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Biomedical subjects

T Bolin

Publications and source records attributed to T Bolin.

At least 19 recordsLinked to original sources
PubMed2001

The effect of oral sucralfate on the acute proctitis associated with prostate radiotherapy: a double-blind, randomized trial.

PURPOSE: Acute rectal complications occur in the majority of patients receiving external-beam radiotherapy for carcinoma of the prostate. Sucralfate has been proposed to reduce radiation-induced mucosal injury by forming a protective barrier on ulcer bases, binding local growth factors, and stimulating angiogenesis. However, there is conflicting clinical evidence as to whether sucralfate, taken prophylactically during radiotherapy, can ameliorate the symptoms of acute radiation proctitis. METHODS AND MATERIALS: A double-blind randomized trial was conducted at four Radiation Oncology Departments in Sydney, Australia, between February 1995 and June 1997. A total of 338 patients with clinically localized prostate cancer receiving small volume radiotherapy, of whom 335 were evaluable, were randomized to receive either 3 g of oral sucralfate suspension or placebo twice a day during radiotherapy. Patients kept a daily record of their bowel symptoms and were graded according to the RTOG/EORTC acute toxicity criteria. RESULTS: One hundred sixty-four patients received sucralfate and 171 received placebo. Both groups were well balanced with regard to patient, tumor, treatment factors, and baseline symptoms, except that the placebo group had a significantly more liquid baseline stool consistency score (p = 0.004). Patients kept a daily diary of symptoms during radiotherapy. After adjusting for baseline values, there was no significant difference between the two groups with regard to stool frequency (p = 0.41), consistency (p = 0.20), flatus (p = 0.25), mucus (p = 0.54), and pain (p = 0.73). However, there was more bleeding in the sucralfate group, with 64% of patients noticing rectal bleeding, compared with 47% in the placebo group (p = 0.001). There was no significant difference between the two groups with respect to RTOG/EORTC acute toxicity (p = 0.88; sucralfate 13%, 44%, 43% and placebo 15%, 44%, 40% for grade 0, 1, and 2, respectively). CONCLUSION: This study suggests that oral sucralfate taken prophylactically during radiotherapy does not ameliorate the symptoms of acute radiation proctitis and may increase acute bleeding. The cause of the increased bleeding in the sucralfate group is unclear. As the pathogenesis of acute and late reactions are different, late follow-up, which includes sigmoidoscopic evaluation, is currently being performed on this cohort of patients.

Administration, Oral↗
PubMed1998

Further localization of a gene for paroxysmal dystonic choreoathetosis to a 5-cM region on chromosome 2q34.

Paroxysmal dystonic choreoathetosis (PDC) is a rare neurological disorder characterized by episodes of involuntary movement, involving the extremities and face, which may occur spontaneously or be precipitated by caffeine, alcohol, anxiety, and fatigue. PDC is transmitted as an autosomal dominant trait with incomplete penetrance. A gene implicated in this paroxysmal disorder has been mapped to a 10-15 cM region on chromosome 2q31-36 in two families. We describe a third family with PDC. Two-point linkage analyses with markers linked to the candidate PDC locus were performed. A maximum two-point LOD score of 4.20 at a recombination fraction of zero was obtained for marker D2S120, confirming linkage to the distal portion of chromosome 2q. The anion exchanger gene, SLC2C, maps to this region, but the family was poorly informative for polymorphic markers within and flanking this candidate gene. Haplotype analysis revealed a critical recombination event that confines the PDC gene to a 5-cM region bounded by the markers D2S164 and D2S377. We compared the haplotype in our family with that in another chromosome 2-linked PDC family, but did not detect a region of shared genotypes. However, identifying a third family whose disease maps to the same region and narrowing the critical region will facilitate identification of the 2q-linked PDC gene.

Adult↗
PubMed1996

Secondary aortoenteric fistulae--changes from 1973 to 1993.

AIM: To investigate a series of patients with secondary aortoenteric fistulas and compare it with a previous series (1985-93 vs. 1973-84). DESIGN: Retrospective study of medical records. SETTING: Sixteen vascular surgical centers in Sweden. PATIENTS: Twenty-seven patients were identified making an overall incidence of 0.5% of all aortoiliac operations. Among aneurysm patients the incidence was significantly lower than in the previous series. One patient record could not be identified. Fourteen primary operations were for aortic aneurysm, 12 for occlusive disease and one was an aortorenal vein bypass. RESULTS: Symptoms of the fistula occurred after a median interval of 90 months which is significantly later than the previous series (32 months; p<0.05). The commonest presentation was bleeding followed by septis. The median diagnostic delay was 10.5 days, which was significantly shorter than in the previous series. Most fistulas involved the duodenum (88%). One patient died before surgery. The postoperative mortality was 28%, significantly lower than in the previous series (58%) (p<0.05). At the end of follow up (median 43 months) significantly more patients were alive than in the previous series (42% vs 18%) (p<0.05). CONCLUSION: Over a 21 year period there seems to have been a decrease in the frequency of secondary aortoenteric fistulas after aneurysm surgery, a longer interval before they occur, a shorter diagnostic delay, and a better survival.

