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S Ritland

Publications and source records attributed to S Ritland.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Retrograde ileography. Contrast imaging of the terminal ileum by colonoscopy].

The distal ileum, the segment most frequently affected by small intestinal disease, may be difficult to visualize by conventional x-ray techniques. In recent years various methods have been described for retrograde ileography during or after colonoscopy. However, these methods require special equipment and may be difficult to perform in practice. We have therefore tried out a somewhat modified technique. Patients with suspected distal ileal disease are examined on a fluoroscopy table at the x-ray department. When necessary, biopsies are taken during the introduction of the scope. With the tip of the colonoscope in the terminal ileum (or coecum) a catheter is introduced through the biopsy channel into the distal ileum. Water-soluble contrast (Mixobar) is then instilled under fluoroscopic control and films are taken in the supine, oblique and prone positions. Owing to gas already present in the ileum a double contrast effect is obtained. The ileography is completed in 5-10 minutes and entails no additional discomfort for the patient. The technique is easy to learn and requires no special equipment. It does not obviate the need for conventional small bowel enema, but may be a valuable supplement to this examination when distal ileal pathology is suspected.

Colonoscopes↗
PubMed1990

[Amebic liver abscess].

Hepatic abscesses represent the most common non-enteric complication of amebic infection, and occur in 1-25% of the patients. We describe two male patients, 44 and 47 years old, who presented hepatic abscesses after travelling in endemic regions. We stress the importance of accurate and early diagnosis. Ultrasonography and computed tomography were of major importance as diagnostic tools.

Adult↗
PubMed1990

Gastrointestinal disturbances in marathon runners.

To determine the prevalence of various gastrointestinal disturbances related to long-distance running and its effect on weight, diet and everyday digestive problems, we gave a questionnaire to 279 leisure-time marathon runners, comprising 10% of the participants in a local marathon race. Their answers disclosed a prevalence of dietary changes, weight reduction and altered bowel habits (mainly looser stools and/or more frequent defaecation) of 37, 38 and 48% respectively. A quarter reported earlier long lasting gastrointestinal problems, which improved in 41% of the runners after they started regular training. Thirty-four percent experienced gastrointestinal disturbances during or after running, 20% to such an extent that it seriously affected their performance.

Adolescent↗
PubMed1989

[Biliary duct obstruction presenting with laboratory levels indicating liver cell damage].

Some patients with extrahepatic biliary occlusion present high levels of serum aminotransferases indicating parenchymatous liver disease. The levels, usually in the range of 400-500 U/l, may sometimes exceed 1,000 U/l. Most of these patients have stones in the bile ducts, but the causes may occasionally be pancreatic tumours and pancreatitis. Typically the maximum enzyme levels are reached within 1-2 days, followed by a rapid fall--whether the gallstones have passed or not. The alkaline phophatase levels are initially normal or slightly elevated, usually increasing slowly to about twice the upper reference level. The pathogenesis of this rapid elevation of the aminotransferases has yet not been fully elucidated. However, the main mechanisms are probably increased permeability of the hepatocyte membrane caused by elevated pressure in the bile ducts, combined with a direct toxic effect of retinated bile acids. Increased enzyme synthesis may also be a contributory factor. Further knowledge of this not unusual enzyme pattern in acute (and sometimes also chronic) biliary obstruction will help to establish a correct diagnosis at an early stage of the disease, and thus avoid a need for invasive, potentially dangerous investigations.

Adult↗
PubMed1989

[Macroamylasemia--an rather unknown condition for Norwegian doctors?].

Three patients with macroamylasemia and different clinical problems are presented. They illustrate the importance of recognizing the macroenzymes as the cause of elevated serum amylases. Several methods exist for confirmation of the condition, as for instance electrophoresis. It may be sufficient, however, to determine serum lipase or amylase in urine that is normal. Macroamylasemia is a benign condition requiring no treatment. It is important to recognize macroamylasemia in order to avoid unnecessary, diagnostic procedures.

Adult↗
PubMed1988

Exercise and liver disease.

