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Biomedical subjects

O Kronborg

Publications and source records attributed to O Kronborg.

At least 163 records · Page 9Linked to original sources
PubMed1984

Incision and drainage v. incision, curettage and suture under antibiotic cover in anorectal abscess. A randomized study with 3-year follow-up.

Conventional incision and drainage was compared with incision plus curettage and primary suture of abscess cavity under antibiotic cover in a prospective, randomized trial of 83 patients with acute anorectal abscess with or without low fistula. All the patients were followed up for three years. The time to healing was on average three weeks less after suture than after incision alone. The difference was statistically significant. Primary healing was obtained in 32 of 42 cases after suture. Recurrence of abscess tended to be more frequent after suture, but the time to healing of initial and recurrent abscesses and fistulas in the three-year observation period continued to be three weeks less after suture than after incision alone, making suture the most attractive treatment.

Abscess↗
PubMed1984

Acceptability and compliance in screening for colorectal cancer with fecal occult blood test.

To evaluate acceptability of and compliance with the Hemoccult-II guaiac test in screening for occult fecal blood, a representative sample of 685 persons 40-74 years old received slides and invitation without previous notice. Sixty-seven per cent accepted. Eight persons (1.7%) had a positive test. Two had rectal cancer, and two had adenomas. Acceptability decreased significantly with age in women but not in men. Eighty-seven per cent agreed to repeated screenings with intervals of 1-2 years. The acceptability was favorable compared with other studies and suggests 70-74 years as the upper limit for screening. Acceptability may even be increased by further information to the population. Written reminders were effective, but telephone calls were not. Compliance was high, since only 20 persons needed further instructions, and the proportion of false-positive tests suggested that dietary instructions had been followed. The high acceptability favors the planning of a major randomized trial of the possible effect of screening on mortality from colorectal cancer.

Adenoma↗
PubMed1983

Plasma catecholamine and serum gastrin concentrations during sham feeding.

Plasma adrenaline, plasma noradrenaline and serum gastrin concentrations were measured before and after sham feeding in eight patients with duodenal ulcer and in four normal subjects. No significant change in the concentrations was observed after sham feeding. In three patients with duodenal ulcer an insulin test resulted in a 25-fold rise in plasma adrenaline. The ulcer patients showed significantly higher levels of plasma adrenaline and plasma noradrenaline than the normal subjects both before and after sham feeding, and this difference was probably not caused only by age difference in the two groups. It is concluded that sympathetic nervous activity and serum gastrin concentrations are not influenced by sham feeding in contrast to the influence of insulin hypoglycemia.

Adult↗
PubMed1983

The remaining colon after radical surgery for colorectal cancer. The first three years of a prospective study.

This study investigates the possible gain and limitation by performing colonoscopy and double-contrast enema immediately after, and every six months after, radical surgery for colorectal cancer. It was possible to perform a complete colonoscopy within three months of surgery in 80 per cent of the 239 patients and at the follow-up time in 90 per cent. Incompleteness was related to insufficient bowel preparation, narrow anastomosis, and long transverse colon. Five patients had synchronous cancers, and 64 had adenomas at the time of surgery. The risk of recurrent adenomas in the latter was higher (17/64) than in those without adenomas (15/175). The adenomas were located above the rectum in 57 of 80 patients who had polypectomy. Four patients with metachronous cancer and one of five patients with local recurrence had another radical operation, while this was possible in none of 40 patients with recurrence diagnosed by other means than colonoscopy and enema. Radical colorectal surgery should be followed by colonoscopy and double-contrast enema, but how often and for how long remains to be established.

Adenoma↗
PubMed1983

Follow-up after colorectal polypectomy. I. A comparison of the effectiveness of repeated examinations of the colon every 6 and 24 months after removal of stalked polyps.

To investigate the effect of follow-up study after colorectal polypectomy, 156 patients with symptomatic stalked adenomas with light to severe dysplasia were allocated at random to colorectal examination every 6 (A) and 24 (B) months after colonoscopic polypectomy. No high-risk group could be identified. Twenty-one of the 23 new polyps were located above the rectum, but 15 could have been removed during examination with the flexible sigmoidoscope. The risk of new adenomas was similar at all 6-month examinations, during the first 4 years of the study. A small carcinoma (Dukes A) was found at 24 months in group B. A fatal colonic perforation was seen in group A after seven previous colonoscopies without complications. The new polyps caused no symptoms other than minimal bleeding in some of the patients, and because increasing the rate of colonoscopies increases risk of complications, it was considered justified to prolong the intervals to 24 and 48 months, at random.

