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Biomedical subjects

S Jarnum

Publications and source records attributed to S Jarnum.

At least 91 records · Page 5Linked to original sources
PubMed1978

Enteric hyperoxaluria: dependence on small intestinal resection, colectomy, and steatorrhoea in chronic inflammatory bowel disease.

The importance of intestinal resection, exclusion of the colon, and steatorrhoea for secondary hyperoxaluria was studied in 81 patients with Crohn's disease and 12 patients with ileostomy after colectomy for ulcerative colitis during a metabolic regime including a fixed oral supply of fat, calcium, and oxalate. Hyperoxaluria (greater than 48 mg (greater than 0.5 mmol) per 24 h) was present in 21 patients with Crohn's disease. All but one half or more of the colon preserved. Renal oxalate excretion was related to the amount of ileum resected. 14C-oxalate absorption was significantly higher in patients with ileal resection and the whole colon preserved than in patients with ileal resection plus hemicolectomy, despite the fact that the latter group had the most extensive ileal resections. Faecal fat and oxalate excretion agreed well in patients without ileostomy (r = 0.76, p less than 0.001), and renal oxalate excretion was significantly higher in patients with steatorrhea and the colon preserved than in patients without steatorrhoea. In all 93 patients 14C-oxalate absorption and renal oxalate excretion was positively correlated with a coefficient of correlation of 0.76 (p less than 0.001). No correlation was present between 47Ca- and 14C-oxalate absorption. The study confirm that a preserved colon is necessary for secondary hyperoxaluria and stresses the importance of ileal resection and steatorrhoea.

Adult↗
PubMed1978

Stereomicroscopic examination of stained rectal biopsies.

The normal mucosal surface morphology in the rectum has been described by investigation of 15 rectal biopsies using a semimacroscopic technique. The structures of the mucosal surface were rendered visible by staining the biopsies as whole mounts with Alcian Green. A regular pattern of the crypt openings was found, and the goblet cells were observed in and just around the crypt openings. The density of crypt openings was calculated as the number of crypt openings per square millimetre (104 +/- 23 openings per mm2, mean and S.D.). Histologic examinations of the same biopsies were performed, and the density of crypt tubules was calculated from serial, horizontal sections (130 +/- 34 tubules per mm2, mean and S.D.). The ratio of crypt openings/crypt tubules was 1:1.25, indicating some branching of the mucosal glands in the rectum.

Biopsy↗
PubMed1978

Clinical studies of the utilization of an oligopeptide-containing synthetic diet. Preliminary communication.

In 12 patients comparative studies were carried out, to assess the therapeutic effect of synthetic diets containing either oligopeptides (Oligopep) or pure amino acids (Viva-sorb). Owing to side effects and failing therapeutic success it was possible to carry through nitrogen balance studies in only 7 patients. No difference could be shown between the two preparations with respect to nitrogen balance, stool mass and clinical effect. Four of the 7 patients had ulcerative colitis.

Adult↗
PubMed1978

Standardized ("trifixed") diet in the study of chronic malabsorption syndromes.

143 patients (70 patients with Crohn's disease, 11 with ulcerative colitis, 40 with an intestinal by-pass operation, 9 with non-tropical sprue, 10 with short bowel syndrome, and 3 with other gastrointestinal disease) were studied during a metabolic regime including a fixed oral supply of 70 g fat, 800 mg calcium, and 200 mg oxalate. Faecal fat, 47Ca-absorption, 14C-oxalate absorption, and renal oxalate excretion were measured, and in the majority of patients a 14C-glyco-cholic acid breath test was also performed. 14Ca-absorption was practically identical (r = 0.92), whether determined by whole-body counting or from the accumulation of absorbed 47Ca in the skeleton of the underarm. 14C-oxalate absorption and renal oxalate excretion agreed well (r = 0.85). Steatorrhoea correlated weakly with renal oxalate excretion (r = 0.63, p less than 0.001), whereas no correlation was present between faecal fat and calcium absorption or between oxalate and calcium absorption under the constant conditions prevailing during the study. It is recommended that a "trifixed" regime with absorption studies of fat, calcium, and oxalate be undertaken previous to therapy that aims at a reduction of steatorrhoea or hyperoxaluria or an improvement of calcium absorption in chronic malabsorption syndromes, not least because therapy of these categories of patients most often continues for years.

