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Biomedical subjects

V Binder

Publications and source records attributed to V Binder.

At least 91 records · Page 5Linked to original sources
PubMed1983

Clinical appearance at diagnosis of ulcerative colitis and Crohn's disease in a regional patient group.

A regional patient group comprising 783 patients with ulcerative colitis (UC) and 185 patients with Crohn's disease (CD) diagnosed during the period 1960 to 1978 was analysed in accordance with clinical appearance at diagnosis. Of the UC patients, 16% showed total colonic involvement, 41% substantial colonic involvement, and 41% rectal affection only. The disease extent was positively correlated to the degree of activity but not to the age or sex of the patients. 70% of the patients were in moderately or very active stage of disease, 28% in slightly active stage, and 2% inactive at the time of diagnosis. 43% of the patients had experienced weight loss, 27% fever, and 53% abdominal pains in their initial attack of the disease. Immunological manifestations were present in 13%. Of the CD patients 31% had small-bowel localization only, 28% large bowel only, 36% ileocolonic affection, and 5% other combinations. Patients with ileal involvement were significantly younger than patients with colonic involvement. There was no sex difference in accordance with the localization of Crohn's disease. 71% of the patients were in moderately or very active stage of disease and 29% in low activity at diagnosis. The intestinal symptoms were independent of the sex and age of the patients, whereas abdominal pains were present significantly more frequently in younger age groups. In all, 76% of the patients experienced abdominal pains, 34% fever, and 54% weight loss. Immunological symptoms from joints, skin, or eyes were present in 12% of the patients.

Abdomen↗
PubMed1983

Treatment of Crohn's disease with peroral 5-aminosalicylic acid.

Eighteen patients with active Crohn's disease entered an open trial with 5-aminosalicylic acid in a slow-release preparation. All had lesions of the small bowel. Ten of them also had Crohn's disease of the colon. 5-Aminosalicylic acid, 500 mg three times daily, was administered for 6 wk. Even with meticulous monitoring, no side effects of any kind were observed, particularly no cases of renal affection, which could have been expected from animal studies. The clinical course was estimated as improved in 13 patients (72%), unchanged in 2 patients (11%), and aggravated in 3 patients (17%); 2 of these 3 were withdrawn from the study and switched to alternative treatment. The Crohn's disease activity index decreased from a median of 226 points to 99 points. On the basis of these results, large-scale controlled therapeutic trails seem warranted in order to establish clinical evidence for the benefit of peroral treatment with 5-aminosalicylic acid in patients with Crohn's disease.

Administration, Oral↗
PubMed1982

Leucocyte function in Crohn's disease. Studies on mobilisation using a quantitative skin window technique and on the function of circulating polymorphonuclear leucocytes in vitro.

Leucocyte function was evaluated by mobilisation to skin windows with chambers and by the chemotactic, phagocytic, and nitro blue tetrazolium (NBT) reducing activity of circulating leucocytes in vitro in 20 patients with Crohn's disease, 21 healthy volunteers, and nine patients with sarcoidosis or tuberculosis. Leucocytes had been mobilised in significantly reduced numbers at 12, 24, 36, and 48 hours in Crohn's disease compared with healthy volunteers (P less than 0.01) and patients with sarcoidosis/tuberculosis (P less than 0.01). The leucocyte migration rate showed that mobilisation in Crohn's disease begins after a prolonged lag phase and is reduced compared with healthy volunteers (P less than 0.01) and patients with sarcoidosis/tuberculosis (P less than 0.02). The reduced mobilisation was not correlated with disease activity. In vitro random migration by leucocytes was slightly lower in Crohn's disease (P less than 0.05) than in healthy volunteers, but there was no difference after removal of the autologous plasma. Chemotactic response to casein did not differ between the groups studied. Serum independent and dependent phagocytosis did not differ from control groups. Serum independent phagocytosis was positively and significantly correlated to the disease activity (rho 0.4812, P less than 0.05). Resting leucocyte NBT reduction was increased in Crohn's disease and sarcoidosis/tuberculosis (P less than 0.01), but during phagocytosis a lower NBT reduction was found in Crohn's disease than in healthy volunteers (P less than 0.02). The inflammatory response in Crohn's disease, with reduced leucocyte accumulation, differs from patients with other granulomatous reactions and is independent of the disease activity. Our data suggest that the defect is not cellular. They support the hypothesis that a pathogenic factor in Crohn's disease may be foreign material that is normally eliminated remaining in the tissue and eliciting a chronic inflammatory response.

Adolescent↗
PubMed1982

Leucocyte function in ulcerative colitis. Quantitative leucocyte mobilisation to skin windows and in vitro function of blood leucocytes.

