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Biomedical subjects

O K Andersen

Publications and source records attributed to O K Andersen.

At least 55 records · Page 3Linked to original sources
PubMed1995

Facilitation of the human nociceptive reflex by stimulation of A beta-fibres in a secondary hyperalgesic area sustained by nociceptive input from the primary hyperalgesic area.

Hyperalgesia was induced in healthy volunteers by topical capsaicin applied on the dorsum of the foot within the receptive field of the sural nerve. Under presence of hyperalgesia different normally non-noxious conditioning stimuli were applied to the hyperalgesic area and the polysynaptic nociceptive spinal reflex and pain ratings were used to assess central excitability. The nociceptive reflex was measured in the knee extensor and flexor muscles evoked by electrical stimulation of the sural nerve trunk at an intensity of 1.5 times the initial reflex threshold (an intensity above the pain threshold). Thermal stimulation of the primary hyperalgesic area (re)established both on-going spontaneous pain and secondary hyperalgesia. Thus, increased nociceptive reflexes were recorded and increased pain intensity reported when A beta-fibres in the secondary hyperalgesic area were activated concurrently with the reflex testing after a non-noxious thermal stimulation of the primary hyperalgesic area. The A beta-fibre activation was achieved by continuous low-intensity electrical stimulation (40 Hz) that was initiated after on-going pain produced by the thermal stimulation had waned. The same measurement without prior thermal conditioning stimulation of the primary area resulted in no reflex facilitation, indicating rapid changes in the central excitability with existence of on-going nociceptive activity. This indicates that the development and maintenance of secondary hyperalgesia are dependent on sustained peripheral nociceptive activity. The study also shows that a central summation of nociceptive and non-nociceptive afferent activity can occur once secondary hyperalgesia is present.

Adrenergic Fibers↗
PubMed1994

[Constriction of the femoral vein after McVay hernioplasty].

Constriction of the femoral vein is a well known complication to the Cooper ligament repair of inguinal hernia. This may occur as the transversalis fascia and aponeurosis are sutured to Copper's ligament, either because a suture is passed through the vein or the vein is compressed by tissue. Clinical presentation is usually signs of deep venous thrombosis or pulmonary embolism. Venography verifies the diagnosis by showing a characteristic constriction of the femoral vein.

Constriction, Pathologic↗
PubMed1994

Electric stimulation of the esophageal mucosa. Perception and brain-evoked potentials.

BACKGROUND: Brain potentials have been used to assess somatosensory, visual, and auditory function, whereas few attempts have been made to evoke brain potentials from viscera. METHODS: The present study evaluated perception and brain potentials evoked by electric stimulation at four different intensities in the esophagus of healthy volunteers. Results were compared with somatosensory evoked potential variables. RESULTS: In 6 of 10 subjects the two highest esophageal stimulus intensities caused a deep pain perception. A positive correlation between average esophageal stimulus intensity and age was demonstrated. The amplitude of brain potentials increased significantly as a function of both esophageal and cutaneous stimulus intensity. The latency of esophageally evoked potentials decreased with stimulus intensity and was substantially longer than cutaneously evoked potentials despite a comparable conduction distance. CONCLUSIONS: The present methods provide possibilities to assess sensory mechanisms and perception related to the human esophagus.

Adult↗
PubMed1993

[Immunomodulating treatment of severe aplastic anemia in adults].

Immune modulating therapy has greatly improved the prognosis in aplastic anaemia, but the response to treatment varies considerably. We describe eight patients who were treated for severe aplastic anaemia. Antithymocyte globulin was given as first line treatment, followed by cyklosporine A if the patient failed to respond. Seven patients entered complete remission, but two of these relapsed later. Both developed paroxysmal nocturnal haemoglobinuria. One patient failed to respond to therapy. She died of bone marrow failure and haemochromatosis 12 months after start of therapy. Immune modulating therapy is discussed in relation to bone marrow transplantation, which is the alternative therapy for younger patients.

Adolescent↗
PubMed1993

Safety of enoxaparin and dextran-70 in the prevention of venous thromboembolism in digestive surgery. A play-the-winner-designed study.

