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Biomedical subjects

U Tage-Jensen

Publications and source records attributed to U Tage-Jensen.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Primary sclerosing cholangitis].

Primary sclerosing cholangitis (PSC) is an uncommon disorder of unknown etiology, characterized by chronic inflammation and fibrosis of the intra- and extrahepatic bile ducts. PSC is commonly associated with chronic inflammatory bowel disease, especially ulcerative colitis, and often in younger men with an extensive colitis. The diagnosis is made by endoscopic retrograde cholangiography. The characteristic findings are multiple strictures and dilatations of the intra- and extrahepatic bile ducts. Patients with PSC usually have a cholestatic biochemical profile. The liver biopsy findings are often non-specific. Different survivals in these patients have been described. However, asymptomatic patients seems to have a more favorable prognosis. The only curative treatment is liver transplantation.

Cholangitis, Sclerosing↗
PubMed1990

Pancreatic insufficiency. Duodenal and jejunal pH, bile acid activity, and micellar lipid solubilization.

To investigate the course of postprandial lipid solubilization in nine patients with chronic, alcoholic pancreatitis, luminal contents were aspirated from the proximal part of the jejunum for 180 min after a meal containing 1.5% fat. Six of the patients had pancreatic insufficiency, whereas three patients were without insufficiency. pH was measured continuously at two sites: at the level of the papilla of Vater and the aspiration site. The fraction of bile acids in the micellar phase of the jejunal aspirates correlated positively to both pH in the aspirates (p less than 0.05) and the fraction of fat solubilized (p less than 0.02). pH was below 4.0 for a longer period of time in the patients with insufficiency, compared to the patients without. However, pH fluctuated rapidly, and there was no correlation between the continuously measured values at the aspiration site and values in the aspirates. Lipid solubilization was not correlated to the lipase activity in the aspirates. We conclude that acidic bile acid precipitation most likely plays a dominant role in the pathophysiology of pancreatic steatorrhea although the methods available are too crude to disclose the precise course of events.

Adult↗
PubMed1988

Plasma catecholamine level and portal venous pressure as guides to prognosis in patients with cirrhosis.

Circulating noradrenaline is increased in patients with cirrhosis, especially in decompensated patients with ascites. Eighty-one patients with alcoholic cirrhosis were followed for up to 8 years in order to establish a possible relationship between plasma catecholamines, haemodynamics, and routine clinical and biochemical variables and survival. Forty-seven (58%) of the patients died during the follow-up period. Univariate analysis showed that plasma noradrenaline and adrenaline concentrations, portal pressure, indocyanine green clearance, serum sodium, bilirubin, and albumin concentrations, and the presence of ascites or cardiovascular disease were of significant prognostic value. In a multivariate analysis (Cox regression model), plasma noradrenaline concentration, portal pressure, serum bilirubin concentration, and the presence of ascites and cardiovascular disease remained significant independent predictors of survival. The results suggest that determination of the circulating level of noradrenaline and portal pressure may add to the prognostic information on survival obtained from routine tests. Thus, the activity of the sympathetic nervous system may indicate the severity of cirrhosis with respect to survival.

Adult↗
PubMed1987

Duodenal bulb acidity in patients with duodenal ulcer.

Intraluminal pH was measured simultaneously in the human stomach and proximal duodenum with six small glass electrodes tied together at 1.5-cm intervals. Twenty-four healthy control subjects and 44 patients with duodenal ulcer disease were studied under fasting conditions and for 3 h after a standard liquid meal. Mean and median hydrogen ion activity, percentage of time with pH below 2 and 3, and the frequency of pH fluctuations were calculated from digital pH data sampled at a frequency of once per second from each electrode. None of these measurements of acidity differed significantly between the two groups or between subgroups of normosecretor controls and hypersecretor ulcer patients. At the time of pH study 15 of the patients had endoscopically verified active ulcer disease and 13 patients were without disease activity. Gastric as well as duodenal bulb acidity was the same in these two subgroups. We conclude that even though duodenal ulcer patients deliver more acid into the duodenum, this does not cause increased luminal acid aggression.

