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Biomedical subjects

H Jiborn

Publications and source records attributed to H Jiborn.

At least 37 records · Page 2Linked to original sources
PubMed1988

Volvulus of the cecum. Report of 26 cases and review of the literature.

The management of cecal volvulus is controversial. From 1971 to 1986, 26 patients with cecal volvulus were treated at Malmö General Hospital. Treatment and patient follow-up are presented, together with a review of 350 patients reported in the literature during the past 15 years. Anatomic background and types of volvulus are described. Simple detorsion is an alternative in high-risk patients without gangrene, but resection is the method of choice also when there is no gangrene present.

Cecal Diseases↗
PubMed1988

Influence of long-term relative bowel rest on the healing of a left colon anastomosis.

The influence of long-term relative bowel rest, using a low residue diet, on healing of a left colon anastomosis was experimentally studied. Retarded and diminished gain of postoperative anastomotic collagen and strength was found. The healing of the anastomosis was uncomplicated, however, and it is concluded that anastomotic integrity after surgery in this condition is safe.

Albumins↗
PubMed1988

Impact of long-term relative bowel rest on conditions for colonic surgery.

Collagen content, bursting wall tension, and suture-holding capacity in the proximal and distal colon of the rat were studied after long-term treatment with a low-residue or a standard laboratory chow diet. Collagen content decreased uniformly in both the proximal and distal colon of the low-residue diet group. In addition, the bursting wall tension of the nonoperated proximal colon was reduced, whereas the breaking strength of a newly constructed anastomosis at three different colonic sites was unaffected.

Animals↗
PubMed1988

Left colon anastomotic healing following colostomy closure. An experimental study on rats.

The impact of colostomy closure on the healing of a left colonic anastomosis performed 4 weeks earlier was studied in rats. Colostomy closure could be safely accomplished but in 3 of 25 rats was followed by faecal obstruction due to narrowing of the primary left colonic anastomosis. After colostomy closure the gain in anastomotic strength was slow and did not exceed the outset value until after 3 weeks. After colostomy closure, accumulation of collagen in the anastomotic region increased earlier than anastomotic strength, indicating delay in collagen maturation.

Anastomosis, Surgical↗
PubMed1988

Healing of anastomoses after obstruction of small intestine.

Anastomotic healing after obstruction of the small intestine was investigated by measurements of development of strength, content of collagen and synthesis of collagen in standardized specimens taken at biopsy of the intestinal wall on both sides of the anastomosis. One hundred and sixteen male Wistar rats were used. Forty-eight rats were used for studies of synthesis of collagen by in vivo labeling with 100 microcuries of tritiated L-proline. Anastomoses performed after two days of obstruction in the ileum had a higher rate of complications than operations performed upon control rats (p less than 0.05). Obstruction of the small intestine resulted in increased content of collagen of the ileal wall as a consequence of increased synthesis of collagen, but this resulted in neither increased capacity to hold suture nor in any differences in development of strength between rats operated upon for obstruction of the small intestine and control rats. Increased turnover of collagen was noted in the vicinity of the anastomoses after obstruction, which might be related to the increased rate of complications found. Rats with complications accumulated more collagen in the intestinal wall after one week compared with rats with obstruction and uncomplicated healing. These rats had persistent obstruction or formation of granuloma, or both.

Anastomosis, Surgical↗
PubMed1987

Collagen metabolism in small intestinal anastomosis.

Collagen metabolism in the small intestinal wall during the first week of anastomotic healing in operated and nonoperated rats was studied. During this period, marked changes in anastomotic strength have been observed. A general and marked increase of collagen synthesis was found throughout the intestine already on the second day. This resulted in increased collagen content. Collagen concentration remained relatively unchanged despite an increase in collagen content as a result of concomitant increase of noncollagenous substances. The previously reported loss of anastomotic strength in the early phase of healing could not be explained by changes in collagen content or metabolism in this study. Cutting of sutures seems to be due to a local process. After 4 days, collagen content increased predominantly in the anastomotic region. It correlated well to the previously observed increase of anastomotic strength.

Animals↗
PubMed1987

Does an intracervical infection influence the fibrinolytic activity and the collagen content of the fetal membranes? A study of ascending infections in pregnant ewes.

