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Biomedical subjects

P Kirkegaard

Publications and source records attributed to P Kirkegaard.

At least 109 records · Page 6Linked to original sources

Sexual dysfunction after low anterior resection for midrectal cancer.

Forty-nine patients under the age of 65 years, who had a low anterior resection performed for cancer of the midrectum, were interviewed. Eight patients were sexually inactive before the operation and were excluded. Postoperatively thirty-five had normal sexual function. Two male patients developed transient erectile impotence while two female patients had given up active sexual life after the operation because of dyspareunia. Two patients, one male and one female had permanent impairment. It is concluded, that severe sexual dysfunction can be seen after low anterior resection for cancer, but no early conclusion about permanent sexual dysfunction should be drawn.

Adult↗

A modified technique for stapled anastomosis after the Hartmann procedure.

In 15 patients the intestinal continuity after Hartmann's operation was restored by a stapling technique which facilitates anastomosis without mobilization of the 'blind' rectal stump. No signs of anastomotic leak was observed, and at follow-up 6-12 months later there were no strictures.

Acute Disease↗

Role of submandibular saliva and epidermal growth factor in gastric cytoprotection.

The role of submandibular epidermal growth factor in protection of the gastric mucosa was investigated in rats. Removal of the submandibular glands and thereby submandibular epidermal growth factor (EGF) caused rats to develop gastric lesions (ulcerations and ulcers) after administration of the duodenal ulcerogen cysteamine. The median output of EGF in gastric juice was reduced from 45.6 pmol/12 h (total range 17.5-65.0) in unoperated controls to less than 0.06 pmol/12 h (total range less than 0.06-1.82) in rats given cysteamine after extirpation of the submandibular glands. The contents of EGF in the submandibular glands was unchanged during cysteamine treatment. Furthermore, the effects of intragastric instillation of exogenous EGF, infusion of saliva without EGF, and infusion of saliva with a high concentration of EGF on the development of cysteamine-induced gastric lesions were investigated in rats without submandibular glands. Exogenous EGF and saliva with a high but still physiological concentration of EGF significantly reduced the median area in the stomach displaying ulcers and ulcerations, whereas saliva without EGF had no effect. Although EGF is a known inhibitor of gastric acid secretion, the dose used in the present study had no effect on gastric acid secretion in chronic gastric fistula rats; removal of the submandibular glands also did not have any such effect. We conclude that exocrine secretion of submandibular EGF has a cytoprotective function in the stomach, an effect that may be physiological.

Animals↗

Treatment of recurrent rectal cancer by electroresection/coagulation after low anterior resection.

Fifteen patients with recurrent rectal cancer after low anterior resection were treated by electroresection/coagulation in order to avoid colostomy. Nine patients were alive without colostomy eight to 16 months after the first treatment and three died without colostomy from metastatic disease 24 to 36 months after the first electroresection. Electroresection/coagulation as treatment of inoperable recurrence after low anterior resection should be considered an alternative to colostomy.

Aged↗

Perineal sinus after removal of the rectum. Occlusion with fibrin adhesive.

Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in the sinus and the other had a rather large spheric cavity. In eight patients the sinus healed after application of fibrin adhesive, even when a fistula to the vagina was present. The method seems to be effective for closing a long, narrow perineal sinus.

Adult↗

Exocrine secretion of epidermal growth factor from Brunner's glands. Stimulation by VIP and acetylcholine.

Brunner's glands of the duodenum are innervated by cholinergic and VIP-ergic nerves, and the glands have been shown to contain epidermal growth factor (EGF). In this study the effect of VIP and acetylcholine (Ach) on secretion of EGF from Brunner's glands was investigated in the rat. Intravenous infusion of VIP stimulated the flow rate of duodenal secretion, an effect which was inhibited by atropine. Ach alone did not significantly increase flow rate, and combined infusion of VIP and Ach induced the same flow as VIP alone. Concentration of EGF in duodenal secretion was increased by infusion of Ach, and this effect was potentiated by VIP. Infusion of VIP alone did not influence EGF concentration. EGF output from Brunner's glands was significantly stimulated by i.v. infusion of VIP and of Ach and combined infusion further increased EGF output. The study has demonstrated exocrine secretion of EGF from Brunner's glands, and it is suggested that stimulation is mediated by interaction of neuronal VIP and Ach.

Acetylcholine↗

Strictures of the male urethra treated by the Otis method.

