Biomedical subjects

M Osnes

Publications and source records attributed to M Osnes.

At least 37 records · Page 2Linked to original sources

PubMed1994

In situ measurement of colorectal polyps to compare video and fiberoptic endoscopes.

The present study was performed to test the reliability of in situ measurements of colorectal polyps when comparing videoendoscopes with fiberoptic endoscopes. In 25 small rectosigmoid polyps 3-12 mm) removed endoscopically, in situ diameters were measured before polypectomy using both video- and fiberoptic endoscopes. Polaroid and videoprint pictures were taken for computerised analysis of the area of the polyps on the pictures. The results showed a good correlation between the polyp diameter measured with the videoendoscope and fiberoptic endoscope (r = 0.97), with no significant difference by parametric testing. The diameter and weight of the removed polyp also correlated well with the diameter measured in situ using videoendoscopes (r = 0.92 and 0.77, respectively) or fiberoptic endoscopes (r = 0.90 and 0.81, respectively). Furthermore, the weight of the removed polyp correlated reasonably well to the computerised area measurement, the correlation coefficient being r = 0.90 for fiberoptic endoscopes and r = 0.75 for videoendoscopes. We conclude that in situ polyp diameter measurements using videoendscopes and fiberoptic endoscopes are similarly reliable and sensitive, and both instruments can be used interchangeably in follow-up studies of polyp growth.

Colonic Polyps↗

PubMed1994

Common bile duct stones are mainly brown and associated with duodenal diverticula.

This study investigated the composition of common duct gall stones from 61 patients, aged 49-94. The stones were collected endoscopically with a dormia basket after endoscopic papillotomy. The cholesterol content was measured both by infrared spectroscopy (mean 29%, range 0-99%) and enzymatically (mean 23%, range 0-96%). The results of the two measurements showed good correlation (r2 = 0.92), indicating that cholesterol can be adequately measured enzymatically. Most of the stones were pigment stones. When examined by infrared spectroscopy, 44 stones (72%) contained less than 50% cholesterol (mean 4%, range 0-23%). The bilirubinate content in these stones was 56%, range 12-100%. Forty two of these stones were brown stones, and only two were black stones. Pigment stones were associated with juxtapapillary diverticula (p < 0.01). It was found that brown pigment stones were the commonest symptomatic bile duct calculi in the patients studied, who are representative of a Western population.

Aged↗

PubMed1994

Growth of colorectal polyps: recovery and evaluation of unresected polyps of less than 10 mm, 1 year after detection.

BACKGROUND AND METHODS: Colonoscopic 1-year control of polyps of less than 10 mm left in situ was carried out in 103 (89%) of 116 originally examined patients. RESULTS: Analysis showed an 85% recovery: 91% and 81% for polyps of 5-9 mm and < 5 mm, respectively. The recovery was significantly related to size and localization, whereas the growth rate was inversely correlated to the originally measured diameter. A linear relationship was demonstrated between anus-to-polyp distances 1 year apart, with a normalized agreement index of 0.70. In only 1 of 189 polyps, an increase of diameter to > 10 mm was demonstrated. The 79 new polyps in 52 (50%) of the patients were significantly smaller, more often right-sided, and related to multiplicity of polyps at the initial examination but not to growth of recovered polyps or cleansing status. CONCLUSION: An acceptable recovery and growth rate of polyps < 10 mm seems to justify the continuation of the study for the remaining 2 years.

Aged↗

PubMed1993

Urinary D-glucaric acid, a marker substance for microsomal enzyme induction. Methodological aspects, responses to alcohol and findings in workers exposed to toluene.

D-glucaric acid, an end product of glucuronic acid metabolism, has been used as a marker substance for microsomal enzyme induction. In this study a convenient microtitre-plate based method for the quantification of urinary D-glucaric acid has been developed and validated. Mean urinary D-glucaric acid excretion in 20 health humans as measured by this method was 3.2 mumol glucaric acid mmol-1 creatinine, 95% confidence interval 3.0-3.4. Moderate alcohol consumption in 18 healthy volunteers did not significantly augment the urinary D-glucaric acid excretion. Occupational exposition to toluene in a printing plant was investigated. In spite of considerable intra- and inter-individual variability, a significant difference between exposed (3.5, 3.1-3.9) and non-exposed (2.6, 2.2-3.0) workers was observed, p < 0.025. We conclude that the measurement of D-glucaric acid can be utilized for biological screening of enzyme induction on a group basis.

Adult↗

PubMed1993

Total protein in common duct bile measured by acetonitrile precipitation and a micro bicinchoninic acid (BCA) method.

