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Biomedical subjects

P Kirkegaard

Publications and source records attributed to P Kirkegaard.

At least 145 records · Page 8Linked to original sources
PubMed1981

The effect of a synthetic met-enkephalin analogue (FK 33-824) on gastric acid secretion and serum gastrin in man.

A synthetic met-enkephalin analogue was infused into seven healthy human subjects on a background infusion of pentagastrin to study the effect on gastric acid secretion and serum gastrin concentration. Gastric acid secretion rose from 4.2 meq H+/15 min to 7.8 meq H+/15 min during infusion of met-enkephalin, 0.1 micrograms/h. Met-enkephalin in a dose of 1 microgram/kg/h had no effect on pentagastrin-stimulated acid secretion. Serum gastrin concentration remained unchanged throughout the study. It is suggested that met-enkephalin could be a partial agonist on the parietal cell. The possible role of met-enkephalin in the cephalic phase of gastric acid secretion is discussed.

Adult↗
PubMed1981

Vasoactive intestinal polypeptidergic nerves and Brunner's gland secretion in the rat.

Vasoactive intestinal polypeptide is known to have powerful effect on the secretions from endocrine and exocrine glands. By immunohistochemical studies on the rat, both a dense network of vasoactive intestinal polypeptide-immunoreactive nerve fibers around the acini of Brunner's glands, and small ganglia with vasoactive intestinal polypeptide-immunoreactive nerve-cell bodies close to the glands were demonstrated. Intravenous infusions of vasoactive intestinal polypeptide in doses of 10, 100, and 1000 ng/kg.h significantly increased flow rate, as well as bicarbonate and protein output from Brunner's glands in the rat. After infusion of vasoactive intestinal polypeptide the secretory cells, which in the control group were rich in PAS-positive mucin, became almost completely PAS-negative. It is suggested that physiologic secretion from Brunner's glands may be stimulated by the vasoactive intestinal polypeptidergic nerves.

Animals↗
PubMed1981

The effect of cysteamine on the Brunner gland secretion in the rat.

Cysteamine in a single subcutaneous administration induces release of gastrin, acid hypersecretion, and duodenal ulcer in rats. Pentagastrin-induced acid hypersecretion has no ulcerogenic effect. The Brunner glands in the proximal duodenum have previously been shown to be an important factor in the natural defence of the duodenal mucosa, and this study has been performed to determine the effect of cysteamine and pentagastrin on the Brunner glands in the rat. The proximal duodenum was isolated in situ and drained by a polyethylene tube. The secretion was studied for two 5-h periods after administration of cysteamine or pentagastrin, and then the Brunner glands were studied histologically. Pentagastrin did not affect spontaneous Brunner gland secretion, whereas cysteamine inhibited the output approximately 50%. After cysteamine the secretory cells were low and depleted of mucus, suggesting that cysteamine interferes with the synthesis of the secretory product. The depression of the Brunner gland secretion may be an important factor in the pathogenesis of cysteamine-induced duodenal ulceration.

Animals↗
PubMed1981

Long-term results of surgery for carcinoid tumours of the gastro-intestinal tract.

54 patients were followed-up 1-22 years (median 11 years) after histological verification of a carcinoid tumour. four patients died before operation; 41 patients had their lesion in the appendix, 13 in different extra appendiceal sites in the gastrointestinal tract. There was a significant difference between the median ages and the mortality rates in the two groups. Only one patient with an appendiceal tumour died of his disease. Appendiceal carcinoid, even with local spreading to the serosa and local lymph nodes, seemed to be adequately treated by a simple appendectomy. Extensive surgery, following the principles of treatment for malignant tumours, should be undertaken, when spread to the caecum or ascending colon is present or when the tumour is of extra-appendiceal origin.

Adolescent↗
PubMed1980

Anterior resection for mid-rectal cancer with the EEA stapling instrument.

Early results of resection with primary anastomosis for cancer of the mid-rectum using a new stapling instrument are reported. Thirty patients with an adenocarcinoma 7 to 12 cm from the anal verge were operated on. One patient died postoperatively from respiratory complications but with no sign of anastomotic dehiscence. Two patients had a clinically recognizable leak that closed spontaneously within 3 days. Three patients had roentgenologically demonstrable leakage but no clinical symptoms. On examination 2 to 11 months after operation, all patients were continent for feces as well as gas, and none had more than four bowel movements per day. In four patients, all with a roentgenologically demonstrable leak, a stricture developed at the anastomosis within 3 months after discharge. All four patients were successfully treated by dilatation. Resection with anastomosis by means of the stapling instrument is practical even at the lowest level, is far less time-consuming and does not require the same degree of training as low anterior resection with conventional suture anastomosis.

Adenocarcinoma↗
PubMed1980

Experimental nonsuture colonic anastomoses.

A comparative study of sutured colonic anastomoses and anastomoses made by isobutylcyanoacrylate was performed in 60 rats. No difference in the strength of the anastomoses, as expressed by the bursting pressure, was found, and there was no difference in the frequency of adhesions or stenoses, provided the cyanoacrylate was meticulously covered by omentum. Histologic evidence of delayed healing was observed in the cyanoacrylate group; however, this did not seem to reduce the strength of the anastomosis. Provided it is covered with an omental tag, isobutylcyanoacrylate may prove to be a valuable adjunct to conventional suture techniques under special circumstances.

Animals↗
PubMed1980

Cimetidine in the prevention of acid aspiration during anesthesia.

In a controlled, randomized, double-blind trial, the value of cimetidine as prophylaxis against acid aspiration pneumonitis was studied. Compared to placebo, cimetidine reduced the volume as well as the acidity of the gastric contents significantly. The patients at risk of developing severe pneumonitis after aspiration (pH less than 2.5 and volume greater than 20 ml) were reduced from 55% in the placebo group to 0 in the group having received cimetidine 400 mg the night before and a further 400 mg on the morning of surgery. Premedication with cimetidine may be useful if rapid intubation cannot be anticipated.

