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Biomedical subjects

B Damgaard

Publications and source records attributed to B Damgaard.

At least 19 recordsLinked to original sources
PubMed1995

Social and sexual function following ileal pouch-anal anastomosis.

PURPOSE: Patients who undergo surgery for ulcerative colitis are usually young and active. When surgery becomes necessary, their future social and sexual function is of major concern. This study was performed to be able to give more detailed information of what is to be expected. METHODS: Forty-nine consecutive patients (26 men and 23 women) who underwent ileal J-pouch-anal anastomosis for ulcerative colitis between November 1983 and September 1986 in the authors' institution were personally interviewed regarding details of their preoperative and postoperative social and sexual functions. RESULTS: Eighty-eight percent had reduced capacity to work preoperatively compared with 6 percent postoperatively. Thirty-one percent resumed work in the period with diverting ileostomy. Leisure time activities were reduced in 47 percent preoperatively, whereas 6 percent had limitations postoperatively. In 35 percent of women, frequency of intercourse was increased postoperatively, and none reported a decreased frequency. None of the women who were able to achieve orgasm preoperatively reported a postoperative disturbance of this ability, and 16 percent experienced an increased quality of orgasm. Postoperatively none reported dyspareunia, vaginal discharge, or changes in their menstrual cycle. Frequency of intercourse and ability to achieve orgasm remained unchanged for the majority of men; however, one developed erectile dysfunction, and one complained of retrograde ejaculation. Sexual activity in men was less affected by the presence of an ileostomy, and 69 percent had intercourse in the period with ileostomy compared with 30 percent of women. None of the patients complained of anal pain, soiling, or fecal leakage during intercourse, but one women reported some discomfort from the pouch during intercourse. None of the patients wanted to return to a life with an ileostomy. CONCLUSION: The social and sexual function, quality of life, after ileal J-pouch anastomosis is improved when compared with the period with ulcerative colitis and the time with diverting ileostomy. In men, however, a frequency of sexual dysfunction similar to what is seen after proctectomy for benign diseases should be underlined.

Adolescent↗
PubMed1994

Evaluation of 18 cases of conservative proctectomy with low transsection of the anorectum for benign diseases.

OBJECTIVE: To present our experience of conservative proctectomy in the treatment of patients with benign diseases of the rectum. DESIGN: Retrospective study. SETTING: University hospital. SUBJECTS: 18 patients with benign diseases of the rectum for whom a pouch was unsuitable. INTERVENTIONS: Conservative proctectomy with transsection of the anorectum. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: In 10 patients the wounds healed primarily. The remaining 8 developed presacral abscesses, which drained either spontaneously or after a drainage operation. At the end of the 19 month follow up period four still had presacral cavities with fistulas to the anal canal, and one patient had died of a cause unrelated to the operation. No patient complained of sexual dysfunction. CONCLUSION: If proctectomy is indicated for a benign disease a limited excision with transsection of the anorectum at the pectinate line is safe if the closed anal canal is examined carefully and residual mucosa removed. It should not be used for patients with severe inflammatory or fibrous changes in the perirectal tissue.

Adult↗
PubMed1993

Enhanced antibody production associated with altered amino acid metabolism in a hybridoma high-density perfusion culture established by gravity separation.

A high density hybridoma perfusion culture was established by separating and recycling cells from the product stream to the reactor using a simple external sedimentation-based separator-an inclined modified Erlenmeyer flask. After 3 weeks, when the optimal perfusion rate of 1.0 day-1 had been reached, viable cell density stabilized at around 10 x 10(6) cells ml-1, a level five times that obtained by simple batch culture. The efficiency of the separator was enhanced by cell flocculation. Specific antibody productivity, which was initially 0.4 micrograms 1 x 10(6) cells-1 h-1, decreased to half that value while cell density was increasing, but recovered to the initial level when the culture finally stabilized at a high cell density. During the final phase, when viable cell density and specific antibody production were high, there was a marked shift in metabolism. Consumption of the two most important substrates for energy generation, glucose and glutamine, caused their broth concentrations to decrease to 1.5 mM and 1 mM, respectively, from input medium concentrations of 25 mM and 10 mM, respectively. At the same time there was an increase in the specific production of glycine and aspartate, their broth concentrations reaching 1.5 mM and 0.02 mM, respectively. We suggest that this shift in metabolism results in enhanced production of ATP from glutamine. The specific glucose consumption and lactate production also indicate that there is a shift to more energy efficient metabolism. The mechanism whereby this leads to enhanced specific antibody production remains to be elucidated. Nevertheless, the combination of high cell density and enhanced productivity obtained with the present perfusion culture resulted in a high monoclonal antibody production-100 mg 1-1 d-1.

Amino Acids↗
PubMed1993

Substitution of transferrin by FeCl3 in the development of a low foetal calf serum concentration medium for KB-26.5 hybridoma cell line.