Although more than 30 years have elapsed since the appearance of the first reports demonstrating that physical activity had no detrimental effect in patients with acute viral hepatitis, bedrest seems to still be widely practised. More recent reports have also shown that exercise during the acute phase may help preserve the physical capacity of the patients. Following acute viral hepatitis patients may start training earlier than previously presumed. Restriction of physical activity has also been widely practised in patients with chronic liver disorders. Most groups of patients studied so far seem to tolerate physical activity well without deterioration of the liver function, and regular training in patients with chronic active hepatitis resulted in increased oxygen consumption and improved working capacity. Thus, physical activity may be of benefit to most patients with acute or chronic liver diseases.

Acute Disease↗
PubMed1987

Granulomatous hepatitis in Yersinia enterocolitica infection.

Liver involvement in infections with Yersinia enterocolitica or Yersinia pseudotuberculosis is apparently rare. In a 69-year-old male patient with acute Yersinia enterocolitica infection with positive faecal culture and a serum titre of 1/1280, the liver tests were slightly abnormal. A liver biopsy revealed granulomatous hepatitis. Follow-up after six months revealed normal liver function and histology.

Granuloma↗
PubMed1986

Gastrointestinal bleeding in marathon runners.

Gastrointestinal bleeding has been proposed to be a contributing factor in the development of 'runner's anaemia'. To study the incidence of gastrointestinal bleeding, 2-3 prerace and 2-3 postrace faecal samples from 63 marathon runners were tested for the presence of blood. Five of the participants had faecal blood before but not after the race. A reasonable explanation for the bleeding was found for four. Eight runners (13%) had positive tests for faecal blood after the competition. Clinical investigation disclosed no gastrointestinal disease. Postrace haematuria was discovered in another 13% of the runners. None of the runners observed overt gastrointestinal bleeding or haematuria, nor did anyone develop anaemia. Gastrointestinal disturbances related to running were reported by 54%. It is concluded that gastrointestinal complaints and gastrointestinal bleeding are prevalent among marathon runners.

Adolescent↗
PubMed1985

Interstitial fluid volume, plasma volume and transcapillary colloid osmotic gradient in patients with hepatic cirrhosis and fluid retention.

Colloid osmotic pressure in plasma (IIp) and in subcutaneous interstitial fluid (IIi) (wick technique), plasma volume (PV) and interstitial fluid volume (IFV) were measured in 12 patients with hepatic cirrhosis and fluid retention. The value of IIp (mean +/- SD) was 21.4 +/- 4.2 mmHg (28.6 +/- 3.4 mmHg in normal subjects (p less than 0.01)), mean IIi was 8.6 +/- 2.2 mmHg (15.8 +/- 2.7 mmHg in normal subjects (p less than 0.01)) and mean transcapillary colloid osmotic gradient (IIp-IIi) was 12.7 +/- 3.8 mmHg compared to 12.8 +/- 2.7 mmHg in normal subjects (p greater than 0.1). Mean PV was increased by 21% compared to normal values (p less than 0.01) and IFV increased by 43% (p less than 0.01). The study demonstrates that reduction in IIp in hepatic cirrhosis is accompanied by a decrease of IIi in subcutaneous tissue resulting in unchanged transcapillary colloid osmotic gradient. The reduction in IIi can partly be explained by simple dilution and partly by a decrease in interstitial protein mass. The wash-down of interstitial proteins in non-splanchnic tissues reduces the tendency to oedema and hypovolaemia.

Adult↗
PubMed1985

The pancreatic ducts in primary biliary cirrhosis and sclerosing cholangitis.

Endoscopic retrograde pancreatograms were examined in a consecutive series of patients with cholestatic disease caused either by primary biliary cirrhosis (PBC) (35 patients) or by sclerosing cholangitis (SC) (38 patients). The pancreatic ducts were abnormal in three of the patients with PBC but in none with SC. Gallstone disease occurred concomitantly in the two patients with most advanced pancreatic involvement. The liver disease was classified as advanced PBC in 11 of the 35 patients. Symptoms of hepatobiliary disease were scarce in most SC patients. Eight of the 38 patients had histologically verified biliary cirrhosis. SC was associated with extensive, but most often inactive or mild, colitis in 97% (ulcerative colitis in 34 and Crohn's disease in 3 patients). Three of these patients had concomitant cholangiocarcinoma.

