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Biomedical subjects

J Lindhagen

Publications and source records attributed to J Lindhagen.

11 recordsLinked to original sources
PubMed1991

Influence of fibre diameter and probe geometry on the measuring depth of laser Doppler flowmetry in the gastrointestinal application.

The measuring depth of laser Doppler flowmetry (LDF) was studied in isolated segments of feline small intestine, using five probes having different fibre geometry, fibre core diameter and fibre centre separation. Recordings were made on the mucosal side at constant systemic blood pressure and venous outflow from the bowel segment. The insertion of a layer of unperfused intestine (average thickness 2.4 mm), between the probe and the perfused bowel wall, reduced the output signal from the flowmeter to an average of 42% of the initial value when a probe with large diameter fibres (700 microns) was used. No LD-signal was obtained through the unperfused tissue layer using the probes with small core diameter fibres (120 microns). Application of a mirror at the serosal surface opposite to the probe, resulted in an average increase of the output signal by 50% using the large fibre diameter probe, whereas no increase was observed with the small fibre probe. Probes based on intermediate fibre diameter and fibre centre separations, gave intermediate results in both experiments. It is concluded that the measuring depth of laser Doppler flowmetry in the gastrointestinal application is highly dependent on the fibre diameter and geometry of the probe. It is possible that, by taking into account these factors, probes may be constructed that are suitable for superficial and transmural measurements.

Animals↗
PubMed1978

Evidence for the existence of a countercurrent exchanger in the small intestine in man.

The vasculature in the human villus forms vascular loops by the supplying arterial vessel and the draining capillaries and/or veins. This study reports two experimental observations that strongly suggest that these vascular loops function as countercurrent exchangers. (1) The elimination of intraarterially injected 85Kr from the human small bowel exhibits an initial very rapid component of the type earlier reported in the feline gut. This component in all probability reflects the extravascular "shunting" in the exchanger of the injected radioactive tracer. (2) When exposing the intestinal mucosa to an isotonic electrolyte solution containing glucose, an osmolality gradient from the tip to the base of the human villi was demonstrated, the tips having an osmolality of around 700 milliosmoles per kg H2O. This hyperosmolality is created by the exchanger acting as a countercurrent multiplier.

Colon↗
PubMed1978

Sexual dysfunction following proctocolectomy.

122 patients, 66 men and 56 women, operated upon by proctocolectomy were interviewed by means of a detailed questionaire regarding any significant change in sexual function. In the majority of the patients (70% of the men and 87% of the women) the sexual relationships were considered to be unchanged or even enhanced. Impaired function was reported by 19 men (29%) and seven women (12%). Male sexual dysfunction consisted of impotence and abolition of ejaculation. True impotence occurred in five men, all above 40 years of age, corresponding to an incidence of 25%. Loss of ejaculation occurred even in young people (about 7%) but was more common in elderly patients (15%). Female dysfunction consisted of dyspareunia and/or inability to achieve orgasm. On the basis of the present results it appears unlikely that impotence is caused by the operative trauma per se. On the other hand loss of ejaculation is probably due to injury of the presacral nerves. Postoperative impotence might probably be improved by medical information and encouragement. Particular precautions during operation might reduce ejaculatory disorders. Careful handling and proper treatment of the perineal wound might prevent scarring and stricture of the posterior aspect of the vulva, a condition that appears to be a common cause of dyspareunia.

Adult↗
PubMed1977

Sympathetic nervous control of intramural blood flow in the feline and human intestines.

Intramural blood flow and flow distribution in the feline and human intestines were investigated by means of a recently developed inert gas elimination technique during electrical stimulation of the regional sympathetic nerve fibers. The results obtained in man and cat showed qualitative and quantitative similarities. Thus, observations made on man strongly suggested that the intestine exhibited an autoregulatory escape from the vasoconstrictor fiber influence in the same manner as was seen in the cat. During the steady state phase of vasoconstriction induced by nervous stimulation at 8 Hz, blood flow in the mucosa-submucosa and in the muscularis was decreased to the same extent as was total blood flow in the cat, implying that flow distribution to these two major portions of the bowel remained unaltered. In man, the vasoconstriction was somewhat more pronounced in the muscularis than in the mucosa-submucosa. Hence, in man a comparatively larger fraction of total blood flow was diverted to the mucosa-submucosa during nervous vasoconstriction.

Animals↗
PubMed1977

Regional intestinal blood flow in ulcerative colitis and Crohn's disease.

