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P Kirkegaard

Publications and source records attributed to P Kirkegaard.

At least 73 records · Page 4Linked to original sources
PubMed1991

Glucose homeostasis after orthotopic liver transplantation in the pig.

Plasma glucose, insulin, and C-peptide were measured in seven pigs after intravenous bolus injection of 1 mg glucagon and injection of 15 g glucose on the 1st, 2nd, 4th, and 7th days after orthotopic liver transplantation. Fasting plasma glucose and the glycemic response to glucagon were lower at the first postoperative day than on any other day (P less than 0.05). Glucose clearance after injection of glucose was normal and without day-to-day variation. Plasma insulin and C-peptide concentrations were higher the first day after glucose stimulation (P less than 0.05), but no impairment of insulin secretion was found during the study. We conclude that, apart from low hepatic glucose production on the first postoperative day, glucose homeostasis was sufficient after liver transplantation.

Animals↗
PubMed1991

Absorption studies after ileal J-pouch anastomosis for ulcerative colitis. A prospective study.

Absorption studies were performed in 17 patients with ulcerative colitis operated on with colectomy and an ileal two-limbed J-pouch anastomosis. The patients were studied 3 and greater than or equal to 18 months after closure of the temporary ileostomy. Increased stool mass (median, 609 g/24 h) was found in all patients and was unchanged with time. Moderate steatorrhoea was present in 29% of the patients 3 months postoperatively, but faecal fat excretion normalized with time. Calcium absorption was normal in all but one patient regardless of time after operation. An abnormal bacterial deconjugation, evaluated by a 14C-glycocholic acid breath test was present in 27% of the patients and increased significantly with time. Forty per cent of the patients had increased faecal bile acid excretion. B12 malabsorption was present in 29-35% of the patients. In conclusion, ileal J-pouch anastomosis for ulcerative colitis causes increased stool mass in all patients and produces moderate bile acid deconjugation and malabsorption in about one-third to half. Substitution therapy with vitamin B12 is necessary in about one-third of the patients. Intestinal adaptation as far as absorption is concerned is minimal after the first 3 postoperative months.

Adult↗
PubMed1991

Gastric and colonic oxygen tension measured with a vacuum-fixed oxygen electrode.

A new electrode system for determination of visceral oxygen tension is presented. The system consists of a transcutaneous oxygen electrode (E5242 Radiometer A/S. Copenhagen), which is screwed into a suction ring and fixed to the organ by applying a vacuum. The electrode membrane is then in contact with the organ surface via a fluid layer with a thickness of a few micrometres, without interference from atmospheric air and without mechanical disturbance of the membrane. The electrode system was tested on the gastric and colonic wall in six pigs. As reference, a silicone tonometer was placed subserously beneath the vacuum-fixed electrode. The silicone tonometer was connected to a second transcutaneous oxygen electrode. The tissue oxygen tension was changed by subjecting the animals to various inspiratory concentrations of oxygen and to hypovolaemia. The oxygen tension measured by the vacuum-fixed electrode (PO2vac) was compared with the oxygen tension measured by the tonometer (PO2tono). A good correlation was demonstrated between PO2vac and PO2tono, the correlation coefficient being 0.8619, confirming that the suction-fixed oxygen electrode measures tissue oxygen. The lowest possible vacuum to hold the electrode unit in place was between 4.0 and 6.7 kPa. Provided the measuring time did not exceed 3 min. vacuum had only slight influence on the measured oxygen values. The mean change in PO2vac induced by varying the vacuum from 7 to 26 kPa, and 26 to 7 kPa, was only +0.23 kPa (-1.2 to +1.9) and +0.19 kPa (-0.3 to +1.3), respectively. The mean stabilization time, defined as the time from electrode application until achieving 95% of the equilibration value, was 66 sec (SEM, 3.4 sec) and 57 sec (SEM, 3.0 sec) on the gastric and colonic wall, respectively. The measured values of PO2vac varied significantly between different areas on the gastric wall (p less than 0.001). When several surface measurements were performed throughout the investigated area, the mean oxygen tension approached the oxygen tension measured by the tonometer. It is concluded that the vacuum-fixed electrode constitutes a reliable, easy and, noninvasive method for measurements of the oxygen tension in the gastric and colonic tissue.

Animals↗
PubMed1990

[Creating a pelvic reservoir in the surgical treatment of ulcerative colitis and familial polyposis of the colon].

Proctocolectomy and creation of an ileum reservoir with ileo-anal anastomosis is now an established method in the treatment of ulcerative colitis and certain cases of familial polyposis of the colon requiring operative treatment. The ideal type of reservoir is, however, not yet defined and the indications for operation and selection of the patients are still being assessed. The present series comprises 103 patients in whom a J-reservoir was created during the period November 1983 to January 1989. The results were registered prospectively one, three, six and 12 months postoperatively. In eight patients, the reservoir had to be removed on account of septic complications. All of the remaining patients had spontaneous defaecation and scarcely 50% employ constipating agents one year after the operation. The frequency of defaecation becomes reduced gradually from seven (4-14) per 24 hours to four (2-6) after one year. None of the patients are incontinent but over 10% still have periods of minimal soiling which require the use of a pad after one year. The procedure is complicated but must be considered to be safe in experienced hands as more than 90% of the patients achieve a satisfactory or acceptable result. In operations for ulcerative colitis and familial polyposis of the colon, the rectum should be preserved in view of subsequent reconstructive surgery.

