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Biomedical subjects

E Pedersen

Publications and source records attributed to E Pedersen.

At least 37 records · Page 2Linked to original sources

Experimental electrical stimulation of the bladder using a new device.

Repeated bladder contractions were evoked during a six month period in three unanaesthetized female minipigs by using unipolar carbon fiber electrodes embedded in the bladder wall adjacent to the ureterovesical junction. In contrast to bipolar and direct bladder muscle stimulation unipolar electrodes at each ureterovesical junction evoked bladder pressure increase similar to those produced in previous investigations in dogs. Sacral nerve stimulation of S2 evoked bladder contraction at a minimal current. Microscopic examination revealed no cellular reactions to the carbon fibers but a subcutaneous reaction to the receivers was seen and was thought to be due to mechanical irritation. The clinical implication of the findings is discussed.

Animals

Interferon induction, 2'-5' oligo A synthetase and lymphocyte subpopulations in out-patients with multiple sclerosis in a longitudinal study.

Nine patients with multiple sclerosis, four with relapsing-remitting disease, and five with chronic progressive disease, together with eight healthy control, were followed for nearly a year with monthly clinical and laboratory examinations. Alpha- and gamma-interferon was induced in lymphocytes with different viruses and PHA, no differences were found between healthy controls and multiple sclerosis patients. The alpha- and gamma-interferon induced enzyme 2'-5' oligo A synthetase in lymphocytes was found to have a tendency to be lower in multiple sclerosis patients than in healthy controls. When medians of ratios of helper/suppressor blood lymphocytes in multiple sclerosis patients were compared with healthy controls, the same results were found, although higher values of ratios were found among the patients and the highest value was found in a patient with chronic progressive disease. No correlation to disease activity could be found in interferon inductions, 2'-5' oligo A synthetase concentrations and ratios of OKT4/OKT8. In particular no change in ratio was found in relation to five exacerbations taking place in the four multiple sclerosis patients with acute relapses.

2',5'-Oligoadenylate Synthetase

Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity.

The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely detrusor contractions preceded by flexor spasms, was seen in only nine patients. The anal sphincter activity was generally increased in relation to detrusor contractions in patients with spinal lesions but decreased in patients with cerebral lesions. The treatment of flexor spasms and uninhibited detrusor contractions is discussed on the basis of this mutual relationship.

Adolescent

Oral hygiene instruction in general dental practice by means of self-teaching manuals.

The present study evaluates the applicability of delivering oral hygiene instruction to patients in general dental practice by means of self-educational programs. Patients (55) seeking dental treatment in 3 general dental practices in Denmark were divided at random into a conventional professional instruction group (C) in which each individual received personal instruction by the dentist and a self-instruction group (S), in which the patients were given self-educational programs. In order to evaluate the effect of the 2 types of instruction, the presence or absence of dento-gingival plaque and gingival bleeding by probing was recorded prior to the instruction and after 3 and 6 months. The patient of the self-instruction group (S) answered a questionnaire about the treatment 1 week after they had received the self-instruction program. An identical improvement in oral hygiene and gingival health was recorded in both treatment groups after 3 and 6 months. This finding indicates, that the self-educational programs were as effective in changing the oral hygiene habits of the patients as was personal oral hygiene instruction by dental personnel. The answers of the patients to the post-treatment questionnaire reflected a favorable attitude towards the use of self-educational programs.

Adult

The effect of the GABA-agonist, progabide, on stretch and flexor reflexes and on voluntary power in spastic patients.

The action of the GABA-receptor agonist, progabide , was investigated in a double-blind study with cross-over to placebo. The stretch and flexor reflexes and voluntary power were measured in 16 patients with spasticity. 2-week treatment periods were used; the median daily oral dosage of progabide was 24.3 mg/kg. The Achilles tendon (T) reflex was significantly suppressed whereas the Hoffmann (H) reflex remained unchanged: the T/H ratio was thus reduced. Hmax /M (direct motor)max ratio and the vibration-induced suppression of the T- and H-reflexes were unchanged. These findings indicate an effect of progabide on the spindles or on the controlling fusimotor system (probably acting on spinal interneurons), whereas influence on presynaptic inhibition and alpha-motoneuron excitability is unlikely. The flexor reflex threshold was increased during progabide treatment and latency at threshold decreased towards normal latency. This indicates some influence of progabide on flexor reflex activity attributed to reinforcement of action of GABAergic interneurons at the spinal level. Isokinetic measurement of voluntary power of knee extension revealed particularly good progress for the fastest movements during progabide treatment, whereas isometric measurement of sustained handgrip remained unchanged, probably reflecting a reduction of spasticity without reduction of voluntary power in non-spastic muscles.

