Biomedical subjects
Publications and source records attributed to H Ostensen.
Accessory ossicles in the elbow are often diagnosed as osteochondritis dissecans or chondromatosis, but no terminologic agreements seem to exist in the literature. Our study of 5 patients suggests that accessory ossicles in the fossa olecrani or coronoidea may represent anatomic variants, perhaps best described as os supratrochleare anterius and posterius, respectively.
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From January 1974 to October 1983, 5072 gastroscopies were performed in 3351 patients with a total of 14,554 biopsy specimens taken from 2565 lesions in the stomach. The endoscopic diagnoses and their histologic counterparts were recorded and the diagnostic yield of specimens from each type of lesion analyzed. Gastric adenocarcinoma was finally diagnosed in 139 patients. The diagnosis was delayed, from 1 to 4 months, in five patients because of false-negative diagnoses. These patients all had ulcerating cancers. Moreover, early gastric cancer was mainly of the ulcerating type. Accordingly, an ulcer lesion is the most important one to biopsy. Only four cancers were found in 959 benign-appearing gastritic lesions. Twenty-one patients with negative biopsy results at the first endoscopy were later shown to have cancer. When these biopsy specimens were re-examined, malignant lymphoma was found in one and adenocarcinoma in three cases. In spite of false-negative endoscopic findings, nonrepresentative biopsy material and false-negative histologic reports, the combination of biopsy results and clinical judgement led to correct and timely treatment in nearly all patients.
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Intravenous urography (IU) was performed in 489 patients aged 0-9 years during 1980-1983. A total of 35 (7.2%), 19 (13.1%) boys and 16 (4.7%) girls had pathological changes at IU. Of these, 11 boys and 5 girls had findings with therapeutic consequences. We have analysed the results of IU and voiding cystoureterography (VC) in 62 patients and show that a normal IU does not exclude vesicoureteral reflux into the renal pelvis. By performing only VC hydronephrosis, pyelonephritic scarring and anomalies may be missed.
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In the period between 1980 and 1983 smoking habits, alcohol consumption, coffee drinking, and familial occurrences of peptic ulcers were studied in patients with gastric or duodenal ulcer in North Norway. The results were compared with those in two control groups matched for sex and age but without anamnestically known previous peptic ulcer disease. Statistically significant increased familial occurrences of peptic ulcer were found in relatives of patients both with gastric and with duodenal ulcer, compared with the control group. Furthermore, significantly more smokers were found in the two groups of patients than in the control groups. Patients with duodenal ulcers smoked more than those with gastric ulcer. Both the consumption of coffee and that of alcohol, however, were significantly reduced in the ulcer patients compared with their controls. Therefore, both familial factors and smoking habits appear to have some relationship or even play etiologic roles in the development of peptic ulcer disease, at least in the northern part of Norway. Coffee drinking and intake of alcohol seem to be of no importance. Both tobacco smoking and familial accumulation of peptic ulcers increased the relative risks of getting both gastric and duodenal ulcer as compared with 'non-exposed' persons. Furthermore, a positive correlation was found in men between the quantity of smoking and the risk of developing duodenal ulcer.
The possible seasonal periodicity of the occurrence of X-ray-negative dyspepsia (RND), first-time-diagnosed gastric ulcer (GU), and first-time-diagnosed duodenal ulcer (DU) was studied in a 3-year period from 1980 to 1983. Of the 1936 patients studied, 1749 had RND, 100 had GU, and 87 had DU. One or more of the three types of dyspeptic disease were more frequently seen in the period from September through January and less frequently in the period from April through August. In conclusion, the present study suggests true seasonal periodicity in the occurrence of peptic ulcer disease, at least in a population living in the northern part of Norway.
From a prospective epidemiological and radiological study of peptic ulcer disease in the northern part of Norway, relations between occupation and the occurrence of new peptic ulcers are presented. Over a 3-year period 1861 patients with dyspeptic complaints, 557 women and 1304 men belonging to 12 different occupational groups, were studied. Special attention was paid to the fishing population, constituting 2488 men and only 55 women. In the period studied 87 gastric ulcers and 118 duodenal ulcers were found. A statistically significantly higher incidence of both gastric and duodenal ulcers was found in fishermen than in the other groups. Furthermore, significantly higher incidences of duodenal ulcers were found in men occupied in 'land or water transport'. Compared with the total male population at risk in the area studied, significantly higher incidences were found for duodenal ulcer in fishermen. The present study confirms prior reports both from Scotland and from North Norway, showing an increased incidence of peptic ulcers in the fishing population.
From a prospective epidemiological study of peptic ulcer disease in the northern part of Norway, incidence rates for gastric and duodenal ulcer are presented. Over a 3-year period 4234 patients were examined radiologically or endoscopically. The population at risk was 72,537 persons, 16 to 93 years old. The yearly incidence rate for gastric ulcer in women was 0.9 per 1000 and for men 1.4 per 1000. For duodenal ulcer the incidence rates were 0.8 and 1.5 per 1000, respectively. The ratio of gastric ulcer to duodenal ulcer is still 1 to 1.1 for both sexes, 1 to 0.9 in women, and 1 to 1.14 in men in the northern part of Norway. Furthermore, the present study indicates a statistically significant positive correlation between increasing age and the occurrence of peptic ulcers for both sexes.
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The clinical importance of the radiological diagnosis gastric cascade has been discussed for many years. In the present study, a group of patients with gastric cascades as their only radiologic gastric finding was compared with a group of patients without any pathological radiologic findings in their stomach. No statistically significant difference was found with regard to abdominal symptoms between the two groups. Furthermore, it was shown that even a slight bending of the body is sufficient to eliminate totally a gastric cascade.
Secretin infusion in man causes an increase in renal blood flow. The aim of the present study was to assess further the cardiovascular effects of the hormone. Secretin was infused at a rate of 2 CU/kg X h to patients with angina pectoris and normal left ventricular function. Cardiac output increased by an average of 20%, the stroke volume increased and the total systemic resistance decreased. Systemic arterial pressure, heart rate and pulmonary capillary wedge pressure were unaltered. The results are compatible with a combined inotropic and vasodilating effect of the hormone. It is concluded that secretin may have potential merits in the treatment of acute left ventricular failure.
The unique pattern of peptic ulcer disease in arctic areas has long been of interest. Results from a retrospective study on the occurrences of gastric and duodenal ulcer for the period between 1962 and 1964 in the northern part of Norway are presented. These results are compared with preliminary data from an ongoing investigation of peptic ulcer in the radiological department at the University Hospital of Tromsø and with those presented by others from the same area in the 1940s. It is shown that the relation between gastric ulcer and duodenal ulcer has changed markedly both for women and men. However, there is still a higher incidence rate of gastric ulcer than of duodenal ulcer in women, whereas the ratio of gastric to duodenal ulcer in men is 1:1. These results contrast sharply with those reported elsewhere in Europe and in the United States.
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In a retrospective study on diagnostic imaging of the stomach and large bowel, we evaluated the examination routines in six Norwegian hospitals for the period between 1975 and 1992. For both organ systems, a shift in routines from radiological examination toward endoscopy was observed. For the stomach there was a significant correlation between an increase in the use of endoscopy and a decrease in the use of X-ray examinations. Additionally, the total number of stomach examinations had declined. For the large bowel, the total number of endoscopic and radiological examinations had increased for all hospitals studied. While not as prominent as for the stomach, an obvious shift from X-ray examinations toward endoscopy was observed. These results should be considered when planning new imaging departments and hospitals in Norway.