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Biomedical subjects

G Hellers

Publications and source records attributed to G Hellers.

At least 73 records · Page 4Linked to original sources
PubMed1980

Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease.

During the period 1955 to 1974 inclusive, 826 patients developed Crohn's disease and were registered citizens of Stockholm County at the time of definite diagnosis. These patients were followed up and investigated with reference to the occurrence of and outcome after treatment for anal fistulae. These fistulae were recorded in 184 patients (23%). The incidence of anal fistulae increased the further distally the intestinal lesion was located. Healing followed local operation for anal fistula before curative intestinal resection in approximately 60% of the patients with small intestinal and combined ileocolic disease. However, patients with colonic Crohn's disease did not heal after such treatment. When curative intestinal resection was the primary procedure, 47% of the patients healed spontaneously. Small intestinal and combined ileocolic disease was associated with a good prognosis--90% were healed at follow-up, while patients with colonic disease had a poor prognosis. The combination of rectal Crohn's disease and anal fistula invariably led to proctocolectomy.

Adolescent↗
PubMed1980

Intestinal metaplasia in the gastric remnant following resection for benign ulcer disease: a comparison between morphology and histochemistry.

A follow-up study including endoscopic examinations was performed on patients previously (23--27 years earlier) treated with partial gastrectomies for benign ulcer disease. From 106 patients satisfactory biopsy specimens were obtained. Intestinal metaplasia was diagnosed on pure morphologic findings and on histochemical findings (alcian blue at pH 2,5). The histochemical method was shown to be more sensitive. The significance of intestinal metaplasia in the carcinogenesis is briefly discussed.

Aged↗
PubMed1980

The incidence of fecal fistula following exploratory laparotomy and appendicectomy in patients with ileocolic Crohn's disease.

The aim of this study was to investigate if appendicectomy en passant in connection with exploratory laparotomy for ileocolic Crohn's disease increases the risk for development of postoperative fecal fistula. This was studied among 105 patients, 65 of whom had an additional appendicectomy and 40 who had not. The postoperative frequency of fecal fistula was 18.5 versus 15% in the two groups. The difference is not significant. On balance, appendicectomy is advised under these circumstances.

Adult↗
PubMed1980

Outcome following treatment of anal fistulae in Crohn's disease.

The results of treating 24 patients with anal fistulae and active intestinal Crohn's disease is reported. Four patients had multiple extended, seven high and ten low fistulae and three patients had sinus tracts. Seven patients with only minor discomfort were treated conservatively and five of them healed. Thirteen were treated by local surgery and ten subsequently healed. Four patients with rectal Crohn's disease and multiple fitulous systems were submitted to abdominoperineal excision. These results indicate that in patients without rectal involvement, conservative treatment and local surgery is indicated.

Adult↗
PubMed1979

Carcinoma of Meckel's diverticulum.

Acute intestinal obstruction in a women, aged 56, was caused by a highly malignant adenocarcinoma arising in a Meckel's diverticulum. Despite radical surgery, the tumour recurred after four months, and the patient died nine months after her first operation. This confirms the general bad prognosis associated with carcimomas of Meckel's diverticulum.

Adenocarcinoma↗
PubMed1978

The incidence of carcinoma in the gastric remnant after resection for benign ulcer disease.

UNLABELLED: During the period 1950-1953, gastric resection was performed on 569 patients for benign ulcer disease at the Serafimer Hospital, Stockholm, Sweden. The purpose of this investigation uas to assess the incidence of cancer and precancerous lesions in the gastric remnant. There were 15 postoperative deaths. 223 patients when traced were dead, and in 130 of these follow-up was adequate. Two cases with carcinoma in the gastric remnant were found among these. 72 patients were lost from follow-up. 253 patients when traced were alive, and in 111 of these, endoscopy and biopsy have been performed. In one patient there was a severe dysplasia but no invasive carcinomas were found. CONCLUSION: 130 dead patients and 111 living patients have been adequately followed after gastric resection for benign ulcer disease. Two carcinomas were found which makes the incidence 0,8%.

Adolescent↗
PubMed1978

Decreasing frequency of cholecystectomies in the counties of Stockholm and Uppsala, Sweden.

The frequency of cholecystectomies was followed in the counties of Stockholm and Uppsala during an eight-year period (1969--1976). In both counties there was a highly significant decrease. This was mostly marked for males under 50 and females under 40 years in Stockholm and for females, regardless of age, in Uppsala. It is unlikely that these figures represent a decrease in the prevalence of gall-stone disease even if a small change is possible. A major alteration in the financing system of out-patient care has taken place during the investigated period and this has probably had an important influence on the cholecystectomy rate. Another important factor may be the consideration of a etiological factors other than gall-stones for minor abdominal disorders.

