Biomedical subjects

T Hausken

Publications and source records attributed to T Hausken.

At least 55 records · Page 3Linked to original sources

PubMed1996

Wide gastric antrum and low vagal tone in patients with diabetes mellitus type 1 compared to patients with functional dyspepsia and healthy individuals.

Autonomous neuropathy in patients with diabetes is associated with dysmotility and abdominal discomfort. The disturbances resemble to some extent those seen in patients with functional dyspepsia. To gain further insight into the disorders, we compared patients with long-standing diabetes, patients with functional dyspepsia, and healthy individuals with respect to abdominal symptoms, width of gastric antral area, and autonomic nerve function. We investigated 42 type I diabetic outpatients by structured interview for abdominal discomfort, ultrasonography of the gastric antrum, assessment of vagal and sympathetic nerve function by respiratory sinus arrhythmia and skin conductance, and measurement of blood sugar and HbA1c. Immediately after a standard meal of soup with meat, 21 (50%) of the 42 patients with diabetes complained of abdominal discomfort (pain, bloating, fullness), which was significantly less frequent (95% CI of difference 0.03-0.5) than previously seen in patients with functional dyspepsia (76%), and significantly more frequent (95% CI of difference 0.3-0.6) than that seen in healthy individuals (4%). Bloating was the most marked postprandial complaint. Mean fasting antral area was significantly wider in patients with diabetes (mean 4.9 cm2, SD 1.7) compared to healthy individuals (mean 3.5 cm2, SD 1.2), 95% CI of difference 0.6-2.2 cm2. Mean postprandial antral area was 14.8 cm2 (SD 4.6) in the patients with diabetes, which is insignificantly wider than in patients with functional dyspepsia (mean 13.0 cm2, SD 4.0) but significantly wider (95% CI of difference 1.9-6.5 cm2) than that seen in healthy individuals (mean 10.6 cm2, SD 3.8). The mean respiratory sinus arrhythmia was 0.7 beats/min (SD 0.7) in the patients with diabetes, which was insignificantly lower than that seen in patients with functional dyspepsia (2.1 beats/min, SD 4.5), and significantly lower (99% CI of difference 3.8-7.1 beats/min) compared to healthy individuals (6.2 beats/min, SD 3.8). It is concluded that patients with diabetes have a wider gastric antrum and more discomfort after a meal than healthy individuals. Compared to patients with functional dyspepsia, patients with diabetes have a wider postprandial antrum but fewer symptoms. The very low vagal tone seen in patients with diabetes may play an important role in the pathogenesis of their gastric motility disturbance and postprandial abdominal discomfort.

Adolescent↗

PubMed1996

Impaired accommodation of proximal stomach to a meal in functional dyspepsia.

In patients with functional dyspepsia, scanning by a novel ultrasonographic method was carried out to investigate postprandial accommodation of the proximal stomach. Twenty patients with functional dyspepsia and 20 controls were scanned fasting in a sitting position after drinking 500 ml meat soup. Images were recorded up to 25 min after the ingestion period using an ultrasound sector scanner with a 3.25-MHz transducer. The area in a sagittal section and the maximal diameter in a oblique frontal section were chosen as the main variables for calculating the emptying fraction of the proximal stomach, defined as: (aV2.5min - aVactual/aV2.5min. All subjects were asked to score total symptoms (1-9) provoked by the meal. From 7.5 to 25 min after the ingestion period the patients exhibited both smaller area in the sagittal section (P < 0.018) and shorter diameter in the frontal section (P < 0.046) compared with the healthy controls, and they suffered more symptoms in response to the meal (P = 0.002). Dyspeptic patients revealed higher emptying fractions (P = 0.0005, ANOVA), and H. pylori status did not influence the emptying fractions. Diagnostic sensitivity of the method at 20 min postprandially was 70% and the specificity was 65%. Patients with functional dyspepsia have impaired accommodation of the proximal stomach to a meal, temporarily related to symptom induction.

Adult↗

PubMed1996

Gastric emptying of a light hospital breakfast. A study using real time ultrasonography.

