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Biomedical subjects

B Hagen

Publications and source records attributed to B Hagen.

At least 37 records · Page 2Linked to original sources
PubMed1999

Parallel pathways mediate inhibitory effects of vasoactive intestinal polypeptide and nitric oxide in canine fundus.

1. The gastric adaptation reflex is activated by the release of non-adrenergic, non-cholinergic (NANC) inhibitory transmitters, including nitric oxide (NO) and vasoactive intestinal polypeptide (VIP). The role of NO in this reflex is not disputed, but some investigators suggest that NO synthesis is stimulated by VIP in post-junctional cells or in nerve terminals. We investigated whether the effects of these transmitters are mediated by independent pathways in the canine gastric fundus. 2. VIP and NO produced concentration-dependent relaxation of the canine fundus. Nomega-nitro-L-arginine (L-NNA) reduced relaxation induced by electrical field stimulation (EFS; 0.5-8 Hz), but had no effect on responses to exogenous VIP and sodium nitroprusside (SNP, 10 microM). 3. Oxyhaemoglobin reduced relaxations produced by EFS and SNP. Oxyhaemoglobin also reduced relaxation responses to low concentrations of VIP (<10 nM), but these effects were non-specific and mimicked by methaemoglobin which had no effect on nitrergic responses. 4. A blocker of guanylyl cyclase, 1H-[1,2,4]oxidiazolo [4,3,-a]quinoxalin-1-one, (ODQ) inhibited responses to EFS, SNP and DETA/NONOate (an NO.donor), but had no effect on responses to VIP. cis-N-(2-phenylcyclopentil)-azacyclotridec-1en-2-amine monohydrochloride (MDL 12,330A), a blocker of adenylyl cyclase, reduced responses to EFS, VIP and forskolin, but did not affect responses to SNP. 5. Levels of cyclic GMP were enhanced by the NO donor S-nitroso-n-acetylpenicillamine (SNAP) but were unaffected by VIP (1 microM). The increase in cyclic GMP in response to SNAP was blocked by ODQ. 6. The results suggest that at least two transmitters, possibly NO and VIP, mediate relaxation responses in the canine fundus. NO and VIP mediate responses via cyclic GMP- and cyclic AMP-dependent mechanisms, respectively. No evidence was found for a serial cascade in which VIP is coupled to NO-dependent responses.

Adenylyl Cyclase Inhibitors↗
PubMed1999

Gender aspects of liver slice incubations with N,N,N-triethylene-thiophosphamide (Thio-TEPA) in rats and mice.

This study was conducted to investigate if biotransformation of N,N,N-triethylene-thiophosphoramide (thio-TEPA) by liver slice incubations reflects the established gender pattern for rat and mouse. Liver slices from rat and mice of both genders were incubated with start concentrations of thio-TEPA of 5.2, 26, 52 and 104 microM for up to 240 min. Male rat liver slices eliminated thio-TEPA faster and formed more TEPA than female liver slices at any concentration. No gender difference was found for the elimination of thio-TEPA in mice, however, the female liver slices formed less TEPA than the male ones. Apparently female rat liver slices formed less TEPA than female mice liver slices. It is concluded that the liver slice incubation system in a robust manner reflects gender differences in rat drug biotransformation with special reference to thio-TEPA. It is also confirmed that these aspects of gender are less pronounced in the examined mouse species than in rats.

Animals↗
PubMed1999

The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals.

OBJECTIVE: To assess the risk-of-malignancy index (a scoring system based on menopausal status, ultrasound features, and serum CA 125) at district hospitals for referral of women with suspected malignant pelvic masses for primary surgery at a central gynecologic oncology unit. METHODS: All seven hospitals in Health Region IV, Norway, agreed to refer women with pelvic masses and risk-of-malignancy indices of 200 or more for centralized primary surgery. In total, 365 women 30 years of age or older, admitted consecutively at the local hospitals, were enrolled in the study from February 1, 1995, to January 31, 1997. RESULTS: Compliance with the study was satisfactory; 84% (65 of 77) of women with risk-of-malignancy indices of at least 200 were referred for centralized primary surgery. Sensitivity and specificity to malignancy were 71% and 92%, respectively, which is in agreement with previous validation of the risk-of-malignancy index in teaching hospital settings. False negatives were due mainly to stage Ia (18 of 24) ovarian cancer, whereas 27 of 28 stage II-IV ovarian cancer cases were identified correctly. CONCLUSION: The risk-of-malignancy index identified women with malignant pelvic masses efficiently. Our study showed the risk-of-malignancy index strategy in a practical setting to be able to centralize primary surgery for advanced ovarian cancer from local hospitals to a subspecialty unit. We recommend the risk-of-malignancy index for detection of patients with advanced ovarian cancer for centralized primary surgery.