A total of 327 patients were included in a play-the-winner (PTW)-designed study comparing the safety of prophylaxis with enoxaparin and dextran-70 in patients undergoing digestive surgery. In a PTW-designed study the treatment of any next patient will depend on the outcome of the previous one. If successful, the next patient will receive the same treatment. Excessive bleeding, on the basis of specified criteria, severe adverse effects, or occurrence of clinically detected venous thromboembolism was classified as failure. The PTW design allocates most patients to the superior treatment. In this study 200 patients were given enoxaparin and 127 dextran-70. The success rate was 83% in the enoxaparin group and 74.8% in the dextran-70 group (p = 0.05). The survival analysis of 'Number of patients before change in treatment' shows a significant difference in favour of enoxaparin (p = 0.05). Enoxaparin seems to be superior to dextran-70 as a prophylaxis in digestive surgery. The PTW model is a suitable design in such studies.

Adolescent↗
PubMed1993

Laparoscopic and open cholecystectomy. A prospective, randomized study.

OBJECTIVE: To compare laparoscopic with open cholecystectomy. DESIGN: Prospective random control trial. SETTING: Central Hospital of Akershus, Nordbyhagen, Norway. SUBJECTS: 74 consecutive patients due to undergo elective cholecystecomy between October 1990 and June 1991. INTERVENTIONS: Two patients were excluded from randomisation, and two were withdrawn after randomisation. The remaining 70 were randomly allocated to open or laparoscopic cholecystectomy (n = 35 in each group). MAIN OUTCOME MEASURES: Duration of operation and postoperative stay in hospital, amount of postoperative pain, incidence of complications, and duration of convalescence and sick leave. RESULTS: Laparoscopic cholecystectomy took twice as long as open (median [range] 100 [52-180] minutes compared with 50 [15-115], p < 0.01), but patients stayed in hospital half the time (2 [1-9] days compared with 4 [2-22], p < 0.01); required less opiate analgesia (4 [0-20] doses compared with 6 [0-13], p = 0.02; took less sick leave (11 [4-267] days (n = 18) compared with 34 [20-48] (n = 22), p < 0.01); and spent less time in convalescence (8 [3-40] days (n = 17) compared with 49 [10-247] (n = 12), p < 0.01). There were six complications in the laparoscopy group and seven in the open cholecystectomy group. CONCLUSION: Because of the significant differences between laparoscopic and open cholecystectomy we have now adopted the laparoscopic method as our standard, but we think that we can improve our results further by refining our operative techniques and giving our patients more information.

Adult↗
PubMed1992

[Laparoscopic closure and tegmentation of perforated ulcer].

Laparoscopy is fully recognized for diagnosis and even treatment of various acute abdominal conditions. In a 42-year-old woman with intense lower abdominal pain, laparoscopy revealed a perforated peptic ulcer. The ulcer was closed and patched with omentum and the abdomen was irrigated, all by laparoscopic techniques. Except for a minor wound infection recovery was uneventful.

Abdomen, Acute↗
PubMed1992

Disodium pamidronate versus mithramycin in the management of tumour-associated hypercalcemia.

Twenty-eight consecutive hypercalcemic patients with cancer referred to our department were included in a randomized study, comparing the second generation bisphosphonate pamidronate (APD) with our standard treatment consisting of rehydration, mithramycin (repeatedly) and supportive care. Three patients were excluded, due to rapid deterioration and death, leaving 25 evaluable patients. APD was administered as a single i.v. infusion of 30, 60 or 90 mg depending on the serum calcium, while mithramycin was given in doses of 1.25 mg and repeated if necessary within the first three days. The primary endpoint of the study was the serum calcium day 6. APD normalized serum calcium in all patients, and 12 out of 14 were still normocalcemic day 12. In contrast, mithramycin was effective only in 3 out of 11 patients, and in these patients hypercalcemia recurred rapidly. The success of APD was underscored by the fact that the patients in this group achieved a significantly better performance status after treatment. No serious side-effects were recorded in either group.

Diphosphonates↗
PubMed1991

[Endoscopic bile duct drainage--technique].

The authors describe the technique of endoscopic implantation of endoprosthesis in the bile duct. From 1978 to 1989 implantation of endoprosthesis was successful in 88.7% of 212 patients. One to three procedures per patient were required for primary implantation. 407 procedures were performed; primary implantation, replacement of endoprosthesis and implantation of additional endoprosthesis. The success rate increased from 55% in the first third of the period to 82.4% in the last third. Ten patients had been previously operated with Billroth II gastrectomy and one with Whipple's operation. Implantation was successful in seven of these patients.

