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Biomedical subjects

R Stenling

Publications and source records attributed to R Stenling.

At least 73 records · Page 4Linked to original sources
PubMed1993

Prognosis after early onset of ulcerative colitis. A study from an unselected patient population.

All patients with onset of ulcerative colitis before the age of 20 years from a population of 65,000 inhabitants were studied. The study period was 30 years (1961 through 1990). There were 32 patients, 18 male and 14 female, giving an incidence of 0.7 patients/100,000/year. Twenty-four patients had total colitis and 8 had limited disease. The observed duration of the disease was 0-30 (mean 18, median 20) years. One patient died of fulminant disease. No colorectal carcinoma was diagnosed. In 7 patients, low-grade dysplasia was diagnosed, which did not progress during an observation period of 2-10 years. DNA aneuploidy was detected in 6 patients. Seven patients (22%) were operated on after a disease duration of 0-10 (mean 4, median 3) years on clinical grounds. No cancer-prophylactic colectomy was performed. It is concluded that, in an unselected population of patients with early onset of ulcerative colitis, mortality and cancer risk are low. The need for operative treatment during the first 15 years of the disease was around 22 per cent. Endoscopic surveillance was given preference over prophylactic colectomy in patients with low-activity or quiescent disease.

Adolescent↗
PubMed1992

Colorectal cancer risk after jejunoileal bypass: dysplasia and DNA content in longtime follow-up of patients operated on for morbid obesity.

Jejunoileal bypass (JIB) has been a widespread operation for treatment of morbid obesity. Bile acids are regarded as cofactors in the carcinogenesis of the colon, and, since intestinal bypass involves increased exposure of bile acids to the large intestinal mucosa, JIB has been postulated to increase the risk for colorectal carcinoma. In experimental studies on animals, the results have indicated an increased frequency of induced carcinomas, but in clinical series only one patient with colon carcinoma has been reported. Thirty women, operated on with JIB 11 to 17 years earlier, were examined by colonoscopy with multiple biopsies, systematically taken for histologic evaluation and flow cytometric DNA analysis. In only one patient, low-grade dysplasia was detected in an initial adenomatous lesion but was not visible macroscopically. No DNA aneuploidy was found. In a control group of 11 patients examined for non-neoplastic disease, neither dysplasia nor aneuploidy was diagnosed. Within 17 years postoperatively, we have, by these methods, not been able to verify any colorectal malignant transformation in patients operated on with JIB. However, since carcinogenesis is a long process, further surveillance will be demanded before an increased risk for colorectal carcinoma can be excluded.

Adult↗
PubMed1992

Effect of oat bran on plasma cholesterol and bile acid excretion in nine subjects with ileostomies.

A higher excretion of dry matter, fat, nitrogen, energy, and total bile acids in ileal effluents; a lower plasma low-density-lipoprotein (LDL) and total cholesterols (12.1% and 9.0% lower respectively); but no change in plasma high-density-lipoprotein (HDL) cholesterol or apolipoproteins A-I and B were observed in nine subjects with ileostomies when they consumed an oat-bran, bread-based, high-fiber diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet (LFD) for 3 wk with a crossover design. Of the nine subjects only the subjects with a low daily excretion of bile acids had an elevated excretion of total bile acids during the HFD compared with the LFD. Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma also decreased by 11.3%, 15.3%, and 10.7%, respectively, after consumption of the HFD for 3 wk.

Adult↗
PubMed1991

Flow cytometric deoxyribonucleic acid analysis in stage I renal cell carcinoma.

Tumor deoxyribonucleic acid (DNA) content was analyzed by flow cytometry in 60 consecutive patients with stage I renal cell carcinoma. Of 59 evaluable tumors 27 (46%) were homogeneously diploid, 1 (2%) was tetraploid and 31 (52%) were aneuploid. Of the 32 nondiploid tumors 25 were heterogeneous concerning ploidy. One of the 27 patients with diploid tumors had metastases compared to 5 of the 32 patients with nondiploid tumors (not significant). There was a significant difference in survival between patients with diploid and nondiploid tumors (p = 0.043). Neither nuclear grade, tumor cell type nor tumor size correlated with survival. Analysis of DNA content seems to predict survival significantly for patients with stage I renal cell carcinoma.

