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Biomedical subjects

S Ewerth

Publications and source records attributed to S Ewerth.

At least 55 records · Page 3Linked to original sources
PubMed1981

Biliary lipid composition in obesity.

Fasting gallbladder bile was obtained under standardized conditions from 15 gallstone-free obese subjects (greater than 130% of ideal weight) and 23 healthy control subjects matched for age, sex, and serum lipid levels. The proportion of cholesterol, expressed as molar percentage of total biliary lipids, was increased in obesity (10.8 +/- 0.6 versus 6.8 +/- 0.4 M % (mean +/- S.E.M.), P less than 0.001), whereas that of bile acids was decreased (64.7 +/- 1.3 versus 71.0 +/- 1.0 M %, P less than 0.001). The cholesterol saturation of bile was higher in obesity (141 +/- 7%) than in controls (96 +/- 5%, P less than 0.001). The results provide an explanation of the enhanced frequency of cholesterol gallstones in obese subjects.

Bile↗
PubMed1981

The acid secretory response to betazole and insulin hypoglycemia after selective proximal vagotomy for duodenal ulcer.

In order to assess the result of vagotomy an insulin test is usually performed postoperatively. The insulin test, however, is associated with troublesome side-effects and potentially dangerous. Also its prognostic value as regards ulcer recurrence is doubtful. In this follow-up study of 118 patients, who had selective proximal vagotomy (SPV) performed for duodenal ulcer between 1968 and 1971, the insulin test is compared with a postoperative betazole (Histalog) test. Both tests were carried out 1-3 months after SPV. The insulin tests were classified according to Hollander. For the betazole tests the following criteria were used: the test was classified as negative if the reduction in peak acid output (PAOB) exceeded 50% or if the postoperative PAOB-value was lower than 15 mmol/h irrespective of the preoperative value. Values outside these were considered positive. At the follow-up 5-9 years after surgery, a total of 17 recurrent ulcers were diagnosed. The sensitivity and the specificity - i.e. the percentage of patients with recurrent ulceration and positive criteria respectively patients without recurrent ulcer and negative criteria - were calculated for the tests. Thus, the sensitivity and specificity for the insulin tests were found to be 53% and 84% respectively and for the betazole tests 59% and 91% respectively. The difference is thus very small and it seems that a postoperative test with a non-vagal gastric stimulant gives as good prognostic information as an insulin test after selective proximal vagotomy. However, both tests give a low sensitivity (53% resp. 59%) and therefore the prognostic value regarding ulcer recurrence is doubtful.

Adult↗
PubMed1980

Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease.

During the period 1955 to 1974 inclusive, 826 patients developed Crohn's disease and were registered citizens of Stockholm County at the time of definite diagnosis. These patients were followed up and investigated with reference to the occurrence of and outcome after treatment for anal fistulae. These fistulae were recorded in 184 patients (23%). The incidence of anal fistulae increased the further distally the intestinal lesion was located. Healing followed local operation for anal fistula before curative intestinal resection in approximately 60% of the patients with small intestinal and combined ileocolic disease. However, patients with colonic Crohn's disease did not heal after such treatment. When curative intestinal resection was the primary procedure, 47% of the patients healed spontaneously. Small intestinal and combined ileocolic disease was associated with a good prognosis--90% were healed at follow-up, while patients with colonic disease had a poor prognosis. The combination of rectal Crohn's disease and anal fistula invariably led to proctocolectomy.

Adolescent↗
PubMed1980

Biliary lipid composition in patients with porta cirrhosis of the liver.

Fasting duodenal bile was collected under standardized conditions in 10 male patients with stable portal cirrhosis of the liver and in 12 healthy male controls matched for age, body weight, and serum lipid levels. The proportion of cholesterol, expressed as molar percentage of total biliary lipids, was lower in patients with cirrhosis than in controls (4.6 +/- 0.6 versus 6.4 +/- 0.4 molar %, mean +/- S.E.M.; P less than 0.025), whereas the proportions of bile acids and phospholipids were similar in the two groups. The cholesterol saturation of bile was lower in cirrhotic patients (68 +/- 8%) than in controls (94 +/- 7%; P less than 0.025). The contribution of deoxycholic acid to total bile acids was diminished in cirrhosis and that of chenodeoxycholic acid slightly increased. The results suggest that, in spite of the disturbances of bile acid metabolism generally seen in cirrhosis, such patients are not prone to develop cholesterol gallstones.

Bile↗
PubMed1980

Intestinal metaplasia in the gastric remnant following resection for benign ulcer disease: a comparison between morphology and histochemistry.

A follow-up study including endoscopic examinations was performed on patients previously (23--27 years earlier) treated with partial gastrectomies for benign ulcer disease. From 106 patients satisfactory biopsy specimens were obtained. Intestinal metaplasia was diagnosed on pure morphologic findings and on histochemical findings (alcian blue at pH 2,5). The histochemical method was shown to be more sensitive. The significance of intestinal metaplasia in the carcinogenesis is briefly discussed.

Aged↗
PubMed1980

The incidence of fecal fistula following exploratory laparotomy and appendicectomy in patients with ileocolic Crohn's disease.