Bile Ducts↗
PubMed1991

[Endoscopic bile duct drainage--results].

212 patients were treated with endoscopic endoprosthetic drainage for bile duct obstruction. 137 patients had inoperable malignant obstruction, ten operable malignant tumor, 35 bile duct stones and 30 various benign strictures. Endoprosthetic stenting was successful in 188 patients (88.7%). The remaining 24 patients were treated with percutaneous transhepatic drainage or biliaryintestinal anastomosis, or received no treatment. In patients with successful implantation of endoprostheses, jaundice was relieved in 81% of the cases and pain in 89.6%. Cholangitis was treated with good results in 93.5%. Biliocutanous fistulas closed in two patients. Patency of the endoprostheses was 87 days on average. Replacement of endoprostheses or insertion of additional endoprostheses was performed 130 times. Complications occurred in 52 of 407 procedures (12.6%). Mortality related to the endoscopic endoprosthetic treatment was 4.2%.

Adult↗
PubMed1991

[Laparoscopic cholecystectomy].

Techniques and instruments have recently been developed to perform laparoscopic cholecystectomy. Compared with conventional cholecystectomy, laparoscopic cholecystectomy results in significantly less post-operative pain and a shorter stay in hospital. We describe the procedure for laparoscopic cholecystectomy, with reference to the first patients treated in this way.

Adult↗
PubMed1989

Duodenal ulcer treated with omeprazole: healing and relapse rates. Does treatment duration influence subsequent remission?

One hundred and twenty-nine patients were studied with regard to healing of duodenal ulcers with 30 mg omeprazole once daily, recurrence rates after 2 and 4 weeks' treatment in patients with ulcers healed after 2 weeks, and recurrences in rapid and slow healers. Cumulative healing rates were 77% and 98% after 2 and 4 weeks, respectively. Eighty-one patients (65%) were without ulcer symptoms after 2 weeks, and 43 (34%) were improved. Seven of 45 patients (16%; 95% confidence limits, 6-30%) with ulcers healed after 2 weeks had relapsed after another 2 weeks of placebo; 3 were asymptomatic. The overall relapse rate after 6 months was 62%. There were no statistically significant differences in relapse rates between 2 and 4 weeks' treatment of patients with ulcers healed after 2 weeks or between rapid and slow healers. Ulcer size, smoking habits, and alcohol consumption were not significantly related to healing or relapse.

Adolescent↗
PubMed1989

Proteolytic and lysosomal enzymes in acute trauma-induced lung injury in sheep.

Surgical preparation of a lung lymph fistula in sheep was previously shown to induce temporary permeability disturbance of pulmonary microvessels. Flow and composition of lung lymph were compared in 19 sheep with acute, and 16 with chronic lymph fistula. Lymph and plasma were analyzed regarding activities of prothrombin, antithrombin III, prekallikrein, kallikrein, functional kallikrein inhibitors and 11 acid hydrolases of lysosomal origin. Levels of prothrombin and antithrombin III fell postoperatively in plasma and reached even lower values in lymph, indicating systemic activation of the coagulation system as well as local activation in the lung. The studied components of the plasma-kallikrein system were unchanged. Lysosomal enzymes were released in lung lymph, reflecting cell injury in the lung. Local activation of proteolytic enzyme systems thus occurs in the lung after trauma. Analysis of organ-specific lymph (= interstitial fluid) may contribute to better understanding of the pathophysiology of trauma.

Animals↗
PubMed1987

Lysosomal enzyme pattern in lung lymph and blood during E. coli sepsis in sheep.

