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Biomedical subjects

S Aune

Publications and source records attributed to S Aune.

At least 19 recordsLinked to original sources
PubMed1989

[Hiatal hernia and reflux esophagitis].

Between 1985 and 1987, 25 patients had abdominal operations for hiatal hernia and/or gastroesophageal reflux disease. Eight of them had complicated reflux esophagitis. One patient had a Belsey Mark IV repair, the others had a Nissen fundoplication. There was no mortality. After a median follow-up of 16 months (range 3-38) six patients had symptoms of "gas-bloat". The esophagitis was healed in ten patients. 22 patients were completely or fairly satisfied with the results of the surgery. Two patients were not satisfied. Both had complicated reflux esophagitis before they were operated on. Patients with esophagitis should be evaluated for surgery before stricture or Barrett's ulcer develop.

Adult↗
PubMed1986

Effects of protease inhibitor pretreatment on hemodynamic performances and survival rate in experimental, acute pancreatitis.

Acute pancreatitis was induced in pigs by manual retrograde injection of Na-Taurocholate into the pancreatic duct. Using chromogenic peptide substrate assays, increased plasma kallikrein activity (KK), paralleled by a reduction in functional plasma kallikrein inhibition values (KKI) were found in the peritoneal exudate in untreated animals. Several of the untreated animals experienced an increased trypsin activity (TRY) in the same exudate. Five out of eight animals died during a 6 hour observation period. Pretreatment with either Cl-INH or aprotinin given intravenously, resulted in a significantly increase in KKI capacity paralleled by unchanged KK and TRY activities in the peritoneal exudate. Furthermore, inhibitor pretreatment significantly improved hemodynamic performances (AP and CO) and the survival rate. The study underlines the pathophysiological importance of trypsin and the plasma kallikrein-kinin system during acute, severe pancreatitis.

Acute Disease↗
PubMed1986

Effects on peritoneal proteolysis and hemodynamics of prophylactic and therapeutic infusions of high doses of aprotinin in experimental acute pancreatitis.

Acute pancreatitis was induced in pigs by retrograde injection of Na-taurocholate into the pancreatic duct. Chromogenic peptide substrate assays showed increased trypsin (TRY) and plasma kallikrein activity (KK), parallel with a reduction of plasma prekallikrein (PKK) and functional kallikrein inhibition (KKI) values, in the peritoneal exudate in untreated animals. Intravenous high-dose pretreatment or therapy with aprotinin starting 3 h after the induction of acute pancreatitis resulted in significantly increased KKI capacity and unchanged KK and TRY activities in the peritoneal exudate. In test animals receiving aprotinin intravenously a significantly increased survival rate and improved cardiac output and arterial blood pressure were found during the 6-h observation period. All animals treated with aprotinin survived the observation period, whereas 63% of the untreated animals died. The study emphasizes the pathophysiological importance of the plasma kallikrein-kinin system in acute pancreatitis.

Acute Disease↗
PubMed1985

Studies on the plasma kallikrein-kinin system in peritoneal exudate and plasma during experimental acute pancreatitis in pigs.

Acute pancreatitis was induced in pigs by retrograde injection of Na-taurocholate into the pancreatic duct. By means of chromogenic peptide substrate assays, increased plasma kallikrein activity, parallel with a reduction of plasma prekallikrein and functional kallikrein inhibition values, was found in peritoneal exudate. In plasma, however, no changes in the kallikrein-kinin system were found during the 6-h observation time. The study demonstrates the presence of components of the plasma kallikrein-kinin system in peritoneal fluid and suggests that the peritoneal cavity to a great extent is a functionally separate compartment from plasma. Activation of the plasma kallikrein-kinin system in peritoneal exudate during acute experimental pancreatitis appears to be of importance for the initial symptoms and the development of shock seen during this condition.

Acute Disease↗
PubMed1985

The diagnosis, occurrence and clinical aspects of primary hyperparathyroidism in patients with recurrent urolithiasis as registered in general practice.

Five patients with primary hyperparathyroidism (surgically verified) and one patient with probable normocalcaemic hyperparathyroidism were diagnosed in a series of 93 recurrent stone formers in general practice. The six case histories are presented. The initial diagnosis was based on repeated albumin corrected total serum calcium determinations. The condition had previously not been diagnosed in four of the six patients, despite one or more hospital admissions. The urinary calcium excretion index ad modum Peacock & Nordin is not recommended as a routine test for use in general practice. Serum immunoreactive parathyroidal hormone related to simultaneous serum calcium values did not give any further diagnostic information in 48 of these patients with, or without, formation of new stones during a mean follow-up period of 3.2 years. The clinical spectrum of primary HPT has apparently shifted during the last three decades from bone disease and renal calculi to more general symptoms.