Adenoma↗
PubMed1983

Follow-up after colorectal polypectomy. II. Repeated examinations of the colon every 6 months after removal of sessile adenomas and adenomas with the highest degrees of dysplasia.

Fifty-five patients with colorectal sessile adenomas and adenomas with the severest dysplasia were followed up every 6 months with colonoscopy and/or double-contrast enema during 4 years, after a clean colon had been obtained, by repeated colonoscopy within 3 months after piecemeal polypectomy. The repetition at 3 months resulted in detection of two cancers. An overlooked cancer was detected at 1 year, and another cancer was diagnosed between examinations. Risk of new adenomas (19 patients) was related to original size, number, and glandular structure of the polyps. Twelve of the 19 patients had new polyps above the rectum. The 336 colonoscopies were complicated by 3 laparotomies, made necessary by perforation and bleeding. The results suggest that intervals between examinations of patients with the present type of adenomas may be prolonged, and patients are now allocated at random to colorectal follow-up examination every 6 and 12 months.

Adenoma↗
PubMed1982

Postoperative radiotherapy in rectosigmoid cancer Dukes' B and C: interim report from a randomized multicentre study.

The design, and complications seen during the first 2 years, of a randomized trial of postoperative radiotherapy for rectosigmoid cancer Dukes' B and C are presented and discussed. It is concluded that the present complication rate-below 10% in 221 patients-permits continuation of the intake, which is planned to include 550 patients, to demonstrate a possible increase in crude 5-year survival by 15% (60-75% in Dukes' B and 25-40% in Dukes' C), on the basis of a 0·01 significance level and a probability that the experiment will be successful of 0·90.

Clinical Trials as Topic↗
PubMed1982

Gastric acid response to sham feeding and pentagastrin before and after parietal cell vagotomy in patients with duodenal ulcer.

The influence of sham feeding (PAOSh) preceding pentagastrin-stimulated gastric acid secretion (PAOPg) was investigated in 28 patients with duodenal ulcer (DU) before vagotomy and in 36 after parietal cell vagotomy (PCV). Sham feeding had little influence on PAOPg, and it is concluded that the two secretion tests may be combined. The ratio PAOSh/PAOPg was significantly reduced by PCV. Fourty-four patients with DU were studied for 1 year after PCV, and their PAOPg was measured preoperatively and their PAOPg and PAOSh postoperatively. Seven of the 44 patients had recurrent ulcer within 1 year. PAOPg had no predictive value pre- and post-operatively, but postoperative PAOSh and PAOSh/PAOPg were both significantly higher in patients with recurrent ulcer. It is concluded that PAOSh and PAOSh/PAOPg after PCV may assess completeness of vagotomy, but the relationship between PAOSh and risk of recurrent ulcer may be stronger than that between PAOSh/PAOPg and recurrence.

Adult↗
PubMed1981

Suprapubic bladder drainage in colorectal surgery.

Seventy-six consecutive patients were studied prospectively in order to assess the value of suprapubic bladder drainage following surgery of the rectum and sigmoid colon. An Argyle-Ingram catheter (ICI) was inserted after the laparotomy incision had been made and the bladder was drained continuously for 24 h after which the catheter was closed and opened only every 6 h for 10 min. The patients were invited to void at will after the first 24 h. The catheter was removed when the post-voided volume became less than 50 ml on each of two subsequent measurements. The longest period of drainage was necessary after rectal excision, while rectosigmoid resections demanded shorter periods. The catheter did not function in one patient and urethral catheterization became necessary after removal of the suprapubic catheter in 4 patients. The method of suprapubic bladder drainage is recommended because it permits spontaneous voiding, allows measurement of residual volume without urethral instrumentation, gives little discomfort to the patient and has few complications.

Adult↗
PubMed1981

A prospective, partly randomized study of the effectiveness of repeated examination of the colon after polypectomy and radical surgery for cancer.

