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Biomedical subjects

S Bülow

Publications and source records attributed to S Bülow.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Metachronous colorectal cancer].

The occurrence of metachronous colo-rectal cancer was investigated in 903 patients under the age of 40 years at the time of diagnosis of the primary cancer. A constant frequency of metachronous colo-rectal cancers was found and a cumulated incidence of 30% after an observation period of 41 years. Metachronous cancer of the colon was encountered most frequently in the right half of the colon regardless of the site of the primary cancer. On the basis of the above mentioned results, a life-long follow-up programme is recommended, consisting of regular examination for blood in the faeces and colonoscopy.

Adenocarcinoma↗
PubMed1991

Cancer incidence among parents of patients with colorectal cancer.

To investigate the genetic factor in the development of colorectal cancer, a cohort study was undertaken of parents of patients with this disease. All 1,524 patients, who were diagnosed with colorectal cancer in Denmark in 1982-84 and were below the age of 60 years, were selected from the National Cancer Register. The parents of these patients were identified from the public population registers. The index persons had a total of 1,478 eligible mothers, of whom 96% were successfully traced, and a total of 1,414 eligible fathers, of whom 96% were traced. These parents were sought in the Cancer Register for cancer cases diagnosed in the period January 1, 1943 to December 31, 1986. The incidence rates for the Danish population were used to estimate the expected numbers of colorectal cancer cases among the parents. Both the mothers and the fathers exhibited an increased risk of colorectal cancer. The standardized incidence ratios were 1.62 (95% CI 1.31-2.01) and 1.87 (95% CI 1.54-2.27), respectively. In a previous study we found that spouses of patients with colorectal cancer in Denmark did not have an increased risk of this disease. The increased risk found in the present study among the parents of patients therefore indicates that a possible genetic factor is present in the aetiology of colorectal cancer, and that it is of importance in the general population.

Aged↗
PubMed1991

[Coloanal reservoir in low rectal cancer].

On the basis of a case history a method of treating low rectal cancer is presented. The method includes resection of the rectum and mucosal protectomy with establishment of a colo-anal reservoir.

Adenocarcinoma↗
PubMed1991

Metachronous colorectal cancer in young patients: expression of the hereditary nonpolyposis colorectal cancer syndrome?

The cumulative incidence rate of metachronous colorectal cancer in patients younger than 40 years of age at diagnosis of the primary cancer has been shown to be 30 percent. Metachronous colorectal cancer is predominantly located in the right colon with a decreasing frequency toward the rectum. The risk of developing a metachronous colorectal cancer was found to be 16-29 times increased when compared with the risk of having a primary colorectal cancer. Because of the resemblance between characteristics of metachronous colorectal cancer and the features of hereditary nonpolyposis colorectal cancer (HNPCC), it is proposed that young colorectal cancer patients developing metachronous colorectal cancer could in fact be HNPCC patients.

Adolescent↗
PubMed1991

Purification and Characterization of Chorismate Synthase from Euglena gracilis: Comparison with Chorismate Synthases of Plant and Microbial Origin.

Chorismate synthase was purified 1200-fold from Euglena gracilis. The molecular mass of the native enzyme is in the range of 110 to 138 kilodaltons as judged by gel filtration. The molecular mass of the subunit was determined to be 41.7 kilodaltons by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Purified chorismate synthase is associated with an NADPH-dependent flavin mononucleotide reductase that provides in vivo the reduced flavin necessary for catalytic activity. In vitro, flavin reduction can be mediated by either dithionite or light. The enzyme obtained from E. gracilis was compared with chorismate synthases purified from a higher plant (Corydalis sempervirens), a bacterium (Escherichia coli), and a fungus (Neurospora crassa). These four chorismate synthases were found to be very similar in terms of cofactor specificity, kinetic properties, isoelectric points, and pH optima. All four enzymes react with polyclonal antisera directed against chorismate synthases from C. sempervirens and E. coli. The closely associated flavin mononucleotide reductase that is present in chorismate synthase preparations from E. gracilis and N. crassa is the main difference between those synthases and the monofunctional enzymes from C. sempervirens and E. coli.

Journal Article↗
PubMed1991

Contaminated fistula following J-pouch ileoanal reservoir. Treatment with a collagen sponge containing gentamicin and metronidazole. Case report.