Calcium, Dietary↗
PubMed1978

Urolithiasis in chronic inflammatory bowel disease.

In a selected material of 228 patients with chronic inflammatory bowel disease (CIBD) the incidence of urolithiasis was 15% (95% confidence limit 11-21). The tendency to urolithiasis is significantly correlated to small-bowel resection and its extent and to obstruction in the urinary tract. On the other hand, there is no definite correlation to the duration or extent of the bowel disease. The significant correlation between urolithiasis and ileal resection is in agreement with the hyperabsorption of oxalate as an important cause of stone formation demonstrated by others. That local factors too play an essential role in the formation of urinary calculi is apparent from the increased incidence of urolithiasis in obstruction of the urinary tract. The incidence of urolithiasis was particularly high (22-25%) among patients with ileostomies. The few and negligible symptoms of and sequelae to, urolithiasis in CIBD encourage a conservative attitude.

Adolescent↗
PubMed1977

Influence of an elemental diet in protein exudation in chronic inflammatory bowel disease.

13 patients with chronic inflammatory bowel disease were treated with an elemental diet (Vivasorb). Intestinal protein exudation was studied during the treatment by means of of 131I-albumin. 131I-albumin studies showed no significant change of albumin degradation and, by inference, of intestinal protein loss in the group as a whole. A high initial albumin degradation rate augured treatment with elemental diet and prednisone to be unsuccessful. It is concluded that measurement of intestinal protein leakage is of no predictive value as regards the effect of treatment of chronic inflammatory bowel disease with elemental diet. Apparently, diminishing protein exudation is a late phenomenon during a course of clinical remission.

Adolescent↗
PubMed1977

Obstructive uropathy in chronic inflammatory bowel disease.

On the basis of intravenous pyelography the frequency of ureteral obstruction was elucidated in retrospect in 140 patients with Crohn's disease and 88 patients with ulcerative colitis. The findings were related to X-ray examination of the gastrointestinal tract and to the clinical condition at the time of examination. 19% of the Crohn patients had ureteral obstruction, typically affecting the right ureter on a level with the linea terminalis. There was a close topographic relationship between radiologically demonstrated intestinal changes and a mass in the homolateral iliac fossa. There was no relation to duration or activity of the disease, urinary tract infections, surgery, or steroid medication. 14% of the patients with ulcerative colitis had ureteral obstruction of varying localization and nearly always arising after colectomy. Renal calculi were found in 13% of the patients with Crohn's disease and in 18% of those with ulcerative colitis. I.v. pyelography is recommended before and after intestinal resection in chronic inflammatory bowel disease to demonstrate the relatively common and often fairly silent urinary tract complications.

Adolescent↗
PubMed1977

Assessment of the therapeutic value of an elemental diet in chronic inflammatory bowel disease.

