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S Jarnum

Publications and source records attributed to S Jarnum.

35 records · Page 2Linked to original sources
PubMed1978

Urolithiasis in chronic inflammatory bowel disease.

In a selected material of 228 patients with chronic inflammatory bowel disease (CIBD) the incidence of urolithiasis was 15% (95% confidence limit 11-21). The tendency to urolithiasis is significantly correlated to small-bowel resection and its extent and to obstruction in the urinary tract. On the other hand, there is no definite correlation to the duration or extent of the bowel disease. The significant correlation between urolithiasis and ileal resection is in agreement with the hyperabsorption of oxalate as an important cause of stone formation demonstrated by others. That local factors too play an essential role in the formation of urinary calculi is apparent from the increased incidence of urolithiasis in obstruction of the urinary tract. The incidence of urolithiasis was particularly high (22-25%) among patients with ileostomies. The few and negligible symptoms of and sequelae to, urolithiasis in CIBD encourage a conservative attitude.

Adolescent↗
PubMed1977

Influence of an elemental diet in protein exudation in chronic inflammatory bowel disease.

13 patients with chronic inflammatory bowel disease were treated with an elemental diet (Vivasorb). Intestinal protein exudation was studied during the treatment by means of of 131I-albumin. 131I-albumin studies showed no significant change of albumin degradation and, by inference, of intestinal protein loss in the group as a whole. A high initial albumin degradation rate augured treatment with elemental diet and prednisone to be unsuccessful. It is concluded that measurement of intestinal protein leakage is of no predictive value as regards the effect of treatment of chronic inflammatory bowel disease with elemental diet. Apparently, diminishing protein exudation is a late phenomenon during a course of clinical remission.

Adolescent↗
PubMed1977

Obstructive uropathy in chronic inflammatory bowel disease.

On the basis of intravenous pyelography the frequency of ureteral obstruction was elucidated in retrospect in 140 patients with Crohn's disease and 88 patients with ulcerative colitis. The findings were related to X-ray examination of the gastrointestinal tract and to the clinical condition at the time of examination. 19% of the Crohn patients had ureteral obstruction, typically affecting the right ureter on a level with the linea terminalis. There was a close topographic relationship between radiologically demonstrated intestinal changes and a mass in the homolateral iliac fossa. There was no relation to duration or activity of the disease, urinary tract infections, surgery, or steroid medication. 14% of the patients with ulcerative colitis had ureteral obstruction of varying localization and nearly always arising after colectomy. Renal calculi were found in 13% of the patients with Crohn's disease and in 18% of those with ulcerative colitis. I.v. pyelography is recommended before and after intestinal resection in chronic inflammatory bowel disease to demonstrate the relatively common and often fairly silent urinary tract complications.

Adolescent↗
PubMed1977

Assessment of the therapeutic value of an elemental diet in chronic inflammatory bowel disease.

Thirty-four patients with chronic inflammatory bowel disease, 23 with ulcerative colitis, and 11 with crohn's disease, weretreated with elemental diet. thirty-one patients had been on high dose prednisonetherapy one to four weeks prior to the diet with no or insufficient response. Fifteen patients (44%) went into remission when elemental diet was introduced as the only change of treatment. Furthermore six patients (18%) went into remission when the dietary treatment was supplemented with high dose prednisone treatment (2 cases) or an increase of prednisone dose (4 cases). Remission occurred in 16 of 21 patients with disease of moderate activity, but in only 5 of 13 cases with severe disease. Remission rate was higher in patients with a limited extent of the lesion, but 8 patients with extensive colitis responded to treatment. There was no significant change of haemoglobin serum iron, transferrin, albumin, orosomucoid, or renal excretion of creatinine. However, significant decreases were observed of sedimentation rate, renal urea excretion, faecal volume and daily number of bowel movements. Colectomy was performed in 8 patients whose condition remained unchanged or aggravated during treatment. Follow-up studies of non-operated patients who went into remission showed that 6 of 13 patients with ulcerative colitis were perfectly well 7-28 months after the study, 3 patients suffered a mild recurrence after 4-24 months, and 4 patients were colectomized 5-10 months later due to severe attack. Of 8 patients with Crohn's disease 4 remained unoperated and free of symptoms 22-35 months after the study.

Adolescent↗
PubMed1976

Early complications in patients previously treated with corticosteroids.

A retrospective analysis is presented is presented of 205 major operations performed over a 10-year period on 95 previously steroid-treated patients with Crohn's disease (C.D.) or ulcerative colitis (U.C.). All patients had been treated both in the medical and in the surgical gastroenterological department. The incidence of early postoperative complications was high, but there was nothing to suggest a relationship between the complications and the intensity of the preoperative steroid therapy. However, mortality rate, duration of hospital convalescence as well as incidence of complications were found to be significantly lower in those patients who had undergone elective in preference to emergency surgery. The fear of an increased complication rate following intensive steroid treatment of patients with acute C.D. or U.C. is, in our opinion, unfounded.

Acute Disease↗
PubMed1976

Serum orosomucoid in ulcerative colitis: its relation to clinical activity, protein loss, and turnover of albumin and IgG.

Serum orosomucoid was compared with clinical activity, routine laboratory tests, intestinal protein loss, and albumin and IgG turnover in 22 cases of ulcerative colitis. Serum orosomucoid was well correlated with clinical activity, haemoglobin and leucocyte counts were not. A significant correlation was present between serum orosomucoid and intestinal protein loss (gastro-intestinal 59Fe-iron dextran clearance), serum albumin, fractional catabolic rates of albumin, and IgG and IgG synthesis rate. No correlation was found between serum orosomucoid and albumin synthesis rate or serum IgG. It is concluded that serum orosomucoid is a highly reliable indicator of disease activity in ulcerative colitis.

