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Biomedical subjects

Mark Berner Hansen

Publications and source records attributed to Mark Berner Hansen.

13 recordsLinked to original sources
PubMed2006

[Capsule endoscopy detection of metastasis of a malignant melanoma in the small intestine].

We report a case of a 74-year-old man with a Clark's level II, 2.5 mm melanoma on his back that was excised. A post-operative PET scan found no lesions. One and a half years later, the patient developed anaemia with blood in his stool. A gastroscopy and colonoscopy found no lesions. Video capsule endoscopy, however, detected a tumour in the small intestine. At laparotomy, the tumour was removed. Histological diagnosis showed metastatic malignant melanoma. We believe that video capsule endoscopy may increase the rate of diagnosis of small-bowel melanoma metastases.

Aged↗
PubMed2006

[Can endoscopic retrograde cholangiopancreatography be made a low-risk procedure?].

Endoscopic retrograde cholangiopancreatography (ERCP) is considered a high-risk procedure. Here we report 30-day morbidity and mortality rates following ERCP in a single referral centre with experienced endoscopists and restrictive selection of patients and indications for the procedure. The specific ERCP-related morbidity rate was 6.9%, and the specific ERCP-related mortality rate was only 0.3%. We conclude that ERCP is a safe procedure in the hands of experts and with the use of selection of patients and restrictive indications for the procedure.

Adolescent↗
PubMed2006

[Treatment by stent of a benign stricture of the colon complicated by a fistula].

We report on a case of a 69-year-old man with a benign stricture of the sigmoid colon due to diverticulosis, complicated by a colovesicular fistula. Due to severe co-morbidity, surgical excision of the fistula and resection of the sigmoid colon were not indicated. Instead, the stricture and the fistula were managed via the insertion of a self-expanding, uncoated metallic stent (SEMS). The clinical symptoms disappeared after insertion of the SEMS. We conclude that SEMS may be a possible therapeutic tool in selected cases of benign stricture of the colon, with or without fistula.

Humans↗
PubMed2006

Functional characterization of serotonin receptor subtypes in human duodenal secretion.

Serotonin (5-HT) stimulates ion secretion in the gastrointestinal tract and the sensitivity for 5-HT might be altered in dyspeptic patients infected with Helicobacter pylori. The purpose of the present study was to characterize the 5-HT-induced electrogenic ion transport in the duodenum of dyspeptic patients with or without Helicobacter pylori infection, and to determine the 5-HT receptor subtypes functionally involved. Biopsies from the second part of duodenum were obtained from 43 dyspeptic patients during routine endoscopy. Biopsies were mounted in modified Ussing chambers with air suction for measurements of short-circuit current by a previously validated technique. Short-circuit current was measured before and after application of graded cumulative doses of 5-HT and a single dose of bumetanide (an inhibitor of chloride/bicarbonate transport), or one of the selective 5-HT receptor antagonists: ketanserin, ondansetron, or SB-204070 (1-butyl-4 piperidinmethyl-8-amino-7-chloro-2,3-dihydro-1,4-benzodioxin-5-carboxylate HCl). Histological examination was performed on duodenal biopsies. Helicobacter urease testing and histological examination determined Helicobacter pylori infection. 5-HT induced a dose-dependent and bumetanide-sensitive short-circuit current, which was independent of the presence of Helicobacter pylori infection. All the three 5-HT receptor antagonists failed to significantly effect basal and 5-HT-induced short-circuit current. Our results indicate that in human duodenum 1) 5-HT is a potent stimulator of bumetanide-sensitive secretion, 2) the serotonergic receptor subtype, which acts as the main mediator of 5-HT-induced secretion is different from the 5-HT(2), 5-HT(3), and the 5-HT(4) subtype and, 3) the sensitivity to 5-HT is not altered by Helicobacter pylori infection.

Adult↗
PubMed2005

Effects of nitric oxide in 5-hydroxytryptamine-, cholera toxin-, enterotoxigenic Escherichia coli- and Salmonella Typhimurium-induced secretion in the porcine small intestine.