Adult↗
PubMed1980

Effect of arginine infusion on endogenous pancreatic glucagon and gastric acid secretion in duodenal ulcer patients and normal subjects.

The effect of intravenous infusion of L-arginine on pentagastrin-stimulated gastric acid secretion was studied in 15 duodenal ulcer patients and 12 healthy subjects. In both groups L-arginine enhanced plasma concentrations of pancreatic glucagon equally and to levels similar to those seen after a protein-rich meal and inhibited the acid response in duodenal ulcer patients and in normal subjects. The study supports previous findings suggesting that pancreatic glucagon is a physiological inhibitor of gastric acid secretion but does not support the hypothesis of a defect in this inhibitory system in duodenal ulcer patients.

Adolescent↗
PubMed1980

Cysteamine-induced duodenal ulcer and acid secretion in the rat.

Duodenal ulcers can be produced in rats within 24 h by a single subcutaneous administration of cysteamine. To determine the role of gastric acid secretion in the pathogenesis of these ulcers, secretory and pathoanatomic studies were performed in chronic fistula rats ater an ulcerogenic dose of cysteamine. A prolonged increase of acid secretion was seen after cysteamine, reaching fourfold the basal level after 5 h. The acid response lasted for 10 to 11 h. After vagotomy cysteamine-induced acid secretion was markedly reduced. Ulcer formation was prevented by vagotomy and by drainage of the gastric juice before it entered the duodenum. When a gastric acid output equivalent to that produced by the ulcerogenic dose of cysteamine was induced by repeated injections of pentagastrin, no mucosal changes were seen in the duodenum. These results indicate that, although some acid in the duodenum is required for ulcer formation, the hypersecretion of acid induced by cysteamine is not the only factor responsible for the development of duodenal ulcer.

Animals↗
PubMed1979

Prognosis after treatment of villous adenomas of the colon and rectum.

With the existing evidence of neoplastic polyps of the colon and rectum as precursors of most or all colonic cancer, information of the short- and long-term course after treatment is a prerequisite of using the knowledge of the polyp-cancer sequence in an effective cancer prophylaxis. One hundred seventy-four patients treated for villous adenomas of the colon and rectum during the years 1960-1975 were re-examined. Survival and cure rates were estimated by actuarial analysis. The death rate of colonic cancer among patients treated for a benign villous adenoma was significantly higher than in an age and sex matched normal population, resulting in a significantly reduced crude survival rate among these patients. Almost all recurrences after treatment of benign villous adenomas occurred within the first four to five years recurrence rate of roughly 30%, indicating that five years seem to be an adequate total control period following treatment.

Adenoma↗
PubMed1979

Primary results after resection and anastomosis for mid-rectal cancer with a new stapling instrument. A preliminary report.

Early results after resection with primary anastomosis for cancer of the mid-rectum using a new stapling instrument are reported. 20 patients with an adenocarcinoma 7-12 cm from the anal verge were operated. On patient died postoperatively from respiratory complications but with no sign of anastomotic dehiscence. One patient had a clinically recognizable leakage which closed spontaneously within 2 days. Three patients had roentgenologically demonstrable leakage but no clinical symptoms. On examination, 1-3 months after the operation, all patients were continent for feces as well as for gas and none had more than four bowel movements per day. Resection and anastomosis by means' of the stapling instrument is practicable even at the lowest level, and is far less time consuming and does not require the same degree of training as low anterior resection with conventional suture anastomosis.

Adenocarcinoma↗
PubMed1979

Interaction of calcium, magnesium, and gastrin on gastric acid secretion.

A dose response study of the effect on gastric acid secretion of synthetic human gastrin-17 (SHG) in doses of 50, 200, and 500 ng/kg/hr was performed in 8 healthy volunteers. The study was repeated on separate days during i.v. infusion of magnesium sulphate (0.4 meq Mg2+/kg/hr), of calcium gluconate (0.1 meq Ca2+/kg/hr) and of magnesium sulphate plus calcium gluconate. Magnesium infusion resulted in an increase in the dose of SHG required for one-half maximal secretion (D50), whereas infusion of calcium decreased D50. The difference in D50 of SHG when administered in combination with magnesium and with calcium was significant. Combined infusion of SHG, magnesium, and calcium resulted in the same D50 of SHG as found when SHG was infused alone. The calculated maximal acid response was almost identical in the four experiments except for a minor but nonsignificant decrease during calcium infusion. The results indicate an interaction of calcium, magnesium, and gastrin on parietal cell function and extend the observations of others in intact humans as well as in isolated gastric mucosa.

Adult↗
PubMed1978

Long-term results after excisional surgery for Chrohn's disease of the terminal ileum.

Resection with the object of cure was undertaken in 20 patients with Crohn's disease in the terminal ileum. These patients were followed up more than five years after operation. Recurrence took place in eight patients, in half of them more than five years after the primary operation. Six patients were submitted to reoperation and two died. Seven out of the eight recurrences were localized to the anastomosis. These results may support the results of a bigger Swedish material which favours more radical primary resections in Crohn's disease.

Adolescent↗
PubMed1977

Uncontrollable hemorrhage and tissue adhesive.

A case is reported of uncontrollable hemorrhage from suture lines in a patient having undergone coronary surgery. Ultimately the bleeding was brought under control by the use of isobutyl-cyanoacrylate. A piece of fascia was affixed to the suture line. Tissue adhesive is a valuable tool in difficult hemostatic situations, and should be available where major surgery is performed.

Adult↗