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Biomedical subjects

E Olsen

Publications and source records attributed to E Olsen.

At least 109 records · Page 6Linked to original sources

Demonstration and partial characterization of an atypical protein in the urine of a patient with primary amyloidosis.

A paraprotein has been isolated from the urine of a patient with primary amyloidosis. Immunologically it was classified as a free lambda light chain. The molecular weight was 22500 daltons. N-terminal amino acid analysis demonstrated homology with lambda IV variable subgroup in 19 of the first 20 amino acids. Extensive homology with lambda IV chains was demonstrated also in the hypervariable region of the light chain. An antiserum produced against the paraprotein was rendered idiotype-specific by absorption with pooled human light chains. This antiserum stained tissue specimen from the rectum and liver of the patient by the indirect immunofluorescence technique. This strongly indicates that the free lambda light chains that can be isolated from the urine are also deposited in the tissues as amyloid substance.

Amino Acid Sequence↗

Unique antigenic determinants (idiotypes) used as markers in a patient with macroglobulinemia and urticaria. Similar idiotypes demonstrated in the skin and on peripheral blood lymphocytes.

An antiserum was raised against a monoclonal IgMk macroglobulin isolated from serum of a patient with recurrent urticaria. The antiserum was made idiotype-specific through adequate absorptions. The anti-idiotype antiserum reacted only with the immunizing protein and its Fab fragments and not with other monoclonal proteins of IgM and IgA class or pooled IgG as assayed in an enzyme-linked immunosorbent assay. IgM antibodies with the same idiotype as the monoclonal IgM protein were detected in the dermal/epidermal junction area of diseased skin. The similar idiotypic determinants could also be demonstrated on membrane-bound molecules of peripheral blood B and T lymphocytes using the immunofluorescence methods.

Electrophoresis, Agar Gel↗

Oligoclonal immunoglobulins and smooth muscle antibodies in arthritic joints.

In twelve synovial fluid/serum pairs from patients with various types of seronegative polyarthritis, homogeneous gamma-bands by agarose gel electrophoresis were found in seven of the synovial fluids and in only one of the sera. In six of the fluids with gamma-bands, smooth muscle antibodies (SMA) were also present, usually in a titre identical to that in serum. In fluids with no gamma-bands, no SMA were detected. In forty synovial fluid/serum pairs from paitients with seropositive rheumatoid arthritis, no gamma-bands were detected in the synovial fluids, and SMA were present in only three pairs. Absorption and inhibition experiments did not give evidence that the SMA activity in seronegative polyarthritis was confined to the gamma-bands in the synovial fluids. The SMA activity in the fluids seemed to be directed against both actin and 'non-actin' muscular antigens. The association between locally produced oligoclonal immunoglobulins and possible locally produced SMA with differnet electrophoretic mobility suggests that in some of thes patients there is a local synovial production of oligoclonal antibodies with different specificities. Thus, even if the results may indicate a local virus infection in some arthritic joints, they may also be dur to an unspecific local stimulation of B cells or to a specific antigen stimulation combined with an unspecific co-activation of other antibody-producing cells.

Arthritis↗

Total artificial heart implantation in calves with pump on an angled port design.

The APP was employed in our 21st TAH calf and has now been implanted in a total of 11 animals. The APP has a dynamic stroke volume of 105 ml, an ejection fraction of 75%, and a peak flow of 14 L/min. The TAH features 2 APPs which have polysulfone cases and contain smooth, seam-free polyurethane sacs. Concavoconvex Bjork-Shiley valves are used. The pumps are pneumatically driven but may be easily converted to pusher-plate drive. A pneumatic drive console and an automatic control unit complete the system. The automatic control unit permits independent control of the right and left hearts as a function of left atrial and aortic pressure respectively. The average survival of the APP TAH calves has been 65 days. Hematologic study has revealed basically normal results with minimal elevation of serum hemoglobin and lactic acid dehydrogenase (LDH), indicative of a low level of hemolysis. Elelvation of central venous pressure (CVP) and total blood volume continue to be a problem with some TAH calves but not all. The APP has led to a dramatic increase in duration of survival and decrease in thromboembolism.

Animals↗

The relationship of health beliefs and a postcard reminder to influenza vaccination.

The relationship of certain health beliefs to influenza vaccination and the effect of a postcard reminder on vaccination rates was studied among 232 high-risk patients. In agreement with the Health Belief Model tested, the patients vaccinated believed influenza to be more serious, believed they were more susceptible to influenza, and believed the vaccine to be more efficacious than did patients not vaccinated. Those not vaccinated were less satisfied with their medical care and felt the vaccine was more expensive than those vaccinated. A postcard reminding patients of influenza vaccination was an effective way to increase the vaccination rate. Patients receiving the card had a 59.7 percent vaccination rate compared to a 30.0 percent rate among those not receiving the postcard. This study suggests that a reminder postcard is an effective means to promote influenza vaccination and that these beliefs are important determinants of vaccination behavior.

Attitude to Health↗

Congenital aortic valve disease with rupture of mitral chordae tendineae.

A new clinical entity is described in which free aortic regurgitation from congenital aortic valve disease caused rupture of the chordae to the anterior leaflet of the mitral valve in 7 men aged 45 to 63 years (mean 52 years); 2 of the patients also had rupture of chordae to the posterior leaflet. Comparing these patients with those with ruptured mitral chordae in association with rheumatic heart disease and patients with spontaneous chordal rupture, differences were evident. No patient had a history of rheumatic fever and none had active infection. The typical clinical presentation was of acute mitral regurgitation into a small left atrium, with severe pulmonary oedema which was often resistant to medical treatment. The cause of chordal rupture in these patients was in part the result of progressive left ventricular dilatation, of direct trauma to the anterior cusp of the mitral valve, and possibly of a genetic factor. The anatomical features of both aortic and mitral valves are described, and in 3 histology of the mitral valve was available; 2 had myxomatous degeneration similar to that seen in patients with spontaneous chordal rupture, and in 1 there was degeneration of collagen tissue. All patients were treated surgically but the mortality was high (5 out of 7,70%). Early operation with replacement of the aortic and mitral valves is recommended if this high mortality is to be reduced.

Aortic Valve↗

Problems with radical corrective surgery after ascending aorta to right pulmonary artery shunt (Waterston's anastomosis) for cyanotic congenital heart disease.

Forty-five patients with Fallot's tetralogy or pulmonary atresia had total correction 2 to 6 years after palliative ascending aorta to right pulmonary artery anastomosis (Waterston's shunt). The operative mortality for total correction is increased in this group. Patients shown subsequently to have had a good anatomical correction died unexpectedly with high central pulmonary artery pressure, falling arterial PO2, low cardiac output, and progressive acidosis. The cause of this syndrome was difficult to determine. Histological examination of the lungs showed that severe pulmonary arteriolar thickening was not present. The factors apparently predisposing to these postoperative difficulties were kinking of the right pulmonary artery and/or lone perfusion of the right lung, remaining uncorrected for several years, in patients with pulmonary atresia or with Fallot's tetralogy with a shunt performed under the age of 3 years. In survivors, stenosis of the right pulmonary artery frequently occurred but was rarely severe. In view of these difficulties, early haemodynamic and angiocardiographic assessment is recommended in all patients with aorta to right pulmonary artery anastomosis, irrespective of the clinical result, in order to delineate the central pulmonary artery anatomy and assess perfusion of each lung; if kinking of the right pulmonary artery and inadequate perfusion of the central pulmonary arteries and left lung are demonstrated, early radical corrective surgery is recommended.

Adolescent↗