Search PubMed⌕ Search

Biomedical subjects

M Osnes

Publications and source records attributed to M Osnes.

At least 73 records · Page 4Linked to original sources

Juxtapapillary duodenal diverticula.

This paper presents a review of the clinical significance of juxtapapillary duodenal diverticula in man. The incidence of such diverticula varies considerably in the literature, and possibly depends on the methods of investigation used. Studies show that the incidence of biliary calculi is significantly higher in patients with juxtapapillary diverticula as compared with patients without such diverticula. The assumed higher rate of diverticula in patients with pancreatitis is probably due to the presence of biliary calculi in these patients. Studies have shown that there is an insufficient choledochoduodenal sphincter in patients with diverticula, and also a higher rate of bacterial contamination of the duodenum and bile ducts in these patients. Fecal type flora has been found in most patients with juxtapapillary duodenal diverticula. Further, pigment gallstones have been found in most patients with diverticula, and analyses of these calculi showed that calcium bilirubinate was the main component. Further studies in our laboratory have shown that bacterial cultures produced beta-glucuronidase, a fact which may be connected with the increased frequency of pigment gallstones. Other studies have shown that there is a higher rate of diverticula in patients with recurrent biliary calculi who had undergone cholecystectomy. Recent data have also shown that there is a higher rate of common bile duct calculi in patients with diverticula, than in those without diverticula and without prior cholecystectomy--a fact supporting the theory on the pathogenesis of biliary calculi in patients with juxtapapillary diverticula. Other, and rare complications due to such diverticula are also mentioned.

Adult↗

Management of NSAID-induced gastrointestinal lesions.

Mucosal lesions in the g.i. tract due to ASA and other nonsteroidal anti-inflammatory drugs are well-known in clinical practice. Though the gastroduodenal mucosa is the area most commonly investigated, several recent reports focus on lesions in the small and large intestine as well. Despite considerable efforts in the field, none of the new substances developed in the past few years have proven convincingly superior to existing drugs. Instead, other approaches are being evaluated: Bypassing of the gastroduodenal mucosa through enteric coating and slow release formulations have been suggested, but the possibility of transferring the deleterious effects to distal parts of the gastrointestinal tract by such formulation modifications calls for extensive evaluation of this area, before these formulations can be applauded as advantageous in this group of patients. Co-administration of protective substances has also been advocated, and, despite somewhat contradictory results, protection has been reported by H2-antagonists alone or in combination with antacids, as well as by cytoprotective agents like Sucralfate, and prostaglandin analogues.

Anti-Inflammatory Agents, Non-Steroidal↗

Colonoscopy in the diagnosis of colorectal cancer.

Many studies show that colonoscopy is the most accurate method available in the diagnosis of colorectal cancer. Furthermore, in some cases it makes it possible to treat malignant polyps adequately by simple polypectomy. Endoscopic removal of adenomas plays an important role in prevention of colorectal malignancies. It has also been shown that there is a high rate of synchronous premalignant and malignant lesions.

Cohort Studies↗

The probability of pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium. A sequentially designed clinical trial.

Endoscopic retrograde pancreatography (ERP) with parenchymatous contrast filling may result in clinical pancreatitis. The aim of the present prospective trial was to assess the frequency of acute pancreatitis after pancreatic parenchymatography with a non-ionic contrast medium, metrizamide. For ethical reasons the examination was designed as a sequential study with clearly defined stopping rules. None of the 48 patients studied developed clinical pancreatitis. This indicates that the probability of pancreatitis after parenchymatography is less than 5%. A high degree of contrast filling was obtained both in patients with normal and in those with pathologic pancreatic ducts. The contrast filling of the ducts was associated with not more than a slight pain. The rise in serum amylase was considerable but was not associated with clinical pancreatitis and returned to preexamination levels within 48 h. The examination shows that the non-ionic contrast medium used is well tolerated in ERP.

Adult↗

Bacterial growth in the duodenum and in the bile of patients with gallstone disease treated with endoscopic papillotomy (EPT).

Bacterial growth in the duodenum and in the bile was studied in 30 patients treated by endoscopic papillotomy (EPT) for stones in the common bile duct. Duodenal sampling was done endoscopically with a microbiology specimen brush, and bile was collected from the common bile duct using a catheter designed to avoid contamination from other sources. The same type of fecal flora was found in the duodenum and in the bile. The majority of patients had more than one strain in the duodenum as well as in the bile. Strains belonging to the Enterobacteriaceae and fecal streptococci dominated. Anaerobes were found in the duodenum in 27.7% of the patients, and in the bile in 16.7%. The heavy bacterial infestation of the common bile duct in our patients did not give rise to clinical symptoms.

Adult↗

Transpapillary biopsies and brush cytology from the common bile duct.

This study comprises 29 patients with a stricture of the common bile duct of unknown etiology, in whom an attempt was made endoscopically to take a biopsy from the ductal wall, in order to establish the diagnosis. Biopsies were obtained from all patients. Follow-up permitted definite diagnosis in 17 patients, from surgery or biopsy. The endoscopic biopsy diagnosis (malignant/benign) proved to be correct in 10 patients, falsely negative in 4. Two were "uncertain malignant" and 1 "not representative". No false positives were seen. Brush cytology provided no additional information. No complications due to the procedure were seen. The results imply that the procedure might be helpful in the evaluation of these patients.

Aged↗