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Biomedical subjects

J N Wiig

Publications and source records attributed to J N Wiig.

At least 37 records · Page 2Linked to original sources
PubMed1995

Prophylaxis of venographically diagnosed deep vein thrombosis in gastrointestinal surgery. Multicentre trials 20 mg and 40 mg enoxaparin versus dextran.

OBJECTIVE: To compare enoxaparin and dextran 70 for the prophylaxis of venographically diagnosed deep vein thrombosis (DVT) after gastrointestinal operations. DESIGN: Part 1: randomised double blind trial; Part 2: single blind study with historical controls. SETTING: Eight Norwegian hospitals. SUBJECTS: 381 Patients undergoing elective gastrointestinal operations. INTERVENTIONS: Part 1 (n = 329): enoxaparin 20 mg subcutaneously starting two hours before operation and continuing until the patient was fully mobilised or had had 10 injections and a placebo infusion of 0.9% sodium chloride, or dextran 70,500 ml at the start of the operation, on the evening of operation, and on the first, third, and fifth postoperative days and placebo subcutaneous injections. Part 2 (n = 52): enoxaparin 40 mg in the same regimen as part 1 (compared with 39 historical controls). Venograms 4-6 days post-operatively. MAIN OUTCOME MEASURE: Venographically confirmed DVT. RESULTS: Part 1: Because of the high overall incidence of DVT an interim analysis was done which showed 33/101 DVT (33%) among high risk patients in the enoxaparin 20 mg group and 33/107 (31%) in the dextran 70 group. The corresponding figures for patients at medium risk were 2/27 (7%) for enoxaparin 20 mg and 5/27 (19%) for dextran 70 (95% confidence interval (CI) for the difference--11.9 to 9.8). Part 2: the dose of enoxaparin was therefore increased to 40 mg and prophylaxis restricted to patients with cancer. There were 6/49 DVT (12%), which was compared with a random sample from the dextran 70 group from part 1 (historical controls) in which the incidence was 15/39 (38%, 95% CI of the difference 4.0 to 8.4). There were no pulmonary emboli, only 4 thrombi were above the knee and there were 4, 1 and 3 clinical DVT in the 20 mg and 40 mg enoxaparin, and dextran 70 groups, respectively. CONCLUSIONS: Enoxaparin 20 mg and dextran 70 are effective prophylaxis for patients at medium risk, but enoxaparin 40 mg is required for those at high risk.

Adult↗
PubMed1994

[Peroperative lavage].

Primary bowel anastomosis was performed after an on table lavage procedure in 29 patients who required surgery for colonic lesions. 13 patients were operated in the acute or subacute stage and 16 had inadequately prepared colons at the time of elective operations. The diagnoses were cancer of the colon in 23 patients, diverticulitis in three, stoma stricture in two and colonic bleeding in one. There were 26 left-sided colonic resections, two transverse colonic resections and one right-sided hemicolectomy. The procedure prolonged the operation time by 38 min. (median), range 16-80 min. The rate of complications was 14%, and there was no mortality. None of the patients presented clinical signs of anastomotic leakage. It is concluded that primary colonic anastomosis after on table lavage is a safe and reliable alternative to staged operations. It saves the patients the discomfort of a temporary stoma and possible morbidity from further operations.

Adult↗
PubMed1991

Association between DNA ploidy pattern and cellular atypia in colorectal carcinomas. A new clinical application of DNA flow cytometric study?

Fresh tissue specimens from 406 colorectal carcinomas were analyzed by DNA flow cytometric study, and the DNA ploidy pattern was compared with Dukes' stage, histologic grade, and degree of cellular atypia. Sixty-one percent of the carcinomas had a distinct aneuploid DNA pattern. The proportion of aneuploid carcinomas was significantly higher in the advanced Dukes' stages than in the localized ones. A highly significant association was found between DNA ploidy pattern and degree of cellular atypia, whereas no association was demonstrated between DNA ploidy pattern and histologic grade. This finding might indicate that cellular atypia has a stronger prognostic impact than the growth pattern of the tumor. The authors suggest that flow cytometric DNA quantification may replace assessment of cellular atypia in the histologic evaluation. Furthermore, together with earlier findings by others, these results indicate that the degree of cellular atypia may be conserved during the development from adenomas to carcinomas.

Adenocarcinoma↗
PubMed1990

[Peroperative ultrasonography in surgery of liver metastases in colorectal cancer. A obligatory examination].

It is not easy to evaluate the real actual benefit of resection of liver metastases from colo/rectal carcinoma. This is partly due to inaccurate preoperative imaging of the metastases. The given sensitivity of the various imaging techniques varies widely. Peroperative ultrasonography is more sensitive than the other techniques. It will influence the operation for metastases in 15-40% of the cases. This technique should therefore be compulsory in connection with surgery for liver metastases.

