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Biomedical subjects

K Nygaard

Publications and source records attributed to K Nygaard.

At least 91 records · Page 5Linked to original sources
PubMed1981

Intestinal and gastric bypass. Changes in intestinal microecology after surgical treatment of morbid obesity in man.

Jejunal bacterial flora, bile acid deconjugation, and breath hydrogen and methane excretion were studied in nine patients with end-to-side and nine patients with end-to-end jejunoileostomy and in eight patients with gastric bypass. Bacterial numbers did not differ significantly between healthy controls and any of the patient groups. Production of fermentation gases in anaerobic cultures supplemented with carbohydrates did not occur with jejunal secretions from healthy controls but was found in all intestinal bypass patients and half the gastric bypass patients. Bacterial bile acid deconjugation activity was significantly higher in end-to-side compared with end-to-end jejunoileostomy patients. In gastric bypass patients bile acid deconjugation was not significantly affected. Breath hydrogen after glucose ingestion was abnormal in six patients with end-to-side and three with end-to-end jejunoileostomy and in six of the patients subjected to gastric bypass. The highest values were found in the later group. Breath methane, which is found in one third of a healthy population, was absent in all 18 patients with intestinal bypass, and this may indicate that a change occurs even in the colonic microflora after this operation. Both intestinal and gastric bypass may change the small-bowel microflora, with the greatest changes occurring after end-to-side jejunoileostomy and the least changes after gastric bypass.

Adult↗
PubMed1979

Repair of hiatus hernia by an abdominal semi-fundoplication technique.

The results of an anti-reflux operation are reviewed. The procedure is similar to the Belsey Mark IV operation, a semi-fundoplication, but performed via an abdominal approach. Forty-five patients were operated upon between 1971 and 1977, 41 had a sliding hernia and 4 a para-oesophageal hernia. Two patients died during the observation period. The follow-up of the remaining 43 patients includes clinical, radiological and manometric examinations. The length of follow-up averaged 35 months (7--70 months). There were 6 anatomic recurrences or persisting sliding hernia and one recurrence of paraoesophageal hernia. Three of the patients with recurrence had been subjected to parietal cell vagotomy and hernia repair, and one was a primary technical failure with persisting hernia. In 32 technically successful repairs of sliding hernia performed as a primary procedure without concomitant PCV, there was one recurrence. Subjectively, 93% (40/43) of the patients considered the operative result excellent or good. Manometric studies showed a significant rise in the lower oesophageal sphincter pressure, from a median value of 6.5 mmHg preoperatively to 12.5 mmHg postoperatively (p less than 0.05) (median value in normal controls, 15.3 mmHg).

Abdomen↗
PubMed1978

Pulmonary complications after bleomycin, irradiation and surgery for esophageal cancer.

Eight patients with epidermoid carcinoma of the esophagus were given radiotherapy of 3000 rads and 120 mg of bleomycin. Esophageal resection was performed five to six weeks later. Four of these patients died within six weeks, three from respiratory failure, and one from complications secondary to an anastomotic fistula. Of the remaining four patients, three showed varying degrees of pulmonary infiltration for several weeks. Interstitial pneumonitis was demonstrated in all the fatal cases. Four patients given the same irradiation and bleomycin doses were only subjected to exploratory surgery. They had no postoperative pulmonary complications. Ten patients given the same irradiation and bleomycin treatment without surgery also showed no pulmonary complications. Sixteen patients received higher doses of radiotherapy and bleomycin. Seven of these developed lung infiltrations terminating fatally in four. The likely mechanism of the observed postoperative pulmonary complications is that the preoperative treatment sensitized the lungs, while the subsequent surgical trauma triggered a reaction in the lungs leading to respiratory failure.

Aged↗
PubMed1978

Small-bowel adaptation after colectomy in rats.

Colectomy with ileoproctostomy or ileostomy was performed in rats. The animals were killed at different time intervals after operation. In histological sections from the small intestine the total crypt cell number and vinblastine-arrested mitoses were counted, and the villus height was measured; these parameters were compared with the corresponding ones in unoperated controls and in rats subjected to ileal transection. After ileoproctostomy the rats remained in good condition, whereas ileostomy was followed by weight loss, debility and a great mortality. After ileoproctostomy, ileostomy and ileal transection there was an increased number of mitoses in the crypts during the 28 days' observation period, indicating an increased rate of cell proliferation. Increased villus height was observed after ileoproctostomy as well as after ileostomy. The mucosal hyperplasia may play a role for the increase in water and salt absorption capacity after colectomy. Probably, however, the hyperplasia of the small-intestinal mucosa cannot fully compensate for the loss of the colon in rats. Preservation of the absorptive function of the rectum, as in ileoproctostomy, is necessary for adequate water and salt absorption.

