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Biomedical subjects

F Burcharth

Publications and source records attributed to F Burcharth.

At least 55 records · Page 3Linked to original sources
PubMed1991

Pancreatic secretion of zinc and copper in normal subjects and in patients with chronic pancreatitis.

Pancreatic secretion of zinc and copper in duodenal juice were measured in 7 healthy persons and in 9 patients with chronic pancreatitis. Stimulation with cholecystokinin and secretin increased secretion of zinc in healthy persons but not in patients. Copper secretion was not influenced. In patients with chronic pancreatitis, the correlations between zinc secretion, and amylase and trypsin secretion were significant while in healthy subjects they were not. Possibly pancreatic zinc secretion in the duodenal juice might be used as a measure of exogenic pancreatic function, and determination of zinc in duodenal juice may replace enzyme determinations in the diagnosis of chronic pancreatitis.

Adult↗
PubMed1991

Possible genetic defects in regulation of glycosaminoglycans in patients with diabetic nephropathy.

The hypothesis of genetic defects in glycosaminoglycan (GAG) regulation among patients with insulin-dependent diabetes mellitus (IDDM) and nephropathy was assessed by studies in tissue cultures of fibroblasts obtained from 7 patients with normal urinary albumin excretion, 11 patients with diabetic nephropathy, and 6 nondiabetic control subjects. The incorporation of [2H] glucosamine and [35S] sulfate into hyaluronic acid (HA), chondroitin sulfate and dermatan sulfate (CS + DS), and heparan sulfate (HS) was measured in cells, matrix, and medium and related to micrograms of tissue protein. Large interindividual variations were seen in all three groups, and the incorporation of [3H] glucosamine into HA, CS + DS, and HS and [35S] sulfate into CS + DS and HS were not significantly different between the three groups. However, the fractional incorporation of [3H]glucosamine into HS was significantly reduced in diabetic patients with nephropathy compared with control subjects. This was the case not only when related to the total amount of GAGs (P = 0.014) but also when related to HA (P = 0.014). No significant difference was seen between control subjects and normoalbuminuric diabetic patients. The degree of N-sulfation of HS was not significantly different between the experimental groups. The results suggest that patients with diabetic nephropathy may suffer from deficiencies of coordinate regulation in the biosynthesis of GAG in fibroblasts, which may lead to a reduced density of HS in the extracellular matrix. If these changes reflect alterations in the biosynthesis of GAG from endothelial, myomedial, and mesangial cells, this observation may be relevant for the pathogenesis of severe diabetic complications.

Adult↗
PubMed1991

Prevalence of hepatobiliary dysfunction in a regional group of patients with chronic inflammatory bowel disease.

A regional group of outpatients with chronic inflammatory bowel disease (ulcerative colitis, n = 396, and Crohn's disease, n = 125) was biochemically screened to estimate the prevalence of hepatobiliary dysfunction. Among the 396 patients with ulcerative colitis, 69 (17%; 95% confidence limits, 14-22%) had at least 1 abnormal laboratory value. Serum bilirubin was elevated in 5%, alkaline phosphatases in 8%, aspartate aminotransferases in 4%, and alanine aminotransferases in 8% of the patients. Two per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin. Further diagnositc evaluation consisting of ultrasonography, liver biopsy, and endoscopic retrograde cholangiography was performed in patients who had biochemical values more than twice the upper normal limit in two consecutive blood tests within a fortnight. Six patients (1%) fulfilled this criterion. Three patients had primary sclerosing cholangitis, of whom two were primarily diagnosed; one patient had cholangiocarcinoma also primarily diagnosed; and two patients were found to have alcoholic hepatic damage. Among the 125 patients with Crohn's disease, 38 (30%; 95% confidence limits, 23-38%) had at least 1 abnormal laboratory value. Serum bilirubin was elevated in 2%, alkaline phosphatases in 18%, asparetate aminotransferases in 3%, and alanine aminotransferases in 10% of the patients. One per cent had decreased plasma coagulation factors (2.7 and 10) and serum albumin concentrations. Three patients (2%) fulfilled the criteria for further evaluation as described above. One patient appeared to have epithelioid granuloma in the liver and one patient had alcoholic liver disease, whereas one patient refused further examination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Ultrasonically guided percutaneous implantation of iodine-125 seeds in pancreatic carcinoma.

Cancer of the pancreas is most often not diagnosed before it has reached unresectable stages. The development of effective palliative treatment for these patients and for those with recurrence after resection is clearly needed. The present study reports the results of ultrasonically guided percutaneous implantation of 125I seeds in 19 patients with cancer of the pancreas. Twelve patients had further adjuvant external radiation. Despite satisfactory seed placement and delivery of the planned radiation dose in most cases, clinical improvement was lacking or only slight and short-lived. No difference in survival or palliation was observed between patients treated with seeds alone compared with patients treated with seeds and external radiation. Survival after seed implantation was short (median 140 days, range 7-401 days). Ultrasonically guided percutaneous implantation of 125I seeds cannot be recommended in the treatment of unresectable carcinoma of the pancreas.

Adult↗
PubMed1990

Ethanol in pancreatic juice after oral and intravenous administration.