Adolescent↗
PubMed1985

Follow-up and prospective studies of the classification of liver disease.

Two hundred patients with different liver diseases were observed during a period of 6-8 years. The diagnosis at the first hospitalization was based on morphological criteria (and, in some cases, additional clinical information). In 162 of the cases an initial 'specific' diagnosis could be made. By the time of the follow-up study the diagnosis was confirmed in 73% of them. In 22 of 38 patients who were initially unclassifiable, the diagnosis was made definite by the follow-up study. Eighty-five patients were hospitalized for re-examination 6-8 years after the initial study. Several of the liver diseases initially had quite typical patterns of clinical chemical data. Allocation by discriminant analysis was therefore in good agreement with the morphological classification. The follow-up study showed that several patients with initially atypical patterns of clinical chemical results had their diagnosis changed. In 35 patients with the final diagnosis of chronic active hepatitis (CAH) or primary biliary cirrhosis (PBC), laboratory data from the last hospitalization were used for discriminant analysis with teaching data from the initial study. Ninety-seven per cent were correctly allocated, and we conclude that these patients retain recognizable patterns of laboratory results for several years, even when given immunosuppressive treatment. The potential clinical usefulness of discriminant analysis of laboratory data for differential diagnosis was evaluated by a prospective study of 65 patients with the morphological diagnosis of CAH or PBC. Correspondence with the morphological classification system was found in almost 90% of the cases.

Chronic Disease↗
PubMed1985

Chronic active hepatitis. Experience from a Norwegian reference hospital during a decade.

During the decade from 1 January 1971 to 31 December 1980. 90 hospitalized patients fulfilled the diagnostic criteria of chronic active hepatitis (CAH). An aetiological agent was identified in 13 of the patients: hepatitis B virus infection in 6 and a drug in 7. The other 77 cases were assumed to be idiopathic. The mean age at presentation was 32 years, and 66 (73%) of the patients were female. The patients have been followed up until death or until 31 December 1981. The mean observation period was 114 months. Twenty-five (28%) patients died. 19 of them of liver disease. Complications or signs of portal hypertension were observed in 62%. Of the 18 patients with upper gastrointestinal bleeding 15 had a portal-systemic shunt performed. Associated diseases in other organ systems were observed in 16 (18%) of the patients. Pronounced biochemical activity was found in 80 (89%) of the patients. Immunosuppressive therapy was started in 84 (93%), either as corticosteroids alone (40 patients) or in combination with azathioprine (44 patients). Azathioprine was later withdrawn in 29 (66%), in 6 because of side effects and in 20 because of clinical and biochemical improvement. Corticosteroids were withdrawn in 22 (26%), in 2 because of side effects and in 18 because of improvement. In 35 of the 45 patients in whom discontinuation was attempted, the treatment had to be reinstituted. Eight of the patients on combined therapy could discontinue both immunosuppressive drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

The incidence of chronic active hepatitis in Norway. A retrospective study.

From all departments of internal medicine in Norway information has been collected about new cases of chronic active hepatitis (CAH) diagnosed during 1981. A questionnaire together with copies of histological examination reports and discharge summaries have been carefully examined to ensure that established diagnostic criteria were fulfilled. Of the 63 reported cases, 58 were recorded as CAH. An aetiological agent was identified in nine cases; six were HBsAg-positive, two were alcohol-induced, and one drug-induced. The other 49 cases were assumed to be idiopathic. The incidence of CAH of all causes was 1.41 per 100,000; of idiopathic CAH, 1.19 per 100,000; and of HBsAg-positive CAH, 0.15 per 100,000. The mean age was 51 years, and a third of the patients in the idiopathic group were 65 years or older at presentation. In this group about 71% of the patients had autoantibodies, and 61% had serum aminotransferase levels more than five times and 46% more than ten times the upper reference range. The proportion of the different aetiological agents was different from what has been reported in other studies. The activity of the disease, judged by the serum level of aminotransferase, was more pronounced than reported in other investigations. This may indicate that only relatively severe cases of CAH were subjected to liver biopsy.

Adolescent↗