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R Jorde

Publications and source records attributed to R Jorde.

At least 73 records · Page 4Linked to original sources
PubMed1992

Reproducibility of glycaemic thresholds for activation of counterregulatory hormones and hypoglycaemic symptoms in healthy subjects.

Nine healthy subjects were studied on two separate occasions, at least two weeks apart, using the glucose clamp technique to produce a gradual hypoglycaemia. Glucose thresholds for neuroendocrine and symptom responses varied up to 1.5 mmol/l between subjects. There was a significant correlation between individual glucose thresholds on day 1 and 2 for adrenaline (p = 0.0008), growth hormone (p = 0.007) and pancreatic polypeptide (p = 0.02), and for autonomic (p = 0.018) and neuroglycopoenic (p = 0.023) symptoms, whereas no significant correlations were found for glucagon and cortisol. The mean intra-individual differences in glucose thresholds between day 1 and 2 were 0.22 mmol/l for the hormones and 0.25 mmol/l for the symptoms. We conclude that healthy subjects differ in hypoglycaemic thresholds, and that the difference reflects individual variation.

Adult↗
PubMed1992

Plasma protein binding of catecholamines, prazosin and propranolol in diabetes mellitus.

In the present study equilibrium dialysis has been used to determine the degree of protein binding of the catecholamines adrenaline and noradrenaline and the adrenergic receptor blockers, prazosin and propranolol in diabetics. The binding of the catecholamines in plasma from Type I and II diabetic patients was not significantly different from that of healthy subjects. The ratio of the bound and free catecholamine concentrations was correlated with the level of albumin (HSA). Significantly reduced protein binding of prazosin was observed in Type I and II diabetic subjects compared to healthy volunteers. The binding of propranolol was significantly reduced in Type I patients. The ratios between the bound and unbound concentrations of prazosin and propranolol were significantly correlated with the levels of alpha 1-acid glycoprotein (AAG). The results suggest that non-enzymatic glycosylation of plasma proteins may increase the unbound fraction of the adrenergic blockers prazosin and propranolol.

Adult↗
PubMed1992

Increments in glucose, glucagon and insulin after morphine in rats, and naloxone blocking of this effect.

In awake rats adapted to experimental conditions and allowed food ad libitum, hyperglycemia was induced by the administration of morphine 10 mg/kg through indwelling catheters in the external jugular vein. High glucose values were measured at 5, 15 and 25 min. Glucagon values were high at 5 and 15 min, and again at basal level at 25 min. Insulin was increased after morphine both at 5, 15 and 25 min, whereas somatostatin levels did not change after morphine. When morphine was administered together with naloxone after an initial 10 min period of naloxone administration, there was no increment in glucose, insulin or somatostatin values; neither at 5, 15 or 25 min. There was a remarkable glucagon decrease after naloxone and morphine remaining from 5 to 25 min. Then, one of the possible mechanisms for the hyperglycemic response after morphine may be an opioid effect on pancreas, stimulating glucagon and thereby causing hepatic glucose output.

Animals↗
PubMed1992

Pre- and postoperative glucose levels for eliciting hypoglycaemic responses in a patient with insulinoma.

Counterregulatory hormones and hypoglycaemic symptoms were studied during a gradual decline in plasma glucose in a 66-year-old man before and 9 weeks after removal of an insulin-producing tumour. Before surgery the adrenaline started to respond first at plasma glucose 2.8 mmol l-1. He reported no autonomic symptoms although plasma glucose fell to 2.3 mmol l-1 with a corresponding adrenaline rise to 4.64 nmol l-1. After surgery adrenaline responded at a plasma glucose of 3.7 mmol l-1 and he started to sweat and tremble at a plasma glucose of 3.1 mmol l-1 (corresponding adrenaline 2.63 nmol l-1). The lack of autonomic symptoms preoperatively may indicate adrenaline insensitivity, possibly as a result of repeated hypoglycaemia.

Aged↗
PubMed1992

The effect of selective beta 1-blockade on glucose thresholds for release of counterregulatory hormones and symptoms in insulin-dependent diabetes mellitus.

To evaluate the effect of beta 1-blockade (metoprolol) on the plasma glucose thresholds initiating counterregulatory hormone responses and symptoms of hypoglycemia, we used a modified glucose clamp technique to produce a standardized gradual glucose decline from 5.0 to 2.0 mmol/l in nine patients with insulin-dependent diabetes mellitus (IDDM) (HbAlc range 6.7-10.3%, duration of diabetes 5-18 years, autonomous neuropathy present in three of the patients). The responses were studied once with metoprolol and once with placebo, in random order. With the beta 1-selective blockade, epinephrine release was triggered at a significantly higher (p less than 0.02) plasma glucose level (3.5 mmol/l) than it was with placebo (3.0 mmol/l). Metoprolol did not change thresholds for growth hormone (3.7/3.5 mmol/l), cortisol (2.9/2.9 mmol/l), glucagon (2.8/2.8 mmol/l) or for pancreatic polypeptide (2.8/2.7 mmol/l). The peak responses of epinephrine and growth hormone were significantly higher (p less than 0.01) with the beta 1-blockade. Metoprolol did not change the thresholds for neuroglycopenic and autonomic symptoms. Six out of the seven patients who answered yes to having hypoglycemia did so at a higher blood glucose with metoprolol than without. In our study, the beta 1-selective blockade altered the responses of counterregulatory hormones, but it did not change the thresholds for hypoglycemic symptoms.

