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Biomedical subjects

A Bakke

Publications and source records attributed to A Bakke.

At least 19 recordsLinked to original sources
PubMed2001

Diminished frequency of interleukin-10-secreting, T-cell receptor peptide-reactive T cells in multiple sclerosis patients might allow expansion of activated memory T cells bearing the cognate BV gene.

T cells responsive to T-cell receptor (TCR) determinants may regulate pathogenic Th1 responses in patients with multiple sclerosis (MS) through interleukin (IL)-10-dependent bystander suppression. In this study, innate IL-10- and interferon (IFN)-gamma-secreting T cells responsive to TCR peptides were quantified in peripheral blood mononuclear cells of MS patients and healthy controls (HC) using the ELISPOT assay. Most HC had vigorous IL-10 but low IFN-gamma frequencies to BV5S2 and BV6S1 peptides. In contrast, MS patients had significantly lower IL-10 frequency responses to the TCR peptides but normal responses to concanavalin A. Patients undergoing TCR-peptide vaccination had moderate responses that fluctuated in concert with vaccination. In an MS patient and HC, expression of BV6S1 by activated memory T cells was inversely associated with the presence of IL-10-secreting BV6S1-reactive T cells. These results suggest that MS patients have diminished frequencies of innate TCR-reactive T cells that may allow oligoclonal expansion of activated autoreactive Th1 effector cells expressing cognate V genes.

Adult↗
PubMed2001

[Voiding problems and urinary tract complications in adolescents and adults with myelomeningocele].

BACKGROUND: The aim of this study was to describe voiding dysfunction and urinary tract complications in a population above 16 years of age with myelomeningocele. MATERIAL AND METHODS: 51 persons were included in the study. Data were obtained by questionnaires, ultrasound and glomerular filtration rate; in those with intact urinary bladder, by cystometry and videocystography. RESULTS: 30 out of 33 persons with intact urinary bladder were incontinent. Those with daily incontinence described this as a major problem. Cystometry concluded with normal detrusor contractions in three, detrusor hyperreflexia in five, and a detrusor hyporeflexia in 25 persons. Three out of 30 had vesicoureteral reflux. Ultrasound showed mild hydronephrosis and/or scarring in three persons. Average glomerular filtration rate was 86% (50-131%). 11 had Bricker diversion and seven continent reservoirs. 15 out of 18 persons with urinary diversion were satisfied with this solution. In persons with urinary diversion, the average glomerular filtration rate was 78% (44-109%). Ultrasound showed hydronephrosis and/or scarring in seven out of 16. Overall, urinary tract infections last year were reported by 56%, and pyelonephritis was more common in those with urinary diversion. INTERPRETATION: Incontinence is a common problem in adults with myelomeningocele. About one third had upper urinary tract changes, but none had renal failure.

Adolescent↗
PubMed2001

[Follow up of urinary tract problems in adults with myelomeningocele].

BACKGROUND: More than 90% of persons with myelomeningocele have a neurogenic bladder disturbance with incontinence and risk of upper urinary tract deterioration. Both aspects need to be considered when planning treatment and follow-up. MATERIAL AND METHODS: The study is based on review of articles and clinical experience. RESULTS: A thorough examination of the patient's voiding methods and incontinence is necessary. Examinations for renal function, reflux and hydroureteronephrosis as well as cystometry should also be carried out. The results of such examinations, together with an assessment of the patient's motor and cognitive function, as well as motivation, will provide a basis for further treatment and follow-up. We suggest a flow-chart for treatment and follow-up of persons above 16 years of age with myelomeningocele. INTERPRETATION: Patients with myelomeningocele should have a thorough examination and an individual plan for treatment and follow-up of their urinary tract dysfunction. Depending on the pathological findings, routine follow-up should be in done intervals from six months to five years.

Adult↗
PubMed2001

Reconstructive urology in the nordic countries--a hospital questionnaire survey.