Colorectal Neoplasms↗
PubMed1990

[Surgeons opinion about cytostatic treatment of gastrointestinal cancer].

Surgeons' opinion on several aspects of the treatment of gastrointestinal cancer with cystostatic drugs was investigated by means of a questionnaire to 51 departments. 48 replied. The surgeons were generally critical of the use of chemotherapy for cancer in the oesophagus, pancreas and stomach. More than half of the surgeons considers that fluorouracil can be used to treat recurrent or metastatic disease of the colon/rectum. A few would use fluorouracil against the other kinds of cancer too. Psychological aspects are considered to be important both for the decision to use chemotherapy and for post-operative control.

Antineoplastic Agents↗
PubMed1990

[Views on simple surgical aspects of gastrointestinal cancer in Norway].

A questionnaire was used to study various aspects of the surgical treatment of cancer of the oesophagus, pancreas, stomach and colon/rectum in Norway. 48 of 51 departments replied. Half of the departments perform radical operations for oesophageal cancer and nearly all do total gastrectomies and low anterior resections for rectal cancer. Palliative surgery is seldom performed for oesophageal cancer, but is frequently performed for gastric cancer. Obstruction of the colon is relieved preferably by primary resection. Low anterior resection is usually performed when a free resection margin of 2 cm can be achieved. Jaundice is relieved palliatively preferably by endoscopy. University hospitals perform total gastrectomy to a greater extent than other hospital and have greater faith in radical operations for pancreatic cancer. Otherwise there are no conspicuous differences of opinion between the different categories of hospitals.

Gastrectomy↗
PubMed1990

[Peroral emptying of the colon. A randomized comparison of 4 and 1.5 liter regimens].

A "clean" colon is needed for adequate endoscopic examination. In order to examine patients' acceptance of two different regimens taken orally, and their efficacy, 32 patients in an outpatient clinic were randomized either to a four litre regimen of a solution of electrolytes and polyethylenglycol or a 1.5 litre regimen supplemented with bisacodyl. The patients' acceptance was better for the 1.5 litre regimen, since only one out of 17 patients failed to drink the solution, while four out of 15 patients were unable to complete drinking the four litres. Insufficient cleaning of the colon caused inadequate examination in four patients. All patients who had followed the four litre regimen were examined successfully. We conclude that the present 1.5 litre regimen is insufficient as pretreatment for colonoscopy.

Adult↗
PubMed1989

[Prevention of thrombosis. Surgical departments in Norway].

Routine perioperative thrombo-embolic prophylaxis was studied by means of a questionnaire to departments of abdominal, orthopedic, urological and gynecological surgery. 171 departments in university, central and county hospitals answered, giving a response rate of 92%. It was found that 90% of the departments in all hospital categories used routine prophylaxis. This practice was most frequent in orthopedics and least frequent in urology. Dextran was preferred in all three hospital categories. Central and county hospitals also applied heparin and heparin/dihydroergotamin. Heparin was always given as 5,000 IU subcutaneously twice daily. Heparin/dihydroergotamin was equally often given as 2,500 IU as 5,000 IU twice daily, irrespective of the kind of surgery. Indications of thrombo-embolic prophylaxis varied within each surgical speciality. The prophylaxis regimen was chosen mostly on medical grounds. The convenience of the nurses was seldom and economic differences only infrequently considered of importance for the choice of prophylaxis regimen.

Humans↗
PubMed1989

[Skin closure. A prospective randomized study].

This prospective randomized study included 100 patients with inguinal hernia and 66 patients operated on for acute appendicitis. In half of each group the skin was closed with a continuous subcuticular resorbable suture, and in the other half with a monofilament nylon matress suture. The patients were followed up after three weeks and again after three months. There was no obvious difference in cosmetic result between the two methods of skin closure. In the patients with inguinal hernia or non-perforated appendicitis there was no increase in postoperative infection of the wound after subcuticular suture. In the case of perforated appendicitis there may have been an increase in infection of the wound after subcuticular suture. Continuous, subcuticular resorbable suture used on the right indications can give a good cosmetic result and few complications of the wound. Further more, a separate outpatient visit for removal of skin sutures or staples can be avoided.

Appendicitis↗
PubMed1987

Epithelial ovarian tumor in a phenotypic male.

Laparotomy in a 41-year-old married man with non-treated left cryptorchidism revealed female internal genitals on the left side, and an epithelial ovarian tumor of intermediate malignancy. Germinal malignancies are frequent in intersexes, but non-germinal gonadal neoplasms are rare. This is the second reported case of epithelial ovarian tumor in intersexes, and the first case of epithelial ovarian tumor in an intersex registered as male.

Adult↗