Systemic release of lysosomal enzymes and local release in the pulmonary microcirculation from sequestrated and activated leucocytes could be an important factor in the development of the lung microvascular injury seen after septicaemia. The maximal activities of 11 lysosomal acid hydrolases (acid phosphatase, alpha- and beta-glucosidase, alpha- and beta-galactosidase, alpha-mannosidase, beta-acetylglucosaminidase, beta-glucuronidase, arylamidase and cathepsins B and C) were measured in serum and lung lymph from seven sheep before and after infusion of live E. coli bacteria. In the early phase of septicaemia (the first hour) the activities of eight enzymes were increased in serum and/or lung lymph (1.1 to 2X pre-infusion values). In the late phase, 3-4 h after sepsis, there were significantly elevated serum activities of beta-glucosidase (5.4X), alpha- and beta-galactosidases (2.7X, 1.5X), beta-acetylglucosaminidase (2.0X) arylamidase (1.2X) and cathespin B (1.7X). In lymph acid phosphatase (1.7X), alpha- and beta-glucosidases (1.6X, 6.4X), alpha- and beta-galactosidases (2.1X, 1.7X). Beta-acetylglucosaminidase (2.6X), and beta-glucuronidase (4.0X pre-infusion) were elevated. The findings of a heterogenicity of changes in serum and lymph activities, as well as the large molecular sizes of some of the enzymes with changed activities indicated to us that permeability changes were not major causes of increased lymph enzyme activities. The results could indicate a local release of enzymes either from sequestrated leucocytes or lung tissue due to local reactions in the lung or lung microvessels. The heterogenous changes in activities for the various lysosomal enzymes as found in the present study indicated that measurement of only one enzyme could be misleading.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Endotoxin-induced human and porcine leucocyte reactions in vitro.

Tube migration of a fixed number of PMN cells in plasma (5 X 10(9) cells/l) was approximately reduced by 50% when 1 ml of cell suspension was exposed to 20 micrograms E. coli endotoxin in 100 microliter NaCl for 2 hours. Procoagulant activity in monocytes increased approximately eight-fold when 1 ml of whole blood was exposed to 2 ng endotoxin in 10 microliters NaCl for 2 hours. Chemiluminescence in both PMN cells (5 X 10(9) cells/l) and mononuclear cells (2 X 10(9) cells/l) in plasma was markedly increased when 100 microliters cell suspension was added to 100 microliters Luminol, exposed to 20 micrograms endotoxin in 100 microliters NaCl and tested immediately. Decreased lysosomal enzyme levels in PMN and mononuclear cells were demonstrated when 1 ml cells in plasma (the same cell numbers as aforementioned) were incubated for 4 hours at 37 degrees C with 200 micrograms endotoxin in 100 microliters NaCl. Similar results were obtained in human and porcine leucocytes, making the pig a suitable animal for studies of humoral and cellular reactions to infections complications following trauma and major surgery.

Animals↗
PubMed1986

Patient compliance with intensive antacid treatment. A multi-centre study.

Patient compliance with respect to a liquid antacid (Novaluzid) was examined in an open multicentre study. The study included 186 patients with various upper gastrointestinal conditions. The patients were randomly assigned to either 2 or 4 weeks' treatment with 10 ml Novaluzid 1 and 3 hours after each meal and at bedtime. They were not informed that they were taking part in a study. The compliance was high, with no difference between the two groups; 82% and 79%, respectively, and showed no dependency on patient age, diagnosis or previous use of antacids.

Antacids↗
PubMed1986

Metabolic burst and motility in granulocytes following trauma and endotoxinaemia in the anaesthetized pig.

The early effects of trauma and endotoxinaemia in pigs have been studied with regard to granulocyte motility and metabolic burst (chemiluminescence). Increased spontaneous chemiluminescence was observed following a moderate aseptic trauma (osteotomies) or endotoxin infusion in healthy pigs. Zymosan-opsonized chemiluminescence was increased post trauma. Endotoxin infusion, however, led to unchanged values during infusion but a significant decreased Zymosan-opsonized chemiluminescence 3 h after ended infusion. Migration capacity was unchanged by trauma, but markedly reduced following endotoxin infusion. When traumatized pigs had an endotoxin infusion 24 h post trauma, the increase in spontaneous chemiluminescence was significantly more pronounced than following endotoxin infusion in healthy pigs, and Zymosan-opsonized chemiluminescence less decreased. Motility, however, was equally reduced as following endotoxin infusion in healthy pigs. These findings correspond well with the known decreased phagocytic capacity of granulocytes in septicaemia, but also indicate a rapid post-traumatic reaction which might be an attempt to reduce the lethal danger of a subsequent infection.

Animals↗