A hospital survey of adult reconstructive urologic surgery in the Nordic countries is presented. The response rate was 80% and included most general hospitals and university clinics. Despite similarities between the healthcare systems of the various countries several differences were found. Cystectomy was performed in a large number of institutions in all countries except Denmark. The annual number of orthotopic bladder substitutions per institution was calculated as three to four (range of medians for each country) and the number of continent cutaneous diversions as two to seven. Open urethral procedures were performed more frequently in Sweden than in the other countries. Surgery for penile curvature and implantation of three-component prostheses for erectile dysfunction was more commonly performed in Denmark and Iceland compared to Sweden.

Denmark↗
PubMed2001

Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction.

OBJECTIVE: Physical disability explains only part of the reduced quality of life found among multiple sclerosis (MS) patients. Bladder dysfunction and sexual disturbance are frequent and distressing problems for MS patients. We therefore estimated the relationship between the presence and degree of sexual disturbance/bladder dysfunction and the patients' quality of life as measured by the SF-36 Health Survey. METHODS: We performed a cross-sectional study of all individuals with the onset of MS between 1976 and 1986 in Hordaland County, Norway. The disease duration at examination was 9-19 years; 194 patients (94%) participated. RESULTS: Fifty-three per cent of the patients with low physical disability (Expanded Disability Status Scale (EDSS) < or = 4.0) reported disease-related sexual disturbance and 44% had bladder dysfunction according to the Incapacity Status Scale. The corresponding figures for the patients with a high physical disability (EDSS > 4.0) were 86 and 81% respectively. The patients with sexual disturbance had markedly and significantly reduced scores on all eight SF-36 scales, this was after adjustment for disease development measured by the EDSS. The patients without sexual disturbance scored 0.5 s.d. lower than a normal population on the social functioning scale, whereas those with marked sexual disturbance scored 1.5 s.d. lower. Similar results were found for the patients with bladder dysfunction. CONCLUSION: Bladder and sexual problems are associated with a marked reduction in the quality of life, also among patients with otherwise low disability. This underlines the need for identifying and treating these problems.

Adult↗
PubMed2000

Quantification of DNA binding to cell-surfaces by flow cytometry.

DNA binding to cell-surfaces has been documented in several studies. The interaction of DNA with cells has been shown to have therapeutic potential as a non-viral form of gene delivery and DNA vaccination. Recently, bacterial DNA binding and internalization has been demonstrated in some cells to trigger secretion of cytokines and cell activation. Previous studies to quantify DNA binding to cells have used radiolabeled DNA. Here we report a non-radioactive assay for quantification of cell-surface DNA binding based on the isoparametric analysis of flow cytometric data as described by Chatelier et al., Embo J., 5 (1986) 1181. This assay has the advantage over previously used procedures in not employing radioactive material and being able to discriminate viable from non-viable cells that bind DNA. With the importance of understanding the interaction of DNA with cells, this assay may have application for the identification and characterization of reagents designed to either enhance or inhibit DNA binding to cells.

Cell Line, Transformed↗
PubMed2000

A fundamental aspect of supportive care delivery: the nurse's opportunity to shape the caring encounter.

Recent advances in supportive care therapies have significantly contributed to the likelihood that a child diagnosed with cancer will be cured. Quantitatively recognized supportive care practices, such as central line care management, pain control, nutritional support, and blood transfusions are typically identified as the major contributors to these improved rates of survival. However, just as important are the more qualitative aspects of the nursing care delivery process. As a fundamental part of nursing's caring role, the encounter with patients and families offers unique opportunities for nurses to participate in the creation of a healing environment. Gaining understanding and skill at balancing professional relationships, while also knowing the risks of caring, are critical components of providing excellent supportive care to pediatric oncology patients and their families. The professional caring encounter is a complex and multidimensional process. Strategies for developing optimal communication and healthy professional caring relationships within the pediatric oncology setting are discussed.

Child↗
PubMed1998

Novel flow cytometry compensation standards: internally stained fluorescent microspheres with matched emission spectra and long-term stability.

