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Biomedical subjects

E Jensen

Publications and source records attributed to E Jensen.

At least 37 records · Page 2Linked to original sources

[Eosinophilic fasciitis (Shulman syndrome)].

We report on a 35-year-old female with eosinophilic fasciitis (Shulman's syndrome). The characteristic features of this disease are scleroderma-like skin indurations, predominantly on the extremities, with joint contractures and intermittent blood eosinophilia. Histologic findings include fibrosis of muscle fascia and eosinophilic infiltration. Systemic corticosteroid therapy usually results in remission of symptoms. In this case refractory to systemic corticosteroids, we report for the fist time a successful therapy using cyclophosphamide.

Adult↗

Increased levels of S-100 protein after cardiac surgery with cardiopulmonary bypass and general surgery in children.

The aim of this study was to evaluate changes in concentrations of the neurospecific protein S-100 in relation to cardiac surgery with cardiopulmonary bypass (CPB) and noncardiac general surgery in children below 3 years of age. Seventeen children underwent surgery for congenital heart disease and all survived without clinical signs of neurological complications. Samples for plasma concentrations of S-100 in these patients were taken on three occasions in connection with surgery: before the start of surgery, after CPB and finally 16-20 h after CPB. In the noncardiac group of 31 children, S-100 concentrations were measured on two occasions: before surgery and during surgery. In both groups, a significant increase in S-100 concentrations was observed during surgery, although the increase in the CPB group was significantly higher than in the noncardiac group. The CPB group included four children with Down's syndrome who had higher mean S-100 concentrations on all sampling occasions compared to the remaining patients. The peak S-100 concentrations after cardiac surgery were related to the duration of CPB, the time from the termination of CPB to the first post-CPB sample, as well as mean arterial pressure and cerebral arteriovenous lactate difference during rewarming. All the children studied (Down's patients excluded) had age-dependent plasma concentrations of S-100 measured before surgery. It can be concluded that CPB initiates a marked but transient release of S-100 into the systemic circulation during open heart surgery in children who are not developing clinical signs of neurological sequelae.

Cardiac Surgical Procedures↗

Determination of polychlorinated biphenyls in human blood by solid-phase extraction including on-column lipid decomposition.

A method for the isolation of polychlorinated biphenyls (PCBs) from human blood using solid-phase extraction (SPE) has been developed. The procedure incorporates decomposition of lipids by concentrated sulphuric acid directly on the SPE column. Conditions for transferring PCBs onto the SPE column and washing the decomposed blood components from the SPE column were optimised. After clean-up the extracts were analysed using gas chromatography with electron capture detection. An average recovery of PCBs from spiked blood samples was about 78+/-8% and an average precision was about 109+/-7%. Quantitation has been done using four internal standards and calibration curves based on five concentration levels. Low procedural blanks made it possible to determine PCBs in blood quantitatively at a level down to 2-10 pg g(-1). The integrated method for blood is fast, less laborious than methods using liquid-liquid extraction and has a low consumption of organic solvents.

Adsorption↗

Evaluation of small intestine submucosa and acellular dermis as diaphragmatic prostheses.

