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Biomedical subjects

F Johnsson

Publications and source records attributed to F Johnsson.

44 records · Page 3Linked to original sources
PubMed1988

The time pattern of gastroesophageal reflux.

The variations in gastroesophageal reflux over 24 h were analyzed in 220 patients with symptoms suggestive of gastroesophageal reflux disease and in 50 normal subjects by studying the results obtained by ambulatory 24-h esophageal pH-monitoring. Three time periods, differing in amount of reflux, were identified: daytime (0700-1700 h), evening (1700-2400 h), and night (2400-0700 h). The greatest amount of reflux was seen during the evening period. This pattern was not solely due to increase in reflux postprandially, since it persisted even after the elimination of postprandial reflux. The pattern was most pronounced in patients with esophagitis. The pressure of the distal esophageal high-pressure zone was measured at 0800 h, at noon, and at 1600 h during one day in another 10 patients. The pressure was significantly lower at 1600 h than at 0800 h and at noon, providing a possible explanation for the changes seen in gastroesophageal reflux. We have described a time pattern of gastroesophageal reflux that has important implications for the design of medical therapy in different groups of patients.

Adolescent↗
PubMed1988

Bile salts in the esophagus of patients with esophagitis.

It is controversial whether bile salts are important in the pathogenesis of esophagitis. By sampling esophageal contents during ambulatory 24-h pH-monitoring we found that in a group of 18 patients with esophagitis all but 1 had detectable concentrations of bile salts in their esophagus. The concentrations of bile salts were low, however, and similar to those found in the gastric juice of 10 normal controls. It is concluded that bile salts are present in the esophagus of patients with esophagitis and that their presence results from duodenogastric reflux. The role of these refluxed bile salts in the pathogenesis of esophagitis is, however, unclear.

Adult↗
PubMed1987

Effects of fundoplication on the antireflux mechanism.

Forty patients with a diagnosis of gastro-oesophageal reflux disease established by 24-h ambulatory pH monitoring were treated by a short 360 degrees fundoplication. Results of postoperative evaluation at 6 months were compared with those from 50 normal volunteers. The amount of gastro-oesophageal reflux at pH monitoring decreased significantly and was less than the reflux in the normal subjects. The pressure and the intra-abdominal length of the distal oesophageal high-pressure zone increased significantly. The pressure was similar to that in the normal subjects while a significantly longer intra-abdominal part of the high-pressure zone was created. The clinical results of the operation were evaluated in 38 patients by an independent gastro-enterologist, and were considered to be excellent in 22 patients, good in 13, fair in 2 and poor in 1 patient. The antireflux procedure provided good control of the gastro-oesophageal reflux in our patients by restoring the major components of the antireflux mechanism.

Adult↗
PubMed1987

Ambulatory 24 hour intraesophageal pH-monitoring in the diagnosis of gastroesophageal reflux disease.

The results of ambulatory 24 hour oesophageal pH monitoring in 20 patients with established gastro-oesophageal reflux disease were compared with those of 20 healthy individuals with normal endoscopy. Cut off limits of pH 3, 4, and 5 were superior to pH 2 with respect to the discrimination of patients from normal subjects, and for the detection of pathological reflux. Using pH 4 as a cut off limit, the ambulant and recumbent periods of pH monitoring were more discriminatory than the postprandial period. Furthermore, it was possible to get complete separation between patients and normal subjects using several combinations of two reflux variables. Another group of 30 patients and 30 controls were investigated. Using percentage time at pH less than 4 as a single determinant of gastro-oesophageal reflux, the sensitivity and specificity were 87% and 97%, respectively, with 3.4% as upper limit for normality. Twenty four hour oesophageal pH monitoring in an ambulatory outpatient environment afforded clinically useful diagnostic accuracy in separating patients with gastro-oesophageal reflux disease from asymptomatic controls.

Adult↗
PubMed1987

Symptoms and endoscopic findings in the diagnosis of gastroesophageal reflux disease.

Two hundred and twenty patients with symptoms suggestive of pathologic gastroesophageal reflux were investigated to elucidate the ability of symptoms and endoscopic findings in establishing a diagnosis of reflux disease as measured by ambulatory 24-h pH-monitoring. Daily occurrence of heartburn or acid regurgitation had positive predictive values of 59% and 66%, respectively. pH-monitoring showed pathologic reflux in 75% of patients with esophageal mucosal erosions. Endoscopic erythema of the distal esophagus predicted reflux disease in only 53%. Symptom registration during ambulatory 24-h pH-monitoring showed that about half of the symptomatic events reported by patients with pathologic reflux occurred within 5 min of a reflux episode. The corresponding figure for patients with normal pH-monitoring was less than 20%. We conclude that it is difficult to establish a diagnosis of gastroesophageal reflux disease by patient history alone, that erythema at endoscopy correlates poorly with pathologic reflux, and that reflux disease may be present even with normal endoscopy findings.

Adolescent↗
PubMed1986

Selenium status in patients with liver cirrhosis and alcoholism.

1. Selenium status and blood levels of other nutrients related to lipid peroxidation were studied in patients with advanced alcoholic liver cirrhosis, in male alcoholics who had been abstinent for at least 1 month and in healthy control subjects. 2. Plasma Se was decreased in alcoholic cirrhosis but not among alcoholics in abstinence. Platelet glutathione peroxidase (EC 1.11.1.9; GSH-Px) activity was decreased in cirrhotic patients, whereas GSH-Px in blood and plasma was the same as in controls for both groups of patients. 3. Plasma retinol and plasma alpha-tocopherol were decreased in alcoholic cirrhosis, whereas plasma ascorbic acid was the same in all groups. 4. The decreases in platelet GSH-Px, plasma Se and alpha-tocopherol indicate a deranged antioxidant defence in patients with advanced alcoholic cirrhosis, but the levels of these and other nutrients were generally not correlated to common clinical chemical indicators of liver disease.

Adult↗
PubMedDate not supplied

OmniMed II: a new system for use with the emphasis erodible mask.

Clinical experience has shown the emphasis erodible mask to be an effective method for performing photorefractive keratectomy (PRK) using an eyecup placed in contact with the corneal surface. A new system (OmniMed II) which incorporates the erodible mask as an element in the optical delivery system has been developed for performing photorefractive keratectomy. With this new configuration the eyecup is no longer used. We describe in detail the advantages of the erodible mask, the associated hardware of the optical delivery system, and the mask shape transfer process.

Cornea↗