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Biomedical subjects

O Kronborg

Publications and source records attributed to O Kronborg.

At least 181 records · Page 10Linked to original sources
PubMed1978

Polyglycolic acid versus chromic catgut in bladder surgery.

The clinical importance of calcified deposits on sutures in bladder surgery was evaluated in a blind paired randomised trial of 3/0 chromic catgut versus polyglycolic acid 3/0. Cystoscopy with photographic recording was performed 8 weeks after operation in 40 patients without and 8 patients with previous or present bladder stones. None had visible calcified deposits at that time and sutures were only visible in 1 patient from each of the 2 groups without bladder stones. It was concluded that neither chromic catgut nor polyglycolic acid sutures carry any significant risk of bladder stone formation, whether infection is present or not; the conclusion includes both patients with and without previous bladder stones, but is less firm in the former because of the small number of patients studied.

Bacteriuria↗
PubMed1978

Assessment of completeness of vagotomy and surgical experience 10 days and 3 months after proximal gastric vagotomy.

Spontaneous and maximum acid secretion was measured before, and 10 days and 3 months after proximal gastric vagotomy (PGV) to determine the optimal time for testing the completeness of vagotomy. Insulin tests were done 10 days after PGV and it was investigated whether any of the tests could distinguish between experienced and less experienced surgeons. Sixty-eight patients were studied, 38 being operated by experienced and 30 by less experienced surgeons. No significant changes were found in BAO and PAO from 10 days to 3 months after PGV in any of the groups. In contrast to the insulin test results, measurements of BAO and PAO did not discriminate between the two groups of surgeons. However, very incomplete vagotomies according to insulin test results were identified by measurements of PAO 3 months after PGV. It is concluded that early postoperative insulin tests are preferable. The surgeon remembers details of the PGV, the patients is liable to accept the test at this time and insulin tests are more sensitive in discriminating between experienced and less experienced surgeons. Measurements of maximum acid secretion should only replace these tests in patients with cardiac diseases and they should then be performed 3 months after PGV.

Adult↗
PubMed1977

Reappraisal of surgery for suppurative cholecystitis.

Ninety-two patients with suppurative cholecystitis operated on as emergency cases were studied in retrospection. Obstructive cholangitis was seen in two, who eventually died. The mortality after cholecystectomy alone was related to the presence of stones in the common bile duct. The mortality after cholecystostomy alone was related to shock and septicemia, but not to the presence of common bile duct stones or obstructive cholangitis. It was concluded that suppurative cholecystitis with accompanying common bile duct stones should be treated with cholecystectomy and choledocholithotomy, because of the lower rate of reoperations and possibly lower mortality than after cholecystectomy alone; an exception should be made in patients with deterioration in clinical condition or patients in whom technical difficulties develop during the operation. These patients should be subjected to a cholecystostomy as the only emergency procedure.

Adolescent↗
PubMed1977

Recurrent ulcer after proximal gastric vagotomy for duodenal and pre-pyloric ulcer.

Factors thought to be important in the development of recurrent ulcer after proximal gastric vagotomy were investigated 1-4 years after operation in 211 patients with duodenal ulcer and in 49 with pre-pyloric ulcer. Recurrent ulcer was found in 25 patients with duodenal ulcer (12 per cent) and in 6 with pre-pyloric ulcer (12 per cent). Recurrence was not related to age, sex, duration of dyspepsia, radiological findings or peak acid output before and 10 days after vagotomy. Fifty-six patients were operated upon by the method of Amdrup and Jensen (1970), including skeletonization of about 2 cm of the oesophagus. The remaining 204 patients were operated on by a technique in which the dissection of the lesser curve was begun at the 'crow's foot' and the oesophageal dissection was extended, in most cases, to more than 4 cm above the cardia. Recurrence was more frequent among the 56 patients in the first group than among the remaining patients with duodenal ulcer. Recurrence was positively related to basal acid output after vagotomy. An increase of peak acid output of 50 per cent was seen in a smaller group with recurrence and patients with dyspepsia within 18 months of vagotomy. It was concluded that the risk of recurrence is not related to the number of parietal cells, as expressed by peak acid output to histamine. The risk may probably be reduced by extension of the oesophageal skeletonization. A marked increase in peak acid output may be seen during the first year after proximal gastric vagotomy in patients with recurrence or dyspepsia.

Duodenal Ulcer↗
PubMed1977

Maximum acid output in duodenal ulcer patients with different length of history and controls without dyspepsia.

Recent studies suggest a normal maximum acid secretion in duodenal ulcer patients with a history of less than three years, but an increase of secretion in those with longer history. The validity of this hypothesis was investigated in groups of patients with operatively verified duodenal ulcer and history for less than 3, 3--6, and 7--10 years. Each group, including 21 men and nine women, was compared to two male and one female group of age-matched controls without dyspepsia. In smaller groups of 16 men it was possible to compare age-matched groups from a population of 376 men with histories for up to 22 years. Finally, 11 men with an ulcer history of less than one year were compared to 11 controls. All subjects had measurements of MAO by the augmented histamine test. MAO was significantly higher in patients with a history less than one year and less than three years, respectively, compared to controls. After correction of MAO for weight or lean body mass the difference remained significant in men, but not in the smaller groups of women. MAO in men with a history of from less than three up to 22 years did not show any maximum. Thus, the study did not support the assumption that gastric hypersecretion is a result of duodenal ulceration.

Adolescent↗
PubMed1977

Influence of different techniques of proximal gastric vagotomy upon risk of recurrent duodenal ulcer and gastric acid secretion.

