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Biomedical subjects

H Andersson

Publications and source records attributed to H Andersson.

At least 199 records · Page 11Linked to original sources
PubMed1981

Experimental model for in vivo determination of dietary fibre and its effect on the absorption of nutrients in the small intestine.

1. An experimental model for the determination of dietary fibre according to the definition of Trowell et al. (1976) is described. Food was subjected to in vivo digestion in ileostomy patients, and the ileostomy contents were collected quantitatively, the polysaccharide components of which were analysed by gas--liquid chromatography and the Klason lignin by gravimetric determination. The model was used for the determination of dietary fibre in AACC (American Association of Cereal Chemists), wheat bran and for studies on the extent of hydrolysis of wheat-bran fibre in the stomach and small intestine. The effect of wheat bran on ileostomy losses of nitrogen, starch and electrolytes was also investigated. 2. Nine patients with established ileostomies were studied during two periods while on a constant low-fibre diet. In the second period 16 g AACC wheat bran/d was added to the diet. The ileostomy contents and duplicate portions of the diet were subjected to determinations of wet weight, dry weight, water content, fibre components, starch, N, sodium and potassium. 3. The wet weight of ileostomy contents increased by 94 g/24 h and dry weight by 10 g/24 h after consumption of bran. The dietary fibre of AACC bran, determined as the increase in polysaccharides and lignin of ileostomy contents after consumption of bran, was 280 g/kg fresh weight (310 g/kg dry matter). Direct analysis of polysaccharides and lignin in bran gave a value of 306 g/kg fresh weight. Of the added bran hemicellulose and cellulose 80--100% and 75--100% respectively were recovered in ileostomy contents. There was no significant difference between the two periods in amount of N, starch and K found in the ileostomy contents. The Na excretion increased during the 'bran' period and correlated well with the wet weight of ileostomy contents. 4. In conclusion, it seems probable that determination of dietary fibre by in vivo digestion in ileostomy patients comes very close to the theoretical definition of dietary fibre, as the influence of bacteria in the ileum seems small. Bacterial growth should be avoided by using a technique involving the change of ileostomy bags every 2 h and immediate deep-freezing of the ileostomy contents. True dietary fibre can be determined by direct analysis of polysaccharides and lignin in the food, at least in bran. Very little digestion of hemicellulose and cellulose from bran occurs in the stomach and small bowel. The 10--20% loss in some patients may be due to digestion by the gastric juice or to bacterial fermentation in the ileum, or both. The extra amount of faecal N after consumption of bran, reported by others, is probably produced in the large bowel.

Adult↗
PubMed1981

Hyperoxaluria in malabsorptive states.

During the last 10 years it has become apparent that hyperoxaluria often is present in malabsorptive states. This secondary hyperoxaluria could be explained by an increased uptake of dietary oxalate due to malabsorption of fatty acids and bile salts. Dietary prescriptions, including a low fat diet is advocated in the treatment of hyperoxaluria in Crohn's disease or after small bowel resection.

Aluminum Hydroxide↗
PubMed1981

Treatment of premature sutural synostosis.

Premature sutural synostoses are currently being treated at the Craniofacial Center at the Department of Plastic Surgery, University of Göteborg. A leading principle has been to release tethered parts of the skull and the facial skeleton in order to let the expanding brain mould the skeletal parts to an acceptable position. This can be achieved within the first year of life. When operating in later stages, the skeletal parts are wired in a semi-static position by a single osteosynthesis, still allowing expansion by the growing brain.

Craniofacial Dysostosis↗
PubMed1980

Labelled bile salt excretion and diarrhoea in coeliac disease.

Faecal excretion of labelled bile salts after intravenous injection of carboxyl 14C-cholic acid was normal or low in eleven patients with untreated coeliac disease without diarrhoea. Five other coeliac patients with evident diarrhoea had increased excretion of labelled bile salts, suggesting that bile salt malabsorption may contribute to diarrhoea in coeliac disease.

Adult↗
PubMed1979

Absorption studies in patients six to 10 years after construction of ileostomy reservoirs.