Adult↗
PubMed1987

Malignancies following long-term azathioprine treatment in chronic liver disease. A report from the Copenhagen Study Group for Liver Diseases.

One hundred and fifty-four patients with histologically verified non-alcoholic chronic liver disease were randomized to azathioprine or prednisone treatment. After a median of 91 months observation time, the cause of death was assessed retrospectively. Autopsy was performed in 82% of 71 deaths. In the azathioprine group 33% (13/39) died from malignant neoplasia, and in the prednisone group (13%) (4/32) (p = 0.08). Considering a possible fatal outcome as a consequence of treatment, this finding urges caution in the long-term application of azathioprine at the usual dose level.

Azathioprine↗
PubMed1987

Randomised study of the influence of non-steroidal anti-inflammatory drugs on the treatment of peptic ulcer in patients with rheumatic disease.

Sixty-seven patients with rheumatic disease, treated with non-steroidal anti-inflammatory drugs (NSAIDs), entered a controlled trial with a diagnosis of duodenal (n = 51), gastric (n = 14), or gastric and duodenal (n = 2) ulcers. The main objectives of the study were a comparison of ranitidine and sucralfate in ulcer treatment, and to observe the influence of continued NSAID administration during peptic ulcer therapy. Ulcers healed within nine weeks in 52 patients. The mean healing time was similar in 27 patients given ranitidine 150 mg bd (4.9 weeks) and 25 patients given sucralfate 1 g qid (4.6 weeks). In patients with unhealed ulcers after nine weeks of treatment, healing was obtained in seven after further therapy for 3-9 weeks. Of the 30 patients who continued NSAIDs during treatment with either ranitidine or sucralfate, 23 ulcers healed (mean healing time: 5.0 weeks). Of 32 patients in whom NSAIDs were stopped, ulcer healing was documented in 29 (mean healing time: 4.6 weeks). The difference in healing rates was not statistically significant (p greater than 0.10). The outcome of ulcer treatment did not differ in patients with rheumatoid arthritis and patients suffering from osteoarthritis. During a 12 month follow up 14 symptomatic ulcer recurrences were recorded.

Adult↗
PubMed1987

5-Aminosalicylic acid in the treatment of Crohn's disease. A 16-week double-blind, placebo-controlled, multicentre study with Pentasa.

The response to 5-aminosalicylic acid (5-ASA) in mild and moderately active Crohn's disease localized in the small bowel was studied in a randomized, double-blind, placebo-controlled trial in four centres. Sixty-seven patients were included, of whom 30 were treated with 1500 mg slow-release 5-ASA/day (Pentasa) for a scheduled period of 16 weeks. In the 5-ASA group 40% of the patients improved, versus 30% of the placebo-treated group ('intent to treat' basis; p greater than 0.1). Four of the patients treated with 5-ASA left the study owing to disease deterioration, versus 10 of the placebo-treated patients (p greater than 0.2). Seventeen patients were secondarily excluded, and the remaining 50 patients (23 receiving 5-ASA) were reevaluated in greater detail. No statistically significant differences in outcome were shown. Three patients (one given 5-ASA) were withdrawn from the study because of presumed side effects, but no serious adverse reactions were recorded. The present results indicate that 5-ASA, at least in the dosage used, is not superior to placebo. Nevertheless, trends towards a beneficial effect in Crohn's disease in the small bowel justify further clinical trials with a larger dosage of 5-ASA.

Adolescent↗
PubMed1986

5-Aminosalicylic acid in patients with an ileo-rectal anastomosis. A comparison of the fate of sulfasalazine and Pentasa.