While intake of clear fluids 2-3 h before surgery is considered safe as it does not influence gastric content, it is not known if the same applies to a light breakfast meal. We therefore studied gastric emptying of a light breakfast in healthy, female volunteers without evidence of gastrointestinal motility disorders. The test meal consisted of one slice of buttered toast with jam, one cup of coffee without milk or sugar and one glass of pulp-free orange juice taken together with a paracetamol mixture. Using gastric ultrasonography, the stomach was identified without problems in all subjects, and gastric emptying curves using changes in gastric antral area and serum-paracetamol were obtained. Emptying of the fluid phase started immediately after intake of the meal. All subjects had solid particles in the stomach 120 min after the meal, 3 patients were considered empty after 180 min, 6 after 210 min and all after 240 min. The gastric antral area returned to fasting value significantly faster than the disappearance of solid particles; median 150 min versus 210 min; P = 0.01. Our results show that in healthy subjects the stomach cannot be considered empty for solid particles the first 4 h after a light breakfast meal. To secure some safety limits, we suggest a 6-h mandatory preoperative fast after a light breakfast.

Acetaminophen↗

PubMed1996

Gastric antral motility in functional dyspepsia. Effect of mental stress and cisapride.

BACKGROUND: Disordered gastric antral motor activity may be induced by mental stress. The effect of cisapride on these abnormalities has previously not been investigated. METHODS: Ten healthy subjects and 19 patients with functional dyspepsia (FD) and erosive prepyloric changes participated in the study. Antral motility was recorded with real-time ultrasonography after ingestion of 500 ml meat soup during i) a 4-min rest period, ii) 2.5 min of mental stress, and iii) a 4-min recovery period. Patients and controls were studied after 3 days of treatment with 10 mg cisapride three times daily and placebo in a double-blind crossover design. RESULTS: Mean postprandial amplitude of antral contractions was lower in patients than controls (p < 0.001). Antral amplitude was reduced by mental stress in healthy persons (p < 0.001) but not in patients. Both fasting and postprandial antral areas were larger in FD patients than controls (p < 0.001 and p = 0.02, respectively). Cisapride reduced the fasting (p < 0.001) and the postprandial (p = 0.05) antral area in the FD group but not in controls. The soup meal produced dyspeptic symptoms in 90% of the patients and in only 10% of the controls (p < 0.001). Cisapride had no significant effect on symptoms or antral contractions. CONCLUSIONS: Mental stress induced antral hypomotility in healthy subjects but not in patients with FD who had reduced motility at base line. Cisapride reduced the enlarged fasting and postprandial antral areas in the patients but had no effect on amplitudes of antral contractions or symptoms.

Cisapride↗

PubMed1996

Three-dimensional ultrasonography of the gastric antrum in patients with functional dyspepsia.

BACKGROUND: We have developed and validated a three-dimensional ultrasound system for transabdominal imaging. The aims of this study was to evaluate its applicability in scanning and volume estimation of the gastric antrum in humans. METHODS: Twenty patients with functional dyspepsia and 20 healthy controls, comparable with regard to gender, age, and smoking habits, agreed to be scanned while ingesting 500 ml of meat soup. A mechanical scanner with a 3.25-MHz transducer coupled to a tilting motor provided in 3 sec multiple images of the antrum during fasting and 1, 10, and 30 min postprandially. On a Unix work station planar contours of the antrum were selected and drawn manually before organ reconstruction and volume computation. RESULTS: Two volume scans of 160 could not be analyzed due to air in the antrum. Up to 5 cm proximal to the pylorus, volumes could be computed in 95% of fasting samples and in 98% of postprandial samples, versus 8% and 75%, respectively, up to 7 cm proximal to the pylorus. We found no significant differences in antral volumes between dyspeptic patients and controls, either fasting or postprandially. Fasting antral volumes in Helicobacter pylori-positive dyspeptics were smaller than in H. pylori-negative patients (P = 0.02). CONCLUSIONS: Three-dimensional ultrasonography by use of a tilting motor makes non-invasive volume estimation of the gastric antrum possible without making assumptions about its geometry. In the present material no difference was found in antral volumes between patients with functional dyspepsia and controls. It is possible that fasting antral volumes in dyspeptic patients are dependent on H. pylori status.

