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Biomedical subjects

U Ohman

Publications and source records attributed to U Ohman.

At least 37 records · Page 2Linked to original sources
PubMed1982

Colorectal carcinoma in patients less than 40 years of age.

The mean incidence of colorectal carcinoma in persons under age 40 in Sweden is 1.74/100,000/year. Over a 30-year period, 1950 through 1979, 1061 patients with colorectal carcinoma were seen, 48 of whom where under age 40 (21 to 39 years) and in this study were compared with older patients. Carcinoma was superimposed upon ulcerative colitis in 18 patients. All patients treated for palliation died within two years. Curability rate. 67 per cent, and the proportion of Dukes' A lesions were the same as in older patients, whereas young patients had fewer B and more C lesions. Five-year survival was 33 per cent overall and 50 per cent in curable cases, not different from the rates in older patients (33 and 47 per cent). Five-year survival was 100 per cent in stage A, 50 per cent in stage B, and 33 per cent in stage C. The age factor had no impact upon survival, and colitic origin of a carcinoma did not decrease survival more than did carcinoma itself. It is concluded that colorectal carcinoma in patients under age 40 differs in no respect from the disease in older patients.

Adult↗
PubMed1982

Colorectal carcinoma in patients with ulcerative colitis.

Analysis of a 30 year (1950 to 1979) series of colorectal carcinoma disclosed 29 patients with ulcerative colitis, who were compared in this retrospective study with 1,032 noncolitic patients. Colitic tumors were often multiple and had a predilection for the transverse colon. Nineteen patients were resected with the intention of cure, for a curability rate of 66 percent, which is comparable to the 69 percent rate in noncolitic patients. The 5 year survival rate was 31 percent overall and 47 percent in curable cases, rates similar to those in noncolitic patients (34 and 47 percent). All patients with Dukes' A lesions survived 5 years. A high incidence of Dukes' C lesions was observed; one third of these patients survived 5 years . Apart from the advanced stage, no signs of "aggressiveness" or particular virulence were demonstrated in colitic cancer. Results of procedures less than proctocolectomy in 13 patients were dismal: 4 died from cancer within 3 years, and 6 developed late carcinoma in the retained part of the bowel, with a fatal outcome in all.

Adenocarcinoma↗
PubMed1982

Prognosis in patients with obstructing colorectal carcinoma.

Over a 30 year interval (1950 to 1979), 1,061 patients with colorectal carcinoma were seen; 148 presented with bowel obstruction and in this retrospective study were compared with those having nonobstructive tumors. The age and sex distribution did not differ between the groups. The curability rate was 53 percent, versus 72 percent for nonobstructed patients; the 5 year survival rate was 16 percent overall and 31 percent in curable cases, versus 37 and 50 percent for elective patients, respectively. Survival within tumor stages did not differ between the groups; the difference in outcome was mainly a result of obstructed patients having fewer stage A and more stage C lesions. Most right-sided growths were primarily resected, while the left-sided growths were mainly treated with staged resection. Operative mortality for curable patients was 8 percent, not different from the 7 percent rate in elective patients. The 5 year survival rate was 19 percent after primary and 35 percent after staged resection. It was concluded that patients with bowel obstruction secondary to colorectal carcinoma have low curability and survival rates, primarily because of advanced disease at the time of diagnosis and treatment.

Aged↗
PubMed1982

Reoperation for primary hyperparathyroidism.

The reasons for failure of the initial exploration and the results of reoperation were analyzed in 53 patients with a diagnosis of primary hyperparathyroidism, 29 of whom were referred after initial operations elsewhere. Seventy-nine reoperations were performed. Sternotomy was used in 15 patients, and in retrospect was necessary in only 5. There was no operative mortality. The reasons for initial failure were incorrect diagnosis in 6 patients, true recurrence in 4 and persistent disease in 43. Persistence was caused by surgical failure in two thirds and pathology failure in one third. Of 47 patients reoperated on for hyperparathyroidism, 39 (83 percent) were cured, a rate warranting this type of surgery. Analysis of a long-term series of initial operations demonstrates a persistence rate of 5 percent (24 of 461) and a recurrence rate of 1 percent (4 of 461) in this disease. The need for reoperation was les than 1 percent over the recent 5 year period.

Female↗
PubMed1982

Effects of intraluminal pressure on regional blood flow in obstructed and unobstructed small intestines in the rat.