The effects of nitric oxide (NO) in the secretory response to the endogenous secretagogue 5-hydroxytryptamine (5-HT), the enterotoxins heat-labile enterotoxigenic Escherichia coli (ETEC) toxin (LT) and cholera toxin (CT), and various cultures of ETEC and Salmonella serotype Typhimurium in the porcine small intestine (Sus scrofa) were investigated. In anaesthetized pigs, jejunal tied-off loops were instilled with 5-HT, LT, CT, various cultures of ETEC or S. Typhimurium. Pigs were given intravenously isotonic saline or isotonic saline containing the NO synthase inhibitor, Nomega-nitro-L-arginine methyl ester (L-NAME). L-NAME significantly induced an increased fluid accumulation in loops induced by 5-HT, ETEC and stn-mutated S. Typhimurium. Fluid accumulation in loops instilled with wild-type S. Typhimurium was increased by L-NAME, although not significantly, while there was no effect on fluid accumulation induced by an invH-mutated isogenic strain. No significant effect of L-NAME was observed on the fluid accumulation induced by the purified enterotoxins LT and CT. The results also demonstrated a relatively large difference in the ability to induce fluid accumulation between the bacteria strains. Diastolic, systolic and mean blood pressures were significantly increased and the body temperature was significantly decreased in groups of pigs treated with L-NAME. In conclusion, the results suggest that NO has a proabsorptive effect in the intact porcine jejunum and is involved in the systemic vascular tone.

Animals↗
PubMed2004

Splenic cysts.

The treatment of splenic cysts is a difficult challenge to surgeons and physicians. This paper reviews the literature on splenic cysts, with special attention to the pathogenesis, diagnosis, and various options of surgical treatment. Splenic cysts are classified as primary or secondary cysts, according to the presence of an epithelial lining. The primary cysts are further subdivided as parasitic or non-parasitic. Secondary cysts are in most cases posttraumatic. Symptoms are usually correlated to the size of the cyst. Prior to surgery, imaging with ultrasound and computer tomography or magnetic resonance should be performed. A cyst puncture should be conducted for diagnostic purposes (amylase and bacteria) as well as to reduce the size of the cyst. Furthermore, the titer of Echinococcus and other biomarkers can be measured. Surgeons should make every possible effort to preserve splenic tissue and spleen-saving techniques with laparoscopic techniques are recommended.

Adult↗
PubMed2003

[Splenic cysts--pathogenesis, diagnostics and treatment].

A case of a benign noninfectious cyst is reported. Splenic cysts are uncommon. They are diagnosed by ultrasonography, computer tomography, and nuclear magnetic resonance. The cysts are either infectious (e.g. parasitic) or noninfectious (e.g. posttraumatic). The cystic content should be analysed for bacteria, parasites, and amylase. Noninfectious cysts larger than four cm and/or symptomatic cysts should be treated surgically with laparoscopic decapsulation.

Aged↗
PubMed2003

The enteric nervous system II: gastrointestinal functions.

The enteric nervous system is involved in most of the physiological and pathophysiological processes in the gastrointestinal tract. This Minireview is part two of three and describes the role of the enteric nervous system in gastrointestinal functions (motility, exocrine and endocrine secretions, blood flow, and immune processes) in health and some disease states. In this context, the functional importance of the enteric nervous system for food intake, the gall bladder, and pancreas will be addressed. In specific, dysmotility, diarrhoea, constipation, non-occlusive intestinal ischaemia (intestinal angina), inflammation, cholelithiasis, cholecystitis, postcholecystectomy syndrome, and pancreatitis can be treated with neuroactive pharmacological agents. For example, serotonin receptor type four agonists can be used for the treatment of constipation, while nitric oxide synthesis inhibitors can be employed for the treatment of intestinal angina.

Animals↗
PubMed2003

The enteric nervous system III: a target for pharmacological treatment.

The past decade has seen major advances in the pharmacological understanding of the nervous system of the gastrointestinal tract, the enteric nervous system, and its importance for gut functions in several states of disease. Indeed, the enteric nervous system has become a promising target in the treatment of many gastrointestinal symptoms and disorders. Some of these new therapeutic concepts, such as botulinum toxin for achalasia and serotonergic drugs for functional bowel diseases, are already in clinical use. This paper is part 3 of three Minireviews in Pharmacology & Toxicology, and presents the neurogastrointestinal pharmacological therapeutic options in gastrointestinal pain, functional gastrointestinal disorders, inflammatory bowel diseases, cancer and related conditions with focus on future drug targets. The diagnosis of gastrointestinal neuropathy, the role of serotonin and related neuroendocrine transmitters, serotonergic drugs, and neurotrophic factors in neurogastrointestinal pharmacology will be addressed in this context.