Adult↗
PubMed1999

Prospectively detected cancer in familial breast/ovarian cancer screening.

BACKGROUND: Early diagnosis and treatment are shown to improve survival of breast and ovarian cancer. Identification and medical follow-up of high-risk groups may be important for early diagnosis. METHODS: A prospective study of 845 women from breast/ovarian- and ovarian cancer kindreds who were classified according to pre-set inclusion criteria (Table I), were offered genetic counseling and annual medical examinations of breasts and ovaries. The material consisted of three series: 1) 754 unaffected women, 2) 49 women with breast cancer, and 3) 42 women with ovarian cancer. RESULTS: In series 1) nine ovarian cancers and 20 breast cancers, in series 2) seven ovarian cancers, and in series 3) three breast cancers were found. All but one of the ovarian cancers were 40 years or older, and 4/16 (25%) were Borderline cancer. All breast cancers were 30 years or older, and 89% were detected before spread. CONCLUSIONS: This is to our knowledge the first prospective report of the combined breast/ovarian cancer findings in breast/ovarian cancer kindreds. A woman with both breast and ovarian cancer is the hallmark of inherited breast/ovarian cancer, and 50% of the ovarian cancers were detected in these families. Borderline ovarian cancer may represent a manifestation of this syndrome. If prophylactic oophorectomy prevents ovarian cancer, oophorectomy at age 45 would have prevented 75% of such cancers. Based on these results we revised our protocol for annual follow-up in these kindreds: 1) clinical breast examination and mammography (ultrasound/cytology if indicated) from 30 years of age, 2) gynecologic examination (including vaginal ultrasound, serum-CA125) from 35 years of age, and 3) discuss oophorectomy at 45 years of age.

Adolescent↗
PubMed1998

CO2 laser conization for cervical intraepithelial neoplasia grade II-III: complications and efficacy.

AIMS: To examine per- and postoperative complication rates and efficacy of laser conization in the treatment of cervical intraepithelial neoplasia (CIN) grade II-III. MATERIAL AND METHODS: Eligible for analyses were all women treated with their first laser conization because of CIN II-III during the time-period January 1, 1983 to December 31, 1992. The study population comprises 1081 women who were permanent residents of one Norwegian county (Sør-Trøndelag). All analyses were performed in SPSS applying chi-square for trend, Mann-Whitney test, survival analyses and logistic regression. RESULTS: In total 86 women (8.0%) were observed with one or two (4:86) complications. Bleeding was most frequent (n = 66) followed by symptomatic cervical stenosis (n = 18). Most bleeding complications (74.2%) occurred one to two weeks postoperatively. Both bleeding complications and the occurrence of cervical stenosis were associated with cone height. Three emergency hysterectomies, two for bleeding and one for bladder perforation, were performed. Persistent disease was diagnosed in 1.9% (20:1053) of the women. All women with persistent disease were diagnosed among those with CIN III. Persistent disease was more than 20 times more common among women with disease-involved resection margins compared to those with free resection margins. CONCLUSIONS: Our evaluation of ten years' consistent use of conization by CO2 laser in the treatment of CIN II-III in an unselected population showed a low overall complication rate (8%) and very high efficacy (CIN II 100%, CIN III 98.1%) of the treatment.

Adult↗
PubMed1997

[Invasive or noninvasive angiography? The role of "classical" catheter angiography].

Within the last decade, diagnostic and interventional angiography have been developed to a high degree of performance, due to the widespread use od DSA, the miniaturisation of the puncture trauma and the introduction sets (catheters, sheaths), the development of high-tech materials (e.g., Nitinol guidewires) and the application of non-ionic, low osmolal contrast media. The specific risks of the procedure, thereby, have been significantly reduced, but could not be totally eliminated. To evaluate vascular diseases non-invasively, special attention was attributed to the progress of colour coded duplex, (spiral) CT-angiography and (CE) MR-angiography, based on the established imaging with US, CT and MRT. The matter is question is whether or not they can substitute the role of conventional angiography as the "gold standard" of vessel imaging. Clinical validity and economic efficiency both determine the indication for the use of invasive or non-invasive methods. In diagnostic procedures, there is a growing tendency for the use of non-invasive techniques, like in imaging of the abdominal and thoracic aorta, the renal, pulmonary and extra- and intra-cranial arteries. Conventional angiography is still reserved for the evaluation of small vessels of the upper and lower extremities, and vessel status in preoperative conditions (carotid, celiac trunk, mesenteric and renal arteries and aneurysms of the cerebral vasculature). Fluoroscopic guiding of catheters and contrast enhancement in interventional procedures, however, cannot be substituted by alternative techniques in the foreseeable future.

