric investigation on suspicion of esophageal motility disorder. Radiography and manometry were carried out simultaneously, and the results were assessed blindly. The examination comprised barium swallow, bread barium swallow, and barium swilling. Considering manometry as the standard, the overall sensitivity and specificity of the radiologic examinations were 90.4% and 92.0%, respectively. We conclude that radiology is an excellent investigation for the separation of patients with and without esophageal motility disorders, but correct subclassification often required manometry.

Administration, Oral↗
PubMed1992

The influence of a solid and liquid bolus on food-stimulated gastroesophageal reflux.

Using a radiological method to demonstrate food-stimulated gastroesophageal reflux (GER), a comparative study was carried out employing a solid, already validated bolus versus a liquid one. One hundred and four consecutive patients received both a solid and a liquid bolus in randomized order. GER was observed in 37 (35.6%) patients receiving the solid bolus versus 28 (26.9%) with the liquid one. This means that the solid bolus provokes significantly more reflux (P less than 0.02). GER, grade II (reflux above the level of the carina), occurred equally often as a result of both types of bolus, however. The study suggests that significant, food-stimulated GER is independent of the consistency of the foodstuffs and may be detected employing a liquid bolus. This result might be used in the examination of infants for GER, using milk as a food stimulus.

Adult↗
PubMed1991

Effect of cholecystectomy on the relationship between hydrostatic common bile duct pressure and sphincter of Oddi motility.

The sphincter of Oddi (SO) motility before and after an artificial elevation of the common bile duct pressure was studied by means of endoscopic manometry in nine female subjects, seven of whom had undergone previous cholecystectomy. An increase in the hydrostatic common bile duct pressure resulted in total inhibition of the phasic SO contractions in the two patients with gallbladders in situ, as well as in four of the cholecystectomized patients. The results thus indicate that the inhibitory effect of hydrostatic common bile duct pressure on the SO motility previously demonstrated in the cat is also present in man. On the other hand, as the inhibition of the phasic contractions failed to occur in three of the postcholecystectomy patients, the findings also suggest that cholecystectomy may result in altered regulation of SO motility in some patients. This mechanism could then contribute to development of pain in susceptible subjects postcholecystectomy. Finally, the results also showed that pain experienced by some patients upon contrast injection during ERCP bears no relationship to SO motility, but is due to an interindividually variable sensitivity of the bile duct wall to the intraluminal pressure variation.

Abdominal Pain↗
PubMed1991

Postprandial gastro-oesophageal reflux demonstrated by radiology.

An investigation to detect food-stimulated gastro-oesophageal (GE) reflux was carried out in 54 consecutive fasting patients, 35 of whom experienced reflux while 19 did not. All patients then received a standard meal (566 kcal), and the investigation was repeated 1 h later. Out of the 35 with GE reflux in the fasting state, 33 also had GE reflux in the postprandial state, and 17 of the 19 patients with no GE reflux while fasting also had none in the postprandial state. It is concluded that the radiological method can identify most patients in whom food-stimulated GE reflux could be of clinical significance.

Administration, Oral↗
PubMed1990

Influence of cisapride on food-stimulated gastro-oesophageal reflux: a radiological study.

The influence of Cisapride on food-stimulated gastro-oesophageal reflux mechanisms was studied in a double-blind cross-over investigation in 24 consecutive patients selected by endoscopy, 12 with microscopical evidence of gastro-oesophageal reflux and 12 with additional macroscopic oesophagitis. 63% had food-stimulated gastro-oesophageal reflux, and Cisapride significantly reduced the tendency to gastro-oesophageal reflux and mucosal contact time between gastric content and the oesophageal mucosa in 73% of these patients. It is concluded that Cisapride could be valuable in the treatment of gastro-oesophageal reflux.

Adult↗
PubMed1990

Food-stimulated cholescintigraphy as a supplement to ERC in patients with suspected bile flow obstruction. A preliminary study.

