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Biomedical subjects

T Lind

Publications and source records attributed to T Lind.

At least 109 records · Page 6Linked to original sources
PubMed1989

Palliative endoscopic dilatation in carcinoma of the esophagus and esophagogastric junction.

The palliative effect of repeated endoscopic dilatation of malignant strictures of the esophagus and esophagogastric junction was prospectively evaluated in 41 patients. Dilatation was performed with Eder-Puestow technique in brief general anesthesia. Substantial improvement in swallowing ability was experienced after each treatment. The dysphagia recurred, however, and the dilatations were repeated at intervals of about 4 weeks. Most patients required less than or equal to three treatments during their remaining lifespan. There were few complications, the most prominent being perforation (in 5% of 128 sessions). Only short hospital stay was required, and 18 patients remained at home during the periods between dilatations. Endoscopic dilation of the esophagus and esophagogastric junction gives good palliation. The technique is simple, cheap and safe. It is suitable for lesions at any site, not time-consuming, available at almost all endoscopy units, and consequently to be recommended in this clinical setting.

Adenocarcinoma↗
PubMed1989

Effect of omeprazole on gastric acid secretion and plasma gastrin.

Omeprazole represents a new class of gastric acid inhibitors, which inhibits the H+, K(+)-ATPase in the secretory membrane of the parietal cell. Single oral doses inhibited pentagastrin stimulated acid secretion with an ED50 of 27 mg. Almost complete inhibition could be achieved with a single dose of 80 mg. Acid secretion then slowly returned and reached normal levels after 3-4 days. Omeprazole also inhibited basal, histamine peptone and vagally stimulated acid secretion with similar potency. For clinical use omeprazole has been formulated as enteric coated granules. During repeated once daily dosing with this formulation the degree of acid suppression increased over the first days after the start of treatment but stabilized within about 4 days. Dose-response studies in both DU-patients and healthy subjects have shown that daily doses of 20-40 mg result in 80-100% reduction of stimulated acid secretion when measured 6 h after dose. Due to the long duration of action the inhibition was still 50-80% when measured 24 h after dose. Studies of 24 h intragastric acidity in DU-patients have shown that once daily treatment with 20 mg omeprazole results in a reduction of intragastric acidity by 97% which in the same study was superior to the 57% reduction caused by treatment with ranitidine, 150 mg twice daily. During omeprazole treatment, plasma gastrin increased in relation to the degree of acid suppression. The level of increase of 24 h plasma gastrin during once daily treatment with 20 mg omeprazole was slightly higher than for ranitidine, 150 mg twice daily, but similar to that seen after highly selective vagotomy.

Dose-Response Relationship, Drug↗
PubMed1989

Long-term follow up of patients with Zollinger-Ellison syndrome (ZES).

We have followed 14 patients with the Zollinger-Ellison syndrome for a median period of 9 years. All patients have suffered from peptic ulcer disease and six of the 14 have had complications such as bleeding or perforated ulcer. Almost half the patients have had diarrhoea as a dominant symptom and 4 patients suffered from multiple endocrine neoplasia. Before 1978, the year when the H2-receptor antagonists were introduced, the majority of the patients were operated with total gastrectomy. After that year there has been no need for gastrectomies, but all but two patients have undergone an explorative laparotomy. We have been able to localize the gastrinoma in 9 of 12 operated patients; in 7 cases it was localized within the gastrinoma triangle. Three of the patients are considered to have been cured after surgery. Eight patients have needed adjuvant acid-reducing medical therapy. Five of these have been failures to high doses of H2-receptor antagonists and have been successfully treated with omeprazole. Five patients have died during the follow-up period and death in two of these cases was related to tumor progression.

Aged↗
PubMed1988

The Ottosson repair in lateral instability of the ankle.

A follow-up study is presented of 27 patients with 29 ankles treated for disabling lateral instability by a modification of the Evans repair, previously described by Ottosson. The median follow-up period was 39 months. Excellent or good results were found in 93% of the ankles. We recommend this modification, as it is technically simple and efficient.

Adolescent↗
PubMed1988

Comparative potency of carbachol, sham feeding, fundic distension and 16,16-dimethyl prostaglandin E2 as stimulants of human gastric bicarbonate secretion.

Six healthy subjects in random order underwent gastric bicarbonate secretion investigations, including stimulation with increasing doses of the cholinergic agonist carbachol, sham feeding, fundic distension and gastric instillation of 16,16-dimethyl prostaglandin E2. Bicarbonate secretion was measured by a computer-based system which continuously recorded pH and PCO2 of the effluent in a high-volume gastric perfusion system. The peak 30 min gastric bicarbonate output in response to carbachol, 150 mg subcutaneously, was 114% (P less than 0.05). Vagal stimulation by sham feeding resulted in a corresponding increase of 112% (P less than 0.05), while fundic distension to a volume of 600 ml gave an increase of 114% (P less than 0.05). In comparison, the response to 80 micrograms 16,16-dimethyl prostaglandin E2 was much greater, the peak bicarbonate output being increased by 245% (P less than 0.05). Both sham feeding and fundic distension appear to be either submaximal stimuli of gastric bicarbonate secretion in man or may possess both stimulatory and inhibitory actions.

16,16-Dimethylprostaglandin E2↗
PubMed1988

Endocrine cells in the human oxyntic mucosa. A histochemical study.