Apart from solely mechanical explanations, premature rupture of the membranes (PROM) has been suggested to be caused by an ascending infection. In order to investigate the role of infection in the mechanism of PROM, pregnant ewes were experimentally inoculated endocervically with either Bacteroides fragilis, Streptococcus intermedius or group B streptococci. These microorganisms were previously reported to be implicated in PROM in humans. The present investigation concerns the possible effect of an experimentally induced ascending infection on the collagen content and fibrinolytic activity (FA) of the fetal membranes. No relationship was observed between an ascending infection during pregnancy and the collagen content content of the fetal membrane specimens. It was concluded that changes in the collagen content bear no etiological significance in the mechanism of premature membrane rupture irrespective of an ascending infection's being present or not. Concerning FA in only one case, experiencing a Strept. intermedius amnionitis, was an elevated FA value observed. This finding indicates that the involvement of FA in the process of membrane rupture following ascending infection during pregnancy cannot be ruled out.

Animals↗
PubMed1987

Is the collagen content reduced when the fetal membranes rupture? A clinical study of term and prematurely ruptured membranes.

In 15 patients experiencing premature rupture of the fetal membranes (PROM) and in 15 control subjects having delivered spontaneously at term, the collagen content of the membranes was determined by the hydroxyproline method. From each patient two membrane specimens were obtained, one from the rupture margin and another from the membranes in close relation to the placental margin. No significant difference in the collagen content was demonstrated between the two groups of patients. Moreover, no significant difference was observed comparing the collagen content within the paired membrane specimens of each patient in each group. Neither was there any obvious change in the membrane collagen content in relation to clinical signs of chorioamnionitis or microbiological findings. It is concluded that changes in the collagen content of the fetal membranes bear no significance as to the etiology of PROM, neither is such a change involved in the mechanism of membrane rupture at term.

Adolescent↗
PubMed1987

Influence of standard heparin or low molecular weight heparin on healing of abdominal wounds and colonic anastomoses in rats.

The influence of standard heparin or low molecular weight (LMW) heparin on healing of abdominal wounds and colonic anastomoses was studied in rats. Subcutaneous injection of 1 XaI U/g b.w. of standard or LMW-heparin or 0.5 ml physiologic saline was given 12 hours preoperatively and daily for 3 or 7 days postoperatively. Breaking strength of the abdominal wound and the anastomosis was measured, as were haemoglobin and albumin in serum. Hydroxyproline as a measure of collagen and tissue dry weight was determined in standardized segments of colonic wall adjacent to the anastomosis. Except for significant increase in breaking strength of the anastomosis after 7-day injection of LMW heparin, no differences in the parameters of wound healing were found after 3 or 7 days. In rats receiving standard heparin there was increased bleeding tendency (reduced haemoglobin) compared with the LMW-heparin group and the controls. The administered heparin thus did not negatively influence healing, and standard and LMW-heparin did not differ in this respect.

Abdomen↗
PubMed1986

Influence of selective mesenteric arteriography on the outcome of emergency surgery for massive, lower gastrointestinal hemorrhage. A 15-year experience.

From 1970 to 1984, 64 patients with massive hemorrhage of lower gastrointestinal origin were treated at the intensive care unit, Surgical Department, Malmö General Hospital. The records of these patients have been studied retrospectively. Emergency exploration for hemostasis was performed on 31 patients, while in 33 patients hemorrhage stopped with conservative therapy. Acute selective mesenteric arteriography revealed the bleeding site in 16 of 28 patients (57 percent). The commonest bleeding sources detected by selective mesenteric arteriography were diverticular disease and angiodysplastic lesions of the colon. Fourteen patients with positive arteriography finding were operated on as emergencies, resulting in two postoperative deaths. Ten patients were operated on as emergencies without preoperative arteriography. Despite intraoperative efforts, no bleeding source was found in three of those patients. In the remaining seven patients, the diagnoses were similar to the 14 patients with positive arteriography. Five of 10 patients in this group died postoperatively. Emergency laparotomy eventually was necessary in seven of 12 patients with negative arteriography. This group had a variety of diagnoses and no postoperative mortality. Positive preoperative mesenteric arteriography findings allowed the surgeon to perform a limited resection of the bleeding bowel segment with a reduced postoperative mortality.

Adolescent↗
PubMed1986

Mechanical and biochemical alterations in the intestinal wall adjacent to an anastomosis.

Mechanical strength of the small intestinal wall 3.5 mm from an anastomosis was studied during the first week of healing and correlated to alterations in collagen content. The mechanical properties of the small intestinal wall 3.5 mm from the primary anastomosis remained constant during the first 3 days of healing. A previously observed decrease in suture-holding capacity of the small intestinal wall thus is a very local process extending less than 3.5 mm from the transection line. After 1 week of healing, the increase of suture-holding capacity correlated well with the increase in collagen content of the bowel wall.

