Search PubMed⌕ Search

Biomedical subjects

C Palnaes Hansen

Publications and source records attributed to C Palnaes Hansen.

16 recordsLinked to original sources

Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors.

PURPOSE: To investigate the accuracy of dedicated pancreatic multidetector computed tomography (MDCT) in the diagnosis of neuroendocrine pancreaticoduodenal tumors (NPTs). MATERIAL AND METHODS: MDCT and other imaging studies in patients with suspected NPTs were identified. Thirty dedicated MDCT studies were done in 23 patients. Fourteen patients (16 operations) subsequently had surgery. Imaging reports were reviewed and findings compared with surgical findings and findings in other imaging studies. RESULTS: Patients with surgery: 19 NPTs (16 extrapancreatic gastrinomas and 3 pancreatic NPTs) were identified at surgery. MDCT identified 16 and somatostatin receptor scintigraphy (SRS) 11 out of 19 tumors. Endoscopic ultrasound detected 11 out of 14 NPTs. Patients without surgery: In 4 out of 9 patients, no NPTs were identified at MDCT. CONCLUSION: Dedicated MDCT of the pancreas can identify many NPTs, including small duodenal and periduodenal tumors, and the detection rate is better than reported in the older literature on CT.

Adult↗

Metabolism and acid secretory effect of sulfated and nonsulfated gastrin-6 in humans.

The antral hormone gastrin is synthesized by processing progastrin into different peptides that stimulate gastric secretion. The effect on acid secretion depends mainly on the metabolic clearance rate of the peptides, but some of them may differ in potency and maximum acid output at similar concentrations in plasma. Sulfated and nonsulfated gastrin-6 are the smallest circulating bioactive gastrins in humans. Their effect and metabolism have now been investigated in nine normal subjects and compared with nonsulfated gastrin-17, a main product of progastrin. Maximum acid output after stimulation with gastrin-17, sulfated gastrin-6, and nonsulfated gastrin-6 were 28.3 +/- 2.0, 24.5 +/- 2.0 (P < 0.02), and 19.3 +/- 2. 3 (P < 0.05) mmol H(+)/50 min, respectively, and the corresponding EC(50) values were 43 +/- 6, 24 +/- 2 (P < 0.01), and 25 +/- 2 (not significant) pmol/l. The half-life of gastrin-17 was 5.3 +/- 0.3 min, the metabolic clearance rate (MCR) was 16.5 +/- 1.3 ml. kg(-1). min(-1), and the apparent volume of distribution (V(d)) was 124.3 +/- 9.6 ml/kg. The half-lives of sulfated and nonsulfated gastrin-6 were 2.1 +/- 0.3 and 1.9 +/- 0.3 min, the MCRs were 42.8 +/- 3.7 and 139.4 +/- 9.6 ml kg(-1) min(-1) (P < 0.01), and the V(d) were 139.0 +/- 30.5 and 392.0 +/- 81.6 (P < 0.01) ml kg(-1). All pharmacokinetic parameters differed significantly from gastrin-17 (P < 0.01). We conclude that gastrin 6 has a higher potency but a lower efficacy than gastrin-17. The efficacy of gastrin-6 is increased by tyrosine O-sulfation, which also enhances the protection against elimination.

Adult↗

The accuracy of the frequency-volume chart: comparison of self-reported and measured volumes.

OBJECTIVE: To assess the accuracy of frequency-volume charts recorded by patients with voiding symptoms by comparing self-reported voiding data with the volumes of urine collected in same period. PATIENTS AND METHODS: The study comprised 18 patients (median age 63 years, range 20-80) and lasted 3 days, during which the patients recorded their fluid intake and voided volumes, and collected 24 h urine samples. RESULTS: The recorded volumes exceeded or underestimated the collected volume in 49% and 51%, respectively, of the samples, but the agreement between the accumulated daily voiding volumes on the charts and the volumes collected was acceptable. The median difference between volumes recorded on the charts and collected as samples was 100 (0-1450) mL per 24 h or 10 (0-117) mL per voiding (not significant). The median daily variation of creatinine in the urine was 1.1 (0.1-9.4) mmol (not significant), indicating that the 24 h collection periods were respected. CONCLUSION: Recordings on frequency-volume charts are valid and useful in the investigation of patients with voiding symptoms.

Adult↗

Assessment of renal function by 51Cr-EDTA and endogenous creatinine clearances in the pig.

