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Sven Nilsson

Publications and source records attributed to Sven Nilsson.

6 recordsLinked to original sources
PubMed2004

The accuracy of clinical examination in the diagnosis of rectal intussusception.

PURPOSE: This study was designed to compare routine clinical examination and defecography in the diagnosis of rectal intussusception in constipated patients and study relationships between rectal intussusception and symptoms. METHODS: A total of 127 consecutive patients with functional constipation were examined in the left-lateral position with rectal palpation and rectoscopy according to a protocol. An overall clinical judgment was made if the patient had intussusception, unclear finding, or no intussusception. Defecography was performed without knowledge of the results of the clinical evaluation. Symptom duration varied between 0.5 to 60 (median, 10) years. All patients fulfilled a bowel questionnaire and all had a full physiologic workup. RESULTS: A diagnosis by digital examination ( P = 0.002) and by rectoscopy ( P = 0.002) as well as the overall judgment ( P = 0.0002) was clearly related to a longer intussusception as measured by defecography. Five of six intra-anal intussusceptions were correctly assessed by clinical examination, whereas the correlation to defecography was poor in the group with short intussusceptions. Neither clinical nor defecographic diagnosis of rectal intussusception were related to the main symptoms of constipation but both were associated with a tendency toward lower anal resting pressures ( P = 0.04 and P = 0.06) and an obtuse anorectal angle (during evacuation, P = 0.01 and P = 0.01). CONCLUSIONS: There is no clear relationship between rectal intussusception and constipation. However, intussusception is related to sphincter function and may be of clinical relevance. A normal clinical examination will exclude most long intussusceptions, whereas a positive finding needs further evaluation with defecography.

Adult↗
PubMed2002

mRNA expression profiling of laser microbeam microdissected cells from slender embryonic structures.

Microarray hybridization has rapidly evolved as an important tool for genomic studies and studies of gene regulation at the transcriptome level. Expression profiles from homogenous samples such as yeast and mammalian cell cultures are currently extending our understanding of biology, whereas analyses of multicellular organisms are more difficult because of tissue complexity. The combination of laser microdissection, RNA amplification, and microarray hybridization has the potential to provide expression profiles from selected populations of cells in vivo. In this article, we present and evaluate an experimental procedure for global gene expression analysis of slender embryonic structures using laser microbeam microdissection and laser pressure catapulting. As a proof of principle, expression profiles from 1000 cells in the mouse embryonic (E9.5) dorsal aorta were generated and compared with profiles for captured mesenchymal cells located one cell diameter further away from the aortic lumen. A number of genes were overexpressed in the aorta, including 11 previously known markers for blood vessels. Among the blood vessel markers were endoglin, tie-2, PDGFB, and integrin-beta1, that are important regulators of blood vessel formation. This demonstrates that microarray analysis of laser microbeam micro-dissected cells is sufficiently sensitive for identifying genes with regulative functions.

Animals↗
PubMedDate not supplied

Role of gastric acid in stomal ulcer after gastric bypass.

BACKGROUND: The pathogenetic mechanisms of stomal ulcer after Roux-en-Y gastric bypass (RYGBP) are unclear. In order to study the role of gastric acid, we measured acidity in the proximal pouch using a pH-sensitive probe. METHODS: 6 patients (5 females, mean age 45 years old at time of operation) with endoscopically confirmed stomal ulcer, were studied 2 to 6 years after RYGBP. All complained of epigastric pain that improved during proton pump inhibitor (PPI) therapy. Control subjects were 6 females (50 years old) who had had RYGBP at least 5 years earlier and denied symptoms of epigastric pain or heartburn. The pH-sensitive probe (Digitrapper-pH, Medtronic) was passed through the nose to the proximal pouch, guided by the calculated distance and pH response. The probe was left in place for 4 hours. The percentage of time with pH <4 was calculated. RESULTS: The probe could be accurately positioned in the proximal pouch both in symptomatic patients and in controls as evidenced by the acid pH reaction. The proximal pouches of patients with stomal ulcer were significantly more exposed to acid compared to controls. The median percentage of time with pH <4 was 69% and 20% in the stomal ulcer and the control group, respectively (P<0.01). Barium follow-through excluded gastro-gastric fistula in stomal ulcer patients. CONCLUSION: RYGBP patients with stomal ulcer have increased acid production in their proximal pouch in comparison with asymptomatic RYGBP patients. Gastric acid appears to have an important role in the pathogenesis of stomal ulcer.

Adult↗