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Biomedical subjects

J Mortensen

Publications and source records attributed to J Mortensen.

At least 55 records · Page 3Linked to original sources
PubMed1998

Excimer laser surgery for keratoconus.

PURPOSE: To determine whether there is increased risk associated with excimer laser surgery of primary keratoconus. SETTING: Department of Ophthalmology, County Council Hospital, Ryhov, Jönköping, Sweden. METHODS: Twenty-four eyes in 23 patients with keratoconus had photorefractive keratectomy (PRK) to reduce the steepness of the cone. A VISX Twenty-Twenty B laser (193 nm) was used for the treatments. Spherical ablations, cylindrical ablations, or both were used. Patients were followed for a mean of 22 months (range 6 to 46 months). RESULTS: Fourteen patients (58%) had improved visual acuity. Eleven (46%) could manage with only spectacles, and three (13%) were fitted with contact lenses to get adequate visual function. All treated corneas healed, and no acceleration of the keratoconus was seen. CONCLUSION: No increased risk was associated with treating primary keratoconus with excimer laser PRK. We found that excimer laser surgery can improve vision and the ability to wear contact lenses, and it did not interfere with subsequent corneal transplantation surgery.

Cornea↗
PubMed1997

A longitudinal study of pulmonary function in Danish patients with systemic sclerosis.

OBJECTIVE: To determine the types, prevalence and development of respiratory abnormalities in patients with systemic sclerosis (SSc), and to correlate the results with clinical and serological findings. METHODS: 176 patients with SSc observed longitudinally were retrospectively included in the study. The change per year of vital capacity (VC), forced expiratory volume in one second/vital capacity (FEV1/VC), diffusing capacity (DLco) and diffusing constant (Kco) of carbon monoxide from the first till the latest pulmonary function test were correlated to clinical and serological findings, including anti-centromere, anti-Scl-70, and antinucleolar antibodies. RESULTS: An isolated reduction of DLco was seen in 47% and a restrictive ventilatory pattern in 25% of the patients. Restrictive ventilatory pattern correlated to pulmonary fibrosis, dyspnoea, a low prevalence (13%) of anti-centromere antibodies and a high prevalence of anti-Scl-70 antibodies (36%). Progression of DLco reduction was related to long disease duration, presence of anti-centromere antibodies and absence of treatment with penicillamine. CONCLUSION: Pulmonary involvement is common in patients with SSc. The occurrence of different serological abnormalities in patients with restrictive disease and in patients with progressive isolated reduction of DLco, suggests that the two types of pulmonary damage may have different pathogeneses rather than being different stages in the progression of pulmonary damage.

Adult↗
PubMed1996

[Incisional hernia. A study of morbidity, mortality and bed utilization in a Danish county].

Four hundred and four patients operated for ventral hernia during a five year period were reviewed with special emphasis on morbidity, mortality and number of days in hospital. The patients were divided into 357 patients who had been operated for ventral hernia only once (A) and 47 patients who had been operated more than once for ventral hernia (B). There were no significant differences between the two groups regarding to ages or preoperative condition. The postoperative complications were 21% in group A and 12% in group B, although this was not statistically significant. Of those who suffered a complication after the operation, 76% had a competing illness prior to the operation. The overall mortality was 0.5%. The patients were hospitalized for a total of 4846 days. In view of the results of this material and of the high recurrence rate demonstrated in the literature, a restrictive attitude towards operations for ventral hernia is recommended.

Adolescent↗
PubMed1996

[A two-year retrospective study of patients with acute myocardial infarction in a Norwegian county hospital].

The article describes a follow-up study extending over a period of two years (1992-93) of patients admitted with a diagnosis of acute myocardial infarction to a Norwegian district hospital. The mortality was 13.8%. In Norway, treatment of acute myocardial infarction is generally standardized, with only minor variations between hospitals. This follow-up illustrates that patients with uncomplicated acute myocardial infarction who do not require emergency surgical intervention can be safely treated in a district hospital.

Adult↗
PubMed1995

Primary suture of anorectal abscess. A randomized study comparing treatment with clindamycin vs. clindamycin and Gentacoll.