Adolescent↗

PubMed1996

Ultrasonography of the human stomach.

UNLABELLED: Improved technology and new systems have expanded the possibilities of using ultrasound in clinical gastroenterology. METHODS: Conventional real-time ultrasound was applied to the stomach in order to study motor activity and accommodation to meals. The antrum was imaged by various modalities of two- and three-dimensional ultrasonography, while duplex sonography was used for studying transpyloric flow. Miniature ultrasound probes and echo-endoscopes were employed for endoscopic ultrasound RESULTS: The examinations provided new information about contractions, distension, co-ordination of movements, and flow. Patients with functional dyspepsia were characterized by rapid emptying of the proximal stomach, wide gastric antrum, early commencement of transpyloric flow, and epigastric discomfort following ingestion of a meat soup. Endoscopic ultrasonography exposed detailed images of the gastric wall and adjacent structures of great importance in clinical decision-making. CONCLUSIONS: The new ultrasound methods have improved our diagnostic capabilities and opened new promising possibilities for further research in the field of motility.

Endosonography↗

PubMed1996

Bismuth-based combination therapy for Helicobacter pylori-associated peptic ulcer disease (metronidazole for eradication, ranitidine for pain).

OBJECTIVES: 180 Helicobacter pylori-positive patients with peptic ulcer disease were randomly allocated to double-blind placebo-controlled treatment with one of four anti-H. pylori regimens consisting of bismuth subnitrate suspension (B), oxytetracycline (OT), metronidazole (M)/metronidazole placebo, or ranitidine (R)/ranitidine placebo. METHODS: Regimen 1: B 150 mg q.i.d., OT 500 mg q.i.d., M 400 mg t.i.d. for 10 days and R 300 mg b.i.d. for 4 wk. Regimen 2: same as regimen 1 except ranitidine. Regimen 3: same as regimen 1 except metronidazole. Regimen 4: same as regimen 1 except metronidazole and ranitidine. Gastroscopy and 14C-urea breath test were performed 4 wk after cessation of therapy, and breath test six months after cessation. RESULTS: According to intention-to-treat analysis, H. pylori eradication rates were 96%, 91%, 20%, and 9% with regimens 1, 2, 3, and 4, respectively. Comparing regimens 1+2 and 3+4, the eradication rates with and without metronidazole were 93% and 14%, respectively (p < 0.0001). Metronidazole increased the occurrence of diarrhea and abdominal pain. Comparing regimens 1+3 with 2+4 ranitidine did not influence H. pylori eradication (58% with and 50% without ranitidine; p = 0.37) or ulcer healing (93% with and 90% without ranitidine; p = 0.72) significantly, but reduced the occurrence of pain (p < 0.01). Six months after treatment, three patients who were H. pylori negative at 4 wk had become positive. These three had all received metronidazole placebo. H. pylori status remained negative in the other 85 patients. CONCLUSIONS: H. pylori eradication with this triple therapy is critically dependent on metronidazole. Adding ranitidine reduces the occurrence of abdominal pain during such therapy.

Adolescent↗

PubMed1995

In vivo comparison of 3D ultrasonography and magnetic resonance imaging in volume estimation of human kidneys.

The objective of this study was to evaluate the accuracy of a three-dimensional ultrasound system (3D-US) compared with Magnetic Resonance Imaging (MRI) in volume estimation of human kidneys in vivo. Twenty healthy volunteers were scanned fasting in supine position with MRI and with a 3D-US. An ultrasound sector scanner with a mechanical transducer coupled to a tilting motor provided images of multiple sections of kidneys. A 3.25-MHz transducer was tilted through 88 degrees yielding 81 frames, and volume estimation was performed on a Unix workstation after manual contour indication. Data acquisition with MRI was performed by using a 1-T magnet. Eighteen included kidneys [mean +/- standard deviation (SD)] measured 155.7 +/- 26.4 mL (range 110.0-205.0 mL) by 3D ultrasound and 171.8 +/- 24.6 mL (range 127.5-211.0 mL) by MRI, yielding a good correlation (r = 0.82, p < 0.001) between the two methods. The mean difference was -16.1 +/- 15.6 mL (SD) and the limits of agreement were -49.0 mL. We conclude that this 3D-US is accurate in volume estimation of human kidneys in vivo.

