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Biomedical subjects

S Gustavsson

Publications and source records attributed to S Gustavsson.

At least 55 records · Page 3Linked to original sources
PubMed1989

Time trends in peptic ulcer surgery, 1956 to 1986. A nation-wide survey in Sweden.

To establish time trends in surgical rates for peptic ulcer disease, all surgical departments in Sweden were requested to complete a questionnaire regarding elective operations for gastric and duodenal ulcers and emergency operations for ulcer perforations performed in 1956, 1966, 1976, and 1986. A total of 8558 operations were reported for these years. The incidence of elective surgery declined steadily, the rates being 72.1, 45.0, 31.9, and 10.7 per 100,000 inhabitants. The male:female ratio fell from 4.2 to 1.5:1, while the duodenal/gastric ulcer ratio remained virtually unchanged. The operation rate for perforation decreased by 50%, from 12.8 to 6.4 per 100,000 inhabitants. We conclude that there has been a dramatic decline in elective peptic ulcer surgery in Sweden that began long before the advent of fiberoptic endoscopy, highly selective vagotomy, or H2-receptor antagonists. The comparable decline in emergency procedures suggests that true changes in the incidence or severity of the disease have occurred. In the future the few patients still needing elective surgery for peptic ulcer may have to be served by a small number of specialized centers.

Female↗
PubMed1989

Association of Campylobacter pylori with induced expression of class II transplantation antigens on gastric epithelial cells.

Campylobacter pylori was identified with immunoperoxidase staining and a mouse monoclonal antibody directed against C. pylori in gastric biopsy specimens from 24 patients with gastritis. C. pylori was not found in gastric biopsy specimens from six subjects with histologically normal mucosa. The monoclonal antibody, which was reactive with a surface protein of approximately 20 kilodaltons, was found to be specific for C. pylori, and the immunoperoxidase staining proved to be more sensitive and rapid than culture in detecting the organism. In the tissue specimens where C. pylori was detected with the monoclonal antibody, there was a strong expression of class II transplantation antigens on the epithelial cells and an increased number of T lymphocytes. These findings indicate that C. pylori may initiate local immune responses.

Antibodies, Monoclonal↗
PubMed1988

Lack of physiological stimulation induces decreased proteolytic activity in nerve terminals.

The effect of optic nerve transsection on proteolytic degradation of axonally transported proteins in the superior colliculus of the rabbit was studied. Proteolysis of labeled proteins was determined in vitro in small pieces of the superior colliculus. Within 2 hours after sectioning the optic nerve there was a decreased degradation of slowly transported labeled proteins in the nerve terminals in the superior colliculus.

Animals↗
PubMed1988

Trends in peptic ulcer surgery. A population-based study in Rochester, Minnesota, 1956-1985.

We evaluated trends in peptic ulcer surgery among residents of Rochester, Minnesota, where medical care delivered to the population by all providers is well documented. The incidence of elective operations on previously unoperated patients declined dramatically during the 30-yr study period, from 49/100,000 population per year in 1956-1960 to 6/100,000 per year in 1981-1985. The decline was greatest for men with duodenal ulcer, less for men and women with gastric ulcer, and least for women with duodenal ulcer. These trends were established long before the introduction of H2-receptor drug therapy in 1977. In contrast to elective operations, the incidence of emergent operations remained at about 10/100,000 population per year. Perhaps because of an increasing proportion of emergency operations, overall survival appeared to worsen from the first decade of study to the last; but, after adjustment for age at operation and sex, no difference in survival over time was detected.

Adult↗
PubMed1988

Roux-Y stasis syndrome after gastrectomy.

The aim of the present study was to determine which factors lead to upper gastrointestinal stasis after Roux-Y reconstruction. Among the 214 patients with Roux-Y reconstructions performed between 1961 and 1983, follow-up data were obtained for 187 (87 percent) after a mean of 6.2 years. Patients with vomiting of food but not bile, postprandial pain, and nausea were considered to have the Roux-Y stasis syndrome. The syndrome was found in 49 patients with gastrojejunostomy (30 percent of those at risk) but in only 2 patients with esophagojejunostomy (8 percent, p less than 0.05). The condition was more common in women than men (p less than 0.05), but it was equally common in patients with and without vagotomy. The mean length of the Roux-Y limb in patients with stasis was 41 cm, which was longer than the 36 cm in patients without stasis (p less than 0.001). When multiple logistic regression was used, the length of the Roux-Y limb emerged as the major risk factor (p less than 0.01). In conclusion, construction of Roux-Y limbs greater than about 40 cm in length may increase the incidence of the Roux-Y stasis syndrome.

Abdomen↗
PubMed1988

Peptic ulcer disease--trends in surgical management in Sweden.