Acetylcholine↗
PubMed2003

The enteric nervous system I: organisation and classification.

Major advances have been made in our understanding of the nervous system in the gastrointestinal tract, the enteric nervous system. Because of its importance, neurogastroenterology is being increasingly recognised in clinical pharmacology. The enteric nervous system is a collection of neurones that can function more or less independently of the central nervous system and controls or modulates motility, exocrine and endocrine secretions, microcirculation and immune and inflammatory processes. Increasing knowledge of the physiology, pathophysiology, and pharmacology of the enteric nervous system will provide a basis for creation of new approaches to the treatment of gastrointestinal disorders. This review is part one of three and will describe the organisation and classification of the enteric nervous system.

Animals↗
PubMed2002

[Blunt isolated pancreatic trauma. Diagnostic problems--a clinical and radiological challenge].

INTRODUCTION: Blunt isolated pancreas trauma is rare, but it is a very serious condition. Diagnosis and treatment are often delayed, which considerably increases morbidity. The delay is caused by uncharacteristic symptomatology and the application of paraclinical and radiological diagnostic methods of low initial sensitivity and specificity. The aim of this study was to describe the diagnostic difficulties and the applicability of the various radiological modalities. MATERIAL AND METHODS: During the period 1995-2000, three patients with blunt isolated pancreas trauma were treated, and the case reports were examined retrospectively. RESULTS: All three showed classical mechanisms of injury, and a characteristic delay in diagnosis and treatment of 24 to 48 hours was seen. DISCUSSION: The frequent delay in diagnosis and subsequent treatment of the blunt pancreas trauma requires a more optimal strategy for handling such traumas. We recommend the following diagnostic algorithm: Repeated measurements of serum amylase initially. Image diagnostics with a dynamic spiral CT-scan with both oral and intravenous contrast. The CT scan is to be repeated or supplemented by MRCP on continued suspicion of pancreas injury, even when the initial CT scan shows normal findings.

Adult↗
PubMed2002

Effects of cyclooxygenase and lipoxygenase inhibition on basal- and serotonin-induced ion transport in rat colon.

The purpose of this study was to determine the effect of a selective cyclooxygenase (COX)-2 inhibitor as compared to non-selective COX and lipoxygenase (LOX) inhibitors in rat colon. Basal- and serotonin (5-hydroxytryptamine, 5-HT)-induced electrogenic ion transport (short circuit current, SCC), prostaglandin E2 (PGE2) release and histological characteristics were measured. Muscle-stripped mucosal sheets of the proximal and distal segment of rat colon were investigated by employing the Ussing chamber technique, radioimmunoassays for PGE2 and light microscopy examinations for control of tissue integrity. 5-HT and PGE2 both induced a concentration-dependent increase in SCC by activation of multiple receptors. The response to 5-HT was bumetanide-sensitive. Neither the non-selective COX inhibitor piroxicam, nor the selective COX-2 inhibitor SC-'236, altered basal- SCC or 5-HT-induced SCC. Indomethacin reduced both basal- and 5-HT-induced SCC in both segments. Nordihydroguaiaretic acid reduced the 5-HT-induced increase in SCC, but did not change basal SCC. 5-HT-induced a concentration-dependent release of PGE2. Only high concentrations of piroxicam and indomethacin reduced basal PGE2 release and 5-HT-induced PGE2 release. Histological examination of the specimens demonstrated only minor changes following mounting in chambers. There were no apparent differences in the morphology following treatment with COX or LOX inhibitors. These results suggest that in rat colon only the COX-1 enzyme is expressed under basal conditions. Furthermore, data suggest neither the COX-1 nor the COX-2 enzyme to be of major importance for 5-HT-induced ion transport in rat colon in vitro. In conclusion, this study supports 5-HT as a mediator of chloride secretion by activating several receptor subtypes and the LOX enzyme, releasing mediators such as leucotrienes.

Animals↗