Bile protein assays are complicated due to interference by other bile substances. In the present study we describe a microtiter plate method for the purification and quantification of bile proteins. The method is based on addition of acetonitrile in three steps to reconstituted freeze-dried bile, followed by ethanol washing of the precipitated proteins. Finally, protein in the precipitate is quantitated by two-point colour development using micro BCA reagents. Overall recoveries of protein in reconstituted bile spiked with exogenous protein (Seronorm) ranged from 91.0% (coefficient of variation; CV = 7.0%) to 97.1% (CV = 2.4%) by recoveries of 125I-Fibrinogen and 125I-Albumin. Bile pigments were largely removed during precipitation and washing, as verified by high pressure liquid chromatography (HPLC). Preferably the samples should be freeze-dried initially, as this lowered the blank readings. Two-point colour development with the BCA reagents were identical for standards assayed directly and standards added to protein depleted bile, and processed through all steps. Hence, no interference by either residual bile constituents nor the reagents upon the BCA protein assay could be detected. Standard curves ranged from 0.05 to 5.0 gl-1 (r > 0.98). Within day reproducibility (n = 15) was 7.8% (CV) and day to day (n = 10) was 12.1% (CV). Mean protein concentration in common duct bile from 30 patients was 1.20 gl-1 (range 0.34-3.87 gl-1). The method appears suitable for assay of bile protein, requires only limited sample volumes and allows processing of many samples within a short time.

Acetonitriles↗

PubMed1992

[Mucosal lesions associated with antiphlogistics--treatment and prevention].

Gastrointestinal side effects associated with nonsteroidal, anti-inflammatory drugs are well known, but recent data suggest that the small and large bowel are target organs in addition to the gastroduodenal mucosa, although the clinical significance of changes in permeability and of mucosal inflammation is unknown. Inhibition of prostaglandin synthesis remains the major pathogenetic hypothesis for the entire gastrointestinal tract, but additional mechanisms are probably involved. Ulcers that occur during non-steroidal anti-inflammatory drug therapy can be treated in the same way as other peptic ulcers, but the duration of treatment should be extended if the non-steroidal anti-inflammatory drug cannot be withdrawn. Prophylactic therapy with H2-antagonists or prostaglandin analogues may be justified in selected high risk individuals.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1992

[Development and use of a database for gastroenterologic endoscopy].

With no commercially available endoscopy database manager available, a standalone system for gastroenterological endoscopy departments has been developed since 1985 through joint efforts of gastroenterologists and dedicated programmers. The present system was implemented for daily use January 1989 and, to date, approximately 19,000 examinations have been recorded. Nurses and office assistants carry out administrative work, but the physician enters the endoscopic data, partly as free text, partly as structured data via automated menus and a mouse. In addition to the immediate printout of the result, valuable data are stored in the computer for administrative and research purposes. Mean data entering time for the physician was four minutes 17 seconds, and altogether eight minutes 40 seconds was spent on the computer system for each patient served.

Database Management Systems↗

PubMed1992

Comparison of low-dose antacids, cimetidine, and placebo on 24-hour intragastric acidity in healthy volunteers.

Low-dose aluminium (Al) antacids are effective in promoting ulcer healing and symptomatic relief in peptic ulcer patients, although the effect on intragastric acidity is very weak. In this randomized, double-blind study, 24-hr intragastric acidity was compared in 11 healthy volunteers, treated with a low-dose Al antacid regimen (1 tablet four times a day), cimetidine (800 mg at bedtime) and placebo, using the double-dummy technique. Standardized meals were given at 8 AM, noon, and 5 PM. Medication was given 1 hr after meals and at bedtime. Intragastric acidity was recorded with a nasogastric monocrystant antimony pH catheter, connected to an ambulatory digital data recorder. No significant difference in intragastric acidity was observed between antacid and placebo treatment. Treatment with cimetidine reduced circadian and nocturnal (but not diurnal) intragastric acidity significantly, as compared to both placebo and antacid treatment. The results support the hypothesis that Al antacids promote peptic ulcer healing by other mechanisms than acid neutralization.

Adult↗

PubMed1992

Quantification of lipopolysaccharides in human bile with or without gram-negative bacteria.

Lipopolysaccharide (LPS) was assayed in 78 samples of human common-duct bile, obtained at endoscopic retrograde cholangiography. The LPS was assayed by a chromogenic limulus amebocyte lysate (LAL) test, after dilution of bile samples in heparinized plasma and inactivation of inhibitors. The assay was not influenced by other biliary constituents, as demonstrated by the recovery of standards. Bile pigments did not influence the results. The LAL test was positive in 60 of the samples, 59 of which had a positive culture for gram-negative bacteria or Candida sp. The levels of LPS were significantly correlated to the total number of bacteria (n = 16, R = 0.55, p less than 0.05). The median LPS level was 35,250 ng/l and showed a very large variation (140 ng/l to 27.8 mg/l). In four of the samples gram-negative bacteria were present, but no LPS could be detected. The study demonstrates the presence of LPS in great quantities in human bile and supports the feasibility of using the LAL test on bile samples. The presence of LPS (within the detection limit) appears to be associated with local microbial colonization.

