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Biomedical subjects

L Lundell

Publications and source records attributed to L Lundell.

At least 145 records · Page 8Linked to original sources
PubMed1988

Omeprazole or ranitidine in the treatment of reflux esophagitis. Results of a double-blind, randomized, Scandinavian multicenter study.

One hundred and fifty-two patients with endoscopically verified erosive and/or ulcerative esophagitis entered a double-blind, randomized study comparing 20 mg omeprazole given once daily and ranitidine 150 mg twice daily. The efficacy and safety of 4 to 8 weeks' treatment were studied. Macroscopic healing of esophagitis was defined as complete epithelialization of all esophageal erosive and/or ulcerative lesions. One hundred and forty-four patients completed the first 4 weeks of treatment in accordance with the protocol. The healing rate was 67% in the omeprazole group and 31% in the ranitidine group (p less than 0.0001). The corresponding figures after 8 weeks' treatment were 85% and 50%, respectively (p less than 0.0001). The higher healing rate for omeprazole was also accompanied by a significantly faster and more substantial improvement in reflux symptoms. In the patient's own overall evaluation of symptoms, these had resolved in 51% of the omeprazole-treated patients already at the end of the 1st week of treatment, compared with 27% of those given ranitidine (p = 0.009). Both omeprazole and ranitidine were well tolerated, and there were no adverse events or clinically significant changes in the laboratory values attributable to the trial medication.

Adult↗
PubMed1988

Causes of malabsorption after total gastrectomy with Roux-en-Y reconstruction.

Malabsorption after total gastrectomy and Roux-en-Y reconstruction was studied in 11 patients. Absorption of fat, xylose and lactose was tested and the orocaecal transit time was radiologically determined. Bacterial colonization of the small intestine was studied by culturing jejunal juice and indirectly with a hydrogen breath test. Ten patients lost weight postoperatively and six had diarrhoea. All 11 had steatorrhoea with mean faecal fat excretion 289 +/- 55 (SEM) mmol free and esterified fatty acids/72 h (upper reference limit 60 mmol/72 h). Low xylose absorption was found in only one patient and low lactose absorption in none. The median orocaecal transit time was only 110 minutes (less than or equal to 60 min in 4 cases). Postoperative weight loss showed significant inverse correlation with orocaecal transit time. Bacterial overgrowth of the small intestine was found in four patients. The cause of malabsorption was assumed to be rapid intestinal transit in four patients and bacterial overgrowth in four others, leaving three in whom pancreatic understimulation is suggested as the reason for steatorrhoea.

Aged↗
PubMed1987

Origin of gastrin liberated by gastrin releasing peptide in man.

Gastrin release induced by gastrin releasing peptide (GRP) in man has been studied in patients before and after complete resection of the antrum and duodenal bulb, as well as after pancreaticoduodenectomy according to Whipple. Studies in healthy subjects showed that 400 pmol/kg an hour of GRP induced a maximal release of gastrin. Infusion of this dose of GRP after a complete resection of the antrum and duodenal bulb induced a small, but significant increase in gastrin concentrations. After pancreaticoduodenectomy, however, GRP infusion had no effect on serum gastrin concentrations. In patients previously subjected to an incomplete antrectomy, GRP infusion was followed by a gastrin response considerably higher than after a complete antrectomy. Our results would suggest that GRP is capable of releasing gastrin predominantly from the antrum and the duodenal bulb, but also a small amount of gastrin from the remaining part of the duodenum. Gastrin releasing peptide infusion and determination of gastrin release may be of clinical significance in showing remaining significant gastrin pools in patients with recurrent ulceration after previous gastric resections.

Adult↗
PubMed1987

Effect of high-dose omeprazole administration on histamine storage and formation in canine gastric mucosa.

The effect of a high dose of omeprazole on the plasma gastrin response to feeding and gastric mucosal histamine formation and storage in the dog has been studied. Tissue from the oxyntic gland area was obtained by introduction of an endoscope through a gastric fistula, and biopsies were taken before, after 4 weeks of oral administration of omeprazole and 1 month after withdrawal of the drug. Omeprazole administration increased the basal plasma concentration of gastrin and induced a substantial increase in the feeding response. Histidine-decarboxylase activity was significantly increased after 4 weeks of omeprazole administration, whereas no effect was found on histamine content and mucosal mast cell density. One month after drug withdrawal, the enzyme activity had returned to pretreatment levels.

Animals↗
PubMed1987

Nutrient malassimilation after total gastrectomy and possible intervention.