Adult↗
PubMed1991

Brewer's spent grain, serum lipids and fecal sterol excretion in human subjects with ileostomies.

A crossover design studying lipid and apoprotein levels in serum and excretion of sterol, nitrogen and fat in ileostomy effluent was performed in 10 subjects fed diets with or without supplementation with brewer's spent grain, which is the residue of barley after the brewing of beer. More cholesterol, nitrogen, fat and energy were excreted in the ileostomy effluents when the subjects consumed a brewer's spent grain supplemented, high fiber diet than when they consumed a low fiber diet. No significant change was found in the daily net sterol excretion. The six subjects with low daily excretion of bile acids (less than 1000 mg/24 h) had increased cholesterol and net cholesterol and decreased bile acid excretion per day, and lowered serum LDL-cholesterol and apoprotein B levels after supplementation with brewer's spent grain. We propose that subjects with low daily bile acid excretion are suitable models for studying the effect of dietary changes on sterol excretion and serum lipid levels. Increased fecal cholesterol excretion is suggested to be the primary mechanism for the serum LDL-cholesterol lowering effect of brewer's spent grain.

Adult↗
PubMed1991

Chronic diarrhoea after radiotherapy for gynaecological cancer: occurrence and aetiology.

The occurrence of chronic diarrhoea was evaluated in 173 consecutive patients previously treated with radiation for gynaecological cancer. A survey of gastrointestinal symptoms showed a high frequency of diarrhoea; 13% of the patients had 21 or more bowel movements a week and 3% had 28 or more. Significantly more patients who had a cholecystectomy were in the group with diarrhoea (chi 2 = 6.26; p less than 0.02). Twenty patients with chronic or intermittent diarrhoea were subject to extended gastrointestinal investigation. Bile acid malabsorption was evaluated by the 75Selenahomocholic acid-taurine test (SeHCAT). Bile acid malabsorption was found in 13 (65%) of the 20 patients further investigated, of whom seven had extremely low whole body retention values, which is consistent with severe malabsorption. The results suggest that bile acid malabsorption is a common cause of diarrhoea after radiation treatment for gynaecological cancer. Bacterial contamination was diagnosed in nine patients (45%) by the [14C]-D-xylose breath test or by the cholyl-[14C]-glycine breath test in combination with a normal test for bile acid malabsorption. All patients with vitamin B-12 deficiency, who were tested for bile acid malabsorption, had low retention times for the SeHCAT (p = 0.05). A significant decline in the frequency of diarrhoea was found after treatment with antibiotics or bile acid sequestrants, or both, in combination with a reduced fat diet.

Adult↗
PubMed1991

Excretion of pseudouridine as an independent prognostic factor in renal cell carcinoma.

Pseudouridine is the most prevalent modified nucleoside excreted in urine, mainly as a degradation product of t-RNA. The level of pseudouridine excretion was analyzed in 71 patients with renal cell carcinoma prior to treatment. An increased excretion was demonstrated in 27 of 48 patients (56%) in stage II-IV, compared to 2 of 23 patients (9%) in stage I. Survival time was significantly reduced in patients with increased excretion. The level of pseudouridine correlated to tumor grade and tumor size. Using Cox's proportional hazard model, only clinical stage and level of pseudouridine excretion were independent predictors of prognosis.

Adult↗
PubMed1991

Metastatic renal cell carcinoma treated with purified leukocyte interferon. Clinical response in relation to tumor DNA content.