Angiography↗
PubMed1997

Residual and recurrent disease after laser conization for cervical intraepithelial neoplasia.

OBJECTIVE: To assess the risk of residual and recurrent disease after carbon dioxide laser conization treatment for high-grade lesions of the cervix uteri, and thus to refine intervals for follow-up. METHODS: The study population comprised all women treated for cervical intraepithelial neoplasia grade II-III over a 10-year period (1983-1992). All women who resided within the county for the entire follow-up period were followed for residual or recurrent disease, verified histologically until the closure date of January 31, 1996. The cumulative incidence of recurrent disease was assessed by survival analyses, and logistic regression was used to predict clinical features at initial treatment that were associated with the risk of residual or recurrent disease. RESULTS: Only 19 of 1081 women (1.8%) were lost to follow-up. Residual disease was diagnosed in 20 (1.9%) study participants. The cumulative incidence of recurrent disease was extremely low, increasing nearly linearly with an annual incidence of three per 1000 woman-years observed. Involved resection margins were associated significantly with both residual disease (crude odds ratio [OR] 18.1; 95% confidence interval [CI] 5.2, 64.0) and recurrent disease (adjusted OR 3.0; 95% CI 1.2, 7.5) when compared with disease-free resection margins as reference. CONCLUSION: We recommend a differential follow-up interval depending upon the histologic evaluation of cone margins. If there is no residual disease, women who have free resection margins should return at a 3-year interval for follow-up. Women who have disease extended to the cone margins are recommended Papanicolaou smears at annual intervals through the fourth postoperative year before returning at a 3-year interval as practiced in the general screening program.

Adolescent↗
PubMed1997

Comparison of light microscopy, in situ hybridization and polymerase chain reaction for detection of human papillomavirus in histological tissue of cervical intraepithelial neoplasia.

The aims of the study were to estimate the prevalence of HPV infection in patients treated for high grade lesions of the cervix uteri (HG CIN), and to evaluate the validity of the histological criteria used for detection of HPV infection. The study comprised 203 women treated for HG CIN by laser conization. Forty-three preoperative biopsies and 160 cone specimens were examined for HPV infection using light microscopy (LM), in situ hybridization (ISH), and polymerase chain reaction (PCR). ISH was performed using commercial biotinylated probes for HPV types 6/11, 16/18, and 31/33/35 (Vira-Type In Situ Kits, Digene Diagnostics, Silver Spring, MD). HPV-PCR was performed with the L1 consensus primers Gp5+/6+. The prevalence of HPV detected by LM was 70%; by ISH 48% and by PCR 83%. Using PCR as the gold standard, LM had a sensitivity of 0.71 and specificity of 0.41. The corresponding results for ISH were 0.51 and 0.65, respectively. The positive predictive value for both tests reached over 80%, but the negative predictive value was less than 25%. This study demonstrates that morphology is an unspecific method of identifying HPV infections. LM identification of HPV infections has no clinical implications. Our analyses comparing test performances of LM, ISH and PCR show that PCR is the superior method.

Adult↗
PubMed1996

Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses.

OBJECTIVE: To evaluate the ability of a risk of malignancy index (RMI), based on a serum CA125 level, ultrasound findings and menopausal status, to discriminate a benign from a malignant pelvic mass and to discriminate early stage (Figo Stage I) from Stages II, III and IV of ovarian cancer. DESIGN: A prospective study. SETTING: Department of Gynaecology, Trondheim University Hospital, Trondheim, Norway. PARTICIPANTS: One hundred and seventy-three women, 30 years or older, consecutively admitted between February 1992 and February 1994 for primary laparotomy of a pelvic mass. MAIN OUTCOME MEASURES: The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and menopausal status, separately and combined into the RMI, to diagnose ovarian cancer. RESULTS: The RMI was more accurate than any individual criterion in diagnosing cancer. Using a RMI cut-off level of 200 to indicate malignancy, the RMI derived from this dataset gave a sensitivity of 80%, specificity of 92% and positive predictive value of 83%. Applying RMI criteria developed by others, the following test performance was found: sensitivity 71%, specificity 96% and positive predictive value 89%. For the Stages II, III and IV of ovarian cancer the sensitivity increased to approximately 90% without any substantial loss in specificity. CONCLUSIONS: The risk of malignancy index is able to correctly discriminate between malignant and benign pelvic masses. It is a scoring system which can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery at an oncological unit.

Adult↗
PubMed1996

Flexible tantalum stents for the treatment of iliac artery lesions: long-term patency, complications, and risk factors.