Adult↗

PubMed1992

Reliability of in situ measurements of colorectal polyps.

A reliable and sensitive in situ method for measuring polyp size is fundamental for growth studies of colonic polyps. A measuring probe inserted through a colonoscope can give a visual assessment of polyp diameter, and from a picture of the polyp the area of the polyp on the picture can be calculated by computerized analysis. To test the reliability and sensitivity of these two in situ measurements, 43 colonic polyps (mean diameter, 8.5 mm; range, 4-20 mm) removed by snare diathermy resection were examined. The maximal diameter was measured, and two Polaroid pictures taken of each polyp. After polypectomy each polyp was subjected to extracorporeal reassessment of diameter and measurement of weight and volume. By computerized analysis of the pictures the following variables were estimated: 1) area of the polyp on the picture; 2) largest diameter; 3) maximum width 90 degrees on the largest diameter; 4) maximum distance from centre of gravity; and 5) minimum distance from centre of gravity. Results showed good correlation between diameter measured in situ and after removal (r = 0.93), diameter raised to the 3rd power and weight (r = 0.93), and also to volume (r = 0.77). Area analysis compared with weight was less good (r = 0.72). A very high correlation was demonstrated between weight and volume (r = 0.99). We conclude that the measurement of diameter in situ with a measuring probe is sensitive and somewhat more reliable than computerized analysis of size. The present 3-year follow-up and intervention study will show which of the two methods is preferable for evaluation of polyp growth.

Colonic Polyps↗

PubMed1992

Gastroduodenal lesions associated with two different piroxicam formulations. An endoscopic comparison.

This endoscopic study was performed to compare the gastroduodenal endoscopic findings after short-term treatment with plain and enteric-coated piroxicam tablets. Sixteen healthy male volunteers (mean age, 22 years; range, 19-27 years) were included in a double-blind, randomized study in which 20 mg piroxicam was given once daily for 2 weeks as plain tablets or enteric-coated tablets in a crossover fashion. The washout period was 5 weeks, and endoscopy was performed before each treatment period to ensure base-line conditions. Endoscopic evaluation of the stomach and duodenum was performed, with separate registration of the duodenum distally to the duodenal bulb. Visual analogue scales of 150 mm were used for grading the mucosal lesions, with separate registration of mucosal injection and erosive and haemorrhagic lesions. A 5-point scale (Lanza scale) was also used, to compare the two scoring systems. A significantly lower lesion score was found with the enteric-coated formulation for all endoscopic variables in both scoring regions. The sum of visual analogue scale scores in the stomach/duodenal bulb after treatment was 121 mm and 74 mm, respectively (p < 0.01), and in the middle and distal duodenum the corresponding figures were 54 mm and 23 mm (p < 0.01). The fixed-point scoring gave identical conclusions, as did the separate scoring by a different investigator evaluating the same endoscopies. Subjective symptoms were similar for the two formulations, and no carryover effects were detected. We conclude that enteric coating of piroxicam tablets may offer a means of protecting the gastroduodenal mucosa in short-term treatment of healthy subjects.

Adult↗

PubMed1992

Naproxen-associated gastroduodenal toxicity: enteric coated granules versus plain tablets.

Two naproxen formulations were compared with regard to gastroduodenal endoscopic findings. Using a dose of 500 mg bid for one week, plain tablets were compared to enteric coated granules in a gelatine capsule in a randomized, cross over, double-blind, double dummy study in 16 healthy, male volunteers. Endoscopic evaluation revealed no difference between the two formulations. Since previous studies with enteric coated naproxen tablets indicated a favourable side effect profile compared to plain tablets, the present data indicates that enteric coated formulations are not all alike, and should be studied individually.

Adult↗

PubMed1992

Gastrointestinal bleeding associated with the use of non-steroidal, anti-inflammatory drugs--symptomatology and clinical course.

The symptoms associated with admission for gastrointestinal haemorrhage were studied in relation to the intake of non-steroidal, anti-inflammatory drugs (NSAIDs) within fourteen days prior to admission. In a prospective, two-year study we included only those with bleeding due to gastroduodenal ulcers or haemorrhagic erosive gastritis. In 94 patients with a median age of 74 years, NSAID use was stated in 54, but the symptoms in these subjects (degree of epigastric pain, nausea or heartburn) were no different from those without previous NSAID use. Correspondingly, no difference was seen as to the clinical course of the bleeding.