UNLABELLED: Gentacoll (Schering-Plough A/S, DK-3520 Farum, Denmark) implant is a biologically absorbable collagen with gentamicin, which enables local use of gentamicin in an abscess cavity. PURPOSE: To increase healing rate in treatment of perianal abscess with primary suture, the effect of intraoperative parenteral clindamycin and Gentacoll was investigated against monotherapy with intraoperative clindamycin in a randomized study. METHODS: One hundred seven patients, 55 in the Gentacoll group and 52 in the control group, were enrolled in the study and followed for three months. RESULTS: Twelve patients (22 percent) in the Gentacoll group developed a new abscess and/or fistula. In the control group nine patients (17 percent) developed a recurrent abscess or a fistula. In both groups 43 patients had an uneventful course. The differences between the two groups were not significant. Of all 107 patients, 19.5 percent had recurrent disease in the follow-up period. Duration of hospitalization and reconvalescence were identical in both groups. One case of superficial thrombophlebitis was seen after clindamycin. No other adverse effects to either Gentacoll or clindamycin were seen. CONCLUSION: The study shows that Gentacoll is a safe preparation but is without value as a supplement to clindamycin in the treatment of acute perianal abscess with primary suture. The study has documented the value of this treatment under cover with a intraoperative dose of clindamycin.

Abscess↗
PubMed1994

[A herbal preparation Resium in symptomatic gallstones. A preliminary study of the effect].

Resium, an old Spanish herb, is claimed to remove gallstone symptoms and to dissolve gallstones. Ten patients admitted for cholecystectomy because of intermittent bile cholics participated in a study for six months to evaluate the effects. None had had complications to their gallstone disease, and all had normal liver biochemistry and a normal well-functioning gallbladder before entry into the study. By ultrasonography minor changes in both directions in stone number and volume were seen. Five patients experienced some relief of symptoms, while the rest had unchanged, or worse symptoms. No adverse events to Resium were seen. In conclusion no effect of Resium upon gallstone size and volume was seen. The design of the study does not allow any conclusion about symptomatic effect to be drawn.

Adult↗
PubMed1994

[Laparoscopic appendectomy. Results and complications].

Thirty-four patients (23 females and 11 males) aged 13-71 years had acute appendicitis on both clinical and laparoscopic evaluation. Twenty-eight patients (82%) were treated laparoscopically whereas conversion to open appendectomy was necessary in six patients. Operation time for laparoscopic appendectomy ranged from 25-90 min. (mean 58 min.), and the patients were discharged 1-14 days after the operation (mean 2.8 days). Five patients developed complications, wound infection in one case, intraperitoneal infectious complications in three cases and postoperative fever in one case. Mean convalescence was two weeks. All patients were satisfied with the performed procedure and the cosmetic result and all were doing well one month after the operation, except for one patient who had pain in the right iliac fossa. The initial results of laparoscopic appendectomy are promising.

Acute Disease↗
PubMed1994

[Endoscopic treatment of bile leakage following biliary tract surgery].

Thirty-two patients aged 15-89 years developed postoperative bile leakage. Twenty-eight had undergone cholecystectomy, with choledocholithotomy in 11, and four had had miscellaneous operations. Endoscopic retrograde cholangiopancreatography (ERCP) showed leakage from the cystic stump in 19 cases, from the T-tube track in five, from gallbladder and liver abscess in two and from major bile ducts in 6 cases. Major bile duct lesions were only mapped, but not managed endoscopically, whereas the remaining 26 patients were treated successfully with internal stenting (22) or endoscopic sphincterotomy (four). One patient developed cholangitis and was managed by antibiotics, no other complications were related to the procedures. ERCP procedures are effective for the most common causes of postoperative bile leakage and ought, therefore, to be the method of first choice for dealing with bile leakage.

Adolescent↗
PubMed1994

Lung mucociliary clearance.