BACKGROUND/PURPOSE: The repair of large congenital diaphragmatic defects in the neonate continues to be a challenge. Polytetrafluoroethylene (PTFE) is the synthetic material most widely used for reconstruction in instances of partial and complete diaphragmatic agenesis. Recurrent hernia is a frequent complication, because this material does not grow with the infant. This study evaluates two novel materials; small intestine submucosa (SIS; Cook Biotech, Lafayette, IN), and acellular dermis (AlloDerm; Lifecell Corp, The Woodland, TX) for diaphragm reconstruction in growing animals. METHODS: Sprague-Dawley rats (100 g, n = 87) were anesthetized and underwent laparotomy. The control group (n = 18) underwent a sham laparotomy with a left subcostal incision and closure. The other two groups underwent central excision of the left hemidiaphragm (50% loss) and reconstruction with either a SIS (n = 35) or AlloDerm (n = 19) patch sutured circumferentially with 6-0 prolene. Seventy-two animals survived the operation, and were killed at five separate time intervals (2 weeks, 1, 2, 3, and 4 months). Chest radiographs were performed monthly and before death. Radiographs were reviewed in a blinded fashion by two observers as were the necropsies, and rib deformity was noted if present. Histological examination of the diaphragm patch was performed in each animal. RESULTS: There was no evidence of rib deformity noted on gross examination at necropsy or on chest radiograph in either experimental group. At necropsy, all patches were intact without hernia, eventration, or contraction. Histology findings initially showed acute and chronic inflammatory changes in both patch materials that lessened at the 2-month time interval. Both prosthetic patches began to thin at 3 months and was most prominent in the SIS rats. At 4 months, both SIS and AlloDerm remained viable without evidence of necrosis. Each patch showed evidence of fibroblastic incorporation and small capillary ingrowth. These changes were more prominent in the AlloDerm group. There was no evidence of skeletal muscle ingrowth. CONCLUSIONS: These data indicate SIS and AlloDerm may be useful materials for prosthetic repair in instances of partial or total agenesis of the diaphragm. Further investigation in a large animal model over a longer duration is indicated.

Animals↗

Concentrations of plasma methylmalonic acid in 80-year-olds show only weak relation to psychological performance.

Most studies of the relation between psychological performance in the elderly and deficiencies of cobalamin and folate have used methods that determine the blood concentrations of these vitamins, which might not reflect the vitamin status in the tissues. Recently, two new markers, plasma homocysteine and methylmalonic acid, have attracted growing interest since they are considered to reflect the status of cobalamins and folates in the tissues. In a previous study, we noted a strong association between five parameters of well-being and lower concentrations of plasma homocysteine. In the present study, we have extended these observations by determination of plasma methylmalonic acid in the same healthy elderly population. In the present study, 18 out of 100 subjects had increased plasma methylmalonic acid and in 7 of these subjects, the concentrations of serum cobalamin, blood folate, plasma homocysteine and serum creatinine were within normal limits. The relation between plasma methylmalonic acid concentrations and concentrations of serum cobalamin and blood folates and five parameters of well-being were investigated. Concentrations of plasma methylmalonic acid were only weakly associated with the concentrations of serum cobalamin and lower scores on the logical reasoning test. The present study clearly shows that the levels of plasma methylmalonic acid show a much lesser association with the parameters of well-being than did plasma homocysteine.

Aged↗

Bannayan-Zonana syndrome: a rare autosomal dominant syndrome with multiple lipomas and hemangiomas: a case report and review of literature.

BACKGROUND: Bannayan-Zonana syndrome is a rare hamartomatous disorder, characterized by macrocephaly, multiple lipomas, and hemangiomas. Inheritance is by autosomal dominant transmission with few reported sporadic cases. Male predominance is also reported. METHODS: We describe a patient who presented with multiple subcutaneous lipomas, mild macrocephaly, and an extradural spinal hemangioma. Other affected family members and 24 other previously reported cases are discussed. RESULTS: Spinal hemangiomas have not been described previously with this syndrome. The patient also had a "malignant bone tumor" removed from his humerus 20 years ago. Two of the patient's siblings also had lymphoma, which is an unusual accompaniment not reported previously. Only the male members in the family showed multiple subcutaneous lipomas. CONCLUSION: Some patients with Bannayan-Zonana syndrome may have hamartomatous lesions producing cord compression or intracerebral hemorrhage, or they may rarely have other malignant tumors; therefore it is important that neurosurgeons are aware of the entity. The early diagnosis of BZS is also important for genetic counseling.

Adult↗

Insomnia in an 80-year-old population: relationship to medical, psychological and social factors.

