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Biomedical subjects

I Balslev

Publications and source records attributed to I Balslev.

At least 55 records · Page 3Linked to original sources
PubMed1986

Radical surgical approach to radiation injury of the small bowel.

During a period of 12 years, 52 patients without tumor recurrence were treated for chronic radiation injury to the small bowel. Eighteen patients also had concomitant large bowel injuries. Forty-seven patients were treated surgically, 42 of whom presented with obstruction, necrosis, or perforation of the bowel and had emergency operations. Thirty-eight patients underwent wide resection of the injured bowel, and six had bypass procedures. Anastomotic leakage occurred in 6 percent of the patients. The operative morbidity rate was 34 percent, and the mortality rate, 9 percent. Based on this experience, when surgery for small intestinal radiation injury is mandatory, the procedure should be a generous small bowel resection whenever possible, and probably should be performed only by experienced surgeons.

Abdominal Neoplasms↗
PubMed1986

Liver-cell adenoma. Case report.

A young woman taking oral contraceptives presented with acute, severe abdominal pain. A liver-cell adenoma (weight 1.6 kg), with intrahepatic bleeding and necrosis, was enucleated at elective laparotomy. The clinical presentation of liver-cell adenoma, ranging from incidental finding to sudden death, is reviewed and the evidence linking oral contraceptives to the tumour is discussed. Reported cases of symptomatic liver-cell adenoma have numerically declined in the past decade. Acute surgical treatment is indicated only to control bleeding. In addition to withdrawal of oral contraceptive medication, enucleation of the tumour or hepatic resection is generally recommended as elective, definitive treatment.

Adult↗
PubMed1986

Surgical treatment of radiation injury to the rectosigmoid.

Radiation-induced injury to the rectosigmoid, the estimated incidence of which was 5.5%, was studied in 92 patients. The condition was surgically treated in 75 cases. Colostomy alone was undertaken in 40 patients, 37 of whom were greatly improved with no need for further surgery, while two had progression of rectal radiation damage and one died. Excisional surgery was performed in 35 cases--Hartmann procedure in 25 and resection with primary anastomosis in 10 cases. Five of these 35 patients died of operative complications. Of the total 16 colonic anastomoses, four leaked. Our impression is that a differentiated policy of proximal colostomy and intestinal resection is safe and effective, although a significant number of the patients will have a permanent colostomy.

Adult↗
PubMed1986

Major or local surgery for cure in early rectal and sigmoid carcinoma--a prospective evaluation.

The results of different types of treatment for early cancer in 158 out of 1,300 patients with rectal and sigmoid cancer were evaluated in a prospective study from 1979 to 1984. Radical surgery was performed in 121 patients (mean age 66 years) with cancer Dukes' A (median diameter 3 cm), while 37 patients (mean age 71) with smaller cancers (median 2 cm) had polypectomy or local excision. Post-operative complications were significantly more frequent in the first group. No patients in any of the two groups with carcinoma in pedunculated adenomas or within the upper half of the submucosa or above 9 cm from the anal verge had recurrent cancer. CEA-measurements had no prognostic value. No difference was found in crude or cancer-related death between the two groups. The overall results support the use of local treatment in elderly patients with complicating disease, having small cancers, not penetrating the tunica muscularis externa of the rectosigmoid wall.

Adenoma↗
PubMed1985

Parietal cell vagotomy or cimetidine maintenance therapy for duodenal ulcer? A prospective controlled trial.

In a prospective controlled trial 86 duodenal ulcer patients with symptoms severe enough to indicate surgery were randomized to a full-dose cimetidine course followed by maintenance therapy for 1 year or parietal cell vagotomy (PCV). The average follow-up period was 57 months. In the group assigned to medical therapy 62% of the patients were free of symptoms during maintenance therapy, and 12% remained well during the follow-up period. Operation was later performed in 35%, whereas 53% had symptomatic recurrence demanding medical treatment regularly. After PCV no patient died, and there were no serious sequelae. The overall recurrence rate was 17%; after treatment of failures 9% continued to have dyspepsia. Since nearly 3/4 of the patients were free of symptoms after PCV, operation seems to be the method of choice in patients with a severe history and fast recurrence after medical therapy. However, the aged and those at high risk of surgery may benefit from cimetidine maintenance therapy.

Adult↗
PubMed1984

Impairment of vitamin D metabolism and bone mineral content after intestinal bypass for obesity. A longitudinal study.

Ten obese subjects who had undergone intestinal bypass operation (end-to-side jejunoileostomy) were studied longitudinally with respect to vitamin D and other indices of calcium metabolism. Investigations were carried out before operation (t0) and after 6 months (t1), 12 months (t2), and a mean of 54 months (range, 49-58 months) (t3) postoperatively. Serum 25-hydroxyvitamin D (25OHD) was subnormal at t0 but after operation values declined gradually to an extremely low level at t3, possibly because of a loss through malabsorption. Serum 24,25-dihydroxyvitamin D remained normal at t1 and t2 but fell to about half the normal level at t3, probably owing to lack of its precursor, 25OHD. In contrast, serum 1,25-dihydroxyvitamin D (1,25(OH)2D) remained normal throughout the study, indicating a marked stimulation of kidney 1 alpha-hydroxylase activity. Serum calcium fell rapidly to a constant subnormal level, and it is concluded that the serum calcium malabsorption is due to factors other than impaired 1,25(OH)2D activity. Bone mineral content (BMC) was unchanged between t0 and t2, but thereafter (between t2 and t3) the mean BMC fell rapidly to about 90% of preoperative value, possibly due to a defective bone mineralization in the late postoperative period. The findings indicate a high risk of bone disease developing after intestinal bypass operation. Substitution with calcium and vitamin D should be given to these patients, but the optimal vitamin D metabolite (or combination of metabolites) for such treatment is still unknown.