The aim of this study was to establish reference values for mucociliary clearance and mucociliary clearance reserve capacity as determined by beta 2-adrenergic agonist-induced increase in mucociliary clearance. We studied 62 healthy females (n = 33) and males (n = 29). Their ages ranged evenly between 18 and 84 years. Fifty-three of the subjects were life-long non-smokers, while nine were ex-smokers. Multiple linear regression analyses showed that mucociliary clearance was significantly faster when the radioaerosol was deposited in the central airways than when it was deposited in the peripheral airways, and faster in life-long non-smokers than in ex-smokers. There was no influence of age, and no convincing association with sex. The variation was less within than between subjects. Mean mucociliary clearance reserve capacity was 21.3% (SD: 10.0%, P < 0.0001). The beta 2 agonist-induced increase in lung mucociliary clearance was significantly larger (P < 0.05) than the stimulation which has previously been reported in patients with asthma, bronchiectasis or cystic fibrosis. The signal-to-noise ratio of the mucociliary clearance reserve capacity in relation to measurement of baseline mucociliary clearance indicates that measurement of mucociliary clearance reserve capacity may be a more efficient means of distinguishing between "normal" and "abnormal" mucociliary clearance than single measurement of baseline mucociliary clearance.

Adult↗
PubMed1993

[Blood transfusion increases the risk of surgical infection].

In a prospective randomized trial the frequency of infectious complications and natural killer cell function were investigated in 197 patients undergoing elective colorectal surgery and having either no blood transfusion (n = 93), transfusion with whole blood (n = 56), or filtered blood free from leucocytes (n = 48). Postoperative infections developed in 13 patients transfused with whole blood (23%), in one patient transfused with blood free from leucocytes (2%) and in two non-transfused patients (2%) (p < 0.01). Natural killer cell function was significantly (p < 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery.

Adolescent↗
PubMed1993

Reduced effect of inhaled beta 2-adrenergic agonists on lung mucociliary clearance in patients with cystic fibrosis.

STUDY OBJECTIVE: It has been suggested that the defective cyclic AMP-dependent Cl- secretion and the increased Na+ absorption from airway epithelia in cystic fibrosis (CF) may lead to dehydrated secretions and impaired mucociliary clearance. Beta 2-adrenergic agonists are unable to stimulate the Cl- transport in the airways in CF while being able to do so in normal airways. Thus, we questioned whether the beta 2-adrenergic agonist, terbutaline, would improve mucociliary clearance in patients with CF as it does in healthy subjects. DESIGN: A double-blind, randomized cross-over trial. SETTING: Whole lung and regional mucociliary clearance of a radioaerosol was measured for 3 h by gamma camera. One minute of cough clearance was measured at 3 h. Pulmonary function was measured before and after the gamma camera study. PATIENTS: Ten young patients with CF were studied; three were heterozygous for deletion of the phenylalanine at position 508 (delta F508), and seven were delta F508 homozygous. INTERVENTIONS: Inhalation of 1 mg of terbutaline (4 puffs) and placebo via a metered-dose inhaler by spacer. MEASUREMENTS AND RESULTS: The largest differences in tracheobronchial retention (percent) in the whole lung and regional lung zones were generally observed within 1 h after terbutaline and placebo treatment: whole lung (mean +/- SD), 60 +/- 22 percent and 63 +/- 20 percent; central zone, 41 +/- 19 percent and 50 +/- 25 percent; midzones, 65 +/- 27 percent and 63 +/- 19 percent; and peripheral zones, 77 +/- 28 percent and 72 +/- 28 percent, respectively [p > 0.1]. Whereas none of these differences was statistically significant, subanalyses suggested an improvement in mucociliary clearance by terbutaline in the three delta F508 heterozygous patients but not in the seven delta F508 homozygous patients. One minute of voluntary coughing resulted in clearance of less than 8 percent of the initial radioactivity, with a trend of more peripheral zone clearance after terbutaline compared with placebo. A small significant decrease in airway resistance was detected 3 h after terbutaline. CONCLUSIONS: We conclude that 1 mg of terbutaline did not improve mucociliary clearance significantly in the patients with CF. Also, the effect of terbutaline was much less than demonstrated earlier in healthy subjects. This is consistent with earlier findings of a lack of beta-adrenergic modulation of Cl- transport in CF. Thus, no rehydration of the dry mucus in CF is expected, and a possible beta 2-agonist-induced increase in ciliary beating would have only a minor effect on overall mucociliary clearance.

Administration, Inhalation↗
PubMed1992

[Left-side colonic ileus treated with peroperative lavage and primary anastomosis].