The pharmacokinetics of 5-aminosalicylic acid (5-ASA) from sulphasalazine (SASP) and the slow-release 5-ASA preparation Pentasa was investigated in a cross-over study in 9 otherwise healthy patients with an ileo-rectal anastomosis. The 24-hour recoveries of the drugs were 90.5% and 84.7%, respectively. The median release of 5-ASA from SASP was 50% and from Pentasa 75%. Equal amounts of 5-ASA (18.0% vs 17.9%) were found in the faeces, and a significantly larger amount (4.4% vs 28.9%) of the metabolite N-acetyl-5-aminosalicylic acid (ac-5-ASA) was found in faeces following Pentasa. A larger amount of 5-ASA was absorbed and subsequently excreted in the urine, mainly as the metabolite (2.5% vs 20.5%) from Pentasa. This confirms previous results in ileostomized patients treated with Pentasa. The present findings also demonstrate that bacterial azo-reduction of SASP in patients with ileorectal anastomosis may be an adequate way to deliver 5-ASA in this type of patient. Both treatments may be used in these patients during a flare up of ulcerative colitis, but randomized studies are needed.

Aminosalicylic Acids↗
PubMed1986

Intraluminal pH in the stomach, duodenum, and proximal jejunum in normal subjects and patients with exocrine pancreatic insufficiency.

In situ pH was measured simultaneously with microelectrodes in the stomach, duodenal bulb, midduodenum, duodenojejunal junction, and proximal jejunum. Fourteen healthy subjects and 8 patients with exocrine pancreatic insufficiency were studied under fasting conditions and for 3 h after a standard liquid meal. The luminal pH gradient was steepest in the proximal 10 cm of the duodenum, where acidity was reduced from pH 2 to pH 5 in the fasting state and from pH 1.7 to pH 4.3 in the second and third postprandial hour. Acidity was further reduced in the distal duodenum to a pH between 5 and 6 at the duodenojejunal junction. The frequent wide and rapid pH fluctuations seen in the duodenal bulb were gradually reduced along the duodenum and became rare in the jejunum. In patients with pancreatic insufficiency, duodenal or jejunal acidity did not differ significantly from the controls, with the exception of the single 10-min period occurring 70-80 min after the meal when duodenal bulb pH was 2.1 as compared with 3.1 in the normal subjects (p less than 0.05). All patients, including 2 patients with a very high duodenal acidity, demonstrated a duodenal pH gradient as steep as that found in the normal subjects, indicating sources of bicarbonate other than the pancreas.

Adult↗
PubMed1984

Autoantibodies and immunoglobulins in patients with alcoholic cirrhosis. Relation to measurements of hepatic function and hemodynamics.

In order to evaluate the possible relation between hepatic function and hemodynamics and the increased humoral immune response of cirrhotic patients, titres of antinuclear antibodies (ANA) and smooth muscle antibodies (SMA) and concentrations of immunoglobulin (Ig) G, A and M were determined in 74 consecutive patients with alcoholic liver cirrhosis. Patients showed significantly (p less than 0.05) increased prevalences of ANA and SMA and concentrations of Ig G, A and M when compared to controls. No significant correlations were found between titres of ANA or SMA and hepatic scan score, galactose elimination capacity, indocyanine green clearance, hepatic blood flow and wedged-to-free hepatic vein pressure. Hepatic scan score correlated directly (rho = 0.38, p less than 0.05) to IgA concentrations; wedged-to-free hepatic vein pressure correlated directly to IgG concentrations (rho = 0.35, p less than 0.05) and to IgM concentrations (rho = 0.42, p less than 0.01). No other significant correlations were found between Ig concentrations and variables of hepatic function or hemodynamics.

Adult↗
PubMed1984

Differences in the etiology of chronic non-alcoholic liver disease in Naples and Copenhagen.

A group of patients with non-alcoholic chronic liver disease from Copenhagen (148) and one from Naples (116) were investigated for the presence of viral and autoimmune serological variables by standardized methods. There were more hepatitis B virus (HBV)-induced cases among the Italians (38.8 versus 15.5%), but the sex ratio and biochemical activity were not different from the Danish ones. Autoimmune markers were much more frequent and in higher titers in Danish HBV-negative patients than in Italian ones. Fewer were women, and thus few Italians fit the theory of autoimmune pathology; rather, their chronic liver disease is caused by other hepatitis viruses than B.

