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Biomedical subjects

B Jeppsson

Publications and source records attributed to B Jeppsson.

At least 73 records · Page 4Linked to original sources
PubMed1994

Repeated dearterializations of an experimental liver tumor: short- and long-term results.

Intermittent dearterialization, as compared to permanent dearterialization, is preferably used in palliative ischemic treatment of liver tumors because collaterals seem to be avoidable. In this study the most efficient time period of hepatic arterial occlusion was assessed and short- and long-term effects of repeated daily dearterializations on the growth of a transplanted liver tumor was evaluated. In five groups of inbred Wistar/Furth rats bearing metastatic liver tumors the hepatic arterial circulation was repeatedly and transiently blocked for 0 (n = 8), 30 (n = 8), 60 (n = 8), 120 (n = 8), and 180 (n = 8) min daily for 5 days, respectively, with an implanted minioccluder. Another group (n = 6) was permanently dearterialized for 5 days. In addition, one group (n = 6) was intermittently dearterialized 120 min/day for 18 days and compared to the no treatment (n = 6) and permanent dearterialization (n = 6) groups. We found that repeated arterial occlusions for 120 and 180 min as well as permanent dearterialization for 5 days almost retarded the liver tumor growth completely. Collaterals developed in all rats subjected to permanent dearterialization and in one of the rats that were dearterialized repeatedly for 180 min. However, prolonged intermittent dearterializations for 180 days significantly delayed the tumor growth compared to permanent dearterialization (P < 0.05) yet collaterals did not develop. Therefore, we conclude that repeated arterial occlusions for 120 min are the optimal method of dearterialization that effectively retards the growth and prevents collateral circulation of this liver tumor. It may have implications in the palliative treatment of human liver tumor when dearterialization is considered.

Angiography↗
PubMed1994

Nitrous oxide for colonoscopy discomfort: a randomized double-blind study.

The possibility of reducing recovery time after colonoscopy was studied using patient-administered nitrous oxide and comparing it with our standard treatment of ketobemidone plus midazolam. Fifty consecutive colonoscopy patients were randomized to receive either (i) intravenous ketobemidone hydrochloride 2.5 mg, midazolam 2.5 mg, and breathing air from a face mask with a demand valve (KHM) or (ii) intravenous saline and a breathing mixture of even parts of oxygen and nitrous oxide (Entonox) from the same valve setup. Patient discomfort during colonoscopy was assessed using visual analogue scales. All patients were allowed to stay for recovery as long as they wanted, and the time was measured. Modified recollection tests were performed prior to colonoscopy and when the patients left the Endoscopy Unit, in order to study the degree of mental impairment induced by the procedure and the medication. All patients had complete colonoscopies of the same duration in both groups. Discomfort during colonoscopy was rated the same in both groups (2p = 0.6413). Both groups of patients scored identically in the precolonoscopy recollection test. Most patients had a lower score after colonoscopy, but Entonox-treated patients scored significantly better than those with KHM (2p = 0.0250). Patients treated with Entonox opted to leave the Unit directly after the procedure (median 0 minutes; interquartile range 0-5 minutes) compared to 38 minutes for those with KHM (interquartile range 10-75 min), 2p < 0.001. It seems from our data that nitrous oxide gives pain relief equal to that in our standard treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Increased intestinal marker absorption due to regional permeability changes and decreased intestinal transit during sepsis in the rat.

BACKGROUND: The intestinal barrier properties are impaired during inflammation and sepsis, but the mechanisms behind this are unknown and were therefore investigated during experimental sepsis in rats. METHODS: The different-sized intestinal absorption markers 51Cr-labeled ethylenediaminetetraacetic acid (EDTA) and ovalbumin were gavaged to rats made septic by intra-abdominal bacterial implantation and to sham-operated rats. Regional tissue permeability was measured in diffusion chambers, and intestinal transit was evaluated by intestinal accumulation of gavaged 51Cr-EDTA. RESULTS: In comparison with the sham-operated rats, septic rats had higher 51Cr-EDTA levels in blood and urine and showed a prolonged intestinal transit. Septic rats also had a lower tissue permeability to both markers in the small intestines but higher permeability to ovalbumin in the colon. Rats receiving morphine to decrease intestinal motility showed similar changes, with a decreased intestinal transit and increased marker absorption. CONCLUSIONS: The results suggest that the increased intestinal absorption during sepsis was due to regional permeability changes and prolonged intestinal transit.