Leucocyte function was evaluated by the in vivo mobilisation to skin windows with chambers and by the chemotactic, phagocytic, and nitro blue tetrazolium reducing capacity of blood leucocytes from 20 patients with ulcerative colitis. The total number of leucocytes mobilised to the chambers after 12 hours did not differ from those in 21 healthy volunteers. After 24 and 48 hours reduced number of leucocytes were mobilised by patients with ulcerative colitis (p less than 0.01). Correspondingly, the leucocyte migration rates were normal initially but were reduced after 18 hours Mobilisation in vivo was positively correlated to the blood neutrophil count (Rho:0.5549 po less than 0.02) but unrelated to clinical activity. Blood leucocytes showed reduced random migration in vitro as well as chemotactic response to casein (p less than 0.01). Serum independent and dependent phagocytosis did not differ from healthy volunteers. Nitro blue tetrazolium reduction by resting leucocytes was increased (p less than 0.01) in ulcerative colitis compared with controls. Our findings suggest altered in vivo mobilisation and in vitro migration of leucocytes in ulcerative colitis with increased spontaneous nitro blue tetrazolium reduction reflecting increased generation of potentially tissue damaging agents. The findings probably reflect changes secondary to the disease but which may be important in maintaining the inflammatory process.

Adult↗
PubMed1982

The chemotactic function of neutrophils in ulcerative colitis.

Neutrophil chemotactic function was investigated in 30 patients with ulcerative colitis (UC) in an active (no. = 15) or an inactive (no. = 15) stage. Peripheral blood neutrophils from active cases had a significantly decreased stimulated migration in modified Boyden chambers. Simultaneously done investigations of neutrophil migration into skin window chambers showed normal results in both active and inactive cases of UC. Thus, the defective chemotaxis during in vitro conditions was not reflected in a quantifiable neutrophil dysfunction in experimental acute inflammation.

Adolescent↗
PubMed1982

Incidence and prevalence of ulcerative colitis and Crohn's disease in the County of Copenhagen, 1962 to 1978.

The incidence of ulcerative colitis and of Crohn's disease in the County of Copenhagen was estimated during the years 1962 to 1978. A total of 909 patients were diagnosed in this area with approximately 500,000 inhabitants. The mean incidence of ulcerative colitis was 8.1 per 10(5) inhabitants. This incidence was constant during the period for women but rose significantly around 1970 for men. The rise in male incidence is due to a rise in the incidence late in life. The prevalence of ulcerative colitis as of December 31, 1978 was 117 per 10(5) inhabitants. The incidence of Crohn's disease was increasing during the period for both sexes with a mean value for the period 1970 to 1978 to 2.7 per 10(5) inhabitants. The prevalence of Crohn's disease as of December 31, 1978 was 34 per 10(5) inhabitants.

Adult↗
PubMed1982

5-aminosalicylic acid in a slow-release preparation: bioavailability, plasma level, and excretion in humans.

The release pattern, bioavailability, and kinetics of a 5-aminosalicylic acid tablet with sustained release were studied in humans. Six ileostomy patients received a single dose (500 mg). Eight and 48 h later, respectively, 58% and 65% of the dose was recovered in the ileostomy effluents, either as 5-aminosalicylic acid still retained in the preparation, free 5-aminosalicylic acid or acetyl-5-aminosalicylic acid. Fourteen healthy volunteers took 1500 mg of 5-aminosalicylic acid per day for 6 days and a steady state plasma acetyl-5-aminosalicylic acid concentration was reached on day 5 (1.1-2.9 microgram/ml). 5-Aminosalicylic acid was not detected in the plasma. At steady state, 40% of the 24-h dose was recovered from feces, and 53% from the urine. The sustained-release preparation studied provides sufficient amounts of 5-aminosalicylic acid to all parts of the gut and its curative effect in ulcerative colitis and Crohn's disease should be examined in controlled trials.

Adult↗
PubMed1982

Does the patient appear acutely or chronically ill? An interobserver study of global assessments of hospital patients.

The general appearance of 201 patients was assessed by a team of observers. Each patient was seen by two experienced physicians, two junior physicians and two medical students who stated whether the patients did not appear ill or whether the patient appeared acutely or chronically ill. The interobserver variation was considerable and the kappa-values ranged from around 0 to 0.75. The level of agreement did not seem to depend on the clinical experience of the observers. One experienced clinician assessed the patients differently from the others.

Acute Disease↗
PubMed1981

Disodium cromoglycate in the treatment of ulcerative colitis and Crohn's disease.