Twenty-eight patients with renal cell carcinoma and evaluable metastases were treated with a purified leukocyte interferon 2-7 x 10(6) IU daily. DNA content was analyzed by flow cytometry. Nine patients had lung metastases only, 12 had dissemination to lungs and to other sites as well, and 7 had metastases in other sites only. Two patients had complete response and one had minor response of lung metastases. Another 3 patients had mixed responses: 2 of them complete disappearance and one minor response of lung metastases but concomitant progression of skeletal and abdominal metastases. The overall response rate restricted to lung metastases only was 21% (6 of 28 patients) including the 3 patients with mixed response. The 6 patients with any kind of response were found among 19 patients with aneuploid primary tumors while no response was noted in 8 patients with diploid tumors.

Adult↗
PubMed1990

Renal cell carcinoma in a renal cyst: a case report and review of the literature.

We report a case of renal cell carcinoma within a simple renal cyst in the lower pole of the right kidney. Excretory urography showed a mass and ultrasonography revealed multiple renal cysts with a solid component arising from the wall in 1. This finding also was visualized by computerized tomography. Analysis of the cystic fluid showed a high cholesterol level but negative cytological results. At operation a 7 mm. tumor arose from the wall of the cyst. Histopathological examination showed grade 3 renal cell carcinoma with an aneuploid deoxyribonucleic acid content.

Aged↗
PubMed1990

The influence of barley fibre on bile composition, gallstone formation, serum cholesterol and intestinal morphology in hamsters.

Frequency of gallstones, concentration of bile acids and cholesterol in bile, concentration of cholesterol in serum, and structure of the small intestinal mucosa were analyzed in male Syrian Golden hamsters fed a stone provoking fibre-free diet with or without supplementation of brewer's spent grain (BSG), a concentrated barley fibre source from the by-product of brewing. A significantly lower frequency of gallstones was found in the animals with 10% BSG dietary supplementation. Addition of 30% BSG after an initial 6-week period with a fibre-free, stone provoking diet seemed to dissolve previously formed gallstones. Total bile acid concentration was higher in bile from animals given a diet supplemented with 10% BSG. In addition, the cholesterol concentration in both serum and bile was lower in the 30% BSG supplemented group. Structurally, a 10% BSG supplementation decreased ileal epithelium height whereas a high supplementation (30%) of BSG induced a decrease in epithelial height both of jejunal and ileal mucosa. The results show that BSG has significant effects on the metabolism of bile acids and cholesterol as well as on the morphology of the small intestinal mucosa.

Animals↗
PubMed1990

Bacterial contamination of the small bowel evaluated by breath tests, 75Se-labelled homocholic-tauro acid, and scanning electron microscopy.

Eighty-one patients with diarrhoea due to suspected bacterial contamination of the small intestine were investigated with the bile acid breath test (BABT) and 75Se-labelled homocholic-tauro acid (SeHCAT). The impact of bile acid malabsorption due to dysfunction of the terminal ileum on BABT was evaluated. The group of patients with abnormal BABT, notably the 6-h accumulated value, showed a high frequency of reduced SeHCAT values (p less than 0.01), indicating that a reliable test for bile acid malabsorption is indispensable for interpreting the BABT in the investigation of small-intestinal bacterial overgrowth. The results of the 14C-D-xylose breath test were compared with the outcome of the combined SeHCAT-BABT in 44 patients. In contrast to previous findings no correlation between the two breath tests was found. On the contrary, a significant negative correlation was encountered (p less than 0.01) for patients in whom either breath test was abnormal. Scanning electron microscopy for demonstration of adherent microorganisms was included in the investigations. No correlations were found with the outcomes of the different breath tests. The effect of antibiotic treatment was evaluated with regard to symptoms and breath tests. The results of the investigation indicate that different tests are needed for the diagnosis of bacterial overgrowth of the small intestine, because of the different metabolic characteristics of the contaminating bacteria.

Bacterial Infections↗
PubMed1990

Morphologic changes in the small intestine after chronic alcohol consumption.

