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Biomedical subjects

J G Stage

Publications and source records attributed to J G Stage.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Extracorporeal shockwave crushing of gallstones. Preliminary report].

Extracorporeal shock wave lithotripsy (ESWL) was used for treatment of symptomatic x-ray negative stones in 23 patients. The number of ESWL sessions per patient was 1.8 (range 1-4). In 18 patients (78%), adequate fragmentation was seen comparable to results obtained elsewhere. Oral bile acid therapy was used after ESWL in the 18 patients mentioned and the mean follow-up period was five months (range 3-8 months). Four patients had by now passed all stones while 12 patients still had remaining stone fragments and one patient a gallstone. After ESWL, one patient was and one patient a gallstone. After ESWL, one patient was referred for cholecystectomy at his own request. Of the remaining five patients, cholecystectomy was performed in two and was scheduled for in three. Complications after ESWL were seen in two patients who developed acute pancreatitis. Thus, our preliminary experience shows that ESWL resulted in fragmentation and passing of gallbladder stones, but not without complications. Like the gallstone groups in Lyon, Montreal and Munich we are convinced that ESWL should be performed in accordance with prospectively designed protocols in order to establish optimal planning of indications and strategies for future treatment.

Adult↗
PubMed1991

[Percutaneous cholecystostomy and laser lithotripsy].

A case of acute cholecystitis in a high risk patient was treated in the acute phase with cholecystostomy guided by ultrasound and with introduction of a pig-tail catheter for drainage. Later, percutaneous laser lithotripsy was undertaken via a flexible choledochoscope. The recent percutaneous therapeutic principles and the possibilities in biliary calculous disease are reviewed.

Acute Disease↗
PubMed1990

Skeletal muscle enzyme activities and metabolic substrates during exercise in patients with postoperative fatigue.

Subjective fatigue was quantified before and 20 days after uncomplicated elective abdominal surgery in 12 patients and compared with changes in heart rate, enzyme activities and skeletal muscle substrates before and after bicycle exercise for 10 min at 65 per cent of patients' preoperative maximum work capacity. Fatigue increased from a mean(s.e.m.) preoperative level of 2.5(0.5) arbitrary units to 4.6(0.5) on postoperative day 20 (P less than 0.01). Body-weight, triceps skinfold thickness and arm circumference decreased postoperatively (P less than 0.02). Postoperative values of muscle enzyme activities indicative of oxidative phosphorylation capacity (citrate synthase and 3-OH-acyl coenzyme A dehydrogenase) were lower than preoperative values (P less than 0.05). Lactate dehydrogenase was unaltered and resting values of muscle glycogen and adenosine triphosphate were higher after operation (P less than 0.05). In response to exercise, heart rate, muscle glucose, glucose-6-phosphate and lactate increased (P less than 0.05), while muscle glycogen and creatine phosphate decreased (P less than 0.05). Increase in postoperative fatigue correlated with the increase in heart rate (P less than 0.05), while no significant correlations were found between fatigue and muscle parameters. Our results suggest that lack of exercise and malnutrition may be of importance in the decrease in work capacity and in fatigue after operation.

Abdomen↗
PubMed1989

LHRH analogue as a depot preparation (Zoladex) in the treatment of advanced carcinoma of the prostate followed by orchiectomy as a second line therapy--a phase II study.

An LHRH agonist, Zoladex, was employed as a monthly depot in 56 previously untreated patients with advanced carcinoma of the prostate. Of 53 evaluable patients, 27 achieved partial remission and 7 were stable. Median duration of response was 10 months. A favorable subjective response was attained in 68% of the patients. During treatment, serum testosterone was in the castrate range in all patients except five. Possible explanations for this escape phenomenon are discussed. No toxicity was observed and treatment was well tolerated in all patients. Thirty-two patients underwent bilateral orchiectomy following treatment failure of Zoladex. In one patient partial remission according to protocol criteria was recorded. Treatment with LHRH agonists seems safe and may serve as an alternative to conventional hormonal treatment of advanced carcinoma of the prostate.

Aged↗
PubMed1989

Fatigue and cardiac and endocrine metabolic response to exercise after abdominal surgery.