Adenomatous Polyposis Coli↗
PubMed1990

The first year with a J-pouch. A prospective evaluation.

Proctocolectomy and construction of a pelvic pouch with ileo-anal anastomosis is now an established method in the treatment of ulcerative colitis, but various procedures are still under evaluation. This series comprises 97 patients with a 20 cm long J-shaped pouch and a short rectal cuff of 2-5 cm, prospectively evaluated after 1, 3, 6 and 12 months. Eight patients had their pouch removed because of septic complications. All the remaining patients evacuate spontaneously, although around one third still use constipating agents after 1 year. The stooling frequency gradually diminished from 7 (4-15) per 24 h to 4 (2-6) after 12 months. Continence also gradually improved during this period. No patient was incontinent of faeces but 13% still experienced episodes of minor soiling after 12 months. The procedure has proved to be safe providing patients are carefully selected, and 90% achieve a satisfactory or acceptable functional result.

Adult↗
PubMed1989

[Simultaneous transplantation of the pancreas and kidney in terminal diabetic nephropathies].

Transplantation of the pancreas in late stages of type I diabetes has been performed increasingly frequently during recent years. By improved surgical techniques and immunsuppressive therapy including cyclosporin A, the 1-year graft function has increased to 60-70% and the patient survival to 85-95% in the institutions with greatest experience. These results are so good, that they nearly reach those from kidney transplantation. Most of the pancreas transplantations have been performed simultaneously with kidney transplantation in patients with end stage diabetic uremia. The results should therefore be evaluated according to these circumstances. In a few institutions transplantation of the pancreas is now performed in patients with persistent proteinuria and proliferative retinopathy in an attempt to avoid development of severe diabetic complications. The first pancreas transplantation in Denmark was performed Januar 31 st 1987, and since then, 17 further transplantations have been performed. All patients had severe diabetic nephropathy and received simultaneous kidney transplantation. According to the Danish heart death criteria the organs were perfused and cooled during the donor operation to keep the warm ischemia as brief as possible. The pancreatic vessels are anastomosed to the iliac vessels. In one group of patients the exocrine pancreatic function was preserved by anastomosis to the jejunum, and in another group of patients the exocrine function was abolished by injection of latex into the pancreatic duct system. The patients receive immunosuppression therapy with methylprednisolone, azatioprine and ciclosporin A and anti-coagulation therapy.

Denmark↗
PubMed1989

[Liver transplantation undertaken on Danes abroad].

The indication for liver transplantation is the end stage of liver disease. Liver transplantations are not carried out in Denmark at present, one of the reasons being that it requires introduction of the brain death criterion, because the donor liver must be removed during maintained circulation. To date (November 1988), liver transplantations have been carried out abroad on seven Danes. One of these died after operation, one has chronic rejection and is to have retransplantation while the remaining five patients are well. In Europe (including Sweden, Norway and Finland) and USA, more than 5,000 patients have been liver transplanted. The one-year survival is approximately 75%. After this, only few liver-related deaths occur and the majority of patients can resume their previous activities. A total of 18 Danes have been assessed in transplantation centres abroad: Two are waiting for transplantation in the near future and seven have been accepted for transplantation at a later date, depending on the course of the disease. In a number of Danes, liver transplantation has been considered indicated but has not been effectuated because the disease was so advanced at the time of referral, that the patient died before transfer or the patient did not desire operation abroad.

Adolescent↗
PubMed1988

Changes in plasma histamine during orthotopic liver transplantation in the pig.

Hypotension and cardiac arrhythmia are commonly seen during liver transplantation both in man and in experimental animals. The cardiovascular changes may be explained by release of vasoactive substances, e.g. histamine, into the systemic circulation. Abdominal operations are followed by an increased histamine concentration in portal blood. If the liver clears excess histamine from the splanchnic system, an increased histamine concentration should not be found in the systemic circulation. We measured plasma histamine in peripheral arterial blood, blood from the right atrium and portal blood in different phase of liver transplantation in ten pigs. Histamine concentration increased in the portal vein in the anhepatic phase (basal 15.85 pmol/ml to 34.67 pmol/ml, median, p less than 0.05) but no changes were found in arterial or right atrium samples. Venous and later arterial revascularisation were not followed by any changes in histamine concentration in arteria and right atrium samples. We conclude that the transplanted liver can eliminate splanchnic histamine and that histamine is unlikely to be involved in the cardiovascular changes which are seen after revascularisation of the liver.

Animals↗
PubMed1988

Is the aminoterminal propeptide of type III procollagen degraded in the liver? A study of type III procollagen peptide in serum during liver transplantation in pigs.

