liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Olaison, Gunnar
Publications (10 of 25) Show all publications
Myrelid, P., Svärm, S., Andersson, P., Almer, S., Bodemar, G. & Olaison, G. (2006). Azathioprine as a postoperative prophylaxis reduces symptoms in aggressive Crohn's disease. Scandinavian Journal of Gastroenterology, 41(10), 1190-1195
Open this publication in new window or tab >>Azathioprine as a postoperative prophylaxis reduces symptoms in aggressive Crohn's disease
Show others...
2006 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 41, no 10, p. 1190-1195Article in journal (Refereed) Published
Abstract [en]

Objective. Recurrence of Crohn's disease (CD) after surgery is common. Azathioprine/6-mercaptopurine (Aza/6-MP) is effective in controlling medically induced remission but, so far, has only been sparsely investigated after surgically induced remission. This study comprises a subset of CD patients considered to have an aggressive disease course and chosen for treatment with Aza postoperatively. Material and methods. In 1989-2000, a total of 100 patients with CD were given Aza/6-MP as a postoperative prophylaxis. Fourteen Aza/6-MP-intolerant patients were compared with 28 Aza-tolerant patients, matched for gender, age, and duration of disease. Patients were prospectively registered for symptoms using a modified Crohn's disease activity index (CDAI) and perceived health was assessed on a visual analogue scale (VAS). The primary outcome variable was the modified CDAI postoperatively integrated over time, other variables were time to first relapse (modified CDAI ≥ 150), time to first repeated surgery, number of courses of steroids, and repeated surgery per year of follow-up. Patients were followed for a median of 84.7months (23.2-140). Results. The modified CDAI integrated over time was 93 for Aza-treated patients compared with 184 for controls (p = 0.01) and time to first relapse was 53 and 24 months, respectively (p < 0.05). Aza-treated patients needed fewer courses of corticosteroids (p = 0.05) compared with controls. Perceived health did not differ between the groups, nor did need of repeated surgery. Time to first repeat operation was 53 and 37 months, respectively. Conclusions. In CD patients considered to have an aggressive disease course, Aza reduced symptoms after surgery and prolonged the time to symptomatic relapse. The findings support a role for Aza as a postoperative maintenance treatment in CD. © 2006 Taylor & Francis.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-35679 (URN)10.1080/00365520600587378 (DOI)28126 (Local ID)28126 (Archive number)28126 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Rubér, M., Berg, A., Ekerfelt, C., Olaison, G. & Andersson, R. (2006). Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis. Clinical and Experimental Immunology, 143(1), 117-124
Open this publication in new window or tab >>Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis
Show others...
2006 (English)In: Clinical and Experimental Immunology, ISSN 0009-9104, E-ISSN 1365-2249, Vol. 143, no 1, p. 117-124Article in journal (Refereed) Published
Abstract [en]

Appendicitis is one of the most common and costly acute abdominal states of illnesses. Previous studies suggest two types of appendicitis which may be different entities, one which may resolve spontaneously and another that progresses to gangrene and perforation. Gangrenous appendicitis has a positive association to states of Th1 mediated immunity whereas Th2 associated immune states are associated with lower risk of appendicitis. This study investigated the inflammatory response pattern in patients previously appendicectomized for gangrenous (n = 7), or phlegmonous appendicitis (n = 8) and those with a non-inflamed appendix (n = 5). Peripheral blood mononuclear cells were analysed with ELISPOT analysis for number of spontaneous or antigen/mitogen stimulated IFN-γ, IL-4, IL-10 and IL-12 secreting cells or with ELISA for concentration of spontaneous or antigen/mitogen stimulated IFN-γ, IL-5 and IL-10. Spontaneously IL-10 secreting cells/100 000 lymphocytes were increased in the gangrenous group compared to the phlegmonous group (P = 0.015). The median concentration of IL-10 secreted after Tetanus toxoid (TT)-stimulation were higher in the gangrenous group and the control group, than the phlegmonous group (P = 0.048 and P = 0.027, respectively). The median concentration of TT induced IFN-γ secretion was higher for the gangrenous group compared to both the phlegmonous group and the control group (P = 0.037 and P = 0.003). Individuals with a history of gangrenous appendicitis demonstrated ability to increased IL-10 and IFN-γ production. The increased IFN-γ may support the notion of gangrenous appendicitis as an uncontrolled Th1 mediated inflammatory response and increased IL-10 may speculatively indicate the involvement of cytotoxic cells in the progression to perforation. © 2005 British Society for Immunology.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-37618 (URN)10.1111/j.1365-2249.2005.02957.x (DOI)36747 (Local ID)36747 (Archive number)36747 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Münch, A., Söderholm, J. D., Wallon, C., Öst, Å., Olaison, G. & Ström, M. (2005). Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy. Gut, 54(8), 1126-1128
Open this publication in new window or tab >>Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy
Show others...
2005 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 54, no 8, p. 1126-1128Article in journal (Refereed) Published
Abstract [en]