Cholescintigraphy after food stimulation was carried out in 40 patients (13 patients with biliary enteric bypass, 14 patients with bile duct stenosis, demonstrated by ERC, 5 patients with endoprothesis and 8 patients with clinically suspected post-cholecystectomy syndrome. Biliary-bowel transit time of one hour or less was considered to be normal. In patients with biliary enteric bypass 11 had a normal transit time; however, one with a concomitant anastomotic leakage, and 2 patients had prolonged transit time and a significant obstruction by the anastomosis. All 14 patients with demonstrated biliary stricture had normal transit time. In 5 patients with endoprothesis, 2 had prolonged transit time in spite of patent endoprothesis. Finally, in the 8 patients with suspected post-cholecystectomy syndrome, 4 had normal sphincter of Oddi manometry and normal transit time, and 4 had abnormal sphincter of Oddi manometry, but only one with prolonged transit time. It is concluded that in patients with biliary enteric bypass (hepatico-jejunostomia) or biliary strictures a biliary-bowel transit time of one hour will be discriminatory between normal and abnormal conditions. This is in contrast to patients with endoprothesis and suspected sphincter of Oddi dysmotility, where a transit time of one hour only will have limited predictive value.

Adult↗
PubMed1990

HIDA-cholescintigraphy in normals. Value of interrupting the migrating motor-complex (MMC).

The value of interrupting the migrating motor-complex (MMC) and computer-assisted technique in HIDA cholescintigraphy was studied in 10 healthy subjects. Sequential scintigrams were sufficient for evaluating biliary-bowel transit time, visualization of the gall bladder and liver wash-out. However, the point of dynamic equilibrium between net uptake and emptying of the tracer of the gall bladder and hepatic areas, required computer assisted technique. Finally, interruption of the MMC resulted in biliary-bowel transit within one hour in all, but only gall bladder visualization in 8, whereas in the fasting state the gall bladder was visualized in all, but with prolonged biliary-bowel transit in one subject.

Adult↗
PubMed1990

Final gastric emptying of solid food in healthy subjects: determined by X-ray examination and radionuclide imaging.

In ten healthy subjects final gastric emptying of solid food was measured by a new scintigraphic method, employing 99mTc labelled pellets, and compared to a radiologic method, employing food with incorporated barium suspension. Final gastric emptying of solid food, measured by the scintigraphic technique, was 5.2 hours and with the radiographic technique 5.5 hours, with no significant difference. It is concluded that significant information concerning gastric emptying of solid food can be obtained by the radiological method.

Adult↗
PubMed1989

Severe destruction of esophageal nerves in a patient with achalasia secondary to gastric cancer. A possible role of eosinophil neurotoxic proteins.

We present a case of secondary achalasia due to an adenocarcinoma of the stomach with no tumor infiltration of the esophagus. Immunohistochemical staining revealed a massive infiltration of activated eosinophils in the muscularis of the esophagus with secretion of the highly cytotoxic and neurotoxic eosinophil cationic protein (ECP). Immunohistochemical staining for the neuropeptides VIP and substance P, as well as the histochemical demonstration of AChE, revealed a nearly total absence of all three neurotransmitters/modulators compared to control. The hypothesis is advanced that eosinophil neurotoxicity is the cause of secondary achalasia.

Adenocarcinoma↗
PubMed1989

The incidence of gastro-oesophageal reflux in children with exogenic and endogenic asthma tested by a new radiological method.

24 asthmatic children and 15 children without any respiratory or gastrointestinal signs of symptoms were investigated for gastro-oesophageal reflux (GER) by a new radiological test in which the child swallowed a piece of rye bread with liver paté after intake of a glass of Mixobar (600 mg/ml barium sulphate). The asthmatic children were divided into an exogenic and an endogenic group. 62.5% of the endogenically asthmatic children had GER (p less than 0.01) and 19% in the exogenic group. In normal children only one child had GER (7%). Furthermore, GER was more frequent in asthmatic children with nightly cough compared to asthmatic children without nightly cough (p less than 0.02). It is concluded that GER reflux occurred significantly more often in patients with endogenic asthma and/or nightly cough when compared to normal children.

Asthma↗
PubMed1989

The incidence of gastro-oesophageal reflux after solid and semi-solid meal.

The influence of different foodstuffs, solid meal, semi-solid meal and solid bolus, was investigated in 21 patients with food-stimulated gastro-oesophageal reflux. All 21 had GE reflux following solid meal, 9 after semi-solid and 11 after solid bolus. The result could not be explained by difference in fat content or reproducibility. It is concluded that information concerning test meals could be of importance when comparing different GE reflux populations.

Adult↗
PubMed1988

Clinical management of the benign cytological report in patients with solitary pulmonary nodules.

The clinical value of the benign cytological report was evaluated in 65 patients with a peripheral solitary pulmonary nodule. The cytological report suggesting a specific benign diagnosis (hamartoma, tuberculoma, carcinoid) was of decisive clinical value in 47 patients. In 18 patients the cytological report only suggested the presence of benign cellular elements and was of limited or even misleading clinical value and comprising two false negative reports. It is concluded, that the benign cytological report suggesting a specific lesion is of decisive clinical value, whereas a cytological report only suggesting benign cellular elements should prompt repuncture or surgical biopsy.