Aorta, Abdominal↗
PubMed1993

Occupational asthma induced by inhaled egg lysozyme.

A 26-year-old man employed in a company which manufactured hen egg white derived lysozyme for use in the pharmaceutical industry was evaluated for occupational asthma. The worker began to experience immediate-onset asthmatic symptoms two months after starting to work with egg lysozyme powder. The work process involved the production of approximately 1,000 kg of purified dried lysozyme powder per week. Prick skin testing was positive to egg lysozyme (50 mg/ml) and other egg protein components, but negative to whole egg white and egg yolk reagents. Serum specific IgE to egg lysozyme was documented. Decrements in serial peak expiratory flow rates were associated with lysozyme exposure at work. A specific bronchoprovocation challenge to lysozyme powder was positive demonstrating an isolated immediate asthmatic response (48 percent decrease from baseline FEV1). This is the first reported case of lysozyme-induced asthma specifically caused by inhalational exposure to egg lysozyme.

Adult↗
PubMed1988

Parastomal hernia in relation to site of the abdominal stoma.

Parastomal hernia is a common late complication of enterostomy, especially colostomy, and sometimes requires surgical treatment. A possible contributory factor, location of the stoma in relation to the rectus abdominis muscle, was studied by examination of 130 patients with permanent intestinal stoma. The bowel had been brought out through the rectus abdominis muscle in 107 patients and lateral to it in 23 patients. The respective prevalence of parastomal hernia in these groups was 2.8 per cent and 21.6 per cent. The highly significant difference indicates that enterostomy should be constructed through the rectus abdominis muscle, not lateral to it.

Abdominal Muscles↗
PubMed1988

Isolated aneurysms of the iliac artery: what are the chances of rupture?

Sixteen patients with 22 isolated aneurysms of the common or external iliac artery were treated between 1974 and 1986. There were ten men and six women with a median age of 69 years. The aneurysm was discovered incidentally in seven patients; and in nine patients it was diagnosed upon rupture. A pulsating abdominal tumour was palpable in 12 patients seven of whom had a ruptured aneurysm. Common symptoms included urological and neurological problems and abdominal pain. Of the seven patients in whom the diagnosis was confirmed prior to rupture, three were operated upon successfully and four were not. Of the latter, two died within 3 months due to coexisting disease while two remain alive after one and 6 years. Of the nine patients with a ruptured aneurysm only four survived. The high risk of rupture justifies elective operation of an aneurysm of the iliac artery in the majority of cases.

Adult↗
PubMed1986

Passage of molecules through the wall of the gastrointestinal tract. Influence of lysolecithin on rat ileal permeability to different-sized molecules.

We have studied the influence of lysolecithin on mucosal permeability to different-sized molecules in the distal part of the ileum. Using a rat experimental model, we determined the intestinal permeability to ethylene glycol (62 dalton), different-sized polyethylene glycols (634- to 1206-dalton PEGs), and dextran 3000, in the absence and presence of lysolecithin. We also examined the morphology of the ileal mucosa and determined the activity of brush border enzymes after deposition of lysolecithin in the gut lumen. We found that lysolecithin did not affect the absorption of ethylene glycol and had no influence on the activities of the enzymes. In contrast, lysolecithin enhanced the desquamation of enterocytes at the villous tips and increased the permeability to 634- to 1206-dalton PEGs and dextran 3000. These findings indicate that lysolecithin may facilitate the uptake of larger, potentially antigenic and toxic molecules in the distal ileum, although the underlying epithelial desquamation might have little or no influence on the absorption of small compounds.

Animals↗
PubMed1986

Sulfur amino acid metabolism in chronic relapsing pancreatitis.

Sulfur amino acid (SAA) metabolism was studied in patients with chronic relapsing pancreatitis (CRP) before and during treatment and compared with results from patients with uncomplicated cholelithiasis, before and after surgery, receiving an identical nutritional support. CRP resulted in decreased total sulfur and inorganic sulfate excretions. Although the nutritional therapy per se accentuated these results, a reduced ability to convert SAAs to inorganic sulfate was seen during the whole investigation. Initially, CRP patients showed a raised serum concentration of inorganic sulfate, implicating an altered renal handling of the compound. Increased outputs of SAAs, N-acetylcysteine and mercaptolactate were seen in CRP patients parallel to a raised leukocyte methionine level, probably a consequence of the catabolic state and a limited utilization of SAAs. During therapy a normalization was achieved. Reduced total and free glutathione concentrations in leukocytes were found in CRP, and it was more pronounced for the free form. This result could be due to a reduced synthesis and increased intracellular oxidation of glutathione as a result of the decrease in ethanol.

Adult↗
PubMed1984

Decreased lysophospholipase and increased phospholipase A2 activity in ileal mucosa from patients with Crohn's disease.