In a 55-year-old woman, a 1 x 5 cm fistula developed in the ileoanal anastomosis after restorative proctocolectomy with J-pouch ileoanal reservoir and temporary ileostomy for intractable ulcerative colitis. The fistula extended between the pouch and the sacral bone. Lasting closure was achieved by intrafistular placement of a collagen sponge containing gentamicin and soaked in metronidazole solution and pouch drainage through a transanal Foley catheter.

Anal Canal↗
PubMed1990

Correlation between in vitro tetraploidy in skin fibroblasts and development of sporadic colorectal carcinomas.

In vitro tetraploidy (IVT) in skin fibroblasts cultures measured by flow cytometry was compared with histological type and degree of dysplasia in 22 patients with adenomas of the colon and rectum. Furthermore, IVT was compared with stage and differentiation in 36 patients with carcinoma of the colon and rectum. In vitro tetraploidy in skin fibroblasts was correlated to type as well as dysplasia in adenomas and differentiation in carcinomas but was not correlated to Dukes' stage in carcinomas. Skin fibroblast genetic instability, expressed as increased IVT (IVT+), has been reported to reflect a genetic predisposition to colorectal cancer in the hereditary nonpolyposis colorectal cancer syndrome. Because IVT+, which appears to be associated with the progression of adenomas to carcinomas, also is found in many of the non-syndrome colorectal cancers, we suggest that development of colorectal cancer is considerably influenced by the constitutive genetic instability of the autosomal dominant colorectal cancer syndromes.

Adenoma↗
PubMed1990

[Proctoscopic versus histologic diagnosis of rectal polyps].

On the basis of the endoscopic appearance, 71 rectal polyps were assessed as adenomata or non-neoplastic polyps, after which the endoscopic diagnosis was compared with the results of histological examination. The diagnosis based on macroscopic examination of the polyps proved correct in only 62% of the cases. It is concluded that the diagnosis of adenoma cannot be established solely on the proctoscopic appearance of a polyp and, as adenomata are premalignant, removal of all polyps found at proctoscopy is recommended.

Adenoma↗
PubMed1990

[Familial adenomatous polyposis].

Familial adenomatous polyposis is a dominant hereditary disease which includes early development of up to several thousand colorectal adenomas and subsequent development of colorectal adenocarcinoma in all of the untreated cases. In addition, various extracolonic manifestations may be observed. These include epidermoid cysts, osteomas, desmoids and gastroduodenal polyps. Conventional proctosigmoidoscopy is employed as the primary diagnostic method as all of the patients have rectal adenomata. Thereafter colonoscopic examination is undertaken and gastroduodenoscopy is performed on account of the risk of development of duodenal adenomas. Treatment consists of prophylactic colectomy at about the age of 15 years. An ileorectal anastomosis is most frequently made but construction of an ileoanal reservoir may be considered in selected cases. Regular prophylactic control examinations of first degree relatives of affected family members should commence at the age of ten years. Recent demonstration of a specific gene for polyposis on chromosome 5 will, together with demonstration of retinal pigmentation permit early preclinical diagnosis in future. Establishment of the Polyposis Register has resulted in earlier tracing and treatment of the condition and an improved prognosis.

Adenomatous Polyposis Coli↗
PubMed1990

Metachronous colorectal carcinoma.

During the period 1943-67, 903 Danish patients aged less than 40 years had colorectal carcinoma. The patients were followed up for up to 41 years and during this period 44 of 501 (9 per cent) operated on for cure developed a metachronous colorectal carcinoma. The cumulative risk of a metachronous colorectal carcinoma was 30 per cent after up to 41 years of observation. The occurrence of a metachronous colorectal carcinoma was evenly distributed in the observation period. The cumulative survival rate after operation for a metachronous colorectal carcinoma was 41 per cent after 20 years of observation. We propose a lifelong follow-up programme after resection of colorectal carcinoma for cure in this age group, including annual Hemoccult test and colonoscopy at 3-year intervals.

Adult↗
PubMed1990

The first year with a J-pouch. A prospective evaluation.

Proctocolectomy and construction of a pelvic pouch with ileo-anal anastomosis is now an established method in the treatment of ulcerative colitis, but various procedures are still under evaluation. This series comprises 97 patients with a 20 cm long J-shaped pouch and a short rectal cuff of 2-5 cm, prospectively evaluated after 1, 3, 6 and 12 months. Eight patients had their pouch removed because of septic complications. All the remaining patients evacuate spontaneously, although around one third still use constipating agents after 1 year. The stooling frequency gradually diminished from 7 (4-15) per 24 h to 4 (2-6) after 12 months. Continence also gradually improved during this period. No patient was incontinent of faeces but 13% still experienced episodes of minor soiling after 12 months. The procedure has proved to be safe providing patients are carefully selected, and 90% achieve a satisfactory or acceptable functional result.