Adult↗
PubMed1983

Autoantibodies and immunoglobulins in alcoholic steatosis and cirrhosis.

Antinuclear antibodies were significantly more prevalent (p less than 0.01) in 143 patients with alcoholic cirrhosis than in 64 patients with alcoholic steatosis and in 94 controls. Smooth muscle antibodies were significantly more prevalent (p less than 0.05) in patients with alcoholic steatosis and cirrhosis than in controls. The prevalence of antimitochondrial antibodies and IgG liver membrane antibodies did not differ significantly between the three groups. Immunoglobulin G, A, and M concentrations were only occasionally increased in patients with steatosis. Patients with cirrhosis had significantly increased (p less than 0.005) concentrations of immunoglobulins G, A, and M when compared to patients with steatosis. These results indicate that the degree of liver damage has more effect than chronic alcoholism on the humoral immune system. Whether this influence is direct or indirect remains to be established.

Adult↗
PubMed1983

The long-term prognosis of non-transfusion-associated non-A, non-B hepatitis. A clinical, epidemiological, and histological investigation.

In a prospective study of the natural course of acute hepatitis, 157 of 1020 patients with biopsy-verified acute hepatitis could be classified as having hepatitis type non-A, non-B. We here report on the long-term prognosis for these 157 patients. The main type of exposure was drug addiction (40%), whereas 40% had no known hepatitis exposure. Only two patients had received blood products (blood transfusion and factor VIII). Follow-up liver biopsy (mean histological follow-up, 22 months) in 94 of the 157 patients showed chronic liver disease in 15-that is, cirrhosis in 6, suspicion of cirrhosis in 2, chronic aggressive hepatitis in 5, and chronic persistent hepatitis in 2. There was a striking predominance of elderly women with no known hepatitis exposure and with a high frequency of autoantibodies in serum among the patients with progression to chronicity, whereas chronic non-A, non-B hepatitis in drug addicts or after blood transfusions seems to be a limited problem. A comparison of histological features in the initial biopsies from patients with progression to chronicity or complete resolution showed piecemeal necrosis and abnormal bile duct epithelium to be of prognostic value.

Adolescent↗
PubMed1982

Azathioprine versus prednisone in non-alcoholic chronic liver disease (CLD). Relation to a serological classification.

One hundred and forty-eight patients with non-alcoholic cirrhosis or chronic aggressive hepatitis entered a prospective, unblinded, randomized trial on the effect of azathioprine versus prednisone. For all 148 patients, there were no differences in survival related to the two drugs. In 99 patients the disease was classified as autoimmune, in 23 as posthepatitic, and in 26 as cryptogenic. No significant differences were seen in survival between these three groups of patients and no differences in survival related to the two drugs were registered within any of the groups. The autoimmune group included the patients with the biochemically most active disease, and a statistically significant reduction in activity was obtained with prednisone as well as azathioprine. Most remarkably, the frequencies of the autoantibodies were reduced parallel to the biochemical improvement in these patients. Immunosuppressive treatment was found to be rather ineffective in posthepatic chronic liver disease of type B; however, no signs of activation of the hepatitis B virus were seen.

Adult↗
PubMed1982

Characterisation of Liver membrane autoantibodies determined by indirect immunofluorescence.

Indirect immunofluorescence studies were performed using sera and IgG-Fab2 fragments from patients with chronic active hepatitis (CAH) who were positive for a liver membrane antibody (LMA). The specificity was investigated using hepatocytes from humans as well as rabbit, rat, guinea pig and monkey. Only sera also positive for smooth muscle antibody gave staining of lymphocytes and absorption with F-actin from rabbit muscle abolished this as well as all other smooth muscle staining without influencing LMA. It was concluded that LMA, routinely detected by indirect immunofluorescence using rabbit hepatocytes, represents specific binding to non-species-specific membrane antigens which are normal constituents of human hepatocytes. The antigen is separately located, and not cross-reactive with F-actin.

Animals↗