A controlled clinical study on disodium cromoglycate (DSCG) at a dose of 800 mg per day versus placebo was carried out in 141 patients with ulcerative colitis and 25 patients with Crohn's disease. Those of the ulcerative colitis patients who had been on sulphasalazine treatment continued that treatment during the trial (101 patients). Forty patients were intolerant of sulphasalazine. No patient received steroids during the last month before the study. Patients with Crohn's disease had their possible sulphasalazine treatment stopped before the trial. No beneficial effect of DSCG as compared with placebo was found, as the DSCG and the placebo group showed the same number of relapses in patients with a clinically inactive ulcerative colitis at the start of the trial and the same number of patients improving, deteriorating, and maintaining steady state in patients with clinically active ulcerative colitis at the start of the trial. There was no difference between relapse rate in DSCG and placebo groups in patients with Crohn's disease. No correlation between the eosinophil count in rectal mucosa and the outcome of the attack of ulcerative colitis could be demonstrated.

Clinical Trials as Topic↗
PubMed1981

Ethical aspects of clinical decision-making.

The aim of the present investigation was to describe and to classify significant ethical problems encountered by the members of the staff during the daily clinical work at a hospital medical department. A set of definitions was prepared for the purpose, including the definition of a 'significant ethical problem'. During a three month period 426 inpatients and 173 outpatients were admitted. Significant ethical problems were encountered during the management of 106 in-patients (25 per cent) and 9 out-patients (5 per cent). No significant difference was found between the frequency of ethical problems in female and male patients, but a positive correlation was noted between the number of problems and the patients' age. The problem types were classified according to a problem list. The results of this investigation suggest that greater attention must be paid to discussions about ethical problems among doctors and other categories of health personnel and that, among others, medical students ought to be taught the analysis of ethical problems.

Adolescent↗
PubMed1980

Social prognosis in patients with ulcerative colitis.

One hundred and twenty-two randomly selected patients with ulcerative colitis (28 of whom had undergone colectomy) were interviewed to obtain data on the quality of their family, emotional, social, and professional lives. They were compared with an age- and sex-matched group of patients with acute conditions from the same area. The two groups were similar in marital status, the frequency of severe family or sexual problems, leisure activities, physical and earning capacity, the incidence of mental disorders before the interview, and intake of alcohol and psychopharmacological drugs. A higher proportion of the patients with colitis had had a higher education and belonged to higher socioeconomic groups than the controls, and this difference had been present at the time of diagnosis. These results show that patients with ulcerative colitis seem to adapt themselves well to their condition and suffer few social or professional disabilities.

Adult↗
PubMed1979

Variations in plasma protein concentrations in individuals with ulcerative colitis: analytical and biological factors.

Eight plasma proteins were determined in specimens taken every second day during a 14 day period from eleven patients with acute ulcerative colitis. The intra-individual variations in the concentrations of albumin, orosomucoid, haptoglobin, IgG, IgA, IgM and complement factors C3 and C4 were larger than expected in normal persons. A two-way analysis of variance was applied to the normalized protein values to estimate to what extent the observed variations could be explained by analytical errors and the influence of biological factors general to all proteins, such as changes in plasma volume and distribution between plasma and extravascular space. In half the non-operated patients the changes in all proteins could be explained by the above mentioned variations. The individual variations seen in the concentrations of haptoglobin, C4 and IgM occurred at random compared to the clinical state of the disease. Only the operated patients showed a more systematic sequence of protein changes.

Analysis of Variance↗
PubMed1979

The relapse-preventing effect of methyl-salazosulphapyridine compared to salazosulphapyridine during long-term treatment of ulcerative colitis. A double-blind controlled trial.

In an attempt to improve the relapse-preventing effect of salazosulphapyridine (SASP) and to encircle the part of the molecule essential for therapeutic actin, methyl-SASP was compared to SASP in a controlled double-blind trial without cross-over. The patient group comprised 33 patients with ulcerative colitis who had been symptom-free for 1--6 months on continuous treatment with SASP (on an average 2 g daily). The daily doses were SASP 1 g X 3 and methyl-SASP 125 mg x 3. Thirty patients completed the trial, 14 on SASP and 16 on methyl-SASP. Applying clinical criteria, the relapse rate after 6 months was 0.14 in the SASP group and 0.69 in the methyl-SASP group. The difference is highly significant. The blood concentrations of SASP, methyl-SASP, sulphapyridine (SP), and methyl-sulphapyridine (methyl-SP) were measured after 3 and 6 months. The methyl-SASP concentration was on an average twice as high as that of SASP, and the methyl-SP on an average 1/10 of SP (the differences are significant). It is concluded that whereas SASP showed a relapse-preventing effect in ulcerative colitis in this study comparable to that previously reported, the effect of methyl-SASP was only comparable to that of placebo, and the active substance in SASP does not seem to be unsplit SASP.

Adult↗