Small bowel circulation in the rat was studied with the microsphere technique before and after 10 minutes of elevated intraintestinal pressure. A distal small bowel loop consisting of 10 vascular arcades was used. The specimens were inflated with nitrogen gas. Regional blood flow in both obstructed and unobstructed small bowels was significantly diminished by an intraintestinal pressure of 40 mm Hg. A pressure of 20 mm Hg impaired circulation only in the obstructed small intestine, whereas the unobstructed intestine did not show a similar decrease. These findings suggest that moderate intraluminal pressures can imply a potential hazard to the vulnerable capillary bed of an obstructed intestine. Hence, it is suggested that intraoperative decompression should be performed to avoid this postoperative threat to bowel viability.

Animals↗
PubMed1982

The histological classification of early gastric cancer (micro-invasive carcinoma of the stomach).

During a 3.5-year period, January 1976 to June 1979, eleven cases of micro-invasive carcinoma of the stomach (early gastric cancer) were detected in 45 gastrectomy specimens having a pre-operative diagnosis of gastric carcinoma. The histological types found in the surgical specimens were highly differentiated (1), moderately differentiated (4), poorly differentiated (3) adenocarcinomas, one specimen had undifferentiated carcinoma, and in the remaining two cases mixed types were found. Multiple lesions were present in five specimens. In ten of the eleven specimens, focal cystic dilatation of the deeper part of the gastric glands were found in areas overlapped by micro-invasive carcinoma and/or in areas overlapped by mucosa showing chronic inflammation. The frequency of cystic dilatation of the gastric gland was much lower in specimens from patients with gastric or duodenal peptic ulcers. Thus, focal cystic dilatation present in negative gastric biopsies should be reported, thereby alerting the referring physician as to the possibility of a gastric malignancy.

Adenocarcinoma↗
PubMed1982

The intramucosal cysts of the stomach. I. In Swedish subjects with gastric or duodenal ulcers.

Gastrectomy specimens from 51 patients operated on because of peptic ulcer disease were searched histologically for the presence of intramucosal cysts. The number of cysts for each cm of mucosa analyzed (cystic index) was calculated. Intramucosal cysts occurred in 34 per cent of the patients. The resultant cystic index was 0.19 (S.D. +/- 0.40). The cystic index was not correlated to age or sex. Comparative studies demonstrated significantly higher (p less than 0.001) proportions of intramucosal cysts in the non-tumoral mucosa from patients with early gastric cancer (cystic index 3.13 - S.D. +/- 3.55). The possible association between benign intramucosal cystic dilatation of the gastric glands and the occurrence of gastric carcinoma deserves further investigation. The occurrence of intramucosal cysts in a biopsy specimen should intensify the search for an early gastric cancer.

Adult↗
PubMed1981

Posthemorrhagic changes in plasma water and extracellular fluid volumes in the rat.

Anesthetized rats were submitted to a standardized hemorrhage to 40 mm Hg by withdrawing 35 to 40% of the total blood volume. The plasma water and the extracellular fluid volumes of the whole animal and selected tissues were estimated with 125 I human serum albumin and 51Cr EDTA, respectively, after recovery periods of 10 and 90 minutes. The plasma water volume of the whole animal decreased, but approximately 50% of the shed plasma water was restored within 10 minutes after the hemorrhage. The extracellular fluid volume of the whole animal did not change significantly after hemorrhage, whereas this fluid compartment was regionally reduced in the liver, spleen, and subcutaneous fat after a 10-min recovery period but only in the liver after a 90-min recovery period.

Animals↗
PubMed1981

Effects of intestinal obstruction of plasma water and extracellular fluid volumes in the rat.

Total and regional plasma water and extracellular fluid volumes were measured in rats after obstruction of the small intestine. The rats lost 12.6 per cent of their initial weight. The volume of the sequestrated fluid in the obstructed intestine corresponded to 91 per cent of the plasma water volume. Intestinal obstruction caused a 19 per cent reduction of the total plasma water volume, while the total extracellular fluid volume was unchanged. Regional extracellular fluid volumes were diminished in the lung, liver and gastric antrum and increased in omental fat. The results indicate regional differences in fluid space responses to obstruction of the small intestine.

Animals↗
PubMed1980

Relation between early and advanced gastric cancer.

Of 75 consecutive inpatients with gastric carcinoma during a 3.5 year period, 40 underwent operation with the intention of cure, 5 had palliative gastric resection and 30 had exploratory celiotomy only. Early gastric cancer was found in 11 cases, that is, 15 percent of patients with gastric carcinoma or 24 percent of patients subjected to gastrectomy. The patients with early gastric cancer were operated on with the intention of cure. Comparison with a previous series from the same geographic area shows that the ratio between early gastric cancer and all gastric cancer increased significantly. This improvement in the management of patients with gastric carcinoma can be ascribed to the use of gastroscopy and biopsy. The survival rates in patients with early gastric cancer are excellent. The prognosis in patients with advanced gastric cancer, on the other hand, is poor and has remained so for the last 30 to 40 years. Twelve of the 75 patients had gastric stump carcinoma; 2 of these were early gastric cancer. Screening of asymptomatic patients for gastric cancer is at present an impossible task in most Western countries, but the risk of cancer after partial gastrectomy for benign lesions makes screening desirable in this selected group of patients.