In this study, insomnia in 80-year-olds was related to medical, psychological and social factors. The data were based on examinations every year in people aged between 80 and 89 years. Of 333 people living in the city of Lund and born in 1908, 67% participated. Increased severity of insomnia was significantly associated with use of diuretics, other cardiovascular drugs, hypnotics and laxatives, and with nervousness, difficulty relaxing, anorexia, nausea, constipation, backache, feeling cold, sweating, loss of weight, dizziness, depression, general fatigue, exhaustion, angina pectoris, cardiac insufficiency, worsened objective and subjective health, presence of negative T-waves on ECG, anxiety, total life satisfaction, neuroticism, disbelief in a just world, feeling lonely and lower survival rates. Thus insomnia has widespread associations with different aspects of life in 80-year-olds.

Aged↗

Metastatic adenocarcinoma arising in a congenital foregut cyst of the esophagus: a case report with review of the literature.

Benign tumors and cysts of the esophagus are rare, and malignant transformation of esophageal cysts is even more rare. In this article, we report on the first case to our knowledge of a patient presenting with metastatic adenocarcinoma arising in a congenital foregut cyst of the esophagus. A 37-year-old woman had multiple cysts along the aerodigestive tract and diffuse soft tissue metastases. Endoscopic biopsies of a mediastinal mass revealed an enteric cyst with a spectrum of columnar epithelium ranging from benign through adenomatous to frankly malignant. There was only transient response to radiotherapy and chemotherapy. Only three other cases of carcinoma arising from esophageal duplication foregut cysts have been reported, and none of these were metastatic. Given the rarity of malignant transformation within an esophageal cyst, prophylactic excision of known esophageal cysts is not warranted. However, biopsy of the cyst may be useful to exclude the possibility of malignancy, particularly if the onset of symptoms has been recent.

Adenocarcinoma↗

Blood pressure in relation to medical, psychological and social variables in a population of 80-year-olds. Survival during 6 years.

OBJECTIVES: To relate elevated blood pressure in 80-year-olds to symptoms, life satisfaction and survival. DESIGN: Examinations of medical, psychological and social factors every year between 80 and 86 years of age. SETTING: Primary health care in the city of Lund in southern Sweden. SUBJECTS: Three-hundred and thirty-three persons living in the city of Lund and born in 1908. Participation rate was 67%. INTERVENTION: Abnormal findings were further examined and treated. MAIN OUTCOME MEASURES: Symptoms, blood pressure, laboratory values, psychological factors, cognition, living conditions, and survival. RESULTS: Hypertension according to the definition used was found in 70%. Women were over-represented (P < 0.05). Amongst persons with alleged hypertension, diuretics (P < 0.001) and 'other cardiovascular drugs' (P < 0.001) were more often used. Analgesics were more often used amongst assessed hypertensives (P < 0.05). Those with assessed hypertension scored better in testing of cognition compared to nonhypertensives (P < 0.05), and less often lived in institutions (P < 0.001). Assessed hypertensives had a better survival than alleged hypertensives during the following 7 years (P < 0.01). CONCLUSIONS: Eighty-year-olds with assessed hypertension in the consulting room showed fewer symptoms and had a better cognition and survival than alleged hypertensives (those with a history of hypertension).

Aged↗

Weight gain during pregnancy does not influence the spread of spinal analgesia in the term parturient.

BACKGROUND: It is still controversial whether the spread of spinal anaesthesia in pregnancy is influenced by particular physique. Investigation was based on a clinical observation that parturients with a pronounced "pregnant" physique, e.g. generalised oedema and heavy abdomen, tended to develop more cephalad sensory blockades than parturients without these physical signs. Using weight gain during pregnancy as a measure for the physique at term, we aimed to determine whether this parameter influences the distribution of analgesia after subarachnoidal injection of plain bupivacaine. METHODS: Thirty women presenting for elective Caesarean section were studied. All the women received 13.5 mg plain bupivacaine via subarachnoid injection at the L2-3 interspace. Thirty minutes after the injection, while the women were in the supine position with a left lateral tilt on a horizontal operating table, the maximum cephalad extent of sensory analgesia (loss of sensation to sharpness of pinprick) was determined. RESULTS: Neither weight gain during pregnancy (6-22 kg, range), height (152-185 cm), weight (56-98 kg) nor body-mass index (20.2-31.8 kg/m2) correlated with the cephalad spread of sensory blockade. CONCLUSION: In parturients, weight gain during pregnancy, height, weight and body-mass index did not influence the extent of sensory analgesia after subarachnoidal administration of plain bupivacaine.