The morphology of the small-intestinal mucosa was studied in 11 alcoholic patients admitted to hospital for detoxification. A first biopsy specimen from the small intestine was taken as soon as possible after admission and a second specimen after about 6 weeks of abstinence. The specimens were studied in the light microscope, in the scanning electron microscope, and by immunohistochemistry. Morphometrically, a slight reduction in villus height in relation to crypt depth was observed. One patient had a subtotal villus atrophy. After abstinence the villus height was increased in five of the six patients who accepted a second biopsy. No obvious changes were seen in the frequency and appearance of peptidergic nerves or endocrine cells. Ultrastructurally, pronounced alterations were seen in the surface ultrastructure of the enterocytes. In two specimens bacterial adhesion to the mucosal surface was also found. The ultrastructural changes were unaltered after abstinence. In serum the concentrations of zinc were reduced, and the levels of copper were elevated compared with a group of teetotallers. A recently developed marker of high alcohol consumption, carbohydrate-deficient transferrin, was as good an indicator as the other conventional biochemical markers.

Adult↗
PubMed1990

A simple index for assessment of disease activity in patients with ulcerative colitis.

Based upon data from a prospective series of 61 patients with ulcerative colitis, most of them with the mild or quiescent form, a simple index for assessment of the disease's activity was devised. The activity index was the sum of three different scores evaluating history, macroscopic findings at endoscopy and microscopic findings in biopsy specimens, respectively. The index was consistent in itself and it may be of value in assessing spontaneous or drug-dependent variations in ulcerative colitis. The serum protein C1 inhibitor, belonging to the acute phase reactants, could not be shown to correlate significantly with the activity index or any of its components.

Adult↗
PubMed1989

DNA content and mucosal dysplasia in ulcerative colitis. Flow cytometric analysis in patients with dysplastic or indefinite morphologic changes in the colorectal mucosa.

In an unselected population of 108 patients with ulcerative colitis in an ongoing endoscopic cancer surveillance program, high-grade dysplasia was diagnosed in 3, low-grade dysplasia in 11, and mucosal changes indefinite for dysplasia in 11 patients. The abnormal biopsy specimens from these 25 patients and samples from other parts of the large bowel obtained at the same examination were investigated by flow cytometric DNA analysis. One hundred thirty-six of 160 samples (85 percent) gave evaluable DNA histograms and, accordingly, 23 patients were retrospectively investigated. Six patients (26 percent) showed aneuploidy (abnormal DNA stemlines) and 1 had possible aneuploidy. All 3 patients with high-grade dysplasia showed aneuploidy (or possible aneuploidy) preceding or coexisting with the severe dysplastic changes. In 1 of these patients, the presence of aneuploidy preceded two diploid carcinomas. One patient was found to have had aneuploidy for seven years without evident malignant transformation. Further prospective studies are necessary to determine the value of DNA analysis in relation to morphologic examination in surveillance of patients with ulcerative colitis.

Adult↗
PubMed1989

Adhesion of bacteria to the human small-intestinal mucosa. A scanning electron microscopic study.

During the period 1 January 1980 to 30 June 1986, a total of 543 small-intestinal biopsy specimens from adults with gastrointestinal symptoms were available for routine analysis with correlated scanning electron microscopy and light microscopy. Adhesion of microorganisms was found in 77 biopsy specimens. Microorganisms in 64 specimens were classified as bacteria, in 10 as microfungi and in 4 as protozoa, including 1 specimen with both bacteria and microfungi. The structural types of bacteria found were morphologically cocciform, 8; short rod-shaped, 14; and long rod-shaped, 43. One specimen demonstrated adhesion of two structural types of bacteria. Bacteria were found in specimens from all age groups in roughly equal frequency. There was no difference in villus structure when comparing specimens from the groups with and without adhering bacteria, whereas ultrastructural alteration--that is, thinning of glycocalyx layer--was significantly more frequent in the group with bacteria. Moreover, within the group of specimens with bacteria the presence of long rod-shaped bacteria was associated with both damage of villus structure and deviation of cell surface ultrastructure. An increased amount of neutrophil granulocytes as an indicator of acute inflammation was found in 6 of 51 specimens with bacterial adhesion but in none of a matched reference material. In contrast, the amount of plasma cells and lymphocytes in the lamina propria and the amount of intraepithelial lymphocytes did not differ.

Adolescent↗