Adult↗
PubMed1980

Plasma water and 51Cr EDTA equilibration volumes of different tissues in the rat.

The EDTA space and the plasma water volume of the whole animal and selected tissues were investigated with constant EDTA infusions of different duration in the rat. The calculated EDTA space increased with the duration of the infusion both in the whole animal and the tissues sampled. The plasma water volume remained constant, and therefore the calculated increase of the EDTA space suggests a slow intracellular accumulation of the tracer. As intracellular accumulation of EDTA increases with experimental time, it is necessary to use as short an experimental interval as possible to reduce this error when determining extracellular fluid volumes.

Animals↗
PubMed1980

Kinetics of 51CrEDTA in the rat.

The kinetics of 51Cr EDTA in the rat has been analysed. A single bolus injection after an equilibration period of 30 min, resulted in a steep monoexponential plasma clearance (T 1/2 = 40.8 +/- 4.3 min). To facilitate estimation of the EDTA space, renal clearance was eliminated by renal vascular ligation. The extrarenal clearance of EDTA was very slow (T 1/2 approximately 800 min) according to a linear function. The EDTA space was 25.7 +/- 1.8 ml/100 g body weight. The EDTA space is considered to measure the extracellular fluid volume.

Animals↗
PubMed1980

Effects of dehydration on plasma water and extracellular fluid volumes in the rat.

Dehydration was induced in rats by depositing 3 ml of hyperosmolar glucose (1670 mOsm/kg) in a closed small bowel loop. The plasma water and extracellular fluid volumes of the whole animal and selected tissues were subsequently studied with 125I human serum albumin and 51Cr EDTA. The fluid accumulation in the bowel was equivalent to 122% of the plasma water volume. The plasma water volume of the whole animal was significantly reduced by 31%, while the extracellular fluid volume reduction by 8% was not statistically significant. The regional extracellular fluid volumes decreased in the lung (9%), the liver (34%), the gastric antrum (15%) and the omental fat (24%). The results show regional differences in tissue response to dehydration.

Animals↗
PubMed1978

Function of the parathyroid glands after total thyroidectomy.

Parathyroid function, defined as the ability to maintain normocalcemia without substitution, was evaluated in 36 patients following total thyroidectomy for carcinoma. In 16 patients, all visualized parathyroid tissue was sliced and autotransplanted into muscle pockets; one year after the operation, 11 patients had substitution for lack of parathyroid function. In 20 patients, the parathyroid glands were preserved in situ with intact vascular supply; one year postoperatively, three patients had evidence of persistent hypoparathyroidism. The difference in the parathyroid insufficiency rate is significant, p less than 0.005. We conclude that parathyroid autotransplantation has been a failure io preserve the parathyroids in situ whenever this is feasible, autotransplantation being reserved for parathyroids unfortunately removed or devascularized.

Adenocarcinoma↗
PubMed1976

Blood flow and oxygen consumption in the feline small intestine; responses to artificial distension and intestinal obstruction.

Relations between blood flow and oxygen consumption were studied in denervated and homologously perfused small intestine of the cat. Under "resting" conditions, oxygen uptake was independent of blood flow within rather wide limits, whereas fractional oxygen extraction displayed a highly significant correlation to flow. Upon artificial distension of the bowel, oxygen uptake became a function of blood flow. It is suggested that there may exist an "autoregulation" of oxygen uptake, striving to satisfy theoxygen need of the bowel irrespective of the current blood-flow rate. It is also suggested that this "autoregulation" is abolished upon distension of the bowel. With respect to intestinal obstruction, the continuing distension of simple obstruction causes an inability of the bowell-wall vasculature to extract and consume the oxygen currently needed, probably a result of disturbed "autoregulation" of oxygen uptake. An intervening decompression seems to re-establish "autoregulation" in the obstructed bowel. The present results afford evidence for "autoregulation" of intestinal oxygen uptake. They further suggest deterioration of "autoregulation" in intestinal obstruction and corroborate the previous suggestion that intra-operative decompression of obstructed bowel restores the ability of its capillary circulation to withstand with retained function, renewed increments of strain and distension.

Animals↗