KB-26.5, a murine hybridoma cell line producing an IgG3 monoclonal antibody used in blood type determination, primarily adapted to grow at 5% foetal calf serum (FCS) concentration has been adapted to grow at 0.5% FCS, maintaining its ability to produce antibodies at the same level. In the final step of adaptation, the addition of insulin, transferrin, ethanolamine and selenium to the media formulation was studied, using factorial assay techniques to check the effect of the different compounds and to optimize their required level for satisfactory growth and antibody secretion. KB-26.5 cells required only 20 micrograms/ml of transferrin to adapt to 0.5% FCS medium. Furthermore, transferrin could be substituted by FeCl3, at a relatively low level of 2 micrograms/ml. Maximum cell density decreased by 31.5% in spinner flask test, but the antibody titer was maintained, thus the specific productivity increased. However, inoculum size had to be increased three-fold with 0.5% FCS medium in order to assure cell growth.

Adaptation, Physiological↗
PubMed1991

[Minicholecystectomy].

Mini-cholecystomectomy was performed in 24 unselected patients with symptomatic gallbladder stones with pain control by intra- and postoperative epidural analgesia. Twenty three patients were discharged on the second postoperative day, while one patient who required re-laparotomy for haemostasis had recovered completely on the third day postoperatively. Median pain score (VAS) was 0 at rest, during coughing and mobilisation. Pulmonary function was not influenced significantly and postoperative fatigue normalized after 48 hours. These preliminary, uncontrolled observations suggest that mini-cholecystectomy is advantageous compared to conventional cholecystectomy, and may represent an alternative to laparoscopic cholecystectomy.

Adult↗
PubMed1991

[Percutaneous cholecystolithotripsy].

Thirty-two high-risk patients with severe complicating conditions and gall bladder symptoms requiring treatment, including acute cholecystitis in 28 of the patients, were treated with percutaneous cholecystolithotripsy (PTCL). This intervention was carried out under general, regional or local anaesthesia and resulted in fragmentation and removal of the stones in 90% of the patients. Cholecystectomy proved necessary in three patients on account of perforation in two and formation of "steinstrasse" in the cystic duct in one. No other complications of puncture or lithotripsy occurred and the postlithotripsy drainage time was, on the average, ten days. It is concluded that the PTCL technique is a realistic therapeutic offer to high-risk patients with gall bladder stones requiring treatment and in whom laparoscopic cholecystectomy or mini-cholecystectomy are not considered suitable.

Aged↗
PubMed1991

[Endoscopic percutaneous transhepatic cholelithotripsy in the treatment of complicated stones in the deep biliary tracts].

The results of endoscopic percutaneous transhepatic cholelithotripsy in seven patients with stones in the deep biliary passages which could not be treated by endoscopic papillotomy (EST) or extracorporeal shock wave lithotripsy (ESWL) are presented. A new dilator technique combined with mechanical or laser-lithotripsy was employed. All of the patients were relieved of the stones after uncomplicated course. It is concluded that endoscopic percutaneous cholelithotripsy which can be carried out under local anaesthesia, should be offered to patients with stones in the deep biliary passages which are not accessible to conventional treatment with EST or ESWL.

Aged↗
PubMed1991

[Extracorporeal shockwave crushing of gallstones. Preliminary report].

Extracorporeal shock wave lithotripsy (ESWL) was used for treatment of symptomatic x-ray negative stones in 23 patients. The number of ESWL sessions per patient was 1.8 (range 1-4). In 18 patients (78%), adequate fragmentation was seen comparable to results obtained elsewhere. Oral bile acid therapy was used after ESWL in the 18 patients mentioned and the mean follow-up period was five months (range 3-8 months). Four patients had by now passed all stones while 12 patients still had remaining stone fragments and one patient a gallstone. After ESWL, one patient was and one patient a gallstone. After ESWL, one patient was referred for cholecystectomy at his own request. Of the remaining five patients, cholecystectomy was performed in two and was scheduled for in three. Complications after ESWL were seen in two patients who developed acute pancreatitis. Thus, our preliminary experience shows that ESWL resulted in fragmentation and passing of gallbladder stones, but not without complications. Like the gallstone groups in Lyon, Montreal and Munich we are convinced that ESWL should be performed in accordance with prospectively designed protocols in order to establish optimal planning of indications and strategies for future treatment.

Adult↗
PubMed1990

[Creating a pelvic reservoir in the surgical treatment of ulcerative colitis and familial polyposis of the colon].

Proctocolectomy and creation of an ileum reservoir with ileo-anal anastomosis is now an established method in the treatment of ulcerative colitis and certain cases of familial polyposis of the colon requiring operative treatment. The ideal type of reservoir is, however, not yet defined and the indications for operation and selection of the patients are still being assessed. The present series comprises 103 patients in whom a J-reservoir was created during the period November 1983 to January 1989. The results were registered prospectively one, three, six and 12 months postoperatively. In eight patients, the reservoir had to be removed on account of septic complications. All of the remaining patients had spontaneous defaecation and scarcely 50% employ constipating agents one year after the operation. The frequency of defaecation becomes reduced gradually from seven (4-14) per 24 hours to four (2-6) after one year. None of the patients are incontinent but over 10% still have periods of minimal soiling which require the use of a pad after one year. The procedure is complicated but must be considered to be safe in experienced hands as more than 90% of the patients achieve a satisfactory or acceptable result. In operations for ulcerative colitis and familial polyposis of the colon, the rectum should be preserved in view of subsequent reconstructive surgery.

Adenomatous Polyposis Coli↗