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Biomedical subjects

T Andersen

Publications and source records attributed to T Andersen.

At least 145 records · Page 8Linked to original sources

Weight gain during treatment with valproate.

An analysis was made of weight changes during treatment with valproate in 63 adult epileptic patients. 36 patients (57%) gained more than 4 kg in weight during treatment, while 27 patients (43%) were stable in weight with weight changes of less than +/- 4 kg. There were no significant differences between weight gainers and weight-stable patients with regard to age, sex, pretreatment overweight, duration of treatment, dosage or serum levels of valproate. From structured patient interviews, it appeared that the 2 groups of patients differed only insignificantly with regard to appetite, thirst and familial predispositions to obesity and diabetes. Consequently, no factors predictive for weight gain could be outlined. Presumable pathogenic mechanisms of importance are discussed.

Adult↗

Occurrence and significance of Mallory bodies in morbidly obese patients. An immunohistochemical study.

Liver biopsies from 61 consecutive patients with morbid obesity (less than 60% overweight) and from 48 patients with alcoholic liver disease were examined for the presence of Mallory bodies. For the detection both routine haematoxylin and eosin stained sections and sections exposed to an immunohistochemical technique were employed. The latter uses an antiserum which recognizes antigenic determinants in Mallory bodies. Using haematoxylin and eosin staining. Mallory bodies were not detected in any of the biopsies from the obese patients, but found to be present in 63% of the patients with alcoholic liver disease. Using the immunohistochemical technique, Mallory bodies were found in the liver of 2 obese patients (3%) and in 36 patients with alcoholic liver disease (75%). None of the Mallory body positive obese patients showed signs of diabetes mellitus, cholestasis or hypocholesterolemia, but both patients admitted previous excessive alcohol consumption. It is concluded that the immunohistochemical detection of Mallory bodies is more sensitive than routine staining. Further, Mallory bodies are rare findings in livers of obese patients and may be related to excessive alcohol consumption.

Adolescent↗

Plasma fibronectin concentrations in morbidly obese patients.

Plasma fibronectin concentrations and liver morphology were investigated in 45 morbidly obese subjects (median overweight 88%) and in 42 normal weight controls, matched for sex and age. A significantly (P less than 0.01) raised plasma fibronectin concentration (median 464 mg/l, range 276-862 mg/l) was found in the obese subjects when compared with concentrations in the controls (median 348 mg/l, range 164-536 mg/l). Plasma fibronectin concentrations of the obese patients correlated significantly to their degree of overweight (r = 0.33, P less than 0.05) as well as to the degree of fatty change found in their liver biopsies (r = 0.33, P less than 0.05). Significantly (P less than 0.05) elevated plasma fibronectin concentrations even in obese subjects without hepatic fatty change indicate that liver fat accumulation is no prerequisite of the obesity-related elevation of plasma fibronectin. Raised plasma fibronectin concentration in obesity may more readily be explained by an increased fibronectin formation by lipocytes.

Adult↗

Liver morphology in morbid obesity: a literature study.

Literature on liver morphology in untreated obesity reveals varying prevalences of various pathological findings. The purpose of this literature study was to summarize and evaluate the published observations and to discuss discrepant findings. A complete search was aimed at utilizing bibliographic methods including a computerized survey. Forty-one original articles were included, comprising information on liver morphology in 1515 morbidly obese patients. Liver biopsy was considered normal in 12 per cent of the cases. The most frequent abnormality reported was fatty change, present in 80 per cent of the biopsies. Portal inflammation was also common (33 per cent). Fibrosis, mainly portal or periportal, was observed in 29 per cent. Cirrhosis, however, involved only 3 per cent. Study of relationships between the degree of liver change and certain possible pathogenetic factors (eg degree and duration of obesity, age, sex, alcohol consumption, diabetes mellitus) does not point towards a single causal factor. Co-influence of additional pathogenetic factors are likely in the development of liver changes in morbid obesity.

Biopsy↗

Pouch volume, stoma diameter, and clinical outcome after gastroplasty for morbid obesity. A prospective study.

In gastroplasty and gastric bypass procedures for obesity much importance has been attached to obtaining a small fundic pouch combined with a narrow outlet, factors considered to determine weight loss. The present study is a prospective investigation of the influence of these stomach dimensions on the clinical outcome. With a standardized radiological procedure 72 examinations were carried out in 27 patients during the first 18 months after gastroplasty by the method of Gomez. Median pouch volume and stoma diameter were unaltered through the observation period. Early pouch volumes ranged from 51 to 244 ml, and stoma size ranged from 6 to 24 mm after 6 months. Within these limits pouch and stoma size were not significantly correlated to the weight loss obtained. Other factors seem to be of major importance for the weight-reducing effect of gastroplasty.

Adult↗

Calcium homeostasis in morbid obesity.

Calcium homeostasis in morbidly obese subjects has attracted little attention. Prompted by reports of elevated serum levels of parathyroid hormone in such patients, calcium homeostasis was investigated in 36 patients with morbid obesity and in 44 normal weight controls. Concerning serum immunoreactive parathyroid hormone (C-terminal), serum ionized calcium (Ca++) and serum albumin corrected magnesium no significant differences between the groups were detected. When albumin corrected, serum total calcium turned out to be significantly elevated (p less than 0.0001) in the obese subjects. Also, serum alkaline phosphatase activity was significantly raised in the obese state. The results demonstrate that calcium homeostasis, as expressed by the metabolically active serum Ca++, is normal in morbid obesity. But the results also point towards an abnormal calcium binding due to either an increased calcium binding to albumin or to calcium complexing small anions.