Animals↗
PubMed1993

Subjective assessment of nutritional status-validity and reliability of a modified Detsky index in a Swedish setting.

In the search for a clinically useful nutritional index for use in a European context, we have translated an American nutritional assessment index - Subjective Global Assessment (SGA), and tested the modified translated version for validity and reliability in a Swedish setting. Judgements by an expert panel resulted in a mean agreement of 71% for clarity, 80% for content validity and 65% for internal consistency. Construct validity was demonstrated by the use of contrasting patient-groups (n = 20) and by 90% agreement with a medical expert as 'gold standard' for unknown patients (n = 20). Inter-rater reliability showed 75% agreement by 3 Registered Nurses (RNs) (n = 20). The individual Kappas for the raters varied from 0.68 to 0.89. The study showed difficulties experienced by raters in relating certain aspects in the SGA-index to normality. However, we concluded that a modified SGA-index translated from one language to another, with all the problems of cultural and idiomatic differences, can be of value for assessing and documenting pre-operative nutritional status of patients undergoing gastrointestinal surgery in a Swedish setting.

Journal Article↗
PubMed1993

Numerical taxonomy of Lactobacillus spp. associated with healthy and diseased mucosa of the human intestines.

Two-hundred and fifty Lactobacillus strains isolated from healthy and diseased mucosa of human intestines of 75 individuals and 49 reference strains were phenotypically classified using 49 unit characters. Data were processed by the Jaccard (SJ) and Simple Matching (SSM) coefficients, and unweighted pair group algorithm with arithmetic averages. Seventeen major clusters were defined at the 76% SJ-similarity level which approximately correspond to the SSM-level of 91%. Seven clusters could be identified: Lactobacillus plantarum (isolates recovered from 5% of the patients), Lact. casei subsp. rhamnosus (17% of the patients), Lact. casei subsp. pseudoplantarum (5% of the patients), Leuconostoc mesenteroides subsp. mesenteroides (3% of the patients), Lact. buchneri (4% of patients), Lact. reuteri (4% of the patients) and Lact. salivarius subsp. salivarius (9% of the patients). Unassigned clusters 1 and 3 both contained homofermentative Lactobacillus strains. Cluster 1 included the type strains of Lact. crispatus, Lact. acidophilus, Lact. jensenii and Lact. gasseri, and cluster 3, the type strains of Lact. delbrueckii subsp. lactis, Lact. agilis and Lact. casei subsp. tolerans. Clusters 1 and 3 were found in 15% and 25% of the patients, respectively. Unassigned clusters 2, 6, 7, 8 and 10 contained homofermentative Lactobacillus strains but no reference strains. Clusters 11, 12, 15 and 17 were made up of heterofermentative Lactobacillus strains but no reference strains. Phenotypical characteristics of the clusters are given. No obvious trends in species (cluster) composition between different intestinal locations could be noted. Most clusters contained isolates from both diseased and healthy mucosa. Exceptions were cluster 15 and cluster 17 which only included isolates from healthy mucosa, and cluster 11 which only included isolates from diseased mucosa. Cluster 15 was isolated in 12% of the patients, and cluster 11 in 8%.

Classification↗
PubMed1993

Administration of different Lactobacillus strains in fermented oatmeal soup: in vivo colonization of human intestinal mucosa and effect on the indigenous flora.