Adult↗
PubMed1984

Studies on pathological plasma proteolysis in severely burned patients using chromogenic peptide substrate assays: a preliminary report.

Changes in components of the plasma proteolytic enzyme systems were studied in nine patients with severe burns using chromogenic peptide substrate assay technique. All patients were critically ill and five died during a four week observation period. Plasma prekallikrein, plasminogen, prothrombin and platelet values decreases regularly in all patients after the injury. These changes were seen together with a high frequency of increases serum FDP values and presence of soluble fibrin. During critical illness extensive plasma proteolysis occurred, indicated by elevated plasma kallikrein and plasmin activities combined with lowered functional plasma kallikrein inhibition, prekallikrein and plasminogen values. The study confirms that plasma pathological proteolysis occurs in patients with severe burns, and indicates that close monitoring of components of the plasma proteolytic enzyme systems can give information of prognostic and therapeutic value in the severely burned patient.

Adolescent↗
PubMed1984

Studies on the kallikrein-kinin system in plasma and peritoneal fluid during experimental pancreatitis.

Using chromogenic peptide substrate assay technique, components of the plasma kallikrein-kinin system and trypsin activity were studied in plasma and peritoneal exudate during acute pancreatitis in pigs. In the plasma no significant changes occurred, but increased kallikrein activity was found in the peritoneal exudate. This finding was paralleled by a reduction in prekallikrein levels and functional kallikrein inhibition values. The trypsin activity in peritoneal exudate, however, increased inconstantly. These results emphasize the significance of peritoneal protease-antiprotease imbalance during acute pancreatitis.

Acute Disease↗
PubMed1983

Determination of components of the plasma proteolytic enzyme systems gives information of prognostic value in patients with multiple trauma.

Components of the plasma proteolytic enzyme systems were studied in 15 multiple trauma patients. There were 9 survivors and 6 fatal cases. All fatal cases had sepsis and/or post traumatic adult respiratory distress syndrome. Within the first day after trauma significantly reduced values were found for plasma prekallikrein (PKK), Hageman factor (HF) and Antithrombin III (AT III). In the survivors these parameters were normalized within the first five days after the injury. In the fatal cases, however, the same parameters remained reduced or declined during the observation period. The fatal cases also revealed a high frequency of positive ethanol gelation tests (EGT), elevated serum fibrin - fibrinogen degradation products (FDP) values and persisting low platelet counts. Analyses of plasma samples from both survivors and fatal cases, fractions by Sephadex G-150 gel filtration, demonstrated alpha 2-macroglobulin - plasma kallikrein complexes. These findings demonstrate activation of the kallikrein-kinin system as a part of pathological plasma proteolysis in multiple trauma patients. Persistent reductions of PKK, HF and AT III combined with positive EGT, elevated FDP values and reduced platelet counts indicate a poor prognosis.

Antithrombin III↗
PubMed1982

Studies on pathological plasma proteolysis in patients with acute pancreatitis. A preliminary report.

Changes in the plasma proteolytic enzyme systems were studied in 14 patients with acute pancreatitis. Ten patients survived whereas four died. In both survivors and fatal cases a high frequency of reduced values of plasma prekallikrein (PKK) functional antithrombin III (AT III) and platelets were found during the first week after admission. These changes were seen together with increased serum FDP values and the presence of soluble fibrin. In the fatal cases PKK, AT III, platelets and functional kallikrein inhibition values observed during the first week after admission, were found significantly more reduced than in the survivors. These observations underline that activation of proteases in plasma is an important pathophysiological mechanism in this state, and that evaluation of this process in patients with acute pancreatitis might give information of prognostic value.

Acute Disease↗
PubMed1979

Results of hepatic lobectomy for primary epithelial cancer in 31 adults.

Hepatic lobectomy for primary epithelial cancer was performed in 31 adults from 1964 through 1977 in the surgical departments of six Scandinavian hospitals. Twenty-three patients were discharged and had a 2 year survival rate of 62 per cent and a 5 year survival rate of 16 per cent. Alternatives to surgery have not yet emerged. Further progress requires centralization.

Adenoma, Bile Duct↗
PubMed1979

Effect of plasma H+-ion concentration on pancreatic HCO-3 secretion.

The relationship between the rate of pancreatic HCO-3 secretion and plasma H+-ion concentration was investigated in 15 pentothal anesthetized, secretin infused pigs (1.8 C.U./kg b.w. h-1, intravenously) during acute metabolic and respiratory acid-base disturbances. Pancreatic HCO-3 secretion increasd to 196 +/- 10% of control during alkalosis and fell to 41 +/- 4% of control during acidosis. Partial metabolic compensation of respiratory acidosis restored HCO-3 secretion to 87 +/- 6% of control. A proportional relationship was found between HCO-3 secretion and plasma pH. Different, proportional relationships were found between HCO-3 secretion and plasma HCO-3 concentration during metabolic and respiratory acid-base changes. HCO-3 secretion was independent of H+-ion concentration in pancreatic juice. Plasma H+-ion concentration, therefore, seems to determine the rate of pancreatic HCO-3 secretion. This finding supports the hypothesis that a proton pump is responsible for pancreatic HCO-3 secretion.