Adult↗

The liver in consecutive patients with morbid obesity: a clinical, morphological, and biochemical study.

Liver morphology and biochemistry were investigated in 61 morbidly obese subjects selected by defined criteria. Median overweight was 82 per cent (range 61 to 170 per cent), and median duration of overweight was 20 years (range two to 45 years). No patient had more than a moderate alcohol consumption and only one was diabetic. Four biopsies (7 per cent) showed normal liver tissue, while fatty change was the main diagnosis in most cases (85 per cent). Increasing degrees of fatty change was significantly (P less than 0.02) associated with presence of lipogranulomas (found in 54 per cent of the biopsies), focal necroses (found in 28 per cent), slight parenchymal inflammation (found in 33 per cent), and Kupffer cell proliferation (found in 49 per cent). Slight portal inflammation was seen in 23 per cent but portal fibrosis in only 2 per cent of the biopsies. No case of cirrhosis was registered. Patients with moderate or severe fatty change, lipogranulomas , focal necroses or with parenchymal inflammation were significantly more obese than patients without these changes (P less than 0.05). Even in absence of fatty change, obese subjects showed a markedly decreased serum albumin concentration and an elevated serum alkaline phosphatase activity (P less than 0.0001) compared with non-obese controls. Serum lactate dehydrogenase and aspartate aminotransferase were significantly raised only in patients with fatty change. With respect to serum bilirubin and plasma cholesterol concentrations no significant differences were detected between patient subgroups and controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Formula diet in the treatment of moderate obesity.

To evaluate the effect of the popular use of formula diets in the treatment of moderate obesity two regimens have been standardized: (1) formula diet replacing three of five daily meals (partial meal replacement (PMR, 1000 kcal (4.19 MJ] and (2) formula diet taken as five pre-meals (pre-meal satiation, PMS greater than or equal to 565 kcal (greater than or equal to 2.37 MJ]. Weight loss and compliance have been evaluated in a prospective 12 weeks randomized clinical trial with allocation to one of the two regimens or to a control group treated with a 1000 kcal (4.19 MJ) conventional diet (CD). CD and PMR were supported by diethylpropion (Dobesin) individually dosaged by the patient. No anorexic drugs was given to the PMS-group. Of 136 consecutively admitted patients 120 were included. After 12 weeks the median weight loss was 7.0, 8.4 and 6.1 kg in the CD-, PMR- and PMS-group, respectively (no significant differences between the groups (P much greater than 0.02]. Thirteen percent dropped out. Consumption of diethylpropion was significantly lower in the PMR-group compared with the CD-group (median 0.15 and 0.60 tablets of 25 mg per d, respectively). Even among selected sub-groups only few subjects obtained a relevant weight loss through continued treatment after the initial 12 weeks. No serious side-effects to the treatments were observed.

Adult↗

Size reduction of extrasellar pituitary tumors during bromocriptine treatment.

The well-known size-reducing effect of bromocriptine on prolactinomas was tested on five types of large, extrasellar pituitary tumors. Twenty patients were treated prospectively for up to 4.5 years with bromocriptine, 30 or 60 mg/d (two patients received 15 mg and 160 mg, respectively). The effect on the size of the pituitary tumors was quantitated by planimetry of computed tomographic scans before and during treatment. The immediate success rate was 16 of 20 tumors. Eleven nonsecreting tumors were reduced by a median of 32% (range of reduction for 50% of cases, 18%-41%) with an immediate success rate of nine of 11. Nine secreting tumors (four that secreted prolactin; three, growth hormone; one, adrenocorticotropic hormone; and one, thyroid stimulating hormone) were reduced by a median of 51% (range of reduction for 50% of cases, 25%-72%). The reduction in tumor size was significantly associated with pretreatment size (r=0.6360, p less than 0.005), but not with the serum concentration of any hormones assayed or previous radiation treatment. Bromocriptine causes a clinically significant reduction in size of nonsecreting as well as secreting pituitary tumors with the same success rate as that of conventional treatments.U

Acromegaly↗

Fatal outcome after jejunoileal bypass for obesity.

A review of all literature on jejunoileal bypass for obesity disclosed 282 deaths, corresponding to a mortality rate of 4.2 percent. This rate has been fairly constant through the last 8 years. The causes of death and the postoperative duration are quantified. Pulmonary embolism, mostly early, and liver disease, sometimes late, dominate among the numerous causes of death. Details are too scarcely reported to allow guidance to better results.

Female↗

The Copenhagen PLAFA project: a randomized trial of gastroplasty versus very-low-calorie diet in the treatment of severe obesity (preliminary results).

Consecutive patients, between 18 and 54 years, suffering from morbid obesity (greater than or equal to 60 per cent overweight) are being randomized to either gastroplasty a.m. Gomez or to a very-low-calorie diet (341 kcal, 1.43 MJ) based on a high-value protein powder with an admixture of calcium, phosphate, sodium, chloride, and magnesium. Through a supplementary daily vitamin-mineral capsule and three tablets of potassium chloride the total regime complies with the 1980 RDA. After initial hospitalization, both groups are seen as out-patients. Twenty-eight patients have so far been studied and none has dropped out. Preliminary results show a substantial weight lose without significant differences between the groups.

Clinical Trials as Topic↗

The Copenhagen PRODI project: preliminary results.

A randomized clinical trial concerning treatment of moderate obesity is described. The study compares: (a) conventional 1000 kcal (4.19 MJ) diet with diethylpropion permitted: (b) isocaloric partial meal replacement with protein powder, and diethylpropion permitted; and (c) pre-meal satiation with protein powder. Preliminary results indicate equally good weight losses by the three methods.

Body Weight↗