In vivo colonization by different Lactobacillus strains on human intestinal mucosa of healthy volunteers was studied together with the effect of Lactobacillus administration on different groups of indigenous bacteria. A total of 19 test strains were administered in fermented oatmeal soup containing 5 x 10(6) CFU of each strain per ml by using a dose of 100 ml of soup per day for 10 days. Biopsies were taken from both the upper jejunum and the rectum 1 day before administration was started and 1 and 11 days after administration was terminated. The administration significantly increased the Lactobacillus counts on the jejunum mucosa, and high levels remained 11 days after administration was terminated. The levels of streptococci increased by 10- to 100-fold in two persons, and the levels of sulfite-reducing clostridia in the jejunum decreased by 10- to 100-fold in three of the volunteers 1 day after administration was terminated. In recta, the anaerobic bacterium counts and the gram-negative anaerobic bacterium counts decreased significantly by the end of administration. Furthermore, a decrease in the number of members of the Enterobacteriaceae by 1,000-fold was observed on the rectal mucosa of two persons. Randomly picked Lactobacillus isolates were identified phenotypically by API 50CH tests and genotypically by the plasmid profiles of strains and by restriction endonuclease analysis of chromosomal DNAs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Impairment of bacterial flora in human ulcerative colitis and experimental colitis in the rat.

Changes in the colonic mucosa-associated microflora were determined both in patients with active and inactive ulcerative colitis and in rats with acetic acid-induced colitis. In patients with active ulcerative colitis, significant decreases in the number of anaerobic bacteria (Brain Heart Infusion medium), anaerobic gram-negatives and Lactobacillus were found, whereas no changes were seen in the number of aerobic bacteria and Enterobacteriaceae. In patients with inactive ulcerative colitis, no significant differences in colonic mucosa-associated microflora could be demonstrated. Similar changes were seen in rats with acetic acid-induced colitis. Thus, 4 days after acetic acid administration, at which time the colitis was well developed as evaluated by morphological appearance and myeloperoxidase activity, reduction in the number of anaerobic bacteria and Lactobacillus was seen. The first day after acetic acid administration, when the colitis had not developed, or after 14 days, when the colitis had been overcome, no alterations were seen in the mucosa-associated microflora as compared with control rats. We conclude that a reduction in the number of anaerobic bacteria and Lactobacillus is a common feature in active colitis regardless of the origin of colitis.

Acetates↗
PubMed1993

Sclerotherapy of edematous gallbladders with different agents. An experimental study in pigs.

Different sclerosing agents were tried in experiments with 32 pigs to achieve ablation of gallbladders rendered edematous by mechanical lithotripsy with the Rotolith lithotriptor. In 16 pigs sclerotherapy was performed with 6% acetic acid, Carnoy's solution, 95% ethanol + 3% sodium-tetradecylsulfate (STS) and hot metrizoate, respectively. These animals were sacrificed immediately after the procedure. Histologic examination showed persistent surface epithelium and glandular epithelium in all specimens. In 6 pigs, the sclerotherapy was done with Carnoy's solution, 95% ethanol + 3% STS and hot metrizoate, respectively, and the pigs were killed 6 days later. Fibrosis of the gallbladder remnants was seen in these animals, but also remnants of surface and glandular epithelium. Hot metrizoate was used in another 10 pigs and these animals were sacrificed after 8 weeks. At histologic examination fibrosis was seen in the gallbladder remnants of 9 surviving animals, but also areas of preserved muscular layer, and development of mucinous cysts were found in more than 50% of the specimens. Thus, none of the sclerosants was able to produce a total ablation of the gallbladder mucosa.

Animals↗
PubMed1993

Percutaneous rotational lithotripsy of gallbladder stones. Clinical results with the Rotolith lithotriptor.

Ten patients (aged 39-94 years) with cholecystolithiasis were selected for percutaneous rotational lithotripsy with the Rotolith lithotriptor either because they were considered high-risk patients for cholecystectomy or because they had refused surgery. The procedure was completed in 7 patients. Five of these were stone-free at cholangiography 1 to 2 days after lithotripsy. Conclusive cholangiograms were not obtained in 2 patients due to gallbladder leakage, which in itself did not cause any serious sequelae. At ultrasonography after one month, one of these 2 patients had no visible gallbladder, the other one had small residual gallbladder stones. Rotational lithotripsy is an alternative to cholecystectomy in patients at high surgical risk, especially elderly patients who have undergone cholecystostomy as an emergency treatment for acute cholecystitis.

