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Biomedical subjects

L Bardram

Publications and source records attributed to L Bardram.

65 records · Page 4Linked to original sources
PubMed1985

Late results after surgical treatment of renovascular hypertension. A follow-up study of 122 patients 2-18 years after surgery.

During the period 1963-1980, 122 patients were operated on for renovascular hypertension at surgical department D, vascular section, Rigshospitalet, Copenhagen. Seventeen patients, with a median age of 24 years, had fibromuscular hyperplasia and 95 patients, with a median age of 48 years, had atherosclerosis. Twenty-four of the latter had bilateral renal artery lesions and 71 had unilateral disease. Ten patients had various other causes of renovascular hypertension. Operative mortality was 4.9%, decreasing to two per cent in the last 8 years. At discharge, 71% of the patients were normotensive without medication, 18% were improved, and 11% were unimproved. At follow-up in 1982, the actuarial 10-year survival rates for patients with unilateral and bilateral atherosclerotic disease were 65% and 48%, respectively. There was no difference between survival rates for patients with fibromuscular hyperplasia and an age- and sex-matched, population. Sixty-nine patients were reexamined with a median follow-up of 9 years. Of the survivors with atherosclerosis, 87% benefitted from the operation: 50% were normotensive without medication and 37% were improved. Of patients with fibromuscular hyperplasia, 93% benefitted from operation: 79% were normotensive and 14% were improved. The results support the value of surgery in patients with renal fibromuscular hyperplasia and to the long-term benefits of surgical treatment of patients with atherosclerotic renovascular disease.

Adolescent↗
PubMed1985

Endocrine liver tumour differential diagnosis from hepatocellular carcinoma.

A liver tumour, initially diagnosed by light microscopy as a hepatocellular carcinoma, was later shown to be endocrine by argyrophilia and electron microscopy. It was tested by immunohistochemistry for insulin, glucagon, gastrin, VIP, pancreatic polypeptide, glicentin, C-peptide and somatostatin. A few cells were shown to contain somatostatin, but the secretion product in most of the cells was not identified. The patient is well, without any sign of endocrine disturbances, 18 months after the operation.

Carcinoma, Hepatocellular↗
PubMed1985

Frequency of endocrine disorders in patients with the Zollinger-Ellison syndrome.

To evaluate the frequency of associated endocrine disorders, 26 patients with the Zollinger-Ellison syndrome were restudied in a uniform screening programme. The examinations were directed primarily against disorders in the pituitary, parathyroid, thyroid, adrenal cortex, and endocrine pancreas. Fourteen endocrine disorders were found in 10 patients (38%). Ten of these were newly diagnosed. Five patients had hyperparathyroidism, and in two of these a pituitary adenoma was also suspected. Two had pituitary adenomas, one was suspected of having a pituitary adenoma and one of having adrenocortical hypofunction, and one showed multiple hormone production with hypoglycaemia and flushing. It is concluded that most cases of associated endocrinopathies are not diagnosed until specifically looked for. In the Danish population of patients with the Zollinger-Ellison syndrome the prevalence is about 38%.

Adrenal Cortex Diseases↗
PubMed1984

Value of nasogastric tube after colorectal surgery.

To evaluate the effect of tube decompression of the stomach after elective colorectal operations, 97 patients were randomly allocated to postoperative treatment with or without nasogastric tubes. Flatus passed earlier in the patient group without tubes. However, no significant differences were found between the two groups with respect to duration and severity of postoperative paralysis, as measured by occurrence and duration of nausea and vomiting, postoperative peroral fluid intake and time for defecation. The frequencies of postoperative complications were small in both groups and without any difference between groups. Tube decompression of the stomach does not relieve intestinal paralysis after elective colorectal operations. Tube decompression should be used only in patients with paralytic ileus.

Adolescent↗
PubMed1982

Breast tumour. An unusual manifestation of a carcinoma of the stomach.

A 59-year-old woman presented with an infiltration in the left breast and a large mass of enlarged lymph nodes on the left side of the neck. Radiological and histological examinations showed that the breast involvement was a mastitis carcinomatosa secondary to a carcinoma of the stomach. A review of the literature revealed ten earlier cases of metastases to the breast from a primary carcinoma of the stomach. The cases are discussed especially concerning the way of tumour spread.

Breast Neoplasms↗
PubMed1981

Prospective controlled vagotomy trial for duodenal ulcer: primary results, sequelae, acid secretion, and recurrence rates two to five years after operation.

In a prospective, controlled clinical trial, vagotomies for duodenal, pyloric, and prepyloric ulcers were performed on 259 patients. Eighty-three patients were randomly selected for truncal vagotomy and drainage (TV + D), 93 patients were randomly selected for selective gastric vagotomy and drainage (SV + D) and 83 patients were randomly selected for parietal cell vagotomy without drainage (PCV). This interim report deals with the primary results, reduction in acid secretion, sequelae, and recurrence rates two to five years after the operation. One patient died after the operation. Postoperative complications were evenly distributed between the three operations. No differences in spontaneous acid secretion (BAO), peak acid output after pentagastrin stimulation (PAOP), or peak acid output after insulin stimulation (PAOI) were found. Patients with recurrent ulcers ahd smaller reductions in BAO than patients without ulcer recurrences, although not significantly. Patients with ulcer recurrences after TV + D had, in contrast to ulcer recurrences after SV + D and PCV, a significantly smaller reduction in PAOP than patients without recurrences. The overall recurrence rate was 13%: 10% after TV + D, 14% after SV + D and 16% after PCV. The risk of ulcer recurrence within the first three years, calculated by an actuarial method, was found to be significantly higher after PCV (0.52% per month) than after TV + D (0.32% per month), but not different from SV + D (0.42% per month). In contrast to TV + D and SV + D, no recurrences after PCV occurred after three years--25% of the patients were followed for five years. It is concluded that the trial, at present, does not point to any evident superiority of PCV.

Adult↗
PubMedDate not supplied

Surgical treatment of the Zollinger-Ellison syndrome.

A consecutive series of patients with Zollinger-Ellison syndrome (ZES) is reported. A total of 53 cases were diagnosed, treated, and followed by one department during the period 1971-1990. Curative surgery was considered in all cases after suppression of acid secretion and after localization of the tumors. Exploratory laparotomy was not employed. Of the 53 patients 13 (24%) died from metastatic gastrinoma during the study. Tumors were ultimately located in 31 of the patients, and 21 of these patients were operated. A total of 12 patients (21%) were cured. The best results were obtained after Whipple pancreaticoduodenectomy in patients with small tumors located after percutaneous transhepatic portography with blood sampling for gastrin assay. In this group 9 of 10 operated patients were cured. Multiple endocrine neoplasia type I did not seem to preclude curative resection. The findings support an aggressive attitude toward local diagnosis and surgical treatment in ZES patients, but they also stress the need for improvements in methods for localizing tumors.

Adult↗