The aminoterminal propeptide of type III collagen was monitored in serum during liver transplantation in nine pigs. The aim was to investigate whether removal of the liver causes any changes in the serum concentration of the propeptide. Another connective tissue component, hyaluronan, a glycosaminoglycan known to be degraded in the liver endothelial cells, was also measured. Removal of the liver caused a significant increase in the concentration of the intact propeptide as well as of hyaluronan. Gel filtration confirmed the increase in the amount of intact propeptide. However, another large propeptide-related antigen, eluted near the void volume, appeared in the antigen profile during the anhepatic phase. This peak probably represents the propeptide still attached to the collagen molecule (pN collagen). The findings indicate that the liver is involved in the degradation of the propeptide and of larger propeptide-holding proteins.

Animals↗
PubMed1988

Adrenergic effects on secretion of amylase from the rat salivary glands.

The present study was undertaken to investigate the effect of adrenergic agents on secretion of amylase from the salivary glands in vivo. Saliva was collected from the distal oesophagus in conscious rats. Adrenaline increased the concentration of amylase in saliva and serum significantly. The result of infusion of alpha- and beta-adrenergic antagonists as well as noradrenaline and isoproterenol showed that secretion of salivary amylase is predominantly mediated by stimulation of beta-adrenergic receptors, especially of the beta 1-subtype. Investigation of the isoenzyme pattern in saliva, pancreatic juice and serum demonstrated that the major component in serum is salivary amylase. This study has shown that beta-adrenergic agents stimulate secretion of amylase from the salivary glands in rats. Though the secretion is mainly exocrine small amounts of amylase is found in serum, which seems to originate from the salivary glands.

Amylases↗
PubMed1988

Is epidermal growth factor involved in development of duodenal polyps in familial polyposis coli?

Duodenal adenomas are a frequent extracolonic manifestation in patients with familial polyposis coli (FPC). Epidermal growth factor (EGF), a polypeptide that stimulates cellular growth and differentiation, is localized in Paneth cells in the small intestine. In two patients with FPC, we found EGF immunoreactivity in duodenal adenomas. Numerous EGF immunoreactive Paneth cells were localized, not as usually, in the bottom of the crypts, but scattered along the crypts alone or in clusters. We do not know whether EGF is involved in the development of duodenal polyps in FPC patients, or whether the present findings represent secondary changes in duodenal polyps.

Adenoma↗
PubMed1987

Pancreatic and intestinal processing of proglucagon in man.

We developed antisera and radioimmunoassays against synthetic replicas of glucagon-like peptide-1 (1-36) and -2, predicted products of the glucagon precursor, and against glucagon-like peptide-1 (7-36) identical to the sequence of glucagon-like peptide-1, but lacking its first six N-terminal amino acids. With these tools, we studied the localisation and molecular nature of glucagon-like immunoreactivity in human pancreas, small intestine and plasma. By immunohistochemistry glucagon-like peptide-1, and glucagon-like peptide-2 immunoreactivity coexisted with glucagon in pancreatic islet cells and with enteroglucagon in small intestinal enteroglucagon-producing cells. By chromatography of tissue extracts we found that glucagon-like peptide-1 and glucagon-like peptide-2-immunoreactivities in the human pancreas (307 +/- 51 and 107 +/- 37 pmol/g tissue) were mainly contained in a large peptide, whereas in the small intestine glucagon-like peptide-1 and glucagon-like peptide-2 immunoreactivities were found in separate smaller molecules (49 +/- 21 and 77 +/- 28/g tissue). By isocratic high pressure liquid chromatography of the large pancreatic glucagon-like peptide we found that this peptide is heterogeneous. By chromatographic analysis glucagon-like peptide-1 immunoreactivity in fasting plasma was mainly found in a large peptide corresponding to the pancreatic form, while after a meal a smaller molecular form coeluting by gel filtration with glucagon-like peptide-1 predominated.

Adult↗
PubMed1987

Late recurrence of upper urinary tract urothelial tumours.

Two case reports of late recurrence of upper urinary tract urothelial tumours 13 years after ipsilateral local resection and 19 years after contralateral nephroureterectomy are used in the discussion on when to perform local resection. In accordance with existing literature we propose local resection in case of low-grade upper urinary tract urothelial tumours.

Adult↗
PubMed1987

Neurotensin-like immunoreactivity after intestinal resection in the rat.

Neurotensin is a tridecapeptide located mainly in the distal small intestine. The present study was carried out in order to investigate the neurotensin response after proximal small intestinal resection in the rat. After resection, the median plasma concentration of neurotensin like immunoreactivity (NTLI) was unchanged compared with sham operated rats. Intragastric instillation of fat increased the plasma concentration of NTLI from 45 pmol/l (34-63) in sham operated rats to 92 pmol/l (46-121) in resected rats. No significant increase in the plasma concentration of NTLI was found after intragastric instillation of amino acids or glucose. The tissue concentration of NTLI increased significantly in the jejunum and ileum after proximal small intestinal resection, while the number of immunoreactive neurotensin cells was unchanged. This study shows that the adaptive responses in the distal small intestine after proximal small intestinal resection also involve the neurotensin producing cells.

Animals↗