Malnutrition is common after total gastrectomy. Different pathophysiological reasons have been reported. We have investigated malabsorption in patients after total gastrectomy and Roux-Y esophagojejunostomy, analyzing the orocecal transit time, the bacterial flora of the upper intestine, and the small intestinal carbohydrate fermentation. Furthermore, we studied the benefit of pancreatic enzymes in this condition. The orocecal transit time was found to be short in 5/11 patients. In 4/11 patients upper intestinal bacterial overgrowth was probable. In the remaining 3/11 patients with steatorrhea, pancreatic dysfunction, due to understimulation, was suspected to be the reason for malassimilation. A subsequent double-blind, cross-over trial on supplementary treatment with pancreatic enzymes was performed in 15 patients. This treatment did not significantly reduce the degree of steatorrhea in these patients.

Aged↗
PubMed1987

Antibiotic prophylaxis in high-risk gastric surgery. A prospective, randomized clinical comparison of cefuroxime and doxycycline.

The efficacy of two antibiotics as prophylaxis in high-risk gastric surgery was evaluated in a prospective, randomized trial: 400 mg doxycycline in a single dose (98 patients) was compared with 1.5 g cefuroxime given twice with an 8-hour interval (101 patients). The two groups were comparable in regard to all relevant factors of importance for susceptibility to infection. The incidence of postoperative abdominal infection was 8.2% in the doxycycline group and 7.9% in the cefuroxime group. The most common extraabdominal infectious complications were in the lungs (20% of the patients in both groups). No subgroup of patients was identifiable in which one antibiotic was superior to the other. The efficacy of the two investigated prophylaxis regimens was apparently identical.

Cefuroxime↗
PubMed1987

Measurement of pouch volume and stoma diameter after gastroplasty.

A balloon technique has been developed for measurement of the pouch volume and stoma diameter after gastroplasty. Twenty-seven patients prospectively included in a randomized study of two types of gastroplasty operation have been investigated 6 months postoperatively. During the operation the proximal pouch was calibrated to be about 40 ml and the stoma diameter to 11 min. Six months after the operation the patients had on average reduced weight by 29 kg. Using the balloon technique, the stoma diameter was 12 +/- 1.6 (s.e.m.) mm and the pouch volume 80 +/- 11.0 ml. There was a significant correlation between the stoma diameter and weight reduction during the first 6 months postoperatively (P less than 0.01). The relationship between the stoma diameter and weight reduction followed best an exponential equation. No correlation was found between the pouch volume and weight reduction. The presented technique for measurement of pouch volume and stoma diameter after gastroplasty may be an important tool to evaluate the influence of various factors on the long-term results of surgical treatment for morbid obesity.

Body Weight↗
PubMed1987

Zinc status and dark adaptation in patients subjected to total gastrectomy: effect of zinc supplementation.

Totally gastrectomized patients could be regarded at risk for development of nutritional deficiencies including trace elements. Sensitive indices for early detection of these deficiencies are lacking. In order to evaluate the nutritional status of trace elements in patients previously subjected to a total gastrectomy we studied the zinc status in 10 patients by determining serum zinc, urinary zinc excretion and also, by a simplified dark adaptation test, the effect on these parameters of 4 weeks of zinc supplementation. The serum zinc level but not the 24-h urinary zinc excretion was lower in gastrectomized patients compared to age-matched controls. A slower dark adaptation was observed in the former patients when measured in the non-fasting state but not when fasted. Dark adaptation was slower in the patients as well as the age-matched controls compared to younger healthy subjects. Zinc supplementation increased the serum zinc levels and the urinary zinc excretion in the gastrectomized patients but had no effect on dark adaptation.

Aged↗
PubMed1986

Plasma gastrin and gastric enterochromaffinlike cell activation and proliferation. Studies with omeprazole and ranitidine in intact and antrectomized rats.

Unoperated female rats were subjected to daily oral treatment with omeprazole (10 or 400 mumol/kg body wt), ranitidine (175 + 175 + 350 mumol/kg body wt), or vehicle and antrectomized rats were treated with omeprazole (400 mumol/kg body wt) or vehicle. After 10 wk of treatment, plasma gastrin levels were high in unoperated rats treated with the high omeprazole dose and with ranitidine, and low in antrectomized controls. Plasma gastrin levels were slightly higher in the low-dose omeprazole group than in the intact controls. In antrectomized rats treated with the high dose of omeprazole, the plasma gastrin level was in the same range as in intact control rats. A close correlation (r = 0.89, p less than 0.0001) was found between the plasma gastrin level and the oxyntic mucosal enterochromaffinlike cell density (as well as the tissue levels of histidine decarboxylase and histamine in the oxyntic mucosa) in all groups. The somatostatin cell density in the oxyntic mucosa was not altered by the various treatments. During a recovery period of 10 wk after the 10-wk treatment, the enterochromaffinlike cell density and histamine concentration decreased by 30%-40% in the rats treated with the high dose of omeprazole, whereas the corresponding values increased by 50% and 40%, respectively, in the control rats. The difference between the two groups, however, was still statistically significant. Plasma gastrin levels and gastric histidine decarboxylase activity returned to control values during recovery. The results suggest that the observed changes in enterochromaffinlike cell density are related to the plasma gastrin levels and that they are reversible. it is concluded that neither omeprazole nor ranitidine per se is likely to induce proliferation of enterochromaffinlike cells.