Results of 629 colonoscopies and 130 double-contrast examinations, performed during the first 2 years of a prospective, partly randomized cancer prophylactic programme, are reported. The patients were not more than 75 years old and had no previous diagnosis of adenoma or cancer. Repeated colonoscopy 3 months after polypectomy in 80 patients increased the chance of obtaining a complete colonoscopy from 70% to 86%, and the hepatic flexure was reached in a further 9%. Thirteen had polypectomy during the second colonoscopy. The gain in number of patients with adenomas was highest in those with sessile villous adenomas, carcinoma in situ, and mucosal carcinoma. Repeated colorectal examinations every 6 months in these resulted in recurrence rates of 13 of 33, 3 of 23, and 2 of 15 (18 months), respectively. The same figures for patients with stalked polyps, allocated to examination every 6 months, were 3 of 34, 1 of 21, and 2 of 14. Colonoscopy was also performed within 3 months of radical surgery for colorectal cancer, and 35 of 142 patients had polypectomy. Repeated examinations every 6 months resulted in recurrence rates for adenomas of 11 of 85, 3 of 46, and 1 of 34. One new cancer after 12 months could be treated radically. Five uncomplicated laparotomies were performed after the 629 colonoscopies because of perforation or bleeding.

Adenocarcinoma, Mucinous↗
PubMed1981

The antrum in duodenal ulcer patients. Relationship between antrum size, nerve of Latarjet, gastrin cell quantity, and gastric acid secretion.

Estimates of the border between antral and fundic mucosa, antral size, antral G-cell density, G-cell population, and total G-cell volume were made from multiple biopsies taken from the gastric curves during parietal cell vagotomy for duodenal ulcer in 33 patients. No relation was found between the landmarks of Latarjet's nerve and the border. The fundic mucosa was underdenervated in 20% of the patients, and the postoperative acid response to sham feeding in these was higher than in patients with an overdenervated or optimally denervated border. No relation was found between antral size, defined as antral mucosal volume containing G-cells, and preoperative acid secretion. However, an inverse relation was found between antral size, defined as antral mucosal volume containing no parietal cells, and preoperative maximum acid secretion, suggesting an inverse relation between areas with and without parietal cells. No relation was found between acid secretion and G-cell densities, G-cell population, or total G-cell volume.

Cell Count↗
PubMed1980

Acid response to sham feeding as a test for completeness of vagotomy.

The reproducibility of acid responses to modified sham feeding by the chew-and-spit technique (PAOsh) was investigated in 21 duodenal ulcer (DU) patients 8 to 14 days after vagotomy. Possible relationships between PAOsh and the acid response to 0.2 U of insulin per kilogram body weight were examined (PAOI) in 23 other DU patients 8 to 14 days after vagotomy. PAOsh was reproducible to a high degree (PSpearman less than 0.001, CV 2.9%), and a highly significant relationship was found between PAOsh and PAOI after vagotomy (PSp less than 0.001). PAOsh and PAOI were similar when PAOI was low, whereas a highly incomplete vagotomy according to PAOI was followed by a somewhat lower, but substantial, acid response to sham feeding. The relationship between PAOsh and PAOI permits the recommendation of modified sham feeding as a safe stimulant of acid secretion in quantitative testing of completeness of vagotomy.

Adult↗
PubMed1980

Recurrent ulcer 5 1/2--8 years after highly selective vagotomy without drainage and selective vagotomy with pyloroplasty.

The recurrent ulcer rates in a prespective randomised trial amounted to 26% and 14%, 5 1/2 t0 8 years after highly selective vagotomy without drainage (HSV) and selective vagotomy with pyloroplasty (SV). Long duration of symptoms before HSV increased the risk of recurrence. High preoperative maximum acid secretion increased the risk of recurrence after SV Furthermore, long duration of symptoms and slow postoperative gastric emptying possibly increased the risk of recurrence after SV. Imcomplete vagotomy as expressed by the quantitative acid response to insulin was also considered to be of significance for the risk of recurrence in the present study.

Clinical Trials as Topic↗
PubMed1980

A randomized double-blind trial of glucagon in treatment of first attack of severe acute pancreatitis without associated biliary disease.

The effects of glucagon versus placebo were evaluated in a double-blind trial including only patients with a first attack of severe acute pancreatitis not associated with biliary disease. All 22 patients had deterioriation of their clinical condition, elevated serum amylase and pulse rate above 100/min. or shock. An initial dose of 1 mg. glucagon was given as a bolus injection followed by infusion of 6 mg. in 1,500 ml. saline/24 hr. for three days. All were treated with nasogastric decompression, fluids, calcium and antibiotics. Severe complications developed in five of the 10 patients receiving glucagon and in eight of the 12 given a placebo. Three of the 10 (glucagon) and five of the 12 (placebo) died from these complications. Hemorrhagic pancreatitis was found in 11 patients at laparotomy or autopsy. Three of the five with hemorrhagic pancreatitis in the glucagon group and four of the six in the placebo group died. Pooling the data of the present and two other studies makes it probable that glucagon has no effect on mortality from acute severe pancreatitis.

Acute Disease↗