Eight patients aged 56-85 years were operated on as emergencies because of left sided mechanical colonic obstruction. The whole colon was mobilized, a Foley-catheter introduced into coecum preferably through the appendicular stump or alternatively a terminal ileotomy and a scavenger tube was introduced into the left colon proximal to the obstruction. By antegrade lavage with isotonic sodium chloride assisted manually colon was emptied, the pathological process resected and a primary anastomosis performed. No cases of anastomotic leakage or infectious complications occurred. One patient had to be operated on again because of a small wound dehiscence. The mean hospital stay was 13 days. The advantages of the treatment are that the patient is managed at the emergency operation, the frequency of complications is low and hospital stay short. It is therefore a good alternative to procedures involving temporary colostomy.

Aged↗
PubMed1992

Postoperative infection and natural killer cell function following blood transfusion in patients undergoing elective colorectal surgery.

The frequency of infection in 197 patients undergoing elective colorectal surgery and having either no blood transfusion, transfusion with whole blood, or filtered blood free from leucocytes and platelets was investigated in a prospective randomized trial. Natural killer cell function was measured before operation and 3, 7 and 30 days after surgery in 60 consecutive patients. Of the patients 104 required blood transfusion; 48 received filtered blood and 56 underwent whole blood transfusion. Postoperative infections developed in 13 patients transfused with whole blood (23 per cent, 95 per cent confidence interval 13-32 per cent), in one patient transfused with blood free from leucocytes and platelets (2 per cent, 95 per cent confidence interval 0.05-11 per cent) and in two non-transfused patients (2 per cent, 95 per cent confidence interval 0.3-8 per cent) (P less than 0.01). Natural killer cell function was significantly (P less than 0.001) impaired up to 30 days after surgery in patients transfused with whole blood. These data provide a strong case against the use of whole blood transfusion in patients undergoing elective colorectal surgery.

Adult↗
PubMed1992

Endoscopic management of postoperative bile leaks.

Thirty-two patients aged 15-89 years developed postoperative bile leakage. Twenty-eight had undergone cholecystectomy, with choledocholithotomy in 11, and four had had miscellaneous operations. Endoscopic retrograde cholangiopancreatography (ERCP) was performed 2-75 days after operation and revealed leakage from the cystic duct stump in 19 cases, from a T tube track in five, from the gallbladder and liver abscess cavity in two and from the major bile ducts in six. Major bile duct lesions were not generally amenable to endoscopic treatment, but the remaining 26 patients were treated successfully with internal stenting (22) or endoscopic sphincterotomy (four); bile secretion in all cases stopped within 1 week. One patient with cholangitis after an ERCP procedure was managed by antibiotics; no other complication occurred and there were no deaths related to the procedure. ERCP procedures are well tolerated in the postoperative period and may be performed under sedation. ERCP is the method of choice for dealing with bile leakage and ERCP procedures are effective for the most common causes of postoperative bile leakage; complications are rare.

Adolescent↗
PubMed1992

Distribution of radioactive aerosol in the airways of children and adolescents with bronchial hyper-responsiveness.

The purpose of this study was to examine the relationship between the pulmonary distribution of inhaled radioaerosol, bronchial responsiveness, and lung function in children and adolescents. The participating subjects (n = 39) were divided into three groups: (1) 14 asthmatics with bronchial hyper-responsiveness (BHR), (2) five non-asthmatic subjects with BHR, and (3) 20 controls without BHR. Pulmonary distribution of [99Tcm) albumin radioaerosol, maximal expiratory flow when 25% of forced vital capacity remain to be exhaled (MEF25), and bronchial responsiveness to inhaled histamine were measured. Twenty subjects (52%) had irregular central distribution and 19 subjects (48%) had regular distribution of radioaerosol in their lungs. No difference in distribution of radioaerosol was found between the three groups of children. The median MEF25 among non-asthmatic subjects (80% predicted) was lower than that found in controls (92% predicted) but higher than that found in asthmatic subjects (55% predicted). A relationship was found between reduced flow at the peripheral airways, as indicated by MEF25 and the degree of central distribution of radioaerosol. Furthermore, subjects with irregular central distribution of radioaerosol had an increased degree of bronchial responsiveness. In conclusion, children and adolescents who have flow rates in the peripheral airways or increased degree of bronchial responsiveness tend to have abnormal distribution of radioaerosols.

Adolescent↗