In flow cytometry, the emission spectral overlap of fluorescein and R-phycoerythrin is usually corrected by electronic color compensation using microspheres surface labeled with the same fluorochromes. However, the inherent chemical instability of these fluorochromes may cause inaccurate compensation. To overcome these problems, Compen-Flow beads, a new type of compensation standards were developed. The CompenFlow beads are a set of 6.0-microm-diameter polystyrene microspheres that are internally stained with selected BODIPY dye combinations. When excited by the 488-nm argon laser line, these beads show a nearly perfect emission spectral match to fluorescein-stained, R-phycoerythrin-stained and unstained lymphocytes, respectively. Moreover, since the dye molecules are oil soluble, they are contained inside the microsphere matrix instead of merely on the surface; thus, the molecules are shielded from environmental factors that could affect an exposed fluorochrome. Our results show a stable fluorescence spectral profile and constant intensity for at least 2 years stored either refrigerated or at room temperature.

Drug Stability↗
PubMed1998

Psychological predictors of symptoms of urinary tract infection and bacteriuria in patients treated with clean intermittent catheterization: a prospective 7-year study.

OBJECTIVE: One of the major clinical problems in relation to clean intermittent catheterization (CIC) are symptoms of urinary tract infection (UTI) and bacteriuria. The aim of the present work was to study to what extent measures of psychological well-being, distress and neurotic personality traits in patients performing CIC could predict symptoms of UTI or bacteriuria 7 years later. PATIENTS AND METHODS: Included in the study were 170 patients with a mean age of 57 years, who had used CIC for 105 months. CIC was practised due to neurogenic bladder dysfunction in two thirds of the patients, and non-neurogenic dysfunction in the remaining patients. All patients had been clinically examined 7 years prior to inclusion. Information about subjective symptoms of UTI and examination of bacteriuria in urine samples had been assessed. All subjects had also undergone repeated psychometric evaluations of psychosocial function, well-being and distress (General Health Questionnaire; GHQ-28; Spielberger State-Trait Anxiety Inventory; STAI X-1) and neuroticism (Eysenck Personality Questionnaire; EPQ-N). The results from selected assessments done 7 years earlier were used to predict reported UTI and findings of bacteriuria in urine samples in 1995. RESULTS: Clinical UTI symptoms were reported by 35% of the patients. These patients had significantly higher GHQ-28 scores in 1988, 1989 and 1995 compared to the remaining 65%. Patients without clinical UTI during 1988/89, but with symptoms suggesting UTI in 1995, had significantly higher GHQ-28, STAI-X1 and EPQ-N scores in 1988 compared to those who did not report symptoms 7 years later. Patients with UTI during 1988/89 who were free of symptoms of UTI in 1995 had scores similar to those who were free of symptoms of UTI both in 1988/89 and in 1995. GHQ-28, STAI X-1 and EPQ-N scores in 1988/89 did not predict current bacteriuria, found in 62% of the urine samples in 1995. CONCLUSION: Social function, well-being and distress are significant predictors of long-term urinary tract complaints, but not of bacteriuria. This finding indicates that the aetiology of UTI complaints and of actual bacteriuria is different. Complaints of UTI may often express distress and not symptomatic infection. Physicians' non-recognition of distress may lead to unnecessary and aggressive interventions for assumed infection such as the prescription of antibiotics. Identification and treatment of psychological distress and impaired social function should become routine in the clinical follow-up of CIC patients. Such a routine could reduce urinary tract complaints, lower the unnecessary use of antibiotics and increase the tolerability of CIC. Prospective intervention studies are needed to verify this hypothesis.

Anxiety↗
PubMed1997

Physical predictors of infection in patients treated with clean intermittent catheterization: a prospective 7-year study.