PURPOSE: To evaluate the long-term success of tantalum stents implanted in iliac artery lesions and to determine potential predictive factors of early and late stent failure. MATERIALS AND METHODS: In 289 patients, flexible tantalum stents were implanted in iliac artery stenoses (n - 223) or occlusions (n - 66). Early and late stent failures were evaluated at 1-79 months (mean, 23 months). Four risk factors were evaluated: lesion type (occlusion vs stenosis), lesion location (common vs external iliac artery), lesion length (< 4 vs > 4 cm), and quality of runoff (good vs poor). RESULTS: The frequency of early stent thrombosis was significantly (P < .001) higher in occlusions (15.2%) versus stenoses (2.7%), in external (12.8%) versus common (1.1%) iliac arteries, in long (16.7%) versus short (0.5%) lesions, and in poor (14.0%) versus good (2.1%) runoff. At multivariate analysis, runoff and location were influencing factors. Primary patency rates at 3 and 5 years were 85% and 70%, respectively, for all stents. Three-year patency rates were significantly higher in short (88%) versus long (63%) lesions and in stenoses (92%) versus occlusions (63%). At multivariate analysis, lesion length was the only predictive factor for 3-year stent patency. CONCLUSION: Stent implantation offers valuable long-term treatment for atherosclerotic iliac artery disease. Success can be predicted on the basis of risk factors.

Adult↗
PubMed1996

Looking out for family caregivers.

Nurses are regularly advised to become involved in community development initiatives, but what exactly does this entail and what are the precautions that should be considered? A 10-week, government sponsored, community-development program for family caregivers allowed nurses to offer education and support to six under-serviced areas of B.C. They offer a critique of the program and recommendations for the future.

Caregivers↗
PubMed1995

[Preoperative identification of malignancy among women with a pelvic mass. Evaluation of a risk index based on ultrasound findings. CA 125 in serum and menopausal status].

A risk of malignancy index (RMI) based on vaginal ultrasound, the tumour marker CA 125 level in serum, and menopausal status was calculated in 134 consecutive patients with a pelvic mass. 41 patients harboured a malignancy, while in 93 the condition was benign. The specificity according to the presence of a malignancy was 95% using the risk of malignancy index, compared with 78% when ultrasound was used alone, and 78% when CA 125 was used alone. The corresponding sensitivities were 73, 71 and 83% respectively. The majority of patients with a false negative index score had early stage ovarian cancer. Only one of the 21 patients with advanced ovarian cancer had a score below the limit of 200. The use of the risk malignancy index is a convenient method for pre-operative identification of cases of advanced ovarian cancer.

Adult↗
PubMed1995

Computer-aided morphometrical analysis of macroconidia in Fusarium sambucinum Fuckel sensu lato strains.

Forty-one strains of Fusarium sambucinum Fuckel sensu lato were classified on the basis of morphological data of the macroconidia obtained by automated microscopic image analysis. The classification factors were determined in six Fusarium strains of the section Discolor. The results show the relative homogeneity within the groups proposed by Nirenberg. A remarkable difference could be detected especially between the groups F. sambucinum, F. torulosum and F. sambucinum sensu lato on the one hand and F. spec nov. on the other.

Evaluation Studies as Topic↗
PubMed1995

Malignant fibrous histiocytoma of the uterus. Some immunohistochemical and ultrastructural observations.

Hysterectomy was performed in a 64-year-old woman because of a uterine malignant tumor which extensively involved both the endometrium and the myometrium. Histological examination revealed a malignant fibrous histiocytoma (MFH) of the pleomorphic-storiform type. The presence of epithelial or heterologous mesenchymal tumor components or cells of smooth muscle derivation was ruled out by immunohistochemistry and electron microscopy. The patient developed pulmonary metastases and died six months after surgery. MFH is a rare primary tumor of the uterus, but it should be considered in cases of malignant mesenchymal tumors without heterologous elements or signs of smooth muscle derivation.

Female↗
PubMed1995

Rehabilitation of the injured athlete.

The authors have presented basic guidelines and considerations for rehabilitation of the injured athlete. The use of various physical agents and therapeutic exercise in the rehabilitation of the injured athlete has been discussed. Clinical pathways for improving range of motion and muscle function and eliminating functional limitations and disability have also been presented. It should be remembered that rehabilitation of the injured athlete at any point in time may focus on any one or combination of these areas. The ultimate goal for rehabilitation of injured athletes is to return them to their prior level of sports activity. Athletes should be discharged from rehabilitation when they have achieved this goal or when no further improvement in their level of function can be expected. Individuals unable to return to their prior level of activity should be provided with alternate activities that they can continue to participate in to maintain an active lifestyle.

Adolescent↗