By means of a recently developed isotope washout technique, regional intestinal blood flow and its intramural distribution were determined during surgery and correlated to the morphological inflammatory and vascular features of ulcerative colitis (UC) and Crohn's disease (CD) at different stages and location. In severe colitis total blood flow was significantly increased (64 +/- 9 ml per min X 100 g; mean +/- SE; n = 13) both in UC and CD, the mucosal-submucosal blood flow amounting to 121 +/- 25 ml per min X 100 g (n = 7). The muscularis blood flow was within normal range (18 +/- 10; n = 7), however. In chronic long-standing quiescent or inactive UC, in "healed colitis," and in chronic segmental colitis (CD), colonic blood flow was normal or even reduced (13 +/- 2; n = 8), the decrease in flow comprising both the mucosa-submucosa (21 +/- 3; n = 3) and the muscularis (7 +/- 3; n = 3). In early exudative stage of CD in the ileum total blood flow was normal (26 +/- 5; n = 7) with a normal mucosal-submucosal blood flow (35 +/- 5; n = 3). In late fibrosing stage total blood flow was reduced (11 +/- 1; n = 6) as was the mucosal-submucosal flow (10 +/- 4; n = 3). The muscularis blood flow was reduced in both these stages of ileal CD (7 +/- 1; n = 6). There was a satisfactory agreement between the obtained blood flow figures and the morphologically observed vascular pattern.

Chronic Disease↗
PubMed1976

Colonic blood flow in cat and man as analyzed by an inert gas washout technique.

An inert gas elimination technique for studying blood flow and flow distribution in the colon was developed on the cat and applied to patients during abdominal surgery. The method involves recording of the elimination of intra-arterially injected 85Kr from a colonic segment whereby the gamma- and beta-radiation of the tracer is registered simultaneously by a scintillation detector and Geiger-Muller tube, respectively. Total blood flow was determined from the recording of gamma-radioactivity using a modification of Zierler's formula, and muscularis blood flow as calculated according to Kety from the mono-exponential elimination recorded by the Geiger-Muller tube. The relative weights of the muscularis and mucosa-submucosa were determined from dissections or histological sections. With these weights and total and muscularis blood flows, flow in the mucosa-submucosa was calculated. Total colonic blood flow was 18 +/- 2 ml per min and 100 g of colonic tissue (mean +/- SE; n = 21). In the muscularis layer blood flow amounted to 11 +/- 1 ml per min and 100 g of muscularis tissue (n = 12), and flow in the mucosa-submucosa was calculated to be 28 +/- 5 ml per min and 100 g of mucosal-submucosal tissue. A major fraction (66 +/- 6%) of total blood flow was distributed to the mucosa-submucosa. As total colonic blood flow was enhanced the increase in flow was diverted only to the mucosa-submucosa. The feline and human large bowel exhibited great qualitative and quantitative circulatory similarities.

Animals↗
PubMed1976

Blood flow in the small intestine of cat and man as analyzed by an inert gas washout technique.

Using a recently developed 85Kr-elimination technique, blood flow and flow distribution of the human small intestine have been investigated in patients during abdominal surgery. Total intestinal blood flow was estimated to be 38 +/- 4 ml per min and 100 g of intestinal tissue (mean +/- SE: n = 19), jejunal blood flow being slightly higher than ileal. In 14 of these patients muscularis blood flow was determined to be 21 +/- 2 ml per min and 100 g of muscularis tissue and mucosal-submucosal blood flow was calculated to be 51 +/- 6 ml per min and 100 g of mucosal-submucosal tissue. Seventy-five +/- 3% of total blood flow was distributed to the mucosa-submucosa and the remaining 25 +/- 3% to the muscularis. It was demonstrated that an increasing fraction of flow was diverted to the mucosa-submucosa with enhanced total intestinal blood flow. The human gut exhibited great qualitative and quantitative circulatory similarities with the feline small intestine.

Animals↗
PubMed1976

Ureteric obstruction complicating Crohn's disease in the terminal ileum.

Ureteric obstruction complicating Crohn's disease of the terminal ileum is reported in three patients. This complication is treacherous, since symptoms of urinary tract disease are mostly absent, as is laboratory evidence of urinary tract infection. It is concluded that inflammatory ureteral engagement should always be suspected in patients with Crohn's disease, particularly when located in the terminal ileum. A preoperative intravenous pyelography should be included as a routine procedure in these patients. The detection of ureteral obstruction is a strong indication for early operative treatment of the disease. Ureterolysis combined with intestinal resection is recommended. The ureteral involvement, which is most likely a late phenomenon of the disease, could provably be avoided if surgical treatment is instituted at an earlier stage of the disease.

Adult↗
PubMedDate not supplied

Ileofemoral venous thrombectomy.

Twentyeight patients with ileofemoral venous thrombosis were treated surgically. Five of the patients had moderate degree of venous congestion, 18 patients had phlegmasia alba dolens and five patients had phlegmasia coerulea dolens. The mean age was 54 years, range 15-80 years, and 15 were men and 13 were women. In all cases the thrombosis was verified by phlebography. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. Peroperative phlebography was used in most cases to guarantee complete extraction of thrombotic material. No operative pulmonary embolism or mortality was encountered. Postoperative continuous heparin infusion in the thrombectomized segment was used for the first week followed by dicumarol treatment. The patients were followed from 6 months to 4 years postoperatively. In two patients thrombectomy was not possible to perform. One of these patients developed a pronounced postthrombotic syndrome, the other developed venous congestion of more moderate degree. Excellent long-term time results were obtained in 82% of the patients and satisfactory in 14%. Thrombectomy is an efficient treatment of ileofemoral venous thrombosis.

Adolescent↗