OBJECTIVE: To study urinary tract complications in patients treated using long-term clean intermittent catheterization (CIC), and to evaluate the physical factors which might be implicated in these complications. PATIENTS AND METHODS: During 1995, 170 patients (84 men and 86 women, mean age 56.9 years) with a mean duration of use of CIC for 8.8 years were assessed for complications related to CIC. The same patients had participated in a thorough follow-up study during 1988-9 and were examined again using questionnaires and the analysis of urine samples. CIC was practised by two-thirds of the patients because they had neurogenic bladder dysfunction and for non-neurogenic dysfunction in the remainder. RESULTS: In this prevalence study, 111 patients (65%) had no signs of clinical urinary tract infection (UTI), while 10 patients (6%) had pronounced symptoms. The remaining 29% had only minor signs of UTI. There were three predictive factors of clinical UTI: women reported more infections than men, the patients most affected by UTI in the present study were those suffering UTI during the 1988-9 study and patients with UTI had the highest mean catheterization volume now, and the highest increase in mean catheterization volume from 1989 to 1995. Bacteriuria was found in 61% of the urine samples, with Escherichia coli the dominant species among women and Gram-positive cocci among men. Patients who did not use anti-infective agents had a 31% rate of sterile urine while the corresponding value among those using antibiotics was 54%. The frequency of catheterization was the only variable predictive of bacteriuria apart from the use of antibiotics. CONCLUSION: This study confirms previous reports showing CIC to be an excellent procedure for minimizing urinary tract complications and supports the current recommendations, e.g., restricting the use of antibiotics in patients using CIC and ensuring that they catheterize sufficiently often to ensure that the mean volume of each catheterization is kept to < 400 mL in adults.

Adult↗
PubMed1997

Inhibition of phytohaemagglutinin-induced lymphoproliferation by soluble annexin II in sera from patients with renal cell carcinoma.

Annexin II (AII) is a member of a family of glycoproteins which bind negatively charged phospholipids in a calcium-dependent manner. Annexins are membrane-associated proteins, expressed both in normal and malignant cells, but have also been detected as soluble molecules in serum and other body fluids. Because of their adhesive properties, it has been suggested that annexins play a role in the metastatic process. An ELISA was established for quantification of soluble AII. Within-run variation was 5.2-10.4% and run-to-run variation 12.4-15.6%. Soluble AII was detected in all sera studies. A strongly positive serum was arbitrarily given the value 100 AII units and used as reference serum. The mean level in sera from 20 normal blood donors was 49 (SE 5.6) AII units. Sera from peripheral blood of five patients with renal cell carcinoma and sera from blood obtained from the renal vein of the same patients contained 47 (SE 20) and 83 (SE 28) AII units, respectively. In two patients, AII levels were increased in renal vein serum as compared with peripheral blood serum. Interestingly, in both cases, and in none of the three remaining cases, phytohaemagglutinin-stimulated lymphoproliferation was suppressed by renal vein serum as compared with peripheral blood serum. Affinity absorption of AII from the renal vein sera with increased AII levels strongly reduced their immunosuppressive activity. Addition of affinity-purified AII to cell cultures suppressed lymphoproliferation. These data show that the level of AII is markedly increased in renal vein sera from some patients with renal cell carcinoma, suggesting that AII may be locally released in vivo. The study also demonstrates an immunosuppressive effect of soluble AII in vitro. We speculate that soluble AII released by the tumour has immunosuppressive properties. This study identifies soluble AII as a novel immunosuppressive factor in sera from patients with renal cell carcinoma. A further study including a larger number of patients is currently in progress, in order to investigate the pathological significance of this finding.

Annexin A2↗
PubMed1997

Perforation of continent urinary reservoirs. Scandinavian experience.

In a questionnaire survey of urological departments in Sweden, Denmark, Finland and Norway, 20 episodes of perforation of continent urinary pouches were found to have occurred in 18 patients, representing an incidence of 1.5%. This complication occurred with ileal as well as colonic segments, without predilection. In one case there was perforation of an appendiceal outlet. Noticeable findings were (a) a long delay (median 10h) to treatment and (b) that investigational procedures such as enterocystography and enterocystoscopy were not commonly employed. Treatment of this potentially lethal complication was by oversewing the perforation, and there were no subsequent major complications. This complication should be strongly suspected if a patient with continent urinary reconstruction presents with acute abdominal pain.

Abdominal Pain↗
PubMed1996

OX-40 antibody enhances for autoantigen specific V beta 8.2+ T cells within the spinal cord of Lewis rats with autoimmune encephalomyelitis.