Collagenous colitis has become a more frequent diagnosis but the aetiology of this disease is still unknown. We describe a female patient with intractable collagenous colitis who was treated with a temporary loop ileostomy. She was followed clinically, histopathologically, and functionally by measuring mucosal permeability before surgery, after ileostomy, and after bowel reconstruction. In our case report, active collagenous colitis was combined with increased transcellular and paracellular mucosal permeability. Diversion of the faecal stream decreased inflammation of the mucosa and normalised epithelial degeneration and mucosal permeability. After restoration of bowel continuity, mucosal permeability was altered prior to the appearance of a collagenous layer.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33212 (URN)10.1136/gut.2004.058750 (DOI)19199 (Local ID)19199 (Archive number)19199 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Wallon, C., Braaf, Y., Wolving, M., Olaison, G. & Söderholm, J. D. (2005). Endoscopic biopsies in Ussing chambers evaluated for studies of macromolecular permeability in the human colon. Scandinavian Journal of Gastroenterology, 40(5), 586-595
Open this publication in new window or tab >>Endoscopic biopsies in Ussing chambers evaluated for studies of macromolecular permeability in the human colon
Show others...
2005 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, Vol. 40, no 5, p. 586-595Article in journal (Refereed) Published
Abstract [en]

Objective Studies of mucosal permeability to protein antigens in humans are limited to in vitro techniques. The use of surgical specimens for such studies has major shortcomings. Endoscopic biopsies in Ussing chambers have been introduced as a means of studying secretion and transepithelial permeability, but have not been evaluated for studies of protein antigen uptake in human intestine.

Material and methods Standard forceps biopsies from the sigmoid colon of 24 healthy volunteers were mounted in Ussing chambers with an exposed tissue area of 1.76 mm2. 51Cr-EDTA (paracellular probe) and horseradish peroxidase (HRP; 45 kDa protein antigen) were used as permeability markers. Mucosal permeability, electrophysiology, histology and energy contents of the biopsies were studied over time. To evaluate the ability of the technique to detect permeability changes, the mucosa was modulated with capric acid, a medium-chain fatty acid, known to affect tight junctions.

Results In the Ussing chamber the mucosal biopsies were viable for 160 min with stable levels of ATP and lactate, and only minor changes in morphology. Steady-state permeability with low variability was seen for both markers during the 30-90 min period. Exposure to capric acid induced a rapid decrease in short-circuit current (Isc) and a slower reversible decrease in transepithelial resistance (TER), as well as an increased permeability to 51Cr-EDTA and HRP.

Conclusions Endoscopic biopsies of human colon are viable in Ussing chambers and are reliable tools for studies of mucosal permeability to protein antigens. The technique offers a broad potential for studies of mucosal function in the pathophysiology of human gastrointestinal diseases.

Keywords
ATP; histology; horseradish peroxidase; intestinal absorption; intestinal mucosa; lactate; short-circuit current; sodium caprate; transepithelial electrical resistance
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13152 (URN)10.1080/00365520510012235 (DOI)
Available from: 2008-04-07 Created: 2008-04-07 Last updated: 2009-06-08
Olaison, G., Runström, B., Hallböök, O., Nyström, P.-O. & Sjödahl, R. (2005). Enterokutana fistlar - krävande tillstånd som kan opereras till läkning. Modern behandling och kirurgisk erfarenhet minskar mortaliteten. Läkartidningen, 102(11), 861-865
Open this publication in new window or tab >>Enterokutana fistlar - krävande tillstånd som kan opereras till läkning. Modern behandling och kirurgisk erfarenhet minskar mortaliteten
Show others...
2005 (English)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 11, p. 861-865Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-33217 (URN)19204 (Local ID)19204 (Archive number)19204 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Olaison, G., Almer, S. & Andersen, P. (2004). Perianal Crohn's disease (Br J Surg 2004, 91: 801-814) [1]. British Journal of Surgery, 91(10)
Open this publication in new window or tab >>Perianal Crohn's disease (Br J Surg 2004, 91: 801-814) [1]
2004 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 91, no 10, p. 1381Other (Other academic)
Abstract [en]