Lysophospholipase (EC 3.1.1.5) and phospholipase A2 (EC 3.1.1.4) were determined in ileal mucosa from patients with Crohn's disease (CD) and non-inflammatory bowel diseases ( NIBD ). In addition, the activities of alkaline phosphatase, sucrase, maltase, and lactase were determined. The lysophospholipase activity, like that of alkaline phosphatase, sucrase and maltase, was decreased in affected areas of CD, whereas the phospholipase A2 activity was rather increased. Lysophospholipase and phospholipase A2 activities in apparently unaffected mucosa from CD patients were in between those in healthy mucosa from NIBD patients and those in affected mucosa from CD patients. These findings point to the possibility that the mucosal activity of lysophospholipase, like that of other brush border enzymes, is decreased in CD. This may render the mucosa less capable to handle lysolecithin, a potentially harmful agent formed in the intestine and known to induce inflammation in a number of experimental systems.

Crohn Disease↗
PubMed1983

The influence of disease at the margin of resection on the outcome of Crohn's disease.

Sixty-seven patients with Crohn's disease undergoing 81 resections followed by a restorative procedure were reviewed to evaluate the influence of microscopic disease at the margin of resection on the recurrence rate. The average follow-up after resection was 5.6 +/- 2.8 years. The resectional margins were classified into three groups depending on the microscopic appearance of the most involved margin. Recurrent disease developed in 36 per cent of the resections without microscopic evidence of Crohn's disease, while 38 per cent of the resections with signs of Crohn's disease developed a clinical recurrence. The recurrence rate increased with the follow-up time, but was independent of microscopical disease at the resectional margins. Therefore we recommend restricted resection of macroscopically diseased bowel. Microscopical involvement does not seem to increase the recurrence rate.

Adolescent↗
PubMed1982

Subcellular fractionation of human intestinal mucosa by large-scale zonal centrifugation. Localization of the lysophospholipase activity in distal ileum.

The subcellular localization of lysophospholipase activity (EC 3.1.1.5) in human ileal mucosa was studied by rate-zonal and isopycnic density-gradient centrifugation. The subcellular organelles (brush borders, basolateral membranes, lysosomes, mitochondria, and endoplasmic reticulum) were fractionated on a continuous sucrose gradient and located by assay of marker enzymes. Most lysophospholipase activity was found in the brush-border membranes, although the enzyme appeared in basolateral membranes as well. The possible physiological implications of this finding are discussed in view of that lysolecithin can impair the mucosal barrier function in the distal part of ileum. The localization of lysophospholipase to the brush-border membrane could thus serve a favourable purpose, preventing an accumulation of lysolecithin that might facilitate the absorption of potentially antigenic and toxic compounds.

Centrifugation, Density Gradient↗
PubMed1981

The incidence and course of perianal complications and arthralgia after intestinal resection with restoration of continuity for Crohn's disease.

The influence of bowel resection for Crohn's disease on the frequency of arthralgia and perianal manifestations was evaluated in a follow-up study of 82 patients. Arthralgia and perianal manifestations were analysed according to two separate periods: the preoperative duration of disease (4.2 +/- 3.2 years) and the postoperative duration (4.3 +/- 2.6 years). In patients operated on more than once, the time before the first and after the latest operation was included in the study. At the time of the follow-up, 19 patients suffered from recurrent disease. The frequency of arthralgia did not change after resection irrespective of whether or not there was recurrence. In patients without recurrence, however, perianal manifestations diminished after resection (P less than 0.05). In the postoperative period only 10 per cent of those without recurrence suffered from perianal lesions compared with 47 per cent of those with recurrence (P less than 0.001). If perianal lesions were in existence preoperatively, they healed spontaneously in 80 per cent of the patients without recurrence, but were still active among those with recurrence (P less than 0.001). Our results indicate that the perianal manifestations are closely connected to the inflammatory process in the intestine. On the other hand, the arthralgia seems to be independent of the inflammatory process of the bowel and may be related to a general defect of the gastrointestinal mucosa in Crohn's disease.

Adolescent↗
PubMed1981

Passage of molecules through the wall of the gastrointestinal tract. Increased passive permeability in rat ileum after exposure to lysolecithin.

The interaction between lysolecithin and mucosal cells in the distal ileum has been studied. Using a rat experimental model, we determined the intestinal permeability to fluorescent dextran 3000 after exposure to different amounts of lysolecithin. At pH 7.3, lysolecithin, 10 mg/ml, significantly enhanced the transmural passage, and at pH 3.5, even 1 mg/ml markedly increased the permeability. However, when lysolecithin was incubated with homogenized mucosal cells, a rapid disappearance of the compound occurred; this was accompanied by formation of free fatty acids and minor formation of lecithin. It appears, therefore, that high concentrations of lysolecithin can impair the intestinal barrier function in the distal part of ileum but that the mucosal cells are well equipped with activities for the rapid removal of such high concentrations. This could be physiologically significant, since the mucosal cells could otherwise be faced with large amounts of lysolecithin that might facilitate the absorption of potentially antigenic and toxic compounds.

Animals↗