24,25-Dihydroxyvitamin D 3↗
PubMed1983

Diverticula of the vermiform appendix. Alternatives of clinical presentation and significance.

The vermiform appendix can be the site of development of diverticula which may suffer either inflammatory complications with or without appendicitis or may only be an incidental finding in an uninflamed appendix. This is a retrospective study of 10 of 575 cases of consecutive appendices removed and examined within a year, with single or multiple appendiceal diverticula with diverticulitis and peridiverticulitis. In six of the 10, the lumen of the appendix did not show any inflammatory changes. In conclusion, one could assume that inflammatory complications of the appendiceal diverticula, although they may mimic acute appendicitis, are quite distinct clinical entities. Acute appendicitis in the presence of appendiceal diverticula may carry an earlier and higher rate of perforation and appendiceal diverticula, as an incidental finding, may justify appendectomy on occasion.

Adolescent↗
PubMed1983

Sexual dysfunction following operation for carcinoma of the rectum.

In a retrospective study, sexual and urologic dysfunction were evaluated after a personal interview with 110 patients operated upon for carcinoma of the rectum with a long observation period. Following abdominoperineal resection in 93 patients, sexual dysfunction was found in 32 per cent, and 18 per cent were totally impotent. In 17 patients who had low anterior resections, none became totally impotent, but six patients had reduced potency or no ejaculation. No relation was found between age, tumor classification, size and localization, or perineal wound infection and postoperative sexual dysfunction. Potency was usually regained within two years. One-third of the patients had experienced urologic symptoms following abdominoperineal resection. Sixteen per cent had minor symptoms at follow-up. Patients were not evaluated by cystometry. No correlation was found between postoperative sexual dysfunction and urologic problems.

Aged↗
PubMed1983

Vitamin D and bone mineral content after intestinal bypass operation for obesity.

Twenty-three obese subjects who had undergone intestinal bypass operation (end-to-side jejunostomy) were studied with respect to vitamin D and other indices of calcium metabolism. Group 1 (11 patients) was examined before and one year after operation. Group 2 (12 patients, bypass operated two to seven years earlier was investigated twice with an interval of one year. The two groups were comparable. Bone mineral content and alkaline phosphatases were unchanged during the study in both groups. Bone phosphorus/hydroxyproline ratio was high postoperatively indicating a high degree of bone mineralisation. Serum calcium declined rapidly in group 1 to a constant level, which was maintained in group 2. The serum levels of iPTH and 1,25(OH)2D did not change within each group, but combining the two groups demonstrated an increase/decrease in iPTH/1,25(OH)2D over the years. The findings suggest that factors other than 1,25(OH)2D and iPTH are involved in calcium metabolism in such patients. The findings do not justify routine administration to such patients of high potency vitamin D derivatives, f.ex. 1 alpha-OH-D3.

25-Hydroxyvitamin D 2↗
PubMed1982

Postoperative radiotherapy in rectosigmoid cancer Dukes' B and C: interim report from a randomized multicentre study.

The design, and complications seen during the first 2 years, of a randomized trial of postoperative radiotherapy for rectosigmoid cancer Dukes' B and C are presented and discussed. It is concluded that the present complication rate-below 10% in 221 patients-permits continuation of the intake, which is planned to include 550 patients, to demonstrate a possible increase in crude 5-year survival by 15% (60-75% in Dukes' B and 25-40% in Dukes' C), on the basis of a 0·01 significance level and a probability that the experiment will be successful of 0·90.

Clinical Trials as Topic↗
PubMed1981

Bone mineral content before and after intestinal bypass operation in obese patients.

With the aim of investigating bone mineral loss after intestinal bypass operation, bone mineral content (BMC) was measured by two-dimensional scanning photon absorptiometry on the distal part of the forearm in 23 consecutive patients who had undergone intestinal bypass operation for obesity. Eleven patients (group 1) were investigated before and 12 months after operation, and 12 (group 2), who had been operated on 2-7 years earlier, were investigated two times at an interval of 12 months. No patient received therapeutic calcium or vitamin D supply. The predominant biochemical findings postoperatively were decreased serum values of calcium, magnesium, albumin, and total protein; there was no change in inorganic phosphate or alkaline phosphatase. Mean BMC was normal in both groups postoperatively as well as in group 1 before operation; there was no significant change in mean BMC during 12 months of observation. However, in BMC measurements on extremely obese subjects, a correction for the excessive fat layer on the forearm was necessary because of different attenuation properties of fat and soft tissues. Neglect of this problem will give a systematic underestimation of BMC, and may lead to false conclusions in cross-sectional as well as longitudinal studies.

Adult↗