Subjective feeling of fatigue was quantified before and 20 days after elective uncomplicated abdominal surgery in 16 otherwise-healthy patients and compared with changes in heart rate and various hormonal and substrate responses to a 10-minute bicycle exercise (65% of preoperative maximal work capacity) preoperatively and postoperatively. Postoperatively, fatigue increased (p less than 0.001) from 3.0 +/- 0.5 to 5.3 +/- 0.5 arbitrary units (mean +/- SEM). Heart rate, plasma catecholamines, and serum growth hormone, lactate, alanine, and glycerol values always increased, whereas serum insulin values decreased in response to exercise (p less than 0.01). During exercise, only heart rate (p less than 0.01) and lactate (p less than 0.05) values were higher postoperatively compared with preoperatively. Increase in fatigue postoperatively correlated significantly to increase in heart rate (p less than 0.01) and correlated positively, but not significantly, to increase in plasma levels of noradrenaline (p = 0.08), growth hormone (p = 0.09), and alanine (p = 0.08) during exercise, but not to increase in serum lactate values (p greater than 0.8). Thus, after uncomplicated surgery, there was increased fatigue and amplified metabolic and cardiovascular response to a given absolute work load. These findings are similar to those observed during detraining and suggest a therapeutic role of exercise in the treatment of postoperative fatigue.

Abdomen↗
PubMed1987

Gastrin and partial gastrectomy in duodenal ulcer patients 25 years postoperatively.

Serum gastrin concentrations were measured in 26 patients (Group A) who underwent partial gastrectomy for duodenal ulcer disease at least 25 years previously. The basal serum gastrin level was 31.6 +/- 1.5 pg/ml, increasing significantly after food stimulation to 36.8 +/- 2.4 pg/ml (p less than 0.05). In 16 of these patients (Group B), endoscopic biopsy specimens were taken from the minor and major curvatures of the stomach, from the jejunal part of the gastrojejunostomy, and from the duodenum. Mucosal gastrin concentrations measured were 0, 20.4 +/- 3 ng/g, and 30 +/- 7.1 ng/g, respectively. Ten of these patients (Group C) had a repeated gastroscopy with food stimulation of the duodenal pouch, using a balloon catheter in the lower duodenum. Serum gastrin concentrations after pouch stimulation did not differ significantly compared with basal values. No changes in the mucosal gastrin concentrations during pouch stimulation were seen. In conclusion, since no gastrin could be detected in the gastric mucosa and the mucosal gastrin concentration in the duodenum was 50 times lower than reported in other studies, the gastrin release measured after food stimulation could have been of extragastric or extraduodenal origin.

Aged↗
PubMed1986

Effects of cimetidine on jejunostomy effluents in patients with severe short-bowel syndrome.

The effect of the H2-receptor blocking agent cimetidine on jejunal effluent was examined in eight short-bowel patients with high-output jejunostomies. Stool mass and faecal excretion of sodium and potassium were significantly reduced by intravenous injection of 400 mg cimetidine four times a day. The amount of calcium, magnesium, phosphate, zinc, and fat in jejunostomy effluent did not change significantly. Cimetidine may be considered an antidiarrhoeal drug in extensively small-bowel-resected patients with a jejunostomy and may reduce the need for parenteral saline supply in these patients.

Adult↗
PubMed1985

Frequency of endocrine disorders in patients with the Zollinger-Ellison syndrome.

To evaluate the frequency of associated endocrine disorders, 26 patients with the Zollinger-Ellison syndrome were restudied in a uniform screening programme. The examinations were directed primarily against disorders in the pituitary, parathyroid, thyroid, adrenal cortex, and endocrine pancreas. Fourteen endocrine disorders were found in 10 patients (38%). Ten of these were newly diagnosed. Five patients had hyperparathyroidism, and in two of these a pituitary adenoma was also suspected. Two had pituitary adenomas, one was suspected of having a pituitary adenoma and one of having adrenocortical hypofunction, and one showed multiple hormone production with hypoglycaemia and flushing. It is concluded that most cases of associated endocrinopathies are not diagnosed until specifically looked for. In the Danish population of patients with the Zollinger-Ellison syndrome the prevalence is about 38%.

Adrenal Cortex Diseases↗
PubMed1982

Prolonged secretory inhibition during cimetidine treatment in Zollinger-Ellison patients.