Adult↗

PubMed1995

Spiramycin in triple therapy of Helicobacter pylori-associated peptic ulcer disease. An open pilot study with 12-month follow-up.

BACKGROUND: Spiramycin (Rovamycin) is a well-established macrolide antibiotic with good anti-Helicobacter pylori activity in vitro. It is acid-stable and found in high concentration in various body fluids and cells after oral administration. Its anti-H. pylori activity in vivo has not yet been tested. METHODS: Twenty-five consecutive patients with endoscopically verified peptic ulcer and a positive biopsy urease test were given spiramycin tables 1.5 MIU instead of oxytetracycline 500 mg q.d.s. in our triple therapy regimen with bismuth subnitrate suspension 10 mL (150 mg bismuth subnitrate) q.d.s. and metronidazole 400 mg t.d.s. for 10 days. Bismuth was taken between meals and spiramycin and metronidazole with meals. Re-endoscopy and 14C-urea breath test were performed 4 weeks after completion of therapy. Those who were H. pylori negative according to the breath test returned for 1-year follow-up. RESULTS: Per protocol analysis at 4 weeks showed that 21 out of 23 patients were H. pylori negative and had healed ulcers. These 21 patients were persistingly H. pylori negative and had no ulcers at 1-year follow-up. H. pylori eradication and ulcer healing rates were thus 91.3%; 95% confidence interval from 72.0% to 98.9%. Side-effects limiting daily activity were significantly less frequent than we have experienced previously using oxytetracycline in triple therapy. CONCLUSIONS: Spiramycin appears to be an alternative to tetracycline in the triple therapy of H. pylori infection. Further studies to position spiramycin as an anti-H. pylori drug are warranted.

Adult↗

PubMed1995

Lansoprazole capsules and amoxicillin oral suspension in the treatment of peptic ulcer disease.

BACKGROUND: Lansoprazole is a potent antisecretory drug also possessing anti-Helicobacter pylori activity in vitro. It is a candidate drug for combination regimens with antibiotics for treating H. pylori infections. METHODS: In a semiblind study, 65 patients with duodenal and/or gastric ulcer and pathologic 14C urea breath test results were treated with either 60 mg lansoprazole every morning only for 14 days or combined with 500 mg amoxicillin oral suspension four times daily between meals, given for 11 days. Endoscopy and breath test were repeated after 6 weeks and 6 months. Patients with unhealed ulcers were withdrawn. RESULTS: Eradication of H. pylori infection was attained in 46% of patients receiving lansoprazole and amoxicillin but in no patient receiving lansoprazole alone. Ulcers healed significantly more often in those who were H. pylori-negative (18 of 19 (95%)) than in those who were H. pylori-positive (20 of 41 (49%)). Adverse events, particularly stomatitis/sore throat and diarrhea, occurred significantly more often when amoxicillin was combined with lansoprazole. CONCLUSIONS: Lansoprazole eradicated H. pylori infection only when combined with amoxicillin. Eradication rates in this study are hardly acceptable, and further studies are necessary to define optimal doses and duration of treatment. Using amoxicillin as an oral suspension may not be of any substantial benefit and may cause stomatitis and sore throat.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1995

Gastric relaxation in response to a soup meal in healthy subjects. A study using a barostat in the proximal stomach.