Analgesia, Obstetrical↗

Impact of autotransfusion after coronary artery bypass grafting on oxygen transport.

BACKGROUND: Autotransfusion of shed mediastinal blood after coronary artery bypass grafting (CABG) has been shown to reduce the requirement for allogeneic blood. We have previously demonstrated in non-randomized studies that the oxygen capacity of shed mediastinal blood is similar to the patient's circulating blood and better than stored allogeneic blood. Therefore, we wanted to examine the influence of autotransfusion of shed mediastinal blood on oxygen transport capacity in patients undergoing CABG. METHODS: A prospective, randomized, controlled study involving 120 patients having elective, uncomplicated CABG was performed. The autotransfusion group received transfusion of shed mediastinal blood for 18 h. Both groups received allogeneic red cells if their hemoglobin concentration decreased below 5 mmol/L. Red blood cell 2,3-diphosphoglycerate (2,3-DPG) was measured preoperatively and at intervals up to the hospital discharged. Hemodynamic measurements as well as blood gas and hemoglobin measurements from samples of arterial and mixed venous blood were used for calculation of oxygen transport capacity. RESULTS: During the autotransfusion period only 2 patients (4%) in the autotransfusion group required allogeneic blood compared to 11 patients (20%) in the control group. The 2,3-DPG levels in the autotransfusion group were unchanged before and after autotransfusion (4.4 vs. 4.3 mumol/ml erythrocyte). In the control group, 2,3-DPG levels decreased from 4.3 to 3.9 mumol/ml erythrocyte during the same period. There were no differences in the other measured parameters for oxygen transport capacity between the groups. CONCLUSION: Autotransfusion of shed mediastinal blood conserves the 2,3-DPG level of the red blood cells, while transfusion of stored blood leads to a decrease in 2,3-DPG levels. Autotransfusion had no effect on hemodynamic parameters, oxygen delivery or oxygen extraction.

2,3-Diphosphoglycerate↗

Characterization and cytokine stimulating activities of heteroglycans from Tremella fuciformis.

Three heteroglycans, T1a, T1b, and T1c, have been isolated from the body of Tremella fuciformis Berk. They are composed of mannose (Man), xylose (Xyl), glucose (Glc), fucose (Fuc), and glucuronic acid (GlcA). According to methylation analysis and partial acidic hydrolysis the main chains of T1a, T1b, and T1c consisted of (1-->3)-linked Man, which was branched at the 2, 4, or 6 positions. The branching points were linked with nonreducing terminal GIcA-residues or (1-->6)-linked glucan-chains. Molecular weights of the three heteroglycans are 53,000, 18,000, and 12,000 D respectively, but they undergo self-aggregation in water. T1a-T1c induce human monocytes to produce interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF) in vitro. Acidic hydrolysate fractions of T1a (T1a-1, 2, 3, 4, 5) with molecular weight from 53,000 to 1,000 D, also induce human monocytes to produce IL-6 as efficient as T1a.

Carbohydrates↗

Good clinical research practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents.

Based on an international consensus conference held in Copenhagen in the autumn of 1994, a set of guidelines for Good Clinical Research Practice (GCRP) in pharmacodynamic studies of neuromuscular blocking agents are presented. The guidelines are intended to be a help for people working in this research field, and it is hoped that the guidelines will assist researchers, editors, and drug companies to enhance the quality of their pharmacodynamic studies of neuromuscular blocking agents.

Clinical Trials as Topic↗