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Biomedical subjects

K O Viddal

Publications and source records attributed to K O Viddal.

23 records · Page 2Linked to original sources

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↗

Tinidazole and doxycycline compared to doxycycline alone as prophylactic antimicrobial agents in elective colorectal surgery.

Forty-two patients admitted for elective colorectal surgery were given tinidazole and doxycycline or doxycycline alone as prophylactic antimicrobials in a double-blind study. There was altogether one abdominal wound infection (2.4%), and one patient developed a perineal fistula three months after the operation. No significant difference in postoperative infections between the two groups could be demonstrated. It is concluded that doxycycline seems effective in reducing wound sepsis after operations on the large intestine and that additional administration of tinidazole will yield little in prophylaxis.

Aged↗

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↗

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↗