BACKGROUND: Meal-induced relaxation of the proximal stomach can be investigated by means of a barostat. Using a standard liquid meat soup that elicits symptoms and a wide antrum in patients with functional dyspepsia, we aimed at finding the best meal size and fat load for studying gastric relaxation. METHODS: In the first trial 200 ml and 500 ml meat soup (1 g fat/200 ml) was given to six healthy individuals. In the second trial a constant volume of soup (200 ml) containing graded amounts of fat (1, 10, and 20 g/200 ml) was given to seven healthy individuals. Gastric relaxation was investigated for 1 h after consumption of the soup. A sagittal cross-sectional antral was assessed ultrasonographically every 10 min, and abdominal discomfort was scored. RESULTS: Overall, a positive response (volume increase of 30 ml or more within 5 min after consumption of the meal) was found in 26 of 30 (87%) investigations. Individual maximal responses ranged from 38 to 482 ml (mean, 180 ml +/- 128). Area under the time-volume curve (AUC) was similar after 200 and 500 ml soup (mean, 100 ml/30 min and 107 ml/30 min, respectively). AUC increased with increasing fat content, with a significant difference between the low-fat and high-fat meal (p < 0.05). The barostat bag induced fed-state antral contractions in most individuals (p < 0.001). There was a negative correlation between AUC and postprandial abdominal discomfort (p = 0.04). CONCLUSIONS: The barostat is a sensitive technique for detecting gastric relaxation, also in response to our standard meat soup meal. The postprandial relaxation response in healthy individuals in dependent on the fat content of the meal. The barostat bag may alter gastric motor activity. Abdominal discomfort after soup ingestion may be related to poor gastric relaxation.

Adult↗

PubMed1995

Monitoring postprandial size of the proximal stomach by ultrasonography.

The purpose of this study was to develop a sonographic method to monitor postprandial size of the proximal stomach. Twenty-three healthy persons were scanned in a sitting position with a 3.25 MHz transducer after ingestion of 500 ml meat soup. The area in a sagittal section and the maximal diameter in an oblique frontal section were chosen as standard measurements. The soup emptied from the proximal stomach in a linear manner (r = 0.99) and at a rate of 2.0 +/- 1.3%/min. Intraobserver error of the scans (mean +/- SD) was 5.6% +/- 2.3% and 9.5% +/- 4.5% for sagittal area and frontal diameter, respectively, and the corresponding interobserver error was 5.3% +/- 4.0% and 8.3% +/- 5.3%, respectively. This sonographic method demonstrated a moderate day-to-day variation, had low intra- and interobserver error, and allowed estimation of initial emptying fractions of the proximal stomach.

Adult↗

PubMed1994

[Gastrointestinal diseases--the place of endoscopy in examination, treatment and control].

Dyspepsia, defined as discomfort in the upper abdomen after a meal, is the most frequent indication for gastroscopy. Such dyspepsia was earlier considered to be an element of the ulcer disease, Moynihan's disease. Whether examination showed an ulcer or not was of minor importance as long as the treatment was the same. Similar opinions still contribute to a negative attitude towards the need to obtain a more specific diagnosis, especially in young patients where risk of cancer is low. We are of the opinion that dyspepsia is a non-specific symptom of several different diseases, and that curative therapy is often available today provided the diagnosis is correct. It is therefore necessary to make an active effort to diagnose the cause of the dyspepsia, also in younger persons. In practice, this means that there are many different indications for gastroscopy. We try, however, to practice a restrictive policy with respect to control gastroscopy.

Cost-Benefit Analysis↗

PubMed1994

[10 days of triple treatment of Helicobacter pylori infection and peptic ulcer. Status after treatment of 4 weeks and of one year].

We treated 143 Helicobacter pylori positive ulcer patients (duodenal ulcer 81, gastric ulcer 24, pyloric ulcer nine, previous duodenal ulcer 27, others two) with a ten days regimen of bismuth subnitrate, oxytetracycline and metronidazole. Four weeks after cessation of treatment the 14C-urea breath test showed that the infection was eradicated in 133 out of 140 patients (95%). The ulcer had healed in 129 (97%) of the H. pylori negative patients. Status at one year after treatment showed that 121 (98.4%) of 123 patients who had become H. pylori negative had remained negative. None of the H. pylori negative patients experienced ulcer relapse. The results show that the treatment is effective and that the rate of recurrence of H. pylori during the first year is very low.

Adult↗

PubMed1994

Volume measurements of gastric antrum by 3-D ultrasonography and flow measurements through the pylorus by duplex technique.