Six patients with a drain in the main pancreatic duct were studied. Ethanol was given orally with individually adjusted doses aiming at a blood value of 0.8/1000 (17.6 mmol/l). Concentrations of ethanol in venous blood and pancreatic juice were recorded for three hours. Similar studies were made when ethanol was administered as an intravenous priming dose followed by a maintenance infusion. After orally administered ethanol, pancreatic juice values were higher than those in blood for a short period of time. The relations between median concentrations and time were incongruous curves consistent with a significant treatment by time interaction. Intravenous administration resulted in a similar pattern, but the interaction was not statistically significant. These findings indicate that the human pancreas may secrete ethanol.

Administration, Oral↗
PubMed1990

Long-term survival after resection of ductal carcinoma in the body and tail of pancreas.

We report on a 62-year-old male, who had resection of a large ductal carcinoma in the body and tail of the pancreas. Four months later a metastasis was removed from the abdominal scar, and 14 months later another metastasis was removed from the anterior wall of the stomach. Moreover, he had a left mastectomy followed by radiation therapy for a primary ductal carcinoma and a transurethral resection of the prostate because of benign hyperplasia. A minor focus of primary highly differentiated adenocarcinoma was found in the chips. More than 6 years later, the patient is without any signs of recurrences.

Carcinoma, Intraductal, Noninfiltrating↗
PubMed1990

Ultrasonically guided percutaneous treatment of liver abscesses.

Twenty-two patients with liver abscesses demonstrated by ultrasonography (US) were treated over a nine-year period. The diagnosis was in all cases verified by puncture. The patients were treated by US-guided puncture or catheter drainage. Seventeen patients (77%) were cured without surgical drainage. Four patients were cured after subsequent surgical intervention. One patient died later of pancreatic carcinoma. There were no complications from the US-guided therapy. For the treatment of liver abscesses we recommend US-guided drainage as the first choice. Close collaboration between surgeon and radiologist is mandatory since some of these patients still need surgical treatment.

Drainage↗
PubMed1989

[Simultaneous transplantation of the pancreas and kidney in terminal diabetic nephropathies].

Transplantation of the pancreas in late stages of type I diabetes has been performed increasingly frequently during recent years. By improved surgical techniques and immunsuppressive therapy including cyclosporin A, the 1-year graft function has increased to 60-70% and the patient survival to 85-95% in the institutions with greatest experience. These results are so good, that they nearly reach those from kidney transplantation. Most of the pancreas transplantations have been performed simultaneously with kidney transplantation in patients with end stage diabetic uremia. The results should therefore be evaluated according to these circumstances. In a few institutions transplantation of the pancreas is now performed in patients with persistent proteinuria and proliferative retinopathy in an attempt to avoid development of severe diabetic complications. The first pancreas transplantation in Denmark was performed Januar 31 st 1987, and since then, 17 further transplantations have been performed. All patients had severe diabetic nephropathy and received simultaneous kidney transplantation. According to the Danish heart death criteria the organs were perfused and cooled during the donor operation to keep the warm ischemia as brief as possible. The pancreatic vessels are anastomosed to the iliac vessels. In one group of patients the exocrine pancreatic function was preserved by anastomosis to the jejunum, and in another group of patients the exocrine function was abolished by injection of latex into the pancreatic duct system. The patients receive immunosuppression therapy with methylprednisolone, azatioprine and ciclosporin A and anti-coagulation therapy.

Denmark↗
PubMed1989

Monitoring of pancreas-graft perfusion by radionuclide and digital subtraction angiography.

The vascularity of a kidney transplant can be evaluated by intravenous radionuclide angiography. A normal functioning transplant should have an isotope histogram with a well-defined peak. Accordingly, a transplanted pancreas may be evaluated in the same way. By intravenous digital subtraction angiography and small amounts of contrast medium, arterial and venous structures can be visualized without catheterization of the arterial system. Five patients had combined kidney and pancreas transplantation. Intravenous angiography with 99mTc-pertechnetate was performed three times a week for the first 5 postoperative wk. Digital subtraction angiography with an intravenous bolus of 80 ml of a low-osmolar nonionic contrast medium (iopamidol) was performed late in the postoperative course or when severe impairment of pancreas-graft perfusion was discovered by radionuclide angiography. One patient had two episodes and three patients one episode of rejection of both kidney and pancreas. Impairment of the pancreas-graft perfusion always preceded or was associated with deterioration of the graft function. In all patients, digital subtraction angiography demonstrated the graft vessels in sufficient detail. No thrombotic complications were observed. We conclude that these two methods can be used for monitoring the kidney and pancreas-graft perfusion. The methods may be of great value, especially in the early postoperative period, when problems with organ function are frequent and early intervention is essential.

Contrast Media↗
PubMed1988

Total hepatofugal portal blood flow in cirrhosis demonstrated by transhepatic portography.