The oxyntic mucosa of the human stomach harbors at least five different endocrine cell types (ECL cells, A-like or X cells, somatostatin cells (D), enterochromaffin (EC) cells, and D1 or P cells). Little is known about their functional roles, and of the hormones they produce only somatostatin has been identified. The relative frequency and regional distribution of the different endocrine cell populations were studied in 13 adults with no manifest gastrointestinal disease. From each of them at least three biopsy specimens were taken at seven fixed locations within the oxyntic mucosa. The specimens were examined for the different endocrine cell types by means of immunocytochemistry (staining with antisera against chromogranin A,5-hydroxytryptamine, and somatostatin) and silver staining techniques (demonstration of argyrophil cells by the methods of Grimelius or Sevier-Munger). Chromogranin-positive cells included all endocrine cells identified by the other staining techniques. Grimelius-positive cells included all endocrine cells except the somatostatin cells. Sevier-Munger-positive cells, finally, included the ECL cells and the EC cells. The frequency of ECL cells could be calculated by subtracting the number of EC cells from the number of Sevier-Munger-positive cells. The ECL cells represented 35% of the total endocrine number, somatostatin cells 26%, and EC cells 25%. The remaining 14% consisted of A-like cells, D1 cells, and P cells. Generally, the endocrine cells predominated in the basal portion of the glands, but the various populations of endocrine cells were not uniformly distributed in the various regions of the oxyntic mucosa. However, representative specimens could be obtained from the main body of the stomach, and the results indicate that the examination of a fairly small number of specimens from the main body of the stomach may be sufficient for assessing the frequency of endocrine cells in the oxyntic mucosa of individual patients.

Adult↗
PubMed1988

Relationship between reduction of gastric acid secretion and plasma gastrin concentration during omeprazole treatment.

We have studied the relationship between reduction of gastric acid secretion and fasting plasma gastrin concentrations during once daily omeprazole treatment. Healthy subjects were given omeprazole for 5 days in daily doses of 5, 10, 20, 40, or 80 mg. Acid secretion and fasting gastrin concentration were measured 6 h (maximal omeprazole effect) and 24 h (minimal omeprazole effect) after the fifth omeprazole dose. Omeprazole in doses lower than 20 mg daily did not suppress pentagastrin-stimulated acid secretion in all subjects 6 h after dosing on the 5th day. Doses of 20-80 mg omeprazole, however, significantly reduced acid secretion 24 h after the fifth dose, the range being 36-76%. A relationship between degree of acid inhibition and fasting gastrin concentration was observed. However, acid secretion needed to be reduced by more than 80% before gastrin levels were clearly affected. This degree of acid inhibition was only achieved 6 h after administration of omeprazole in doses of 20 mg and higher. The inhibitory effect of omeprazole on acid secretion decreased 24 h after dosing. Thus, fasting gastrin concentrations were moderately increased in the beginning and normalized at the end of each 24-h period during treatment with daily doses of 20-80 mg omeprazole.

Adult↗
PubMed1987

Fetal heart rate monitoring during labour--too frequent intervention, too little benefit?

For many obstetricians and midwives continuous electronic fetal heart rate monitoring during labour has replaced the traditional method of intermittent auscultation. Of the eight prospective randomised controlled trials designed to assess its value in obstetric care, four were concerned with mothers defined as being at high-risk, three with normal or low-risk patients, and the eighth with the total population of a maternity hospital over several months. None suggested any major advantage of continuous fetal heart rate monitoring over intermittent surveillance in terms of neonatal mortality, morbidity, cord blood pH values, or the five minute Apgar score. The rates of caesarean section and forceps delivery were higher in the continuously monitored group. For low-risk mothers there is a good case for a return to the traditional method of intermittent auscultation with its lower false-positive rate, lesser incidence of intervention, and opportunity for greater contact between the maternity care staff and the mother.

Cesarean Section↗
PubMed1987

[Dome fractures].

Explore the source record for details and available documents.

Adolescent↗
PubMed1987

A prospective study to compare serum human placental lactogen and menstrual dates for determining gestational age.

In a group of 575 healthy pregnant women with certain menstrual dates the estimation of the length of gestation from maternal serum human placental lactogen concentrations has been compared with gestational age calculated from the last menstrual period and ultrasonic measurements of the fetal biparietal diameter. In 412 of these patients labor started spontaneously, and the estimated dates of delivery determined by these three methods were also compared. In the range of 9 to 17 weeks of pregnancy, gestational age can be determined by human placental lactogen measurement to within 7 days (+/- 1 SD) which compares favorably with other methods. Regarding the prediction of the expected date of delivery, 88% were delivered within 2 weeks of the date predicted by last menstrual period, 82% within 2 weeks of the sonar date, and 80% by the date determined by human placental lactogen assessment. Prediction of delivery in a further group of 139 women with uncertain dates gave 73% within 2 weeks by sonar date and 69% within 2 weeks by human placental lactogen determination. We suggest human placental lactogen measurements should become part of routine antenatal care complementing rather than replacing the role of ultrasonic scanning. For those doctors and patients who wish to avoid more exposure to ultrasonic scanning than absolutely necessary, human placental lactogen estimates offer an alternative method for assessing the length of gestation.

Female↗