Adult↗

PubMed1992

Growth of colorectal polyps: design of a prospective, randomized, placebo-controlled intervention study in patients with colorectal polyps.

One hundred and sixteen patients were included, during 18 months, in a double-blind placebo-controlled intervention study, with calcium, vitamins A, C, E and selenium (in a cocktail) or placebo against growth of colonic polyps. Patients were randomized within three arms, according to diameter of the largest polyp, < 5 mm, 5-9 mm or > 9 mm. Polyps > 9 mm were resected, the others were left to be measured annually before resection after 3 years. The protocol (performed in all of the patients) included registration of demographic data, family and personal history, measurement of polyps, collection of blood specimens, stools and biopsy samples. Registration of nutritional status, diet history and 5-day prospective food consumption, was performed in 108 patients. The patient compliance was registered every third month by the hospital pharmacist, with concomitant delivery of new boxes of capsules. Additionally, stool collections were performed from all of the patients for the measurement of faecal calcium, bile salts and fat. Inclusion rate of 37, 41 and 38 patients in each of the three 6-month periods was uniform. The group with the largest polyps measuring 5-9 mm comprised 44% of the material. The sex ratio corresponded to that in overall referrals for colonoscopy. The age relationship of size and multiplicity of polyps and the distribution of polyps in the large bowel corresponded to previous experience in polyp-bearing individuals of the same age.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1991

[Familial clustering of asbestos-related diseases].

This article describes the case histories of four individuals in the same family, all of whom developed asbestos-related disease. Special emphasis is placed upon the case of a woman, who after seemingly minimal exposure to asbestos, in the form of cleaning her husband's working clothes, developed a malignant mesothelioma. The incidence of asbestos-related disease has increased steadily over the past ten years. This probably reflects the extensive use of asbestos in Norway since World War II, and the long latency period of the disease. The authors recommend obtaining an in-depth history of exposure when asbestos-related disease is suspected.

Aged↗

PubMed1991

The SADE system: an endoscopic database manager.

The development of the SADE database manager was commenced in 1985 since no commercially available systems were suited for the needs of a large endoscopy unit. Over a period of five years, this database was programmed, revised and enhanced through the joint efforts of gastroenterologists and programmers, the SADE system being implemented for daily use on 1 January 1989. The patient administration and medical record modules are fully implemented and functional, while the statistical module has only recently been finished. The present features of the system are described, and the limitations discussed. Instant report generation and direct access to previous medical data are the most immediate benefits of the system. The initial intention to have structured anamnestic data had to be modified to suit the need for flexibility and ease of free text input by the users.

Computer Systems↗

PubMed1991

SADE database for endoscopic procedures: aspects of clinical use.

The time aspects of daily use of a clinical database system in an endoscopy department were studied. The SADE database system for endoscopic procedures was introduced for daily use at Ullevål Hospital on 1 January 1989. The average weekly programme of the endoscopy unit includes 57 gastroduodenoscopies, 23 colonoscopies and 12 ERCP/EPTs. During three consecutive weeks of the study the mean physician input time was 4 min 17 sec per patient (range 57 sec to 15 min), individual variation depending mainly on the extent of the report. Assistants spent a mean time of 4 min 23 sec for each patient. Thus, a total of 8 min 40 sec was spent for every patient seen. Endoscopic units should analyze their routines and needs before introducing an electronic data base manager.

Database Management Systems↗

PubMed1991

The multi-crossover model for classifying patients as responders to a given treatment.

The strength and the validity of the multi-crossover model (MCO model) were investigated to optimalize the procedure for correctly classifying individual responders to a given therapy. One hundred and fifteen patients with non-ulcer dyspepsia from seven Norwegian hospitals were included in a 6-week double-blind MCO-designed trial with alternating weekly treatments with ranitidine and placebo. An individual effect score (X score) was calculated on the basis of the number of times the active drug was associated with less symptoms than the preceding or following placebo period. Patients categorized as responders (X score greater than or equal to 4) or unclassifiables (X scores = 2 or 3) after the MCO period continued single-blind active treatment for 4 weeks and were then reclassified by means of cross-tabulation of efficacy and adverse effects. Eighty-five per cent of the MCO responders and 62% of the 42 MCO unclassifiables were reclassified as responders. The reclassified responders were then included in a single-blind follow-up placebo period until relapse or for a maximum of 8 weeks. The relapse rate was significantly greater (p less than 0.01) and the time to relapse significantly shorter (p less than 0.01) in the group of MCO responders than in the MCO unclassifiables. The large response and relapse rates in the group of MCO responders verify that the MCO model is a reliable method for correctly classifying responders to treatment. Our results indicate that by including patients with an X score of 3 in the definition of 'responder', the MCO model could be modified to optimalize the procedure for correct classification.

Clinical Trials as Topic↗