In 23 Zollinger-Ellison patients who had been treated continuously with cimetidine for more than 3 months repeated measurements of basal acid output (BAO) were carried out 10-12 h after the last drug dose, to evaluate the prolonged inhibition of gastric acid during continuous cimetidine treatment. Most patients had a markedly prolonged inhibition of BAO after a few weeks of treatment compared with the BAO before cimetidine treatment. The prolonged inhibition became significant after 6 to 12 months of treatment (p less than 0.05). In some patients the prolonged inhibition was transient. In seven patients cimetidine therapy was discontinued for 3 days. Measurement of BAO after 12, 36, and 60 h of withdrawal revealed a marked inhibition lasting more than 60 h in four patients. Determination of plasma cimetidine could not demonstrate any detectable amounts after 12 h of withdrawal. The prolonged inhibition of BAO observed during continuous cimetidine treatment is of significant importance for evaluating secretory data. The phenomenon is still unexplained.

Adult↗
PubMed1980

Intraperitoneal pressure: ascitic fluid and splanchnic vascular pressures, and their role in prevention and formation of ascites.

Seventeen patients with ascites due to cirrhosis underwent hepatic venous catheterization and pressure measurement in the ascitic fluid. Intraperitoneal fluid hydrostatic pressure (IFP) ranged 3.5-22, mean 11.2 mm Hg, and correlated closely to the pressure in the inferior vena cava (r = 0.97, P < 0.001), which was on average 1.8 mmHg above that of ascitic fluid (P < 0.005). Wedged hepatic venous pressure (WHVP) (range 19-43, mean 32 mmHg) correlated directly to IFP (0.89, P < 0.001) and was significantly higher than that of ten cirrhotic patients without ascites (range 12-27, mean 20 mmHg, P < 0.005). After diuretic therapy WHVP decreased to an average of 20 mmHg. Mean plasma colloid osmotic pressures were 20 mmHg (range 18-24 mmHg)( and 23 mmHg (range 19-29 mmHg) in patients with and without ascites, the values being significantly different (P < 0.05). Colloid osmotic pressure of ascitic fluid ranged 1-14, mean 4.9 mmHg. Mean ratio between albumin concentration in ascitic fluid and plasma was 0.31 (range 0.12-0.77). In five pigs portal venous pressure (PVP) increased during infusion of fluid into the peritoneal cavity. The increase in PVP was smaller than that of IFP (P < 0.02), indicating that ascitic fluid stems the pressures in the splanchnic venous vascular bed up to a higher level, but that the transmural hydrostatic pressure difference decreases simultaneously. The results are discussed in relation to the local 'oedema-preventing' mechanisms: (a) increased interstitial hydrostatic fluid pressure, (b) decreased interstitial fluid colloid osmotic pressure, (c) increased lymph flow, and it is concluded that the peritoneal space can be considered as a special part of the interstitium in which IFP is considered to play an important role in regulation of ascitic fluid.

Adult↗
PubMed1979

Delay in the diagnosis of insulinomas.

The median diagnostic delay in 32 patients with verified insulinomas was 2 3/4 years (range 1/4--18). The median delay in the 1939--1958 period was shorter (2 years, n = 17) than in the 1959--1978 period (3 years, n = 15). Thus, modern developments with insulin estimations were without noticeable effect upon the diagnostic delay. The findings can probably only be explained by a poor awareness of the insulinoma syndrome in the medical profession.

Adenoma, Islet Cell↗
PubMed1979

Angiography in the diagnosis of carcinoid syndrome.

The diagnosis of carcinoid syndrome has been confirmed by selective abdominal angiography in a consecutive series of 18 patients. In eight patients the primary carcinoid tumour was removed before angiography. The primary lesion was demonstrated in eight of ten cases. Metastases from the carcinoid tumours was present in all 18 patients. All cases of mesenteric metastases and 12 of 14 cases with liver metastases were visualized by angiography. All but one of the liver metastases were highly vascularized and therefore easy to recognize, making angiography a good monitor in the control of medical therapy or in planning of surgical intervention.

Abdominal Neoplasms↗
PubMed1979

CT scanning in patients with Zollinger-Ellison syndrome and carcinoid syndrome.

Computed tomography of the upper abdomen was performed in 11 patients with Z--E syndrome and 6 patients with carcinoid syndrome. The liver, pancreas, spleen and upper part of the retroperitoneal space were examined to localize a primary tumour and/or metastases. The CT findings were correlated to the final diagnoses obtained by operation or by other diagnostic procedures. The correlation between CT and the clinical findings was acceptable, and we are of the opinion that with further experience this new noninvasive radiological technique might be a helpful tool in the preoperative evaluation in these diseases. Furthermore, CT is an easy method in the control of a tumour or metastases during treatment.

Adult↗