Different techniques of proximal gastric vagotomy were used from 1970 to 75 in 267 patients with duodenal ulcer. A 1-4 years clinical follow-up showed an unacceptable high rate of recurrent ulcer (23-24%) in patients having skeletonization of the lower 2 cm of the esophagus, regardless of the extent of preserved antral innervation (6-9 cm). Extension of the esophageal dissection resulted in a lower recurrence rate (8%) and a higher frequency of complete vagotomies as expressed by the average acid response to insulin. No constant relationships were found between reductions of basal acid output and peak acid output to histamine 10 days after proximal gastric vagotomy and the risk of recurrent ulcer.

Duodenal Ulcer↗
PubMed1977

Proximal gastric vagotomy with suprapyloric mucosal antrectomy for duodenal ulcer.

The feasibility of doing proximal gastric vagotomy with suprapyloric mucosal antrectomy for duodenal ulcer was investigated in a pilot study of seven patients. The aim was to reduce the risk of recurrent duodenal ulcer after proximal gastric vagotomy without causing a simultaneous increase of the risk of dumping and diarrhoea. The patients were subjected to pre- and early postoperative gastric secretory tests, radiologic and endoscopic examinations of gastric motility 2 months later, and a clinical follow-up 1 year after the operation. Basal and maximum acid secretion was reduced by 86 and 70% in average in 6 patients. One patient developed mild dumping. Neither recurrent duodenal ulcer nor diarrhoea was accounted. However, 3 patients developed severe gastric stasis and 2 of these had to be reoperated, one having an anastomotic ulcer between fundic and suprapyloric mucosa. The results of this rather timeconsuming and tedious operation did not encourage further trial, but suggested proximal gastric vagotomy alone as being the operation of choice for duodenal ulcer without pyloric or duodenal stenosis.

Duodenal Ulcer↗
PubMed1976

Polyglycolic acid (Dexon) versus silk for fascial closure of abdominal incisions.

Suture-granulomas were previously found in 6% of patients subjected to colorectal surgery. It was therefore investigated whether the use of polyglycolic acid (Dexon) instead of silk for fascial closure of abdominal incisions would reduce the rate of granulomas without an accompanying increase in rate of wound dehiscences. The two sutures were evaluated in a triple blind, randomized trial, using the paired sample principle in patients subjected to elective gastrointestinal surgery. One gram of Pentrexyl powder was applied to the subfascial space in all the patients and the wounds were examined 10 days, 1 and 3 months after the operations. The trial was terminated when a closed sequential analysis had shown a significantly higher rate of dehiscences after closure with silk (12/163) than after closure with polyglycolic acid (1/163). Seven patients had granulomas after silk and one after polyglycolic acid at that time. Postoperative wound infections occurred in 7 patients after silk and 8 after polyglycolic acid. It is concluced that the use of polyglycolic acid (Dexon) nearly eliminates the risk of suture-granulomas, without increasing the risk of wound dehiscences; on the contrary, the rate of dehiscences was lower after polyglycolic acid.

Abdomen↗
PubMed1976

Billroth I gastric resection versus truncal vagotomy and pyloroplasty in the treatment of gastric ulcer.

Forty-five patients with benign gastric ulcers were treated by truncal vagotomy and pyloroplasty or Billroth I gastric resection in a randomized, controlled trial. Postoperatively, one Billroth I patient died. During the follow-up recurrence occurred in three patients treated by vagotomy, but in no Billroth I patient. The overall functional results according to the classification of Visick were slightly, but unsignificantly better after Billroth I than after vagotomy and pyloroplasty.

Aged↗
PubMed1976

Relationships between gastric acid secretion and recurrent duodenal ulcer after selective vagotomy and pyloroplasty in men.

Relations between gastric acid secretion measurements and recurrence of duodenal ulcer within 1 to 4 years after selective vagotomy and pyloroplasty were evaluated in a series of 117 men. The discriminatory ability of spontaneous, histamine- and insulin-activated acid secretion measurements was significant and similar to that after truncal vagotomy and drainage. The measurements were of no practical value for the diagnosis of recurrent duodenal ulcer after vagotomy, but they provided a rationale for selective surgery in patients with duodenal ulcer and patients with recurrent duodenal ulcer after vagotomy.

Duodenal Ulcer↗
PubMed1975

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms↗
PubMed1975

A controlled, randomized trial of highly selective vagotomy versus selective vagotomy and pyloroplasty in the treatment of duodenal ulcer.

The results of highly selective vagotomy without drainage and selective vagotomy with pyloroplasty for duodenal ulcer were compared in a randomized, controlled trial of a series of 100 patients. The frequency of dumping, diarrhoea, and epigastric fullness was significantly lower after highly selective (6, 6, and 8 percent) than after selective vagotomy (30, 20, and 28 percent) one year after the operations. Recurrent and persisting duodenal ulcers appearing from one to four years after the operations were significantly more frequent after highly selective (22 percent) than after selective vagotomy (8 percent). No significant relationships were found between recurrent ulceration and gastric acid secretion measurements after the two operations. The Hollander response was early positive in 28 percent and late positive in 30 percent of the patients subjected to highly selective vagotomy, while the corresponding figures after selective vagotomy were 26 and 32 percent. The overall clinical results of the two operations were not different according to the classification of Visick. Excluding the patients with recurrence resulted in significantly better clinical results after highly selective vagotomy.

Adult↗
PubMed1975

The effect of beta-adrenergic blockade upon basal and pentagastrin-stimulated gastric acid secretion and upon gastrin response to food.

Beta-adrenergic blockade with 10 mg of propanolol had no significant effect upon the spontaneous gastric acid secretion, while the maximum (pentagastrin) acid secretion was depressed in healthy subjects and patients with duodenal ulcer. The gastrin response to food was significantly higher during beta-adrenergic blockade. It is suggested that a minor part of the maximum acid secretion may be due to activation of beta-receptors, while the gastrin response to food is probably not related to activation of beta-receptors.

Depression, Chemical↗