Thirty-four patients with chronic inflammatory bowel disease, 23 with ulcerative colitis, and 11 with crohn's disease, weretreated with elemental diet. thirty-one patients had been on high dose prednisonetherapy one to four weeks prior to the diet with no or insufficient response. Fifteen patients (44%) went into remission when elemental diet was introduced as the only change of treatment. Furthermore six patients (18%) went into remission when the dietary treatment was supplemented with high dose prednisone treatment (2 cases) or an increase of prednisone dose (4 cases). Remission occurred in 16 of 21 patients with disease of moderate activity, but in only 5 of 13 cases with severe disease. Remission rate was higher in patients with a limited extent of the lesion, but 8 patients with extensive colitis responded to treatment. There was no significant change of haemoglobin serum iron, transferrin, albumin, orosomucoid, or renal excretion of creatinine. However, significant decreases were observed of sedimentation rate, renal urea excretion, faecal volume and daily number of bowel movements. Colectomy was performed in 8 patients whose condition remained unchanged or aggravated during treatment. Follow-up studies of non-operated patients who went into remission showed that 6 of 13 patients with ulcerative colitis were perfectly well 7-28 months after the study, 3 patients suffered a mild recurrence after 4-24 months, and 4 patients were colectomized 5-10 months later due to severe attack. Of 8 patients with Crohn's disease 4 remained unoperated and free of symptoms 22-35 months after the study.

Adolescent↗
PubMed1976

Early complications in patients previously treated with corticosteroids.

A retrospective analysis is presented is presented of 205 major operations performed over a 10-year period on 95 previously steroid-treated patients with Crohn's disease (C.D.) or ulcerative colitis (U.C.). All patients had been treated both in the medical and in the surgical gastroenterological department. The incidence of early postoperative complications was high, but there was nothing to suggest a relationship between the complications and the intensity of the preoperative steroid therapy. However, mortality rate, duration of hospital convalescence as well as incidence of complications were found to be significantly lower in those patients who had undergone elective in preference to emergency surgery. The fear of an increased complication rate following intensive steroid treatment of patients with acute C.D. or U.C. is, in our opinion, unfounded.

Acute Disease↗
PubMed1976

Serum orosomucoid in ulcerative colitis: its relation to clinical activity, protein loss, and turnover of albumin and IgG.

Serum orosomucoid was compared with clinical activity, routine laboratory tests, intestinal protein loss, and albumin and IgG turnover in 22 cases of ulcerative colitis. Serum orosomucoid was well correlated with clinical activity, haemoglobin and leucocyte counts were not. A significant correlation was present between serum orosomucoid and intestinal protein loss (gastro-intestinal 59Fe-iron dextran clearance), serum albumin, fractional catabolic rates of albumin, and IgG and IgG synthesis rate. No correlation was found between serum orosomucoid and albumin synthesis rate or serum IgG. It is concluded that serum orosomucoid is a highly reliable indicator of disease activity in ulcerative colitis.

Adolescent↗
PubMed1976

Bile acid metabolism and plasma protein turnover in Crohn's disease.

Postprandial duodenal bile acids, intestinal protein loss, and albumin and IgG turnover were studied in 19 non-operated patients with Crohn's disease. A lesion of the terminal ileum was present in 18 of 19 patients, either alone or associated with regional colitis. Identical bile acid studies were made in a control group of 20 patients with chronic diarrhoea of undetermined origin. Duodenal bile acid concentration was decreased in 9 of 19 patients with Crohn's disease, and in 5 of 20 patients with unexplained diarrhoea. The glycine/taurine-ratio was increased in 8 of 17 patients with Crohn's disease, but in only one of the 20 control patients. Abnormal intestinal protein loss was present in 13 of 14 patients with Crohn's disease. The fractional catabolic rate of albumin and IgG was increased in all 17 cases of Crohn's disease studied, except the patient with no protein loss. A statistically significant and positive correlation was observed between glycine/taurine-ratio and fractional catabolic rate of both albumin and IgG. No patient with Crohn's disease harboured an abnormal bacterial flora in the proximal small intestine. It is concluded that, in the absence of abnormal bacterial flora in the proximal jejunum, the glycine/taurine-ratio is more valuable as an indicator of terminal ileopathy than postprandial duodenal bile acid concentration in nonoperated patients with terminal ileitis. Abnormal intestinal protein loss and increased catabolic rate of albumin and IgG are practically always present in active Crohn's disease and are strong evidence of an organic gastrointestinal lesion in patients with normal radiographic findings.

Adolescent↗