During a 5-year interval 72 consecutive patients with urethral strictures were treated by internal urethrotomy according to the method of Otis. The etiology, surgical technique, complications and postoperative management are discussed. The results after a mean followup of 29 months showed an over-all success rate of 82 per cent (95 per cent confidence limits 71 to 90 per cent). It is concluded that internal urethrotomy should be considered for primary treatment of urethral strictures, since the procedure is easy and complications are few.

Adult↗

The effect of ileotransversostomy on carrageenan-induced colitis in guinea pigs.

By oral administration of degraded carrageenan a colitis-like disease can be induced in guinea pigs which almost exclusively affects the caecum. To study the effect of degraded carrageenan on the distal colon and rectum, an ileotransversostomy was performed. In the non-operated group of animals ulcerative lesions and changes in the mucosal surface structure were observed only in the caecum and proximal colon after administration of degraded carrageenan. Animals with ileotransversostomy had similar lesions, but the distal colon and rectum were also severely affected, with formation of crypt abscesses in the rectum. This study indicates that the long transit time in the caecum, which enables bacterial decomposition and/or absorption of degraded carrageenan, is the reason that only the proximal colon is affected in non-operated animals. After ileotransversostomy degraded carrageenan reaches the distal colon in an active form that produces ulcerative changes.

Animals↗

The effect of vasoactive intestinal polypeptide on meal-stimulated gastric acid secretion in man.

The effect of vasoactive intestinal polypeptide (VIP) on meal-stimulated gastric acid secretion was studied in six healthy volunteers. Acid secretion was stimulated by instillation of a 10% solution of peptone, which was adjusted to pH 5.5, circulated through the stomach via a double-lumen gastric tube by a peristaltic pump. The acid secretion was estimated by continuous titration by a pH-stat. The subjects were studied twice on separate days, receiving an intravenous infusion of either VIP (1 microgram/kg/h) or saline. No effect on acid secretion was found. Mean serum gastrin concentration rose from 42 pmol/l to 150 pmol/l during meal stimulation and was unaffected by infusion of VIP. Plasma VIP concentration during infusion of saline was 6.8 pmol/l and during VIP infusion, 82.8 pmol/l. Plasma VIP concentration was unaffected by the peptone meal.

Adult↗

Neurotensin inhibits meal-stimulated gastric acid secretion in man.

The effect of physiological doses of exogenous neurotensin on meal-stimulated gastric acid secretion and serum gastrin concentration was investigated in six healthy subjects. Acid secretion was reduced by 32% during intravenous infusion of neurotensin, the plasma neurotensin concentration being within physiological range. Serum gastrin concentration was unchanged during infusion of neurotensin. The results strongly suggest that neurotensin participates in the regulation of gastric acid secretion and support the theory that neurotensin may play a role in the intestinal phase of gastric acid secretion in man.

Adult↗

Epidermal growth factor inhibits cysteamine-induced duodenal ulcers.

The effect of the duodenal ulcerogen cysteamine on secretion of epidermal growth factor from Brunner's gland pouches was studied in the rat. Total output of immunoreactive epidermal growth factor was reduced to approximately 55%, compared with controls, 5 h after administration of cysteamine (300 mg/kg, s.c.). Furthermore, measurements on tissue extracts of the pouches revealed that 5 h after cysteamine treatment, Brunner's glands were depleted of epidermal growth factor. The effect on ulcer development of intraduodenally applied exogenous epidermal growth factor (1 micrograms/kg . h) also was studied. Luminal epidermal growth factor significantly inhibited the formation of cysteamine-induced duodenal ulcer, compared with controls receiving saline. The effect was not due to inhibition of gastric acid secretion or stimulation of duodenal bicarbonate secretion since the dose of epidermal growth factor used, when tested on chronic fistula rats, had no effect on acid secretion and did not influence bicarbonate secretion from Brunner's gland pouches. These results demonstrate that epidermal growth factor has a cytoprotective effect on the duodenal mucosa, and it is suggested that inhibition of synthesis and secretion of endogenous epidermal growth factor may be a pathogenetic factor in cysteamine-induced duodenal ulcer.

Animals↗

Pyogenic liver abscess. A case report with a short review of current concepts of diagnosis and management.

A case of a large pyogenic liver abscess in a 16-year-old boy with appendicitis is presented. The clinical picture, bacteriology and treatment of the disease are discussed on the basis of 397 cases reported in the literature. It is concluded that ultrasound scanning of the liver is essential for early diagnosis and that the treatment of choice is percutaneous needle aspiration in combination with bactericidal antibiotics.

Adolescent↗