[No abstract available]

Publisher
p. 1381
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-45617 (URN)10.1002/bjs.4825 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Andersson, R., Olaison, G., Tysk, C. & Ekbom, A. (2003). Appendectomy is followed by increased risk of Crohn's disease. Gastroenterology, 124(1), 40-46
Open this publication in new window or tab >>Appendectomy is followed by increased risk of Crohn's disease
2003 (English)In: Gastroenterology, ISSN 0016-5085, E-ISSN 1528-0012, Vol. 124, no 1, p. 40-46Article in journal (Refereed) Published
Abstract [en]

Background & Aims: Appendectomy is associated with a low risk of subsequent ulcerative colitis. This study analyzes the risk of Crohn's disease after appendectomy. Methods: We followed-up 212,218 patients with appendectomy before age 50 years and a cohort of matched controls, identified from the Swedish Inpatient Register and the nationwide Census, for any subsequent diagnosis of Crohn's disease. Results: An increased risk of Crohn's disease was found for more than 20 years after appendectomy, with incidence rate ratio 2.11 (95% confidence interval [CI], 1.21-3.79) after perforated appendicitis, 1.85 (95% CI, 1.10-3.18) after nonspecific abdominal pain, 2.15 (95% CI, 1.25-3.80) after mesenteric lymphadenitis, 2.52 (95% CI, 1.43-4.63) after other diagnoses. After nonperforated appendicitis, there was an increased risk among women but not among men (incidence rate ratio 1.37, 95% CI, 1.03-1.85, respectively, 0.89, 95% CI, 0.64-1.24). Patients operated on before age 10 years had a low risk (incidence rate ratio 0.48, 95% CI, 0.23-0.97). Crohn's disease patients with a history of perforated appendicitis had a worse prognosis. Conclusions: Appendectomy is associated with an increased risk of Crohn's disease that is dependent on the patient's sex, age, and the diagnosis at operation. The pattern of associations suggests a biologic cause.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25308 (URN)10.1053/gast.2003.50021 (DOI)9749 (Local ID)9749 (Archive number)9749 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Andersson, P., Olaison, G., Bendtsen, P., Myrelid, P. & Sjödahl, R. (2003). Health related quality of life in Crohn's proctocolitis does not differ from a general population when in remission. Colorectal Disease, 5(1), 56-62
Open this publication in new window or tab >>Health related quality of life in Crohn's proctocolitis does not differ from a general population when in remission
Show others...
2003 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 5, no 1, p. 56-62Article in journal (Refereed) Published
Abstract [en]

Objective  All treatment in Crohn's disease, although palliative, aims at restoring full health. The objective of this study was to compare health-related quality of life and psychosocial conditions in patients with Crohn's proctocolitis with a general population.

Patients and methods  One hundred and twenty-seven patients with Crohn's proctocolitis (median age 44 years, 44.1% men) were compared with 266 controls (median age 45 years, 50.7% men). A questionnaire consisting of the Short Form-36 (SF-36), the Psychological General Well-Being Index (PGWB) and a visual analogue scale (VAS) evaluating general health as well as questions regarding psychosocial conditions was used. Disease activity was evaluated by Best's modification of the classical Crohn's Disease Activity Index.

Results  Patients in remission had a health related quality of life similar to controls according to the SF-36 apart from general health where scores were lower (P < 0.01). Patients with active disease scored lower in all aspects of the SF-36 (P < 0.001 or P < 0.0001) as well as the PGWB (P < 0.0001). In a model for multiple regression including age, gender, concomitant small bowel disease, permanent stoma, previous colonic surgery, disease activity, duration, and aggressiveness, disease activity was the only variable negatively predicting all 8 domains of the SF-36 in the patient group (P < 0.001). The mean annual sick-leave for patients and controls were 33.9 and 9.5 days (P < 0.0001), respectively. Sixty-eight percent of the patients and 78.4% of the controls (P = 0.04) were married or cohabited, 67.7% and 78.0% (P = 0.04), respectively, had children.