Adolescent↗
PubMed1976

Bile acid metabolism and plasma protein turnover in Crohn's disease.

Postprandial duodenal bile acids, intestinal protein loss, and albumin and IgG turnover were studied in 19 non-operated patients with Crohn's disease. A lesion of the terminal ileum was present in 18 of 19 patients, either alone or associated with regional colitis. Identical bile acid studies were made in a control group of 20 patients with chronic diarrhoea of undetermined origin. Duodenal bile acid concentration was decreased in 9 of 19 patients with Crohn's disease, and in 5 of 20 patients with unexplained diarrhoea. The glycine/taurine-ratio was increased in 8 of 17 patients with Crohn's disease, but in only one of the 20 control patients. Abnormal intestinal protein loss was present in 13 of 14 patients with Crohn's disease. The fractional catabolic rate of albumin and IgG was increased in all 17 cases of Crohn's disease studied, except the patient with no protein loss. A statistically significant and positive correlation was observed between glycine/taurine-ratio and fractional catabolic rate of both albumin and IgG. No patient with Crohn's disease harboured an abnormal bacterial flora in the proximal small intestine. It is concluded that, in the absence of abnormal bacterial flora in the proximal jejunum, the glycine/taurine-ratio is more valuable as an indicator of terminal ileopathy than postprandial duodenal bile acid concentration in nonoperated patients with terminal ileitis. Abnormal intestinal protein loss and increased catabolic rate of albumin and IgG are practically always present in active Crohn's disease and are strong evidence of an organic gastrointestinal lesion in patients with normal radiographic findings.

Adolescent↗
PubMed1975

Fecal radioiodide excretion following intravenous injection of 131-I-albumin and 125-I-immunoglobulin G in chronic inflammatory bowel disease. An aid to topographic diagnosis.

Simultaneous studies with 131-I-albumin and 125-I-immunoglobulin G (IgG) were made in 48 cases of chronic inflammatory bowel disease. Twenty-one had ulcerative colitis and 27 had Crohn's disease which was confirmed at laparotomy in every case. Intestinal protein loss was measured simultaneously by means of 59-Fe-iron dextran in 44 patients. All patients had abnormal intestinal protein loss. A high correlation was shown between fecal 59-Fe clearance and fractional catabolic rate of albumin, confirming the validity of 59-Fe-iron dextran as a test substance to measure intestinal protein loss. Fecal radioiodide excretion of 131-I from 131-I-albumin (A) and 125-I from 125-I-IgG (G) was significantly different in ulcerative colitis and Crohn's disease. The ratio G/A was close to unity (smaller than 1.60) in ulcerative colitis and Crohn's disease with exclusive or predominant involvement of the colon, whereas it was high in Crohn's disease of the small intestine and highest in cases with jejunal involvement. Thus, the ratio may be valuable in topographic diagnosis of chronic inflammatory bowel disease. A high ratio was found in 2 patients with Crohn's disease of the small intestine and normal radiography of the small intestine, and a low ratio was present in 7 cases of ulcerative colitis with normal radiographic findings. In all 9 patients with normal radiography, fecal 59-Fe clearance was elevated as evidence of abnormal intestinal protein loss. No correlation was present between the size of protein loss and the pathoanatomic extent of the lesions on subsequent laparotomy in 25 patients with Crohn's disease. Fecal radioiodide excretion (131-I from 131-I-albumin and 125-I from 125-I-IgG) was positively correlated with diarrhea (daily stool mass) in both ulcerative colitis and Crohn's disease. Intestinal protein loss was not.

Adolescent↗
PubMed1975

Intestinal disaccharidases in Greenland Eskimos.

Jejunal biopsies from 19 adult Greenland Eskimos were studied regarding disaccharidases, two intracellular beta-galactosidases, and morphological appearance. Fifteen of the patients (79%) had low lactase activity, and 3 of these (16%) had sucrase-isomaltase deficiency as well. Two patients had low trehalase activity. Microscopical appearance was essentially normal in all the biopsies, except for a certain stromal plasma cell infiltration. All the patients with low lactase activity had a measurable residual activity of brush border lactase, which was localized in the middle and apical parts of villi, as normally seen for digestive enzymes. Lysosomal acid beta-galactosidase and cytosol hetero beta-galactosidase were not altered. In the patients with sucrase-isomaltase deficiency there was a complete absence of active sucrase-isomaltase complex. The residual maltase, as well as the very weak residual isomaltase, was exerted exclusively by the heat stable maltases (maltase II and III). The material is the first one in which multiple, but not generalized disaccharidase deficiencies are demonstrated.

Adolescent↗
PubMed1975

Treatment with elementary diet in gastrointestinal disease.

Experiences with Vivasorb in the treatment of gastrointestinal diseases are reported. The author successfully treated severe cases of Crohn's disease and distal ulcerative colitis. In severe total ulcerative colitis, marked improvement with Vivasorb could be achieved in only one of three cases. The administration also proved successful in one case of agnogenic chronic diarrhea. No effect could be achieved in two patients with internal and external bowel fistulae, nor in three patients with short bowel syndrome in the immediate postoperative phase.

Adult↗