Animals↗
PubMed1986

Histamine storage and formation in canine gastric mucosa--effect of pentagastrin stimulation.

Histamine storage and formation in the dog gastric mucosa were studied during basal conditions and after pentagastrin stimulation. Histamine formation (histidine decarboxylase activity), histamine content as well as the density of mast cells of the oxyntic gland mucosa were evenly distributed. Histamine content of the mucosa was significantly correlated to the density of mucosal mast cells. In the basal secretory state, histamine formation and histamine content of the oxyntic gland mucosa were of the same magnitude as in the antral mucosa. Pentagastrin stimulation induced a small but significant decrease in histamine content of the oxyntic gland mucosa and a subsequent acceleration in the rate of amine formation. Neither histamine content nor histidine decarboxylase activity of the antral mucosa was affected by pentagastrin infusion.

Animals↗
PubMed1986

Polyamine levels in human gastric carcinoma.

The results of experiments from several cell systems support the hypothesis that a connection exists between increased biosynthesis of polyamines (putrescine, spermidine, and spermine) and cellular growth. We have studied the polyamine levels and the activity of ornithine decarboxylase (a rate-limiting enzyme in mammalian polyamine synthesis) in human gastric carcinoma. Putrescine and spermidine levels were significantly elevated as compared with corresponding 'normal' gastric mucosa. The enzyme activity was also higher in neoplastic tissue, but the difference did not reach statistical significance. The present results may be interpreted to support the suggested role of polyamines in rapid tissue growth as represented by human gastric carcinoma.

Aged↗
PubMed1986

Effect of Roux-en-Y gastroenterostomy on gastric emptying of a solid meal following antrectomy and vagotomy.

Gastric emptying of a 51Cr labelled solid meal was studied before and at least 6 months after operation for pyloric-prepyloric ulcer disease. All patients underwent an antrectomy, selective gastric vagotomy but 10 were randomized to a gastroduodenostomy and 12 to a Roux-en-Y gastrojejunostomy. There was no significant difference in the emptying rate between patients studied preoperatively (T 75 = 48 +/- 21.8 min) and those investigated after a Billroth I gastroduodenostomy (T 75 = 45 +/- 15.8 min). However, the emptying rate was significantly retarded in the Roux-en-Y patients as compared to those studied preoperatively (T 75 + T 50 + T 25). In the former group, an initial retardation of emptying of the meal was most apparent (T 75 = 89 +/- 81.7 min). Due to a high standard deviation, the difference between the Roux-en-Y and gastroduodenostomy groups did not reach statistical significance. Our results would indicate that retarded gastric emptying is not a regular phenomenon after a Roux-en-Y gastrojejunostomy provided that a selective gastric vagotomy had been performed and the investigation been carried out at least 6 months after the operation.

Adult↗
PubMed1986

Pancreatic resection additional to gastrectomy for gastric cancer. Effect on postoperative morbidity.

In a 7-year period, 127 patients were treated for gastric carcinoma. Of those younger than 70 years and subjected to gastric resection, 30 (55%) also had pancreatic resection. In older patients the corresponding figure was 11 (28%). The patients with simultaneous pancreatic resection had significantly increased incidence of postoperative intraabdominal complications, the most frequent of which were of septic nature. The number of reoperations was higher and the hospital stay longer in the patients with simultaneous gastrectomy and pancreatic resection.

Aged↗
PubMed1985

Recovery from energy deficit in golden hamsters.

Hamsters feeding at greater than 2-h intermeal intervals (IMI) lose weight but recover from weight losses without hyperphagia if they are allowed to feed at 2-h IMIs (Am. J. Physiol. 236 (Endocrinol. Metab. Gastrointest. Physiol. 5): E105-E112, 1979). To determine the relative importance of changes in energy expenditure and fat synthesis in their energy regulation, measurements were made of resting metabolic rate, respiration by brown adipose tissue (BAT), locomotion, fecal energy content, and insulin and hepatic lipogenic enzyme responses to feeding in underweight hamsters allowed to feed at 2- or 5-h IMIs. Energy deficit suppressed the resting metabolic rate and general locomotor activity and increased the activity of fatty acid synthetase (FAS). Heat production by BAT increased in underweight hamsters. Increase in IMIs blocked the postprandial insulin release, reduced plasma insulin concentration and FAS activity, and increased malic enzyme activity. Thus ad libitum feeding hamsters recover from energy deficit by reducing energy expenditure, whereas failure to add additional meals and impaired insulin and changed lipogenic responses to feeding produce energy deficits in infrequently feeding hamsters.

Adipose Tissue, Brown↗