Adaptation, Physiological↗
PubMed1978

Intestinal bypass. Experimental study on the influence of the excluded intestinal segment.

Five groups of operated rats with 10% of the small intestine in continuity were studied. In one group the animals were subjected to 90% resection of the small intestine, and in the other groups a 90% jejuno-ileal bypass was performed. In two of the latter groups different lengths of the excluded intestinal segment was resected. The bypassed segment was anastomosed to the colon in three of the groups and to the skin as an ileostomy in one group. There were no differences in haemoglobin concentration, liver function parameters or fat absorption between the five groups, but measurements of body weight seem to indicate that the bypassed intestinal segment exerts a general harmful effect on the rats. This effect is more pronounced when the excluded segment is long, and the effect seems to be the same whether it is connected to the colon or to the skin. The mechanism for this effect is not fully ascertained.

Animals↗
PubMed1978

The continent reservoir ileostomy: review of a collective series of thirty-six patients from three surgical departments.

A reservoir ileostomy was created in 36 patients. Three patients died from septic complications in the postoperative period, and one patient died from rectal carcinoma during the observation period. In six patients the reservoirs were removed during the observation period because of nipple-valve extrusion, nonspecific ileitis of the reservoir, or recurrence of Crohn's disease. Complications from the reservoir and its outlet were quite frequent and included fistula formation in eight patients, nipple-valve extrusion in 12 patients, nonspecific ileitis of the reservoir in five patients, and stenosis of the nipple in one patient. Malabsorption of vitamin B12 and fat due to a stagnant loop syndrome was found in four of seven patients examined for this. Fifteen patients underwent 25 reoperations for complications from the reservoir and its outlet. Twenty-six patients still have their reservoirs. Twenty-five of them are continent. They do not wear external appliances and they empty their reservoirs with a tube two to five times daily. One patient is incontinent due to an unrepaired nipple-valve extrusion.

Adolescent↗
PubMed1977

Crohn's disease. Recurrence after surgical treatment.

A series of 76 patients who have undergone surgical treatment for Crohn's disease is presented. In 14 of the patients surgery was performed for recurrence after previous resection. In total, 91 intestinal resections and one bypass--operation were carried out. Postoperative mortality comprised 4 patients (5.3%), and there were 4 late deaths. Sixty-six patients were followed up for periods ranging from 2 to 11 years, with a median of 4.0 years. Recurrence rates and reoperation rates were determined by actuarial analyses. The yearly recurrence rate seemed constant during the observation period, averaging 15.2%, and the cumulative recurrence rate was thus 77% after 9 years. The reoperation rate also seemed to be constant, and on the average 5.5% per year, and the cumulative reoperation per cent after 9 years was 45. There was no significant difference between cumulative recurrence rates after primary operations and after operations for recurrence. There was a significantly higher risk of relapse during the first year after non-radical excision of the diseased part of the gut than after radical excision. The majority of the patients were in good general condition at time of review; only 3 patients suffered from marked symptoms with reduced working capacity.

Adolescent↗
PubMed1977

Intestinal bypass. A comparison between two different bypass operations and resection of the small intestine in rats.

General nutrition, intestinal absorption and liver structure and function were compared in rats subjected to: 1) 90 per cent resection of the small intestine, 2) 90 per cent small intestinal bypass with end-to-side jejunoileostomy (ES bypass), and 3) 90 per cent small intestinal bypass with end-to-end jejuno-ileostomy and anastomosis between the excluded segment and the colon (E-E bypass). The E-E bypass group showed the highest mortality rate and the lowest body weight. In this group the haemoglobin concentration, the faecal fat excretion, and the liver function parameters were more abnormal than in resected rats. Rats with E-S bypass showed results in between the other two groups. In none of the animals was fatty infiltration or cirrhosis of the liver observed. It is concluded that intestinal bypass in rats has a more deleterious effect than resection, and this seems to be more pronounced when the excluded segment is anastomosed to the colon. Factors that might be responsible for this effect are discussed.

Alanine Transaminase↗
PubMed1977

Amyloidosis and Crohn's disease.

Amyloidosis associated with Crohn's disease was found in 7 patients among 85 subjected to intestinal resection for granulomatous enterocolitis. Most of the patients had symptoms of inflammatory bowel disease of relatively short duration before the diagnosis of amyloidosis was made and were without suppurative complications. Systemic involvement was seen in 6 of the patients. One died postoperatively from renal failure, and in 2 other patients kidney transplantation was performed because of deterioration of a pre-existent renal insufficiency. Six patients were alive 6 months to 10 years after amyloidosis was diagnosed. There is great risk of rapid deterioration of kidney function postoperatively in these patients. However, our experience suggests that in some cases the progression of amyloidosis may be delayed or even brought to a halt after surgical treatment of Crohn's disease.

Adolescent↗