Adult↗
PubMed1990

Fertility and pregnancy in women with familial adenomatous polyposis.

A questionnaire study was carried out among 58 Danish women with familial adenomatous polyposis concerning fertility, pregnancies, abortions and deliveries. Further data were obtained from obstetric records and general practitioners. The fertility and the course of the pregnancy of women with polyposis, frequency of miscarriages, legal abortions, mature and premature infants corresponds to the frequency among the obstetric population in Denmark. Of the 73 infants, eight (11%) were delivered by caesarean section. Of the 16 women who gave birth after an operation for familial adenomatous polyposis, 5 (31%) had a caesarean section. Of the seven infants who died, two had lethal congenital malformations and three infants were very premature.

Abortion, Legal↗
PubMed1990

Gastrointestinal regulatory peptides in familial adenomatous polyposis.

The etiology of adenomas in the stomach and duodenum in patients with familial adenomatous polyposis (FAP) is unknown. In this study the plasma concentration of epidermal growth factor (EGF), and other gastrointestinal polypeptides with a possible trophic effect on the gastrointestinal mucosa, was unchanged before and after meal stimulation. In 3 of 7 patients an increased EGF immunoreactivity was found in duodenal adenomas. This study has not indicated that regulatory peptides are involved in development of duodenal polyps in FAP, but suggests further studies to determine the role of EGF in FAP.

Adenoma↗
PubMed1989

[Cimetidine treatment of stomach cancer].

The effect of cimetidine treatment in cancer of the stomach was investigated in a double-blind, multicentre study comprising eight departments in Greater Copenhagen. Immediately after operation (or the decision not to operate) 181 patients were subdivided at random to treatment with a placebo or cimetidine in a dosage of 400 mg twice daily for two years or until death. Compliance control was carried out every third month. The mean survival in the cimetidine group (450 days, 1-1,826) was significantly longer (p = 0.02) than in the placebo group (316 days, 1-1,653).

Adult↗
PubMed1989

Duodenal adenomas in familial adenomatous polyposis: their structure and cellular composition with particular reference to endocrine hyperplasia.

134 duodenal biopsies from 14 patients with familial adenomatous polyposis were evaluated by light microscopy for the presence of adenoma. Staining reactions for endocrine cells were applied. 90 biopsies contained adenoma, almost all of the tubular type (98%) with dysplasia, ranging from mild to moderate. Accompanying hyperplasia of argyrophil and argentaffin endocrine cells was found in 91% and 64% of the adenomas, respectively. Based on histological criteria it is concluded that the risk of carcinoma development in the duodenum could equal that in colon and rectum. The observation of endocrine hyperplasia is new, and further investigations are needed before the significance of this finding can be evaluated.

Adenoma↗
PubMed1989

Electron microscopic studies of endocrine hyperplasia in duodenal adenomas in familial adenomatous polyposis.

Electron microscopical studies on endocrine cell hyperplasia of duodenal adenomas from five patients with familial adenomatous polyposis were performed. All the endocrine cell types normally found in the duodenal mucosa were identified. A constant feature was proliferation of duodenal-enterochromaffin cells but an increase in the number of all other endocrine cell types apart from pyloric-gastrin cells and somatostatin cells, was also observed. Certain types of intestinal endocrine cells (the intestinal enterochromaffin cell and the glicentin cell) are rare cells in the normal duodenal mucosa. The finding of these cells may indicate increased biological aggressivity.

Adenoma↗
PubMed1989

Multiple adenomas in terminal ileum 25 years after restorative proctocolectomy for familial adenomatous polyposis. Report of a case.

A patient with familial adenomatous polyposis was treated with colectomy, mucosal proctectomy, and a straight ileoanal anastomosis in 1962. Thirteen to 21 years later recurrent adenomas developed at the ileoanal anastomosis, and 25 years after the operation multiple adenomas were found in the terminal ileum up to 12 cm from the ileoanal anastomosis. It is concluded that colectomy and mucosal proctectomy, with or without an ileoanal reservoir, does not eliminate the future risk of adenoma formation. Thus, this method should be used only in selected polyposis patients.

Adenoma↗