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Biomedical subjects

T Ihre

Publications and source records attributed to T Ihre.

48 records · Page 3Linked to original sources
PubMed1976

Function of the anal sphincters in patients with intussusception of the rectum.

Patients with intussusception of the rectum--six with anal incontinence and nine continent--were examined with respect to the function of the anal sphincters. Anal pressure was recorded continuously during rest, during maximal voluntary squeezing of the anal muscles, and during gradual expansion of the rectum by means of a balloon inserted into the rectal ampulla. The maximal anal pressure at rest, which is mainly due to activity of the internal anal sphincter, was lower (P less than 0-001) in the incontinent patients (31 mmHg +/- 5-6) than the continent (67 mmHg +/- 4-3) and the former had significantly smaller relaxations of the internal sphincter upon rectal distension (P less than 0-05). The increase in anal pressure during voluntary squeezing, a function of the external sphincter, did not differ significantly compared with healthy subjects in either incontinent or continent patients. On the basis of the above findings, it is concluded that the function of the internal sphincter is impaired in the incontinent patients.

Aged↗
PubMed1976

Influence of autonomic nerves on the internal and sphincter in man.

The internal and sphincter receives its parasympathetic nerve supply from the sacral outflow and its sympathetic supply from the thoracicolumbar outflow of the spinal cord. In order to investigate the influence of the tonic discharge of these nerves, eight healthy subjects receiving high spinal anaesthesia (T 6-T 12) and five receiving low spinal anaesthesia (L 5-S 1) were examined. Continuous recordings of anal pressure and electromyographic activity from the external sphincter were obtained during rest and during expansion of the ampulla recti by means of an air-filled balloon. The results were compared with those obtained in an earlier study from 10 subjects with a bilateral pudendal block which paralysed the striated sphincter muscles without affecting the autonomic nerve supply to the internal sphincter. Anal pressure at rest decreased significantly more with high spinal anaesthesia (32 +/- 3-2 mm Hg) than with low (11 +/- 7-1 mm Hg) or with pudendal block (10 +/- 3-9 mm Hg) and the relaxations of the internal sphincter induced by rectal distension were somewhat smaller with high spinal anaesthesia. However, the remaining anal pressure at maximal relaxation, induced by a substantial rectal distension, was essentially the same with the three forms of anaesthesia. It is concluded that, at rest, there is a tonic excitatory sympathetic discharge to the internal anal sphincter in man. However, this seems to be without excitatory effect when the sphincter is relaxed after a substantial rectal distension. Furthermore, the results indicate that at rest there is no tonic parasympathetic discharge affecting the sphincter tone.

Adult↗
PubMed1976

Specific metabolic pathways of steroid sulfates in human liver microsomes.

The hydroxylation of steroid sulfates has been studied in liver microsomal preparations from adult humans. Ten different C18, C19, and C21 steroid sulfates and the corresponding unconjugated steroids were used as substrates. In several cases it was found that steroid sulfates were efficiently hydroxylated in a way that differed both qualitatively and quantitatively from the hydroxylation of the corresponding unconjugated substrates. Only the hydrophobic (nonsulfurylated) end of the steroid sulfate molecule was hydroxylated. The steroids sulfurylated in position 3 were generally better substrates for the liver microsomal hydroxylase system than those sulfurylated in position 17. The findings that unconjugated and sulfoconjugated steroids are metabolized along different pathways in the liver may be of general significance. Sulfoconjugation and subsequent hydroxylation may also be an important pathway in the metabolism of xenobiotics in man.

Adult↗
PubMed1975

Impact of change to early diagnosis and surgery in major upper gastrointestinal bleeding.

The diagnostic, operation, and mortality rates in two series of patients with major upper gastrointestinal bleeding have been compared. In one (1968-69) patients were admitted to medical wards, radiology was the only investigation, and few were operated on. In 1972-74 a more vigorous policy was adopted with investigation by both radiology and endoscopy, more (and earlier) surgery, and intensive care by a surgical team. Failure to reach a diagnosis fell from 38-9% to 5-7%; the operation-rate increased; transfusion requirements decreased; and mortality in both operated (47% v. 11%) and non-operated (17% v. 8%) fell. A policy of early and vigorous investigation and management by a surgical team is urged for patients presenting with severe bleeding from the duodenum, stomach, or oesophagus.

Diagnostic Techniques, Surgical↗
PubMedDate not supplied

Intussusception of the rectum-internal procidentia: treatment and results in 90 patients.

A series of 90 patients with intussusception of the rectum (internal procidentia) has been studied. In 11 per cent of the patients there was also an enterocele and in 3 per cent, a large proctocele. Forty patients were operated upon by the Ripstein procedure. Indications for operation were, in most cases, incontinence for gas and/or feces. Seventy-five per cent of the preoperatively incontinent patients were, at follow-up 2 to 10 years after operation, continent. When indications for surgery were pain and or a sensation of obstruction, the results were poor; most of these patients had unchanged symptoms postoperatively, and some even had increased symptoms. There was one postoperative death. Of 50 patients treated conservatively during a period of 2 to 10 years, only two had to be operated upon: one due to the development of a rectal prolapse and the other due to severe pain and an increased sensation of obstruction.

Adolescent↗