Acid-Base Equilibrium↗
PubMed1979

Endoscopic retrograde brush cytology in patients with primary and secondary malignancies of the pancreas.

Endoscopic retrograde brush cytology (ERBC) was performed in 29 patients with primary pancreatic malignancies verified later by histology. Results were positive in 21 patients, suspicious in five, and negative in three. ERBC performed in seven patients with uncertain findings at endoscopic retrograde cholangiopancreatography (ERCP) was positive for malignancy in six and suspicious in one. Endoscopic aspiration cytology (EAC) performed in 10 patients with primary tumours was positive for malignancy in three, suspicious in two, and negative in five cases. ERBC and/or EAC performed in five cases with secondary tumours were positive for malignancy in one and negative in four. It is concluded that ERBC gives a high rate of positive or suspicious (90%) diagnosis of malignancy in patients with primary pancreatic lesions. In secondary tumours cytology seems to be negative in most cases. The study further shows that many of the malignant tumours found by ERP are secondary lesions. Cytology is often able to detect malignancy when ERP has proved inconclusive.

Adenocarcinoma↗
PubMed1979

Dysphagia after proximal gastric vagotomy.

Ten patients were examined before and after proximal gastric vagotomy with videotape recordings of barium passage in esophagus, esophageal pressure recordings, and the insulin test. Four of the patients complained of dysphagia after the operation. The dysphagia subsided spontaneously after 1--2 months. Patients with dysphagia showed dilatation of the body of the esophagus and a tapered narrowing in the distal segment. The pressure recordings showed increased frequency and strength of rhythmic pressure waves compared with the preoperative findings. Our results support the theory of a neuromuscular dysfunction.

Adult↗
PubMed1979

Immunoreactive secretin release in patients after duodenectomy and partial or total pancreatectomy.

Seven patients were investigated 8--22 months after duodenectomy and pancreatectomy for chronic pancreatitis or cancer. Seven other patients, admitted for minor surgery, served as controls. 40 ml 100 mmol/l HCl was infused over 5 min into the jejunum 10 cm beyond the gastrojejunal stoma in the duodenectomized patients and 10 cm beyond the pylorus in the controls. Plasma immunoreactive secretin (IRS) increased from 3.0 +/- 0.8 pmol/l (mean +/- S.E.M.) to 9.8 +/- 0.5 pmol/l (p less than 0.01) in the duodenectomized patients. In the controls the increase was significantly higher than in the patients (p less than 0.01)--from 1.5 +/- 0.3 pmol/l to 19.5 +/- 3.3 pmol/l (p less than 0.01). The study shows that the jejunum is able to release IRS after acid infusion in duodenectomized patients.

Adult↗
PubMed1978

Bacteriological studies of common duct bile in patients with gallstone disease and juxta-papillary duodenal diverticula.

Bile samples from the common duct were collected at cholecystectomy and cultivated aerobically and anaerobically. Two groups of patients were studied, patients with juxta-papillary duodenal diverticula and patients without diverticula. All patients had chronic cholecystitis and concrements in the gallbladder, but no biliary obstruction. A significantly higher incidence of positive cultures was found in patients with diverticula than in the control group. The positive samples contained bacterial species belonging to the intestinal flora. We propose an ascending route of infection and assume that bacteria may play a role in the formation of gallstones so often seen in patients with juxta-papillary duodenal diverticula.

Adult↗
PubMed1977

Mucosal changes in the gastric stump 20-25 years after partial gastrectomy.

Out of 421 patients who had partial gastrectomy 20-25 years ago for gastric or duodenal ulcer, 108 were examined by endoscopy with multiple biopsy. In no case were the endoscopic appearances of the mucosae interpreted as malignant, though in 2 patients the clinical history suggest malignant disease. Histological examination revealed infiltrating carcinoma in 4 patients, 3 of whom had intramucosal carcinoma only. 3 further patients had severe dysplasia (carcinoma-in-situ). Only 1 patient had a near-normal mucosa close to the anastomosis; in the remainder the gastric remnant showed various degress of dysplasia, metaplasia, or chronic atrophic gastritis. In the patients with carcinoma only 28 (12%) of the 226 biopsy specimens revealed the malignant lesion. Patients who have had partial gastrectomy for benign lesions are at high risk of gastric-stump carcinoma. If, 20 years after operation, they have an endoscopy with multiple biopsy, stump carcinoma may be detected early when the prognosis after operation is probably good.

Adult↗