Adrenergic beta-Antagonists↗
PubMed1990

The incidence of ulcerative colitis in Northern Norway from 1983 to 1986. The Northern Norwegian Gastroenterology Society.

In a 3-year prospective epidemiologic multicentre study in Northern Norway the average annual incidence of ulcerative colitis was 12.8 per 100,000. Both inpatients and outpatients were included. There was a significant sex difference in annual incidence in the health region (15.1 per 100,000 in males versus 10.4 per 100,000 in females), which was most pronounced Nordland county (16.6 per 100,000 in males versus 10.4 per 100,000 in females). The highest incidence was seen in the age group 20-29 years, with an incidence of 30.3 in men and 20.3 in women per 100,000 per year. A family history of first-degree relatives with inflammatory bowel disease was obtained in 10.1%. The pathologic changes were equally distributed among the rectum and the distal and total colon. Ulcerative colitis located to the distal colon seemed more associated with extraintestinal manifestations.

Adult↗
PubMed1989

Addison's disease and pregnancy.

Five case reports are presented illustrating that pregnancy and Addison's disease are not incompatible, provided adequate substitution therapy is given.

Addison Disease↗
PubMed1989

The incidence of Crohn's disease in northern Norway from 1983 to 1986. Northern Norway Gastroenterology Society.

In a prospective epidemiologic multicentre study in Northern Norway, the incidence of Crohn's disease was 5.8 per 100,000 per year. The highest incidence was found in the county of Nordland, located in the south, and the lowest in Finnmark, located in the north of the region (6.7 and 3.9 per 100,000 per year, respectively). Similarly, there was a lower incidence in rural than in urban areas. Crohn's disease was found as frequently in the large as in the small bowel. The location in the large bowel seemed more often to be associated with extraintestinal manifestations. The male to female ratio was almost 1:1. In males a peak incidence was seen in the age group 20-29 years old, whereas no similar peak was seen in the females. Twenty-two per cent of the cases were diagnosed before the age of 20. In 13.4% of the cases a family history of inflammatory bowel disease was found.

Adolescent↗
PubMed1988

Gastrointestinal regulatory peptides during oxytocin infusion in post-term pregnancies.

The plasma concentrations of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide (VIP), insulin, secretin, somatostatin, motilin, pancreatic polypeptide (PP) and gastric inhibitory polypeptide (GIP), as well as blood glucose, were measured in eight healthy women before, during and after oxytocin infusion in post-term pregnancies. Plasma VIP increased significantly (P less than 0.01) during oxytocin infusion. Plasma secretin showed a significant (P less than 0.05) decrease during oxytocin infusion. Plasma somatostatin remained unchanged during oxytocin infusion, but thereafter a significant (P less than 0.05) increase occurred. Both plasma motilin and plasma PP showed a non-significant increase during oxytocin infusion with sustained levels thereafter. No changes were found for plasma insulin, GIP and blood glucose.

Adult↗
PubMed1988

ACTH deficiency, hyperprolactinemia and benign intracranial hypertension. A case report.

A 26-year-old female with ACTH deficiency, hyperprolactinemia and benign intracranial hypertension is reported. Her symptoms of adrenocortical insufficiency and persistent amenorrhea appeared after her last child birth one year previously. During an infectious disease she became critically ill with hypotension and was treated with iv penicillin. A bacterial infection was, however, not diagnosed. After 4 days she developed symptoms and signs of intracranial hypertension. She improved gradually within 10 days without specific therapy against the intracranial pressure. Endocrine investigation disclosed a secondary adrenocortical failure. The lesion appeared to be located in the pituitary gland since plasma ACTH and cortisol did not respond to CRH. A moderately elevated serum PRL was found, whereas the pituitary reserves of TSH, GH, LH and FSH were normal, as was a computed tomographic scan of the pituitary gland. The patient was given cortisone substitution therapy and recovered immediately. Within the following year she regained normal menstruations and became pregnant. A possible autoimmune etiology of her isolated ACTH deficiency precipitated in the puerperium is discussed.

Adrenal Cortex↗
PubMed1988

Peptic ulcer bleeding in patients with and without dyspepsia.