The V beta 8.2 T cell receptor (TCR) component is the predominant V beta gene product associated with antigen specific CD4+ T cell response to the major encephalitogenic epitope of myelin basic protein (MBP) in Lewis rats. Lewis rats were actively immunized with MBP in complete Freund's adjuvant and the V beta 8.2 positive and negative cells were analyzed for IFN-gamma mRNA production and OX-40 cell surface expression during the onset of EAE. The V beta 8.2+ T cells isolated from the spinal cord produced the majority of mRNA for IFN-gamma and also showed a marked enhancement for OX-40 expression compared to V beta 8.2+ T cells isolated from the lymph nodes. Only a fraction of IL-2 receptor positive T cells examined ex vivo from the inflammatory compartments co-expressed the OX-40 antigen. These results suggested that OX-40 cell surface expression could be used to identify and isolate the most recently activated T cells ex vivo. OX-40+ T cells isolated from the spinal cord were highly enriched for the V beta 8.2 T cell receptor component compared to OX-40- or unsorted spinal cord lymphocytes. OX-40+ T cells isolated from the spinal cord had an enhanced response to MBP, whereas OX-40+ cells isolated from the lymph nodes responded to both MBP and purified protein derivative. These data suggest that activated T cells can be isolated and characterized with the OX-40 antibody which only respond to the antigens present at the local site. The data also imply that isolation of OX-40+ T cells will be useful in identifying V beta biases and autoantigen specific cells within inflamed tissues even when the antigen specificity is unknown.

Animals↗
PubMed1996

Bladder, bowel and sexual dysfunction in patients with multiple sclerosis--a cohort study.

A population-based cohort study focusing on bladder, bowel and sexual dysfunction in MS-patients was performed. The total cohort under study comprised 209 patients. The duration of the disease was nine to 19 years. A total of 57.5% reported some to major bladder dysfunction. The corresponding figures of bowel and sexual dysfunction were 41.3% and 51% respectively. The dysfunction increased with higher age, higher age at onset of MS, duration and course of the disease. The most unfavourable course of the disease was the relapsing remittent secondary progressive form, where almost 70% became worse during an eight year's observation period, in contrast to patients with the relapsing remittent form, where less than 30% became worse. The study shows that a high number of MS patients is in need of a neuro-urological work-up, and that effort should be made to prevent or delay a secondary progressive course of the disease.

Adult↗
PubMed1995

Ureteroscopy in pregnancy.

PURPOSE: We report our experience with ureteroscopy in pregnancy. MATERIALS AND METHODS: From 1984 to 1994, 24 pregnant women with lasting symptoms of ureteral obstruction underwent diagnostic and therapeutic ureteroscopy. Most of the women were in the second or third trimester of gestation. RESULTS: A rigid ureteroscope was introduced easily to the upper third of the ureter or into the renal pelvis in all patients. Ureteral calculi were extracted in 13 cases. There were no serious complications. CONCLUSIONS: Ureteroscopy is a safe procedure that may be used to diagnose and extract obstructing ureteral calculi during pregnancy when conservative measures fails.

Adult↗
PubMed1994

Psychosocial Adjustment to Illness Scale (PAIS-SR) in a Norwegian material of patients with functional dyspepsia, duodenal ulcer, and urinary bladder dysfunction. Clinical validation of the instrument.

BACKGROUND: There is an increasing interest in the psychosocial impact of a disease, but few instruments available to measure it. METHODS: The internal consistency and construct validity of the Norwegian translation of the Psychosocial Adjustment to Illness Scale (PAIS-SR) was examined in a total of 557 patients. RESULTS: The seven dimensions of the psychosocial adjustment to medical illness from the original test were represented in the Norwegian translation. Psychologic distress, social environment, and vocational environment explained most of the variance. The instrument had high internal consistency with Cronbach's alpha coefficients of > 0.75 on six of seven subscales. The PAIS-SR differentiated between groups of patients with urologic and upper gastrointestinal disease and seemed to give meaningful and useful clinical data. Patients with functional dyspepsia (n = 97) had higher score on psychologic distress than the other groups, whereas patients with duodenal ulcer (n = 97) were significantly less affected in their social life than the other patients. CONCLUSIONS: The Norwegian translation of the PAIS-SR had high internal consistency, acceptable construct validity, and good discriminating validity.

Adolescent↗