[Neutralization of lidocaine-adrenaline. A simple method for less painful application of local anesthesia]. / Neutralisering af lidocain-adrenalin. En enkel metode til mindre smertefuld anlaeggelse af lokalanalgesi.

The amount of sodium bicarbonate necessary to neutralise commercially available lignocaine-epinephrine (pH 4.7) to physiologically neutral pH (7.4) was established. The analysis showed that neutral pH could be accomplished by adding 1.0 ml sodium bicarbonate (8.4 g/l) to 10 ml lignocaine-epinephrine (1%, 5 microgram/ml). Chemical analysis also established that the neutralised lignocaine-epinephrine was stable for 24 hours after adding sodium bicarbonate. A double-blinded randomised clinical trial with crossover design done on volunteers from hospital staff proved that injection of neutralised lignocaine-epinephrine is less painful than commercially available lignocaine-epinephrine (p < 0.001).

[Dermatome-shaving of psoriasis. 7 years of experience]. / Dermatom-shaving af psoriasis. Syv års erfaring.

Data from the records of 112 patients who were treated with dermatome shaving for psoriasis vulgaris were analysed. One hundred and eight patients with 202 areas treated were included in the study. Complications occurred in nine patients. Thirty-seven patients and 104 areas did not recur during mean follow-up periods of respectively 1.4 years and 1.9 years. In all 108 patients the median recurrence free period was eight months (range: 0-5.6 years). The median recurrence free period for the 202 areas was 13 months (range: 0-8.2 years). Reshaving of partial recurrences in 46 patients led to 40% that did not recur.

[Peroral cleansing for coloscopy--a possibility of establishing ambulatory coloscopy service]. / Peroral udrensning til koloskopi--en mulighed for at etablere ambulant koloskopiservice.

A controlled trial was carried out to investigate whether precoloscopy purging can be satisfactorily done on an out-patient basis. One hundred and ninety-nine patients were randomized to purgation as either in-patients or out-patients. The purgative method used was oral intake of a polyethyleneglycol solution. The two patient groups were compared with respect to quality of purgation, side-effects and patient satisfaction. The same quality of purgation and the same frequency of side-effects were seen in both inpatient and out-patient groups. The patients preferred the out-patient procedure. There were variations with respect to sex and age. It is concluded that the purgative procedure described is satisfactory for out-patient use, which thus enables some coloscopy activities to be carried out on an out-patient basis.

Dermatome shaving of psoriasis. Seven years experience in 112 patients.

Data from the records of 112 patients who were treated by dermatome shaving for psoriasis vulgaris were analysed. A psoriatic "area" was defined as all psoriatic skin lesions present in a specific region at the first treatment, and 108 patients with 202 areas were included in the study. In 68 patients the treatment was limited to a single area, and 40 patients had from two to nine areas treated, mainly on the legs and arms. Complications occurred in nine patients; one had a wound infection that required treatment with an antibiotic, in five patients healing was prolonged, and three patients developed unsightly scars. Thirty-seven patients and 104 areas have not recurred during mean follow-up periods of 1.4 years and 1.9 years, respectively. In all 108 patients the median recurrence free period was eight months (range: 0-5.6 years). The median recurrence free period for the 202 areas was 13 months (range: 0-8.2 years). Reshaving of partial recurrences in 46 patients led to 40% that did not recur. The best prognostic factor available is to do a test shave before initiating more extensive treatment.

[Check-ups of colorectal neoplasms--current practice]. / Kontrol af kolorektale neoplasmer--nuvaerende praksis.

In order to investigate the practice for control of patients with colorectal adenomata and cancer, a questionnaire investigation was carried out in 1990-1991 among 53 Danish surgical departments. The investigation revealed great differences in the control programmes offered to these patients as regards the methods, the intensity and duration. In addition, differences were present in the control pattern for adenomata in specialist departments as compared with the remaining departments where there was a tendency to very frequent but, on the other hand, brief control. On the basis of these results, it is considered necessary that a reference programme should be prepared on this subject.

[Loop ileostomy--the first choice for relief of colon and rectum]. / Loop-ileostomi--første valg ved aflastning af colon og rectum.

In numerous comparative investigations, loop-ileostomy has proved superior to transversostomy. The operative technique is described and experience from 27 loop-ileostomies carried out in a department for organ surgery are reviewed. The qualities of the method as compared with transversostomy are discussed on the basis of the literature and the authors' own results. It is concluded that loop-ileostomy may, in general, be preferred for temporary and palliative relief of the colon.

[Preparation for radiographic examination of the colon. An alternative cleansing method]. / Forberedelse til røntgenundersøgelse af colon. En alternativ udrensningsmetode.

Two regimens for emptying of the bowel prior to radiographic examination of the colon were compared in a controlled, blinded investigation. Both of the regimens included directions about laxatives and diet for 24 hours. In the standard regimen, this was supplemented by an enema while, in the cololax regimen, this was supplemented by oral ingestion of an electrolyte polyethylene glycol solution. The two regimens were found to be equally effective as regards the effect on bowel emptying. The Cololax regimen was associated with the greatest number of side effects and 40% found the taste of Cololax disagreeable. The ages of the patients were of no significance. The Cololax regimen has the advantages that it may be carried out by the patient himself in his own home and that it saves staff resources for the enema. Further analysis of the results suggests that Cololax regimen with improvement in the taste may be the most effective method and the method preferred by the patients.

[Colorectal neoplasms. Study of the attitudes among Danish gastroenterologists]. / Kolorektale neoplasmer. En holdningsundersøgelse blandt danske gastroenterologer.

The results of a questionnaire concerning colorectal neoplasms are discussed with reference to the relevant literature. Coloscopy is the examination of first choice in the diagnosis and follow-up of colorectal neoplasms but double-contrast barium enema (DCBE) is still justified, particularly in cases where coloscopy proves difficult. In the light of present knowledge, the replies to the questionnaire appear to attach too much importance to frequent early control examinations of patients with cancer and adenomata at the expense of more relevant long-term control. Before a control programme for colorectal neoplasm is commenced, a clean colon should be ensured. Patients attending control examinations should be informed about the symptoms of interval cancer.

Polyps of the large intestine in Aarhus, Denmark. An autopsy study.

In 336 consecutive autopsies a total of 305 tumors were recorded in the large intestine. Of these, 184 were adenomas occurring in 26% of the 196 men and 17% of the 140 women, resulting in an overall prevalence of 22%, or 15% when standardized to the world standard population (WSP). The prevalence of adenomas increased with age, and a shift from distal to proximal location occurred in the older age groups, mostly accounted for by the greater tendency to multiplicity in old age. Regardless of age 57% of the cases of adenomas could have been identified by flexible sigmoidoscopy. The prevalence of hyperplastic polyps was 13%, and an association between these and adenomas was found. Five adenocarcinomas occurred in the study. With some exceptions, which are discussed in detail, the results are in accordance with studies from other countries with a high incidence of colorectal cancer and similar socioeconomic composition. The study supports the theory of the adenoma-carcinoma sequence.