Adult↗
PubMed1988

The shape of the duodenal loop. Radiological, physiological and clinical aspects in patients with X-ray negative dyspepsia.

The survey is based on nine previously published papers and is divided into three main sections dealing with the relationship between the duodenal loop and the radiological, the physiological and the clinical examinations in patients with X-ray negative dyspepsia. In the first section the development of the duodenal loop, the various types of development anomalies and their radiological image are discussed. Furthermore the causes of the extensive variation in the indications of the duodenal anomaly incidence and the duodenal anomalies which have been the basis of the examinations, are discussed. Only severe duodenal anomaly is included in these examinations, namely those demonstrable both in the supine and the erect position, which means developmental anomalies corresponding to the superior and transverse parts of the duodenum. Patients with a normal duodenal shape have been used as controls. Patients with duodenal anomaly had reduced food-stimulated gastro-oesophageal sphincter pressure, more frequently a positive acid-reflux-test and increased food-stimulated serum-gastrin and serum-pancreatic polypeptide secretion. The results of the examinations for duodeno-gastric reflux and gastric emptying varied. Patients with anomalies located at the transverse part of the duodenum had prolonged gastric emptying and an increased tendency to duodeno-gastric reflux, whereas patients with anomalies located at the superior part of the duodenum showed quick gastric emptying and the same frequency of duodeno-gastric reflux as patients with a normal duodenal shape. Furthermore, patients with anomalies located at the transverse part of the duodenum had a significantly higher food-stimulated duodenal contraction frequency compared to patients with anomalies located at the superior part of the duodenum and patients with a normal duodenal shape. On the other hand the three groups had a similar food-stimulated antral contraction frequency. The shape of the duodenal loop was related to dyspeptic symptoms. Food-provocation, symptoms of gastrooesophageal reflux, and irritable bowel were found in patients with duodenal anomalies as well as in patients with a normal duodenal shape. However, the symptoms seemed significantly more frequent in patients with duodenal anomalies. At a 5-year follow-up examination this difference could not be demonstrated except for food-provocation, but unchanged or exacerbated dyspeptic inconveniences seemed significantly more frequent in patients with duodenal anomalies.

Adult↗
PubMed1987

The incidence of severe duodenal anomalies in patients submitted to barium meal examination, in normals, and in different clinical subgroups.

The incidence of severe duodenal anomalies (MD) has been investigated in 458 patients submitted to barium meal examination and in 176 subjects comprising various clinical subgroups. The incidence of MD in patients submitted to barium meal examination was 11.6%. The incidence of MD in 25 normals was 4%, which was not significantly different from the incidence (10%) of MD in patients with gastroesophageal reflux symptoms. Compared with in normals, MD occurred with a significantly higher incidence in 45 patients with X-ray-negative dyspepsia (24%), in 36 patients with the irritable bowel syndrome (44%), and in 37 patients with asthma (38%). It is concluded that demonstration of MD in a patient is only indicative of a possible disorder.

Adolescent↗
PubMed1987

Duodenal diverticula demonstrated by endoscopic retrograde cholangio-pancreatography (ERCP)--their relationship to biliary calculi and gastrooesophageal reflux.

In 24 patients with duodenal diverticula, demonstrated by ERCP, food-stimulated gastrooesophageal reflux was demonstrated in 33% of the patients and biliary tract calculi in 81%. This is in contrast to a previous study in patients with duodenal diverticula demonstrated by barium examination where gastroesophageal reflux occurred in 81% and biliary tract calculi in 38% of the patients. Differences in clinical selection are believed to be the underlying cause to these varying results.

Adult↗
PubMed1987

The incidence, reproducibility and mechanism of gastrooesophageal reflux demonstrated by radiology in normals, dyspeptics, and patients with oesophagitis.

The incidence, reproducibility, and mechanisms of food-stimulated gastrooesophageal reflux demonstrated by radiography were investigated in 100 subjects: 30 normaldeletes, 52 dyspeptics, and 18 patients with oesophagitis. The average incidence and reproducibility were in normals: 17%-76% respectively, in dyspeptics: 40%-86% respectively, and in oesophagitis: 83%-81% respectively. In normals only active gastrooesophageal reflux was noticed whereas in dyspeptics and patients with oesophagitis free as well as active gastrooesophageal reflux occurred.

Adolescent↗