Adolescent↗
PubMed1978

The incidence of carcinoma of the gallbladder and bile ducts in Sweden 1958 to 1972.

Between 1958 and 1972, 5913 carcinomas of the gallbladder and bile ducts were diagnosed in Sweden. These patients were divided into three groups, each covering a five year interval. The mean incidence was calculated for each group and related to age and sex. During the fifteen years of study a marked increase in the incidence was found, especially in elderly women.

Adult↗
PubMed1978

Roux-en-Y loop reconstruction as remedial operation for reflux gastritis after gastric resection.

Reflux gastritis is a symptom-complex consisting of antacid-resistent epigastric pain, nausea and frequent vomiting, weight loss and anaemia, sometimes with evident gastrointestinal haemorrhage. Gastric secretory studies usually show achlorhydria. The onset of symptoms is usually abrupt in previously healthy subjects. From 1973 to 1977, eleven patients with the established diagnosis of reflux gastritis have been treated with a Roux-en-Y reconstruction, as a remedial operation. There was no mortality in the series. At follow-up after a mean time of two years, the result was graded as excellent in ten patients and as fair in one. It is concluded that the Roux-en-Y procedure can be recommended in patients with reflux gastritis.

Aged↗
PubMed1978

The Mallory-Weiss syndrome. A review of 23 cases with special reference to coagulation defects.

The Mallory-Weiss syndrome is defined as bleeding from longitudinal tears in the gastro-oesophageal junction. The characteristic history consists of repeated vomiting followed by sudden haematemesis. During the past 4 1/2 years, 23 patients, 17 males and 6 females with the diagnosis of Mallory-Weiss syndrome were treated in our institution. An aetiological factor has been sought for. In a review of the case-records, we discovered that many patients had coagulation defects on admission. This was verified with extended coagulation tests at later follow-up. It is proposed that non-bleeding lacerations in the cardiac orifice in conjunction with vomiting is a common occurence, and that the Mallory-Weiss syndrome may be regarded as a complication occuring predominantly in patients with some coagulation defect.

Adult↗
PubMed1978

A retrospective study of carcinoma of the pancreas with special reference to the results of surgical treatment.

469 patients treated for carcinoma of the pancreas in the County of Stockholm in 1963--73 were analysed for mean survival time, mean hospital-stay, post-operative complications and mortality. The results of treatment with palliative biliary by-pass procedures and radical surgery were compared. The mean survival time after by-pass operation was 5,7 months and after radical surgery 12,8 months. The mean hospital-stay was 39 and 83 days respectively. The post-operative mortality after palliative biliary by-pass procedures was 16%, and the frequence of major post-operative complications 10%. The corresponding figures after radical surgery were 25% and 30% respectively. Despite the longer survival time, it is doubtful if patients benefit from radical surgery.

Adult↗
PubMed1977

Muscle metabolism in patients with chronic obstructive lung disease and acute respiratory failure.

1. The concentration of metabolites in intercostal and quadriceps muscle, and pulmonary function, were studied in twelve patients with chronic obstructive lung disease and acute respiratory failure before, during and after standardized treatment at an intensive care unit. The findings were compared with those obtained in hospitalized patients of comparable age with non-pulmonary diseases. 2. On admission, when the patients had marked hypoxaemia, hypercapnia and acidosis, the concentrations of ATP and creatine phosphate were low in both intercostal and quadriceps muscle, particularly the latter. The lactate concentration was increased in relation to control values but glycogen did not differ significantly. 3. In response to therapy, the Pa,CO2 and the patient's acidosis decreased, the vital capacity increased and lung mechanics improved along with the clinical condition. At the same time there were significant increases in the concentrations of ATP, creatine phosphate and glycogen in intercostal and quadriceps muscles, to values similar to, and for glycogen in excess of, those found in control subjects. Lactate concentration fell significantly during treatment. 4. In view of the low initial muscle concentrations of ATP and creatine phosphate in the patients, it is suggested that dysfunction of the respiratory muscles may be an important component of respiratory failure. Moreover, the concentration of energy-rich compounds in muscle rose significantly as the patients responded to treatment, which emphasizes the importance of adequate nutritional therapy in this disorder.

Acute Disease↗