In the present retrospective study the hospital records of all patients admitted to the University Hospital of Tromsø with their first ulcer bleeding during 1973-1985 were reviewed. The patients were grouped as dyspeptics and non-dyspeptics. The case history gave adequate information in 298 patients--243 with dyspepsia and 55 without. Pyloric ulcers were significantly (p less than 0.05) more frequent in the patients with dyspepsia than in those without (17.7% versus 5.5%), and the non-dyspeptic men were significantly (p less than 0.02) older than their dyspeptic counterparts (64.5 +/- 1.3 years versus 53.4 +/- 0.8 years). There were also significantly (p less than 0.01) more patients with chronic diseases among those without dyspepsia (49.1% versus 23.5%), whereas the consumption of anti-inflammatory drugs was fairly similar in the two groups.

Adult↗
PubMed1987

A re-examination of patients with previously detected autoantibodies to smooth muscle.

A group of patients which previously had been found to possess smooth muscle antibody (SMA) activity was re-examined for persistence of the autoantibody. The mean observation time was four years (range 0.5-9 years). Thirty out of 140 patients, who initially had SMA associated with rheumatic or other symptoms, had autoantibody activity at re-examination. Most were low in titer, and none of the 30 had developed chronic liver disease. Twenty-four patients with SMA at the first testing were analyzed because of liver pathology. Five had CAH at that time. SMA in low titer associated with liver pathology was a transient phenomenon. SMA in high titer combined with liver pathology seems to be a persistent condition with respect to both parameters, although no additional patients developed CAH between the first testing and re-examination.

Autoantibodies↗
PubMed1987

Ranitidine 150 mg at night in the prevention of gastric ulcer relapse.

After healing of a gastric ulcer, 53 patients were randomly allocated to either 12 months maintenance treatment with ranitidine 150 mg at night or an identical placebo. Fifty patients completed the trial. The patients were interviewed every third month. If symptoms indicated a relapse, endoscopy was done; and if an ulcer was found the maintenance trial was terminated. All remaining patients were endoscoped after one year. The accumulated relapse rate in the ranitidine group (36%) was significantly lower (p less than 0.01) than in the placebo group (76%), as also was the antacid consumption (p less than 0.01). Four of the six ulcers found at the final one year endoscopy were asymptomatic. In all but two of the 26 patients with relapse of symptoms an ulcer was found at endoscopy. The patients that suffered a recurrence had significantly (p less than 0.05) higher maximal acid output than those without ulcer recurrence. The time needed for healing of the relapse ulcers (four or eight weeks) corresponded to that needed for healing of the preinclusion ulcers. It is concluded that ranitidine 150 mg at night significantly reduces the gastric ulcer recurrence rate, and that relapsing ulcers are similar to the initial ones in healing response.

Adult↗
PubMed1987

An endoscopic study of ulcer recurrence and mucosal changes following vagotomy and excision of gastric ulcer.

Follow-up of patients operated on for gastric ulcer--137 with selective gastric vagotomy (SGV), pyloroplasty and ulcer excision (1967-1976) and 72 with proximal gastric vagotomy (PGV) and ulcer excision (1974-1984)--was supplemented with data from recent clinical, endoscopic and biopsy studies in 78 of the patients. Ulcer recurred in 27/137 SGV and 7/72 PGV cases (20.3 and 9.9%). Four patients died of gastric cancer 5-7 years after SGV. Of the endoscopically reexamined patients, 1/42 with SGV and 1/36 with PGV were found to have asymptomatic ulcer. The incidence of gastric stasis with food retention was 35.7% in the SGV, and 8.3% in the PGV group, and the respective incidences of severe gastric mucosal inflammation with fibrinous deposits were 42.9% and 2.7%. Mild or moderate dysplasia was shown in biopsies from 16.6% of the SGV and 8.3% of the PGV group. The high dysplasia incidence, especially after SGV, and the four gastric cancer deaths in that group indicate a need for long-term follow-up evaluation of possibly increased gastric cancer risk following vagotomy.

Adult↗
PubMed1986

Cancer detection in biopsy specimens taken from different types of gastric lesions.

From January 1974 to October 1983, 5072 gastroscopies were performed in 3351 patients with a total of 14,554 biopsy specimens taken from 2565 lesions in the stomach. The endoscopic diagnoses and their histologic counterparts were recorded and the diagnostic yield of specimens from each type of lesion analyzed. Gastric adenocarcinoma was finally diagnosed in 139 patients. The diagnosis was delayed, from 1 to 4 months, in five patients because of false-negative diagnoses. These patients all had ulcerating cancers. Moreover, early gastric cancer was mainly of the ulcerating type. Accordingly, an ulcer lesion is the most important one to biopsy. Only four cancers were found in 959 benign-appearing gastritic lesions. Twenty-one patients with negative biopsy results at the first endoscopy were later shown to have cancer. When these biopsy specimens were re-examined, malignant lymphoma was found in one and adenocarcinoma in three cases. In spite of false-negative endoscopic findings, nonrepresentative biopsy material and false-negative histologic reports, the combination of biopsy results and clinical judgement led to correct and timely treatment in nearly all patients.

Adenocarcinoma↗