We present a method for estimating volumes of abdominal organs using 3-D ultrasonography. In vitro validation experiments demonstrated excellent agreement between estimated and true volumes. In vivo estimations after ingestion of 500 ml meat soup showed greater antral filling and poorer emptying of the gallbladder in patients with functional dyspepsia (FD) than in healthy controls. Abnormal antral filling was associated with dyspeptic symptoms. The relationship between motility and transpyloric movements of luminal contents after ingestion of 500 ml meat soup was studied in healthy subjects by duplex technique. Accurate timing of antegrade and retrograde flow were recorded using bidirectional velocity curves. Mid-cycle and end-cycle reflux were often observed; end-cycle reflux was more frequent in conjunction with coordinated than with uncoordinated antroduodenal contractions. The peristaltic closure of the pylorus was normally preceded by a short gush of duodenogastric reflux.

Dyspepsia↗

PubMed1994

In vitro evaluation of three-dimensional ultrasonography in volume estimation of abdominal organs.

The purpose of this study was to evaluate the accuracy and precision of a three-dimensional (3D) ultrasound system in volume estimation of abdominal organs in vitro. A mechanical sector scanner coupled to a stepping motor recorded images of porcine stomach and kidneys. The transducer was tilted through 88 degrees yielding 81 frames, and volume estimation was performed digitally after interactive manual contour indication and organ reconstruction in 3 dimensions. This 3D system showed good correlation (r = 0.998) between estimated and true volumes. Volume estimation of stomach and kidneys using 3.25 MHz probe demonstrated limits of agreement of 0.877 to 1.146 and 1.007 to 1.125, respectively, depicting estimated volumes as a proportion of true volumes in 95% of the examinations. Intra- and interobserver variation of the tracing procedure revealed low values. We conclude that this 3D ultrasound system performs high accuracy and precision in volume estimation.

Abdomen↗

PubMed1994

Effect of glyceryl trinitrate on antral motility and symptoms in patients with functional dyspepsia.

Nitric oxide (NO) is considered to be an important physiologic non-adrenergic, non-cholinergic vagal transmitter in the neural regulation of gastric adaptive relaxation, which accommodates the gastric fundus to ingested food. Ten consecutive patients with functional dyspepsia (FD) and erosive prepyloric changes were studied twice on separate days, once without drug administration and once after intake of one tablet of glyceryl trinitrate (GTN), 2.6 mg, 2 h before ingestion of 500 ml meat soup. Width of antral area, amplitude (maximal area reduction as fraction of relaxed area), and frequency of antral contractions were measured ultrasonographically in standardized sections. Postprandial abdominal discomfort was scored. Without GTN, postprandial antral area and symptom scores were positively correlated (r = 0.64, p = 0.05). After administration of GTN, antral area both fasting and 10 min postprandially was reduced (p = 0.02 and p = 0.01, respectively), whereas amplitude and motility index of antral contractions tended to increase (p = 0.07 and p = 0.09, respectively). Abdominal discomfort was not significantly reduced by GTN (p = 0.13). The results suggest a relationship between postprandial antral distension and discomfort. Moreover, GTN (by generation of NO) reduced abnormal antral filling in patients with FD.

Adult↗

PubMed1994

Ultrasonographic assessment of fasting liquid content in the human stomach.

BACKGROUND: Disturbed antroduodenal motility plays an important role in the pathophysiology of functional dyspepsia (FD). Such motility disturbances can be investigated by transcutaneous ultrasound. When it is measured in a standardized section, patients with FD have on an average significantly larger antral area than healthy controls. METHODS: In this study we investigated the relationship between the antral area measured by ultrasound and the amount of fasting gastric content quantitated by aspiration through the gastroscope in 30 patients. In five healthy controls we measured the increment of the antral area after ingestion of graded volumes of water. All recordings were made in interdigestive phase I. RESULTS: Measurements of the antral area were highly reproducible, with small variations within an hour and from day to day. There was a highly significant correlation between ultrasonographically measured antral area and amount of fasting gastric juice and between increment of antral area and amounts of ingested water. CONCLUSIONS: The ultrasonographically measured antral area during fasting is highly reproducible. Enlarged fasting antral area reflects increased volume of gastric juice.

Adolescent↗