Adult↗
PubMed1992

Inhibitory effect of 2-deoxy-D-glucose on liver tumor growth in rats.

Since tumor cells are more dependent on glycolysis for energy supply than other cells, we tested whether its inhibition by 2-deoxy-D-glucose (2-DG) affects tumor growth. Male Wistar rats were inoculated in the liver with tumor cells from a chemically induced colonic adenocarcinoma. From day 5 after inoculation 2-DG (400 mg/kg/24 h) was continuously infused into the hepatic artery for 5 days; controls received saline in the same fashion. Seven days after the end of infusion, the animals were sacrificed. A second experimental group of rats was treated with isolated liver perfusion for 30 min with oxygenated blood through the portal vein and hepatic artery simultaneously. In the perfusate, 400 mg/kg 2-DG were added, and the rats were sacrificed at 10 days after perfusion. A first control group underwent perfusion without 2-DG, and a second control group received i.v. infusion of 2-DG (400 mg/kg/30 min) for 30 min over 5 days. A nontreated control group was also added. All animals survived the procedures. The concentration of blood glucose increased in the rats receiving 2-DG i.v. and intraarterially but was unchanged in the other groups. The tumor growth was significantly reduced by 2-DG in all experimental groups, with no difference between the groups. It is therefore concluded that 2-DG is of potential interest in the treatment of malignancies. Since local application of 2-DG avoids the risk for systemic side effects, this approach should be explored further.

Animals↗
PubMed1992

Effect of fermented oatmeal soup on the cholesterol level and the Lactobacillus colonization of rat intestinal mucosa.

Rats were fed with freeze-dried oatmeal soup fermented by six different Lactobacillus strains from rat and man; the formula is intended for enteral feeding. The serum cholesterol levels after 10 d were lower for rats eating oatmeal as compared to a commercial product, Biosorb Sond. Colonizing ability of the administered strains were evaluated in vivo. Only Lactobacillus reuteri R21c were able to, effectively, colonizing the mucosa; it represented about 30% of the Lactobacillus population 24 d after termination of the administration. L. reuteri R21c was easily recognized by the ability to produce a yellow pigment on agar plates. The identity was confirmed by carbohydrate fermentations (API 50CH), plasmid pattern and endonuclease restriction analysis of the chromosomal DNA.

Animals↗
PubMed1992

Systematics of the Lactobacillus population on rat intestinal mucosa with special reference to Lactobacillus reuteri.

The systematics of the Lactobacillus population of the intestines of 88 different rats was studied; 80 rats had been fed on fermented oat-meal soup (Molin et al. 1992). One-hundred-twenty-two Lactobacillus strains from the intestinal mucosa were phenotypically classified together with twenty-eight reference strains of Lactobacillus and Leuconostoc, using 49 unit characters. Data were examined using Jaccard coefficient, and unweighted pair group algorithm with arithmetic averages. Two major and eleven minor clusters were defined at the 76% SJ-similarity level: Cluster 1 included thirty isolates which could not be identified further, but had resemblance to the type strains of L. jensenii, L. gasseri, L. crispatus, and to some extent to L. acidophilus. Cluster 12 including fifty-four intestinal isolates was identified as L. reuteri; and so was cluster 13 (five isolates). Isolates of the major clusters were found in all parts of the intestines. The genomic homogeneity of the L. reuteri isolates was scrutinized by endonuclease restriction analysis of the chromosomal DNA, and the isolates could be divided into six genomic strains.

Algorithms↗
PubMed1992

Reduced clearance of leukocytes from lungs in septic rats.