In order to study temporal changes in surgical rates for peptic ulcer disease a survey investigation covering 82% of the surgical departments in Sweden was made. Since 1956 there was a marked and steady decline in elective procedures while the decline in emergency procedures for perforations was much less pronounced. In 1986, the incidence of elective and emergency operations was 1.2 and 0.6 procedures per 10,000 inhabitants, respectively. In the future, the few patients needing elective surgery for peptic ulcer may have to be served by a small number of specialized centres.

Emergencies↗
PubMed1988

Time trends in peptic ulcer surgery in Sweden. A preliminary report of a nation-wide survey.

In order to establish time trends in surgical rates for peptic ulcer disease, we sent a questionnaire to every surgical department in Sweden. Eighty-two per cent of the departments responded. Since 1956 there was a marked and steady decline in elective procedures (-83%) and to a much lesser extent also in emergency procedures for perforations (-30%). The decline was most pronounced for duodenal ulcer in men. In 1986, the incidence was 1.2 and 0.65 operations per 10,000 inhabitants for elective and emergency operations, respectively. In the future, the few patients needing elective surgery for peptic ulcer may have to be served by a small number of specialized centers.

Cross-Sectional Studies↗
PubMed1987

Relationship of backwash ileitis to ileal pouchitis after ileal pouch-anal anastomosis.

To assess whether the presence of backwash ileitis predisposed to the subsequent development of ileal pouchitis after ileal pouch-anal anastomosis, 131 patients who had the operation were studied. Fifteen patients had nonspecific inflammation in the terminal ileum noted at the time of the operation, while 20 patients subsequently developed pouchitis. No correlation between the two conditions was found. Pouchitis developed in two of 15 patients (13 percent) with backwash ileitis and in 18 of 116 patients (16 percent) without the ileitis (P greater than 0.05). Among the 20 patients with pouchitis only two (10 percent) had had previous backwash ileitis. It is concluded that the presence of backwash ileitis does not predispose to later development of pouchitis, and so does not contraindicate use of the inflamed terminal ileum for construction of the ileal pouch and anastomosis.

Adenomatous Polyposis Coli↗
PubMed1987

Assessment of Campylobacter-like organisms in the postoperative stomach, iatrogenic gastritis, and chronic gastroduodenal diseases: preliminary observations.

Campylobacter-like organisms (provisionally named C. pyloridis) were demonstrated in gastric biopsy specimens by histopathologic analysis and bacterial culture. C. pyloridis organisms were found in 12 of 26 patients (46%) with gastric or duodenal ulcer but in none of 10 healthy volunteers without histologic evidence of gastritis. Iatrogenic antral gastritis, induced by 7 days of treatment with nonsteroidal anti-inflammatory drugs, was not associated with the presence of C. pyloridis. Organisms were found in 6 of 24 patients who had undergone gastric operations, but the prevalence of C. pyloridis was not higher in those with symptoms of alkaline reflux gastritis than in asymptomatic postgastrectomy control patients. We conclude that C. pyloridis is less common in patients with drug-induced and postoperative gastritis than in patients with peptic ulcer.

Campylobacter↗
PubMed1987

Total gastrectomy for benign disease.

Among 37 patients who underwent total gastrectomy for nonmalignant disease, operative mortality was 4 per cent after 27 elective operations and 10 per cent after 10 emergency operations. Three other patients died 1 to 6 months after operation. Major postoperative complications occurred in 24 per cent. Long-term follow-up of 26 patients (81 per cent of survivors) after a mean +/- SEM of 8.4 +/- 1.1 years showed that 73 per cent of patients had no or only occasional, easily controlled, mild abdominal symptoms and good enough health to enable them to work or carry out normal activities for their age. The patients lost a mean of 15 per cent of their body weight, however, and about one third of them had weakness and diarrhea. A quarter of them had anemia despite iron and vitamin B12 therapy. Our conclusion was that total gastrectomy is a reasonable operation for benign diseases. Nonetheless, in view of the substantial postoperative mortality and morbidity, the operation should be used only when less extensive operations will not suffice.

Adult↗
PubMed1987

Psychological group counseling for the prevention of ulcer relapses. A controlled randomized trial in duodenal and prepyloric ulcer disease.

The effect of psychological counseling on 1-year ulcer relapse rate of recurrent duodenal and prepyloric ulcer disease was evaluated in 148 patients randomly allocated into three treatment groups; psychological counseling group, maintenance cimetidine (400 mg at bedtime), and placebo cimetidine at bedtime. Ulcer relapses were monitored by endoscopy at 6 and 12 months after inclusion and at symptomatic recurrence. The estimated proportion of relapse-free patients after 12 months follow-up in the psychological counseling group (0.43 +/- 0.08) did not differ significantly from the placebo group (0.47 +/- 0.07), whereas the corresponding value for the cimetidine group (0.70 +/- 0.07) was significantly higher (p less than 0.01). The effect of cimetidine on ulcer recurrence, however, was confined to smokers; relapse risk among nonsmokers did not differ significantly between the treatment groups. The negative outcome of psychological counseling raises doubts as to whether duodenal or prepyloric ulcer recurrences can be prevented by such a therapeutic approach.