We investigated 108 patients with cirrhosis of the liver and portal hypertension by percutaneous transhepatic portography to demonstrate the occurrence and frequency of total hepatofugal portal blood flow. Sixteen patients (14.8%) had a total hepatofugal portal blood flow. The aetiology of portal hypertension and the portal pressure did not differ from that in the group of patients with hepatopetal portal blood flow. A significantly higher percentage of patients in the group with hepatofugal flow had gastro-oesophageal varices (P less than 0.025). All patients with varices had bled. Half of the patients in the group with hepatofugal blood flow had a false splenoportographic diagnosis of portal vein thrombosis. In conclusion, total hepatofugal postal blood flow exists more often than hitherto assumed. Hepatofugal blood flow does not relieve portal hypertension nor prevent development of gastrooesophageal varices or bleeding.

Adult↗
PubMed1988

Klatskin tumours.

Klatskin tumours are cholangiocarcinomas localized in the bifurcation of the common hepatic bile duct in the liver hilum. The tumor is rare. The recent increase in incidence is probably due to more accurate diagnostic procedures. The tumours constitute approximately 30 percent of the extrahepatic cholangiocarcinomas. The symptoms are progressive obstructive jaundice, weight loss and pain. In the early stage of the disease the diagnosis is difficult, as is preoperative histological verification. Ultrasonography reveals dilated intrahepatic bile ducts and a normal common duct. Sometimes the tumour in the liver hilum can be seen and fine-needle biopsy obtained. In nearly all cases transhepatic cholangiography can verify the diagnosis. Evaluation of resectability includes hepatic arteriography and portography. The tumour is very rarely resectable when vessel involvement is apparent. Resection of the tumour provides the only chance of cure, but only 25 per cent of the tumours are resectable and only half of these can be resected completely. Resection of the quadrate liver lobe facilitates dissection, and hemihepatectomy is often necessary for a curative resection. Surgical bypass and intubation may palliate jaundice, but a similar palliation may be obtained by non-operative biliary drainage by endoprostheses. The median survival for resected patients is approximately 1 1/2 year. Median survival for patients with unresectable tumours is less than 6 months and insignificantly prolonged by palliative procedures. Cholangiocarcinoma localized at and obstructing the bifurcation of the common hepatic bile duct (Fig. 1) has obtained the name Klatskin tumour from Gerald Klatskin, who in 1965 described 15 cases and found some characteristics for this type of cholangiocarcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma, Bile Duct↗
PubMed1988

Preoperative evaluation and preparation in pancreatic carcinoma.

The preoperative evaluation in patients with pancreatic carcinoma includes ultrasonography or CT to diagnose and localize the tumour, to rule out metastases and to guide biopsy for cytological and/or histological verification. In patients with jaundice direct cholangiography, either transhepatic (PTC) or endoscopic (ERC), is necessary to give exact anatomical delineation of the tumour. Further, these procedures may be used to establish preoperative biliary drainage or to insert an endoprosthesis for permanent biliary drainage in inoperable cases. In patients without jaundice endoscopic pancreaticography (ERP) may delineate the pathology. Selective arteriography, both of the coeliac and superior mesenteric artery, visualize possible variations in arterial anatomy and tumour invasion. Stricture of one of the main arteries is usually a sign of inoperability. As venous phase portography only in some cases gives precise visualization of both the splenic, superior mesenteric and portal vein, transhepatic portography with selective catheterization of the splenic and superior mesenteric vein should be performed to diagnose strictures or invasion of the portal venous system. Only a few cases with invasion of these veins will be operable. The preoperative preparation in patients with pancreatic carcinoma includes correction of electrolytes, hypoalbuminemia, anemia, and, in patients with jaundice, treatment of K-vitamin deficiency. All patients should have prophylactic anti-thromboembolic treatment. Whether preoperative biliary drainage in jaundiced patients is of any benefit is still controversial, but may be indicated in patients with heavy jaundice and/or septic cholangitis.

Angiography↗
PubMed1987

Implantation of a pressure cuff around the subphrenic oesophagus.

The possibility of implanting a pressure cuff around the subphrenic oesophagus as a barrier to reflux was tested in six pigs. The oesophagus tolerated cuff pressures from 48 to 95 cmH2O, corresponding to intra-oesophageal pressures from 27 to 75 cmH2O. The pigs with the perioesophageal cuff swallowed a solid diet without difficulty. However, dysphagia occurred in pigs kept alive for more than a month and the main reason was malfunction of the device because of surrounding fibrosis. This problem should be solved before implantation of the device in humans is attempted.

Animals↗
PubMed1986

The colostomy plug: a new disposable device for a continent colostomy.

A new disposable device for colostomy control is described. It is a two-piece system consisting of an adhesive base plate and a disposable colostomy plug, attachable to the plate. The plug is made of a soft, pliable plastic material with open cells, containing a carbon filter which allows flatus to pass odour-free. It is packed and compressed in a water-soluble film, which disintegrates immediately after insertion, allowing the plug to expand and prevent the passage of faeces. The device has been tested in 53 patients. Faecal continence and the passage of flatus without noise or odour was achieved in 90%. The median application period until the plug became obstructed with mucus or faeces was 8 h (range 5-24 h or more), the application period being somewhat longer for patients who used bowel irrigation. Patients not using bowel irrigation applied a colostomy bag during the night.

Adult↗