The absorption of fat, bile salts, and vitamin B12 was studied in 14 proctocolectomised patients six to 10 years after construction of a continent ileostomy. All patients were in excellent health and displayed no signs of malnutrition. Schilling test disclosed subnormal absorption of vitamin B12 in one patient and borderline values in five. Faecal loss of bile acid was increased in 12 patients and fat malabsorption occurred in two. Except for slightly pathological liver tests in two patients, routine laboratory tests, including plasma concentration of vitamin B12 and folic acid, were normal. There were no signs of sodium or potassium depletion.

Adult↗
PubMed1979

Faecal excretion of intravenously injected 14C-cholic acid in patients with conventional ileostomy and in patients with continent ileostomy reservoir.

Bile salt absorption, as determined by the faecal excretion in i.v. injected 14C-cholic acid (FBS) was studied in 13 ileostomy patients before and after conversion to Kock's continent ileostomy reservoir. The result was compared with that obtained in 8 ileostomy patients in whom about 50 cm of the terminal ileum has also been removed. As compared with 16 healthy controls, FBS was moderately increased in the conventional ileostomy patients, but still within normal limits. After conversion to ileostomy reservoir all patients had pathological FBS, although less severe than in the ileostomy patients with ileal resection. Bacterial contamination probably contributes more than the structural mucosal changes to the bile malabsorption in the pouch, whereas reduced mucosal surface and short small-intestinal transit time are the main causes of malabsorption in ileostomy patients in whom an appreciable amount of the terminal ileum has been resected.

Adult↗
PubMed1979

Transit time in constipated geriatric patients during treatment with a bulk laxative and bran: a comparison.

Transit time, as estimated from the passage through the gut of an isotope (131I)-containing capsule, was studied in 10 constipated, geriatric in-patients on a bulk laxative regimen and during treatment with wheat bran. The patients received a conventional bulk laxative (Vi-Siblin, 6 g twice daily) during a period of 8 weeks. The bulk laxative was then replaced by bran (10 g twice daily) during the following 8-week period. Measurements of transit time were taken after 4 and 6 weeks on each regimen. The mean transit time was 126 h for the bulk laxative regimen and 89 h for the bran treatment, the difference being statistically significant. The decrease in transit time for the bran treatment was essentially due to a faster passage through the rectosigmoid part of the bowel. Less additional laxative therapy was needed during bran treatment than during the bulk laxative treatment. The favourable properties of bran may tentatively be explained by the effects remaining in the distal part of the colon. A slight but significant lowering of the serum calcium level and a significant increase of the total iron-binding capacity of the serum were found after 7 weeks of bran administration, whereas no change was observed after 42 weeks. No significant change was demonstrated in serum iron during bran treatment.

Aged↗
PubMed1979

A study on liquid diet in geriatric patients.

The intake of energy and nutrients was studied during 16 days in nine geriatrics immobilized patients who had received a conventional liquid diet for an extended period of time. The intake of energy averaged only 870 kcal/24 h. Fat intake was very low, averaging 16 g/24 h, which corresponds to 17 per cent of the total energy intake. The mean protein intake was 33 g/24 h. To improve the energy and nutrient content a food supplementation was added to the liquid diet. During the following 16 days the intake of energy increased to a daily mean of 1380 kcal. Fat and protein intake increased to 38 and 73 g/24 h, respectively. No essential change in the volume consumed after addition of the food supplementation was observed. Urinary nitrogen excretion was analyzed during the study. A positive nitrogen balance occurred after the patients had received the food supplementation.

Aged↗
PubMed1979

Gastric bile acids before and after Roux-en-Y transposition for bile reflux gastritis and in asymptomatic controls.

Eight patients with severe postgastrectomy syndromes for predominantly bile reflux gastritis were examined by quantification of bile acids in the gastric remnant before and after a standardized liquid meal. Gastroscopy with biopsy and determination of gastric acid secretion and gastric emptying were performed. Six of the patients were also studied 3 months after Roux-en-Y transposition. Controls consisted of six completely asymptomatic partially gastrectomized patients studied 4--11 years postoperatively and six healthy students without any history of gastrointestinal disease. The healthy subjects had virtually no reflux of bile acids in the fasting state or after a meal. Both the symptomatic and asymptomatic patients had reflux in the fasting state and postprandially. The reflux of bile acids was, however, significantly greater late in the fasting period and early in the postprandial period in the symptomatic patients than in those without symptoms. The Roux-en-Y transposition eliminated the bile acid reflux and the symptoms of bile reflux gastritis but did not change the gastric emptying pattern. In patients with reflux gastritis the acid disappearance in the gastric remnant was moderate and the maximal acid output was unchanged after Roux-en-Y transposition.