The aim of this study was to investigate if appendicectomy en passant in connection with exploratory laparotomy for ileocolic Crohn's disease increases the risk for development of postoperative fecal fistula. This was studied among 105 patients, 65 of whom had an additional appendicectomy and 40 who had not. The postoperative frequency of fecal fistula was 18.5 versus 15% in the two groups. The difference is not significant. On balance, appendicectomy is advised under these circumstances.

Adult↗
PubMed1980

Outcome following treatment of anal fistulae in Crohn's disease.

The results of treating 24 patients with anal fistulae and active intestinal Crohn's disease is reported. Four patients had multiple extended, seven high and ten low fistulae and three patients had sinus tracts. Seven patients with only minor discomfort were treated conservatively and five of them healed. Thirteen were treated by local surgery and ten subsequently healed. Four patients with rectal Crohn's disease and multiple fitulous systems were submitted to abdominoperineal excision. These results indicate that in patients without rectal involvement, conservative treatment and local surgery is indicated.

Adult↗
PubMed1980

Influence on symptoms and transit-time of Vi-SiblinR in diverticular disease.

Nine patients complaining of constipation and with diverticuli of the colon on barium-enema were examined with regard to transit-time, bowel movements and subjective symptoms. They were treated with placebo and Vi-SiblinR, using a doubleblind cross-over technique. The transit-time remained normal during the Vi-SiblinR treatment. The feces became softer and increased in weight and the subjective symptoms were significantly reduced (p less than 0,05).

Aged↗
PubMed1979

Carcinoma of Meckel's diverticulum.

Acute intestinal obstruction in a women, aged 56, was caused by a highly malignant adenocarcinoma arising in a Meckel's diverticulum. Despite radical surgery, the tumour recurred after four months, and the patient died nine months after her first operation. This confirms the general bad prognosis associated with carcimomas of Meckel's diverticulum.

Adenocarcinoma↗
PubMed1978

The incidence of carcinoma in the gastric remnant after resection for benign ulcer disease.

UNLABELLED: During the period 1950-1953, gastric resection was performed on 569 patients for benign ulcer disease at the Serafimer Hospital, Stockholm, Sweden. The purpose of this investigation uas to assess the incidence of cancer and precancerous lesions in the gastric remnant. There were 15 postoperative deaths. 223 patients when traced were dead, and in 130 of these follow-up was adequate. Two cases with carcinoma in the gastric remnant were found among these. 72 patients were lost from follow-up. 253 patients when traced were alive, and in 111 of these, endoscopy and biopsy have been performed. In one patient there was a severe dysplasia but no invasive carcinomas were found. CONCLUSION: 130 dead patients and 111 living patients have been adequately followed after gastric resection for benign ulcer disease. Two carcinomas were found which makes the incidence 0,8%.

Adolescent↗
PubMed1978

Decreasing frequency of cholecystectomies in the counties of Stockholm and Uppsala, Sweden.

The frequency of cholecystectomies was followed in the counties of Stockholm and Uppsala during an eight-year period (1969--1976). In both counties there was a highly significant decrease. This was mostly marked for males under 50 and females under 40 years in Stockholm and for females, regardless of age, in Uppsala. It is unlikely that these figures represent a decrease in the prevalence of gall-stone disease even if a small change is possible. A major alteration in the financing system of out-patient care has taken place during the investigated period and this has probably had an important influence on the cholecystectomy rate. Another important factor may be the consideration of a etiological factors other than gall-stones for minor abdominal disorders.

Adolescent↗
PubMed1978

Results of the treatment of rectal prolapse operated according to Ripstein.

59 patients have been submitted to abdominal rectopexi according to Ripstein. The operative mortality was 5%, which was, however, not wholly due to the operation. The mortality-rate shows, however, that patients older than 60 years of age must be carefully evaluated preoperatively. The recurrence-rate was 5,4% with a mean observation period of 5 years. The method appears to be satisfactory for treatment of rectal prolapse.

Adult↗
PubMed1978

Fistula-in-ano. A six year follow up study of 143 operated patients.

Of 143 patients operated upon for anal fistulae, all but eight have healed satisfactorally, Impaired healing was seen in patients with high fistulae operated with a modified Elting repair, and in patients suffering from Crohn's disease. When the internal opening was localized and the fistula laid open and excised, healing took place in almost all cases. This method may cause incontinence with high fistulae, and other methods must be used. A loop suture technique gave satisfoactory results both in regard to healing and anal control. Following a modified Elting repair in nine cases, recurrence was seen in four. However, we still believe this method is of value since it leaves the sphincters intact.

Female↗
PubMed1978

Roux-en-Y loop reconstruction as remedial operation for reflux gastritis after gastric resection.

Reflux gastritis is a symptom-complex consisting of antacid-resistent epigastric pain, nausea and frequent vomiting, weight loss and anaemia, sometimes with evident gastrointestinal haemorrhage. Gastric secretory studies usually show achlorhydria. The onset of symptoms is usually abrupt in previously healthy subjects. From 1973 to 1977, eleven patients with the established diagnosis of reflux gastritis have been treated with a Roux-en-Y reconstruction, as a remedial operation. There was no mortality in the series. At follow-up after a mean time of two years, the result was graded as excellent in ten patients and as fair in one. It is concluded that the Roux-en-Y procedure can be recommended in patients with reflux gastritis.

Aged↗