In anaesthetized pigs, clearances of 51Cr-EDTA (EDTA) and endogenous creatinine were compared with renal clearance of inulin measured during constant infusion after bolus injection. Creatinine was determined by enzymatic (Kodak Ektachem) as well as conventional (Jaffé) methods. In saline-loaded pigs, renal clearance of constantly infused EDTA was 97.0 +/- 6.7 mL min-1 and identical to the clearance of inulin (94.1 +/- 9.1 mL min-1). There was good agreement between individual clearances. The extraction fractions of the two markers were indistinguishable (0.26 +/- 0.02 and 0.28 +/- 0.03, respectively). In other experiments the clearance of EDTA calculated from the first 4 h of the time course of the plasma concentration after single injection was 64.4 +/- 3.7 mL min-1, correlating well with inulin clearance (63.0 +/- 1.2 mL min-1). When calculated only from the monoexponential phase of the disappearance curve ('slope clearance'), significantly higher results were obtained (+33%, P < 0.001). Renal clearance of EDTA after single injection was 7.5 +/- 1.5 mL min-1 (approximately 12%) lower than inulin clearance (P < 0.001). Values of creatinine clearances determined by the two analytical methods showed a poor agreement with inulin clearance. It is concluded that, in pigs, glomerular filtration rate may be estimated by the clearance of EDTA using constant infusion or single injection of EDTA and that the renal clearance of endogenous creatinine is a less useful a measure of GFR.

Animals↗

The release of gastric inhibitory peptide, glucagon-like peptide-I, and insulin after oral glucose test in colectomized subjects.

BACKGROUND: The physiologic role of the colon as an endocrine organ is not clear. We therefore studied the enteroinsular axis in patients with ulcerative colitis after colectomy. METHODS: The subjects included 11 patients with a conventional ileostomy, 10 patients with an ileoanal reservoir, and 10 normal controls. The concentrations of glucose, insulin, gastric inhibitory peptide (GIP), and glucagon-like peptide-I (GLP-I) were measured in plasma during an oral glucose test. RESULTS: The peak level of glucose and peak levels and area under the curve (AUC) of insulin and GIP were higher in patients (P < 0.05). Neither the peak level nor the AUC of GLP-I differed between patients and controls, but time to peak level was four times longer in patients with an ileoanal reservoir (P < 0.05). CONCLUSION: Colectomy seems to affect the enteroinsular axis, leading to hyperinsulinemia and an impaired glucose tolerance. Moreover, patients with an ileoanal reservoir have a slower GLP-I response after intake of glucose.

Adult↗

Metabolism and influence of glycine-extended gastrin on gastric acid secretion in man.

Glycine-extracted gastrins are the immediate precursors of the bioactive carboxyamidated gastrins. The effect on gastric acid secretion and the pharmacokinetics of glycine-extended gastrin-17 were studied in 8 normal subjects. The elimination in plasma after bolus injection was biexponential, the half-lives being 4.1 +/- 0.2 and 21.8 +/- 0.9 min, and clearance and apparent volume of distribution being 7.9 +/- 0.6 ml/kg/min and 69.5 +/- 2.7 ml/kg, respectively. Infusion of the peptide at three consecutive dose rates did not stimulate gastric acid secretion, although plasma concentrations reached supraphysiological levels. Nor did glycine-extended gastrin-17 influence submaximal acid secretion induced by amidated gastrin-17. In contrast to amidated gastrins, the concentration of glycine-extended gastrins in peripheral venous plasma did not increase significantly after a meal. The postprandial rise in amidated gastrin was unaffected by concomitant infusion of glycine-extended gastrin-17. A reduction in glycine-extended gastrin-17 concentrations in plasma during constant-rate infusion of the peptide was observed after a protein meal (p < 0.05). This reduction was reflected by an increase in glycine-extended gastrin-17 is without immediate effect on gastric output in man. The postprandial increase in clearance might be due to increased splanchnic blood flow with subsequently increased peptide elimination.

Adult↗

Hepatic metabolism of vasoactive intestinal polypeptide during liver transplantation in the pig.

In order to investigate hepatic clearance of vasoactive intestinal polypeptide we measured its concentration in blood from the common carotid artery, right atrium and portal vein during orthotopic liver transplantation in six pigs. Just after laparotomy we found a significantly higher concentration of vasoactive intestinal polypeptide in portal plasma compared to that of the right atrium (p less than 0.05). This difference was soon eliminated by a fall in portal concentration, and, apart from fluctuations in portal concentration, no significant gradient between portal and atrial blood was recorded during the remaining part of the operation. When portal concentrations exceeded 30 pmol/l, the median reduction after transhepatic passage was 29% (range 16.8%-63.9%), while portal concentrations less than 30 pmol/l had a median reduction of only 6.3% (range 1.4%-16.5%) (p less than 0.05). No gradient between right atrial and systemic arterial blood was recorded. We suggest that a concentration-dependent clearance of splanchnic vasoactive intestinal polypeptide takes place in the porcine liver.

Animals↗

Diagnosis, treatment and outcome of parathyroid cancer. A report of eight patients.