Aged↗
PubMed1978

Determination of the faecal excretion of labelled bile salts after i.v. administration of 14C-cholic acid. An evaluation of the bile salt malabsorption before and after surgery in patients with Crohn's disease.

By measuring total faecal radioactivity, correlated to 24-hour enterohepatic circulation, following i.v. administration of 14C-cholic acid, bile salt malabsorption was evaluated before and/or after surgery in 80 patients with Crohn's disease localized to the ileum and/or the colon and the results related to the length of ileum diseased or resected. Before operation bile salt malabsorption was observed only in patients with inflammation of the terminal ileum, but no significant correlation was found between bile salt excretion and the extent of ileal disease. In patients subjected to ileal resection with sacrifice of the ileocaecal valve, bile salt malabsorption correlated strongly to the length of ileum resected. This correlation was about the same in ileostomy patients and in patients subjected to restorative operation. We concluded that determination of 14C in faeces is a more sensitive test than the Schilling test and the faecal fat excretion test in reflecting ileal dysfunction, at least in patients with ileal resections.

Adult↗
PubMed1978

Urinary oxalate excretion related to ileocolic surgery in patients with Crohn's disease.

Urinary oxalate excretion was studied in healthy subjects and before and after surgery in patients with Crohn's disease. Urinary oxalate excretion in relation to the length of diseased or resected ileal segment in patients subjected to restorative and colectomy procedures, as well as in relation to faecal excretion of fat and bile salts and to urinary excretion of vitamin B12 and calcium, was also studied. The studies were performed in patients on a free diet or standard hospital diet and on a high-oxalate and/or high-fat diet. When patients subjected to ileal resection in conjunction with minor colonic resection were studied on a high-oxalate diet, urinary oxalate excretion increased with length of ileum resected and correlated with faecal fat excretion and urinary excretion of vitamin B12 but not with faecal excretion of bile salts. Increasing the dietary fat intake in these patients further increased urinary oxalate excretion. Although urinary oxalate excretion increased somewhat in colectomized patients on a high-oxalate diet, indicating an increased absorption of dietary oxalate, this increase showed no correlation either to faecal fat or bile salt excretion, or to urinary excretion of vitamin B12. The result are consistent with the "solubility theory". A diet low in fat and oxalate and high in calcium is recommended in patients with hyperoxaluria.

Adult↗
PubMed1978

Bile salt malabsorption in the radiation syndrome.

The fraction of faecal activity (FBS) excreted after intravenous administration of 14C-labelled cholic acid was measured in 20 patients with gastrointestinal symptoms (diarrhoea, abdominal pains, malabsorption and rectal haemorrhage) after pelvic irradiation. An FBS excretion of 52 +/- 16 per cent (mean +/- SD) was found in 13 patients with diarrhoea and 18 +/- 12 per cent in 7 patients without diarrhoea. In normals the excretion is not above 18 per cent. Bile salt malabsorption appears to be an important factor in the pathogenesis of diarrhoea in these patients.

Adult↗
PubMed1977

Urinary oxalate on a high-oxalate diet as a clinical test of malabsorption.

100 g of spinach a day was added to the hospital diet of fifty-four patients with suspected malabsorption. Hyperoxaluria was found in thirty-eight patients; all of them had steatorrhoea. No patient with steatorrhoea had a urinary oxalate excretion of less than 40 mg a day. Ten other patients had hyperoxaluria, but the faecal fat determinations were regarded as unreliable in almost all and malabsorption could not be confirmed. It is suggested that in clinical practice determination of urinary oxalate after an oral load of oxalate could replace faecal fat determination in most patients with suspected malabsorption.

Adolescent↗