Conclusion  The health related quality of life for patients with Crohn's proctocolitis in remission does not differ from the general population. The disease has, however, a negative impact on parenthood, family life and professional performance.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-24877 (URN)10.1046/j.1463-1318.2003.00407.x (DOI)9279 (Local ID)9279 (Archive number)9279 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
Andersson, P., Olaison, G., Hallböök, O., Boeryd, B. & Sjödahl, R. (2003). Increased anal resting pressure and rectal sensitivity in Crohn's disease. Diseases of the Colon & Rectum, 46(12), 1685-1689
Open this publication in new window or tab >>Increased anal resting pressure and rectal sensitivity in Crohn's disease
Show others...
2003 (English)In: Diseases of the Colon & Rectum, ISSN 0012-3706, E-ISSN 1530-0358, Vol. 46, no 12, p. 1685-1689Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Anal pathology occurs in 20 to 80 percent of patients with Crohn's disease in which abscesses, fistulas, and fissures account for considerable morbidity. The etiology is not clearly defined, but altered anorectal pressures may play a role. This study was designed to investigate anorectal physiologic conditions in patients with Crohn's disease compared with healthy controls.

METHODS: Twenty patients with Crohn's disease located in the ileum (n = 9) or the colon (n = 11) without macroscopic proctitis or perianal disease were included. All were subjected to rectal examination, anorectal manometry, manovolumetry, and rectoscopy. Comparison was made with a reference group of 173 healthy controls of whom 128 underwent anorectal manometry, 29 manovolumetry, and 16 both examinations.

RESULTS: Maximum resting pressure and resting pressure area were higher in patients than in controls (P = 0.017 and P = 0.011, respectively), whereas maximum squeeze pressure and squeeze pressure area were similar. Rectal sensitivity was increased in patients expressed as lower values both for volume and pressure for urge (P = 0.013 and P = 0.014, respectively) as well as maximum tolerable pressure (P = 0.025).

CONCLUSIONS: This study demonstrates how patients with Crohn's disease without macroscopic proctitis have increased anal pressures in conjunction with increased rectal sensitivity. This may contribute to later development of anal pathology, because increased intra-anal pressures may compromise anal circulation, causing fissures, and also discharging of fecal matter into the perirectal tracts, which may have a role in infection and fistula development.

Keywords
Crohn's disease, anorectal manometry, manovolumetry, anal pathology
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-24876 (URN)10.1007/BF02660776 (DOI)9278 (Local ID)9278 (Archive number)9278 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
Söderholm, J. D., Olaison, G., Peterson, K., Franzén, L., Lindmark, T., Wirén, M., . . . Sjödahl, R. (2002). Augmented increase in tight junction permeability by luminal stimuli in the non-inflamed ileum of crohn's disease. Gut, 50(3), 307-313
Open this publication in new window or tab >>Augmented increase in tight junction permeability by luminal stimuli in the non-inflamed ileum of crohn's disease
Show others...
2002 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 50, no 3, p. 307-313Article in journal (Refereed) Published
Abstract [en]

Background: Crohn's disease is associated with deranged intestinal permeability in vivo, suggesting dysfunction of tight junctions. The luminal contents are important for development of neoinflammation following resection. Regulation of tight junctions by luminal factors has not previously been studied in Crohn's disease. Aims: The aim of the study was to investigate the effects of a luminal stimulus, known to affect tight junctions, on the distal ileum in patients with Crohn's disease. Patients: Surgical specimens from the distal ileum of patients with Crohn's disease (n=l 2) were studied, and ileal specimens from colon cancer patients (n=l 3) served as controls. Methods: Mucosal permeability to 51Cr-EDTA and electrical resistance were studied in Ussing chambers during luminal exposure to sodium caprate (a constituent of milk fat, affecting tight junctions) or to buffer only. The mechanisms involved were studied by mucosal ATP levels, and by electron and confocal microscopy. Results: Baseline permeability was the same in non-inflamed ileum of Crohn's disease and controls. Sodium caprate induced a rapid increase in paracellular permeability - that is, increased permeation of 51Cr-EDTA and decreased electrical resistance - which was more pronounced in non-inflamed ileum of Crohn's disease, and electron microscopy showed dilatations within the tight junctions. Moreover, sodium caprate induced disassembly of perijunctional filamentous actin was more pronounced in Crohn's disease mucosa. Mucosal permeability changes were accompanied by mitochondrial swelling and a fall in epithelial ATP content, suggesting uncoupling of oxidative phosphorylation. Conclusions: The tight junctions in the non-inflamed distal ileum of Crohn's disease were more reactive to luminal stimuli, possibly mediated via disturbed cytoskeletal contractility. This could contribute to the development of mucosal neoinflammation in Crohn's disease.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25309 (URN)10.1136/gut.50.3.307 (DOI)9750 (Local ID)9750 (Archive number)9750 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
Organisations

Search in DiVA

Show all publications