Leukocytes have previously been shown to sequestrate in the lungs and liver in association with traumatic and septic shock. In a rat model of gram-negative sepsis of intra-abdominal origin, a previously described in vivo technique was used for dynamic studies of leukocyte sequestration in different organs using white blood cells labeled with 111-indium-oxine. One group of rats was either studied immediately after induction of sepsis or for 6 h under a scintillation camera for continuous registration of the activity distribution (i.e., presence of leukocytes). Another group was studied 12 h after induction of sepsis for 60 min. The activity increased immediately over the lungs, indicating sequestration of the leukocytes during the first 6 h, but there was no significant difference in this respect between septic and control animals. It does not seem possible to study leukocyte sequestration dynamically in this way. When the labeled leukocytes were administered 12 h after induction of sepsis, however, the activity of septic animals' lungs was seen to remain elevated over the time period studied compared with control rats, in which the activity slowly decreased. In the liver and spleen, the activity increased in both groups, but significantly more so in control animals, which may be explained by disturbed leukocyte margination and cell turnover in the septic animals. This study has indicated that leukocyte distribution in different organs is affected by sepsis and this reaction can be studied using radiolabeled leukocytes.

Animals↗
PubMed1992

A simple two-stage technique of total hepatectomy in the rat.

We describe a novel, two-stage technique of total hepatectomy in the rat. In the first stage, acute and progressive atrophy of the posterior liver lobes attached to the inferior vena cava is induced by selective portal venous branch ligations. Two weeks later, when these lobes comprise approximately only 3% of the total liver mass, the hepatic artery is ligated and the enlarged anterior liver lobes are resected. An end-to-side porto-caval shunt is then carried out to ensure vascular integrity of the splanchnic area. This procedure was associated with no operative mortality and glucose-supplemented animals had a mean survival time of 20 +/- 5 hr. The anhepatic state was associated with significant metabolic and biochemical changes associated with necrosis of a small residual liver parenchyma. This animal preparation is a reproducible model of the anhepatic phase of experimental fulminant hepatic failure.

Animals↗
PubMed1992

A new self-propelling nasoenteric feeding tube.

A new fine-bore nasoenteric feeding tube was tested in 19 post-operative patients. It is a silicone rubber tube, which at its distal end has 5 loops with a diameter of approximately 4 cm. The loops are easily straightened during insertion into the stomach, but ease transpyloric passage after removal of the guidewire. 4 h after insertion, 18 tubes had reached the duodenum or upper part of the jejunum. In only 1 patient was there regurgitation of the tube into the stomach after insertion.

Journal Article↗
PubMed1992

Tumours of Oddi: diagnosis and surgical treatment.

A retrospective review of 56 patients operated upon for tumours of Oddi was performed in order to determine optimal diagnostic and therapeutic procedures. Common presenting symptoms were jaundice (86%) and anemia (21%). Mean size of the tumour was 2.3 cm. Five tumours were benign and 51 were malignant. According to the classification of Martin, five were grade I: 10 grade II; 18 grade III; and 18 grade IV. Forty-seven patients underwent resection of the tumour: three local excisions for small benign tumors, six ampullectomies (followed in three by a Whipples' procedure for recurrence) and 41 Whipples' procedures. The hospital mortality was 5.3%, minor complications appeared in 21%. The overall five years survival was 41%. It was 75% in grade I, 50% in grade II, 40% in grade III and 10% in grade IV. The patients who received ampullectomies were alive with a follow-up of one, two and three years. All patients operated upon for a benign tumour were alive except one who died of cardiac failure. Ultrasonography and duodenoscopy are the most useful tests for the diagnosis of tumours of Oddi. Prognosis depends on the degree of infiltration of the duodenal wall and the presence of positive lymph nodes. Whipples' procedure is best but ampullectomy can be used in elderly or poor risk patients. Malignant tumours of the ampullary region are infrequent and reported to constitute between 0.02 and five percent of all cancers of the digestive tract. With wider application of endoscopic techniques, there has been an increasing interest in this group of tumours during recent years. In the literature tumours of Oddi are usually reported in the group of periampullary tumours, including tumours of the ampulla itself, duodenal wall surrounding the ampulla, the distal part of the common bile duct and head of the pancreas. We have wanted to distinguish specifically the tumours of the ampulla of Vater and have adopted the term tumour of Oddi introduced by Marchal and Hureau.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholestasis↗