Eight patients presented parathyroid cancer between 1963 and 1990. There were seven women and one man with a median age of 55.5 years (range 34-81). At admission the median serum calcium concentration was 3.75 mmol/l (range 3.0-5.0), and four patients presented with a hypercalcaemic crisis. Six patients had a pathological bone resorption and five had reduced kidney function or urinary stones. All cases were treated by en bloc resection of the tumour and affected adjacent structures. One patient with a local lymph node metastasis died after seven months, and one in whom it was impossible to remove the tumour died after 14 months. Two patients had recurrences three and nine years after the operation, respectively. The first was treated with mithramycin, but died 33 months later, the other was reoperated on and was still normocalcaemic 2-9 years after diagnosis.

Adult↗

The results of completion angiography after acute lower limb thromboembolectomy.

The results of completion angiography after acute thromboembolectomy with a Fogarty balloon catheter were evaluated. There were 62 patients (median age 72 years, range 44-92 years) and completion angiograms were made in 44 of them (71%). Incomplete runoff was demonstrated in 26 patients (59%) and rethromboembolectomy or vascular reconstruction was made in 18 cases (41%) under the same anaesthesia, while additional vascular surgery was technically impossible in 8 patients (18%). Supplementary surgery resulted in radiological improvement in 56% of operated cases. Reocclusion rate after 6 months was 50% in patients without patent tibials compared to 15% in patients with two or three patent tibial arteries (P less than 0.05). Eighteen patients had no completion angiograms after thromboembolectomy and 5 (28%) required early reoperation due to ischaemia. Completion angiograms are advocated in all cases of acute thromboembolectomy before the patient leaves the operating table.

Acute Disease↗

Ulcerative colitis and Crohn's disease of the colon. Is there a macroscopic difference?

The diagnostic reliability of currently accepted gross pathologic signs in patients with ulcerative colitis and Crohn's disease of the large intestine was evaluated. Of 198 patients who had colectomy or proctocolectomy because of inflammatory bowel disease, 52% had ulcerative colitis and 37% had Crohn's disease, 11% were indeterminable according to histologic evaluation of the surgical specimens. Cobblestone mucosa was most common in Crohn's disease (P less than 0.001) and pseudopolyposis in ulcerative colitis (P less than 0.01), but there was considerable overlap. Strictures and skip lesions occurred in both diseases with a similar incidence. It is concluded that the differential diagnosis between ulcerative colitis and Crohn's disease of the large intestine should not be made from macroscopic examination of the resected specimens.

Colitis, Ulcerative↗

Somatostatin treatment of gastrointestinal fistulae.

Output from gastrointestinal fistulae to the skin was measured in five patients during total parenteral nutrition and restricted oral intake. Supplemental infusion of somatostatin during six days caused a significant reduction in discharge in all patients compared to the pretreatment level, but none of the fistulae closed as a result of the treatment. Somatostatin may be considered an adjuvant drug to parenteral nutrition and restricted oral intake in the conservative treatment of external fistulae from the gastrointestinal tract.

Adult↗

Psoas abscess complicating Crohn's disease.

Six cases of psoas abscess complicating Crohn's disease are presented. The most common manifestations were weight loss, pain, fever and a palpable mass in the flank or iliac fossa. CT-scan confirmed the diagnosis. The treatment of choice in this condition is either laparotomy with drainage and primary resection of affected bowel or initial ultrasound-guided percutaneous drainage followed by early resection of the affected bowel.

Abscess↗

Perforated gastric ulcer.

A retrospective study is presented of 297 patients operated upon for perforated benign gastric ulcer in Denmark from 1975 to 1984. Male:female ratio was 0.9:1, mean age 64.2 years. The numbers of gastric and prepyloric perforations were almost equal (156:141), but gastric perforations were more frequent in elderly women and prepyloric perforations in younger men. Simple closure was performed in 83 per cent of the patients, gastric resection in 14 per cent and simple closure and vagotomy in 3 per cent. The postoperative mortality rate was 21 per cent and was related to the high proportion of elderly patients with concurrent diseases and delayed treatment.

Adolescent↗

Gastrocolic fistulas.

Sixteen patients were treated for gastrocolic fistula arising as a complication of peptic ulcer (11 cases), colonic perforation (2), gastric cancer (1), colonic cancer (1) or pancreatitis (1). The predominant symptoms were diarrhoea, weight loss and abdominal pain. Barium meal and barium enema were the most reliable means of diagnosis, and no fistula was gastroscopically demonstrable. A one-stage en bloc resection of the involved gastrocolic region was performed in eight cases. Other operations were simple excision (3), gastric resection with closure of the colonic wall (2) and colectomy with closure of the gastric wall (2). In one case cure was achieved with cimetidine, without surgical intervention. Four patients died postoperatively and two had recurrence of fistula.

Adult↗