Adolescent↗
PubMed1987

HCO3- secretion in rat duodenum after treatment with omeprazole and ranitidine.

The bicarbonate secretion by the duodenal mucosa, which is stimulated by luminal acid, is very probably important in mucosal protection against the acid. It was of interest to investigate whether long-term deprivation of the mucosa of this acid stimulus affected the alkali secretion. Sprague-Dawley rats were treated for 4-6 weeks with either omeprazole, 14 mg/kg body weight twice daily, or ranitidine, 300 mg/kg twice daily, by means of gastric intubation. The rate of bicarbonate secretion by the duodenal mucosa was determined in situ by continuous titration. Neither the basal secretion nor the increase in secretion in response to stimulation by prostaglandin E2 or luminal acid (pH 2.0 for 5 or 60 min) differed in treated animals from that in controls that had received placebo (p greater than 0.05). Thus, 4-6 weeks of treatment with omeprazole or ranitidine did not reduce duodenal mucosal bicarbonate secretion in the rat, nor did these drugs diminish the ability of this mucosa to respond to prolonged luminal acidification or luminally administered prostaglandin E2.

Animals↗
PubMed1987

Reflux esophagitis: assessment of therapy effects and observer variation by video documentation of endoscopy findings.

Twenty-eight patients with endoscopically confirmed erosive or ulcerative esophagitis completed an 8-week placebo-controlled trial evaluating the symptomatic and endoscopic improvement obtained with ranitidine, 150 mg twice daily. Twice daily the patients recorded the number of episodes of retrosternal pain, regurgitation, and pyrosis on a diary card during a trial period of 1 week and during the 1st and 5th study week. Video documentation of endoscopy findings was undertaken before and at the end of the trial. The symptomatic relief obtained with ranitidine was significantly better than that obtained with placebo. The videotapes were assessed blindly and independently by three experienced fiberoptic endoscopists. The tapes were also recoded and reassessed by the same endoscopist. No systematic difference between different observers, either before or after treatment, could be detected. The interobserver variation, expressed as Kendall's tau b correlation coefficient, was 0.44 to 0.74. This coefficient was higher in intra-observer variation (0.63 to 0.91). Corresponding kappa-values for inter- and intra-observer variations were 0.12 to 0.30 and 0.27 to 0.85, respectively. The esophagitis, as judged by all observers, improved more in the ranitidine group than in the placebo group, but the difference did not reach statistical significance.

Clinical Competence↗
PubMed1987

Is duodenal ulcer really a psychosomatic disease? A population-based case-control study.

Risk factors for prepyloric and duodenal ulcer were analysed by means of a questionnaire in 132 patients and 132 population controls, pairwise matched for age and sex. Several factors associated with a lower socioeconomic status, such as short education, low income and low housing standard, and a job characterized by low satisfaction, low demands, and low autonomy, were more prevalent among the patients. The odds ratio (OR) with 95% confidence limits (CL) in smokers versus non-smokers was 2.9 (CL, 1.7-5.0). A trend emerged in relation to the daily number of cigarettes, with an OR of 4.1 (CL, 2.2-7.5) for those smoking more than 10 cigarettes. The risk of having peptic ulcer disease was virtually unrelated to other psychiatric and somatic morbidity, to marital status, personal worries, type-A behaviour, experience of a hectic or psychologically demanding job, and to consumption of coffee, alcohol, and drugs. Our data lend no support to the concept that peptic ulcer disease is a disorder related to psychologic stress. Causative agents other than smoking should probably be sought among factors characterizing the life style of low socioeconomic classes.

Adolescent↗
PubMed1987

Effect of olsalazine sodium on migrating motor complexes in the upper small bowel of human volunteers.

The effect of a peroral dose of olsalazine sodium on the migrating motor complexes (MMC) in the upper small bowel was studied by manometry in nine healthy volunteers during fasting. Recordings were obtained from the duodenum and/or the upper jejunum for 4.0 - 7.5 h. During total baseline observation periods of 30 h, fourteen MMCs could be identified compared to ten complexes during post dose registrations of 25 h. This gives an average mean interval for baseline pre dose complexes of 2.2 h, and for post dose complexes 2.5 h. If excluding the two subjects, who had the longest interval until the first MMC before dosing and did not present any MMC after dosing, the corresponding figures are 1.9 h and 1.9 h, respectively. Although our material is small with respect to the large individual variation in the recordings the results indicate that MMC does occur after an olsalazine sodium dose which is twice the dose normally recommended. Besides we can conclude that there is no apparent interference with the time for MMC occurrence in the upper small bowel in fasting humans.

Administration, Oral↗