Animals↗
PubMed1985

Changes in collagen content of the small intestinal wall after anastomosis.

Collagen content of small intestinal anastomosis in the rat was investigated in relation to previously reported changes in suture-holding capacity. The decrease in suture-holding capacity during the first 3 days previously observed, the inflammatory phase, did not correlate with collagen content during this period. However, the increase in suture-holding capacity from the third to the seventh days, the phase of fibroplasia, correlated well with an increased collagen content in the intestinal wall in both the ileum and jejunum. Anastomotic strength and collagen content correlated well after the third day. Deposition of collagen, not only in the wound but also in the intestinal wall and within the loop of the suture during the phase of fibroplasia, is the likely explanation for the rapid increase of suture-holding capacity during this period.

Animals↗
PubMed1985

Effect of diverting colostomy on collagen metabolism in the colonic wall. Studies in the rat.

The effect of total bowel rest by colostomy on collagen metabolism was studied. Fecal diversion led to a marked decrease of collagen and protein synthesis in the excluded colon. These changes were accompanied by a decrease in the amount of collagen and noncollagenous components. In the colonic part proximal to the colostomy site, a less marked decrease in collagen content was observed. It was concluded that stimulation of intraluminal bulk might be important as a regulating factor for collagen turnover. It remains to be determined if the observed changes in collagen metabolism affect colonic healing.

Animals↗
PubMed1985

Effect of diverting colostomy on breaking strength of anastomoses after resection of the left side of the colon. Studies in the rat.

In the present investigation, the effect of a proximal diverting colostomy on suture holding capacity and on anastomotic strength of the excluded left colon was studied. Suture holding capacity was increased 7 days after fecal diversion. Anastomotic strength development, however, was significantly delayed. These differences were accompanied by a diminished collagen response in the anastomotic region after fecal diversion. This might suggest impairment of healing in the excluded colon. The gross appearance of the anastomoses would, however, indicate that increased collagen formation and greater strength development in animals without colostomy is a result of more complicated healing.

Animals↗
PubMed1985

Influence of intraperitoneal Escherichia coli with septicemia on the healing of colonic anastomoses and skin wounds. An experimental study in the rat.

In rats a standardized left colonic resection was performed and colonic continuity restored by an end-to-end anastomosis in one layer. The rats were subjected to an LD50 septic challenge by intraperitoneal injection of live Escherichia coli pre- or postoperatively. Controls received saline in a corresponding manner. Groups of animals were sacrificed on the 3rd or 7th postoperative day. The breaking strengths of the anastomosis and of the skin wound were measured. The collagen content of the anastomotic segments was analyzed. There were no differences in anastomotic or skin wound strength between septic animals and controls. Collagen content was unaffected. Wound healing was not influenced by sepsis in this model.

Animals↗
PubMed1985

Comparison of healing in the left colon and ileum. Changes in collagen content and collagen synthesis in the intestinal wall after ileal and colonic anastomoses in the rat.

Collagen metabolism was compared after anastomosis in the small and large intestine of rats. Animals were sacrificed 2 and 4 days postoperatively, when three standardized biopsy specimens were taken on either side of the anastomosis. In one group of rats, anastomosis was performed in both ileum and colon and 3H L-proline was given 24 hours before sacrifice, for studies of collagen synthesis. Animal weight, specimen dry weight, collagen concentration, collagen content per standardized biopsy, specific activity of collagen and total radioactivity were measured. Weight loss was greater after colon than after ileum anastomosis, indicating that the rats were more severely affected by colon surgery than by comparable operations on the ileum. Collagen content increased earlier and more in large intestinal than in small intestinal wall. The earlier activation of collagen synthesis in colon may have been related to differences in intestinal contents (e.g. bulk or bacteria).

Animals↗
PubMed1985

Healing of ileocolic anastomoses. Breaking strength and collagen content in the intestinal wall after ileocolic resection and anastomosis in the rat.

Breaking strength, collagen concentration and collagen content of the intestinal wall were studied in rats after ileocolic anastomosis. The values were compared with findings in control rats without operation and in previous studies of ileal and colonic anastomosis. Collagen content and concentration in the ileal wall were lower on the third day of healing than previously found during ileal healing. Breaking strength decreased in the early phase to the same extent as in previous experiments, but the restoration of strength from the third day on was more rapid than previously noted in ileal anastomoses. The changes observed in the ileum following ileocolic anastomosis were more like the pattern in colon. It is suggested that intestinal content (bacteria and intraluminal bulk) influences the collagen metabolism in the intestinal wall.

Animals↗