Achilles Tendon

The clinical effect of the GABA-agonist, progabide, on spasticity.

In a double-blind cross-over trial of two 2-week periods, the clinical effect of progabide was compared to placebo. 16 patients with spasticity in a stationary phase completed the trial. 14 had multiple sclerosis, 2 hereditary spastic paraplegia. 5 were female and 11 male. The median age was 45.5 years (range 30-62 years). The median daily dosage of progabide was 24.3 mg/kg (range 14.3-32.7 mg/kg). During progabide treatment, there was a reduction in spastic hypertonia (P less than 0.01), a suppression of tendon reflexes (patellar) (P less than 0.01), and a reduction in the frequency of flexor spasms (P less than 0.05). No significant changes in voluntary power were registered. The global clinical impression revealed a therapeutic effect in 87% of the patients (95% confidence limits 61-98%). The improvement was judged as medium or important in 50% of the patients (95% confidence limits 23-77%). No side-effects or laboratory abnormalities were seen.

Adult

Neurourodynamic evaluation of voiding dysfunction in multiple sclerosis.

During a period of 2 1/2 years, 198 patients with definite MS were admitted to our neurological department. 88 were investigated neurourodynamically because of distinct voiding dysfunction. 73 patients showed detrusor hyperreflexia, 14 detrusor hyporeflexia or areflexia and one had normal findings. There was no obvious correlation between the occurrence of the symptoms, irritative and obstructive, and the allocation of the patients into different cystometric groups. The predominant symptom was urge incontinence. More men had been treated or were permanently treated with intravesical catheter, but mean residual urine did not show any sex difference. In 36 patients with detrusor hyperreflexia, dyssynergia was observed and was classified into 3 groups. In the group with clonic sphincter EMG activity during voiding, 5 of the patients had dyssynergia because of flexor spasms transmitted to the sphincter. In patients with dyssynergia characterized by increased sphincter activity throughout detrusor contraction, a large mean residual urine was noted, but dyssynergia did not always prevent acceptable emptying. A low rate of complication in the upper urinary tract was observed. Treatment is discussed.

Adult

Estimation of levels of IgG to multiple sclerosis specific brain antigens in the cerebrospinal fluid of MS patients.

The binding of partially purified multiple sclerosis (MS) specific brain antigens (MSG2) and of the corresponding antigens of non-MS brains (KG2) to cerebrospinal fluid IgG of patients with MS and other neurological diseases was assayed employing sandwich enzyme linked immunosorbent assay (ELISA). Assay of the antigen-antibody binding revealed that the concentration of MSG2 required for the optimum binding to IgG in the undiluted MS CSFs was lower than that of KG2 in all cases. The index for IgG binding capacity of an antigen (IgBC) was expressed as a ratio of the optical density of the enzymic products in ELISA at the optimal antigen-antibody binding to the lowest concentration of the antigen required for the optimal binding. The IgBC of MSG2 was found to be linearly correlated with the IgG concentration in the CSF of MS patients. These results indicate that IgG with specificity to MSG2 may be present in the CSF of MS patients.

Adult

The acute effect of the GABA-agonist, THIP, on proprioceptive and flexor reflexes in spastic patients.

THIP (Lu 2-030) is pharmacologically a specific and potent GABA-receptor-agonist which in animal studies depresses monosynaptic and, to a smaller extent, polysynaptic spinal reflexes. 5 spastic patients were investigated by means of neurophysiological tests comparing the acute effect of a single oral dose of THIP (15-25 mg) to "the test situation without drug administration" with an interval of 2 days. The neurophysiological tests included quantitative studies of proprioceptive reflexes (T-reflex, vibratory inhibition of the T-reflex, resistance to passive movement of a spastic muscle and clonus) and of the flexor reflex (threshold and latency). The voluntary power was measured by a static technique. THIP clearly reduced the monosynaptic T-reflex and reinforced vibratory inhibition of the IA monosynaptic pathway. The flexor reflex threshold was slightly increased during THIP administration, but the changes were not significant. Flexor reflex latency, resistance to passive movement, clonus and voluntary power were unchanged.

Adult

The effect of the GABA-agonist, progabide, on benign essential tremor. A controlled clinical trial.

In a double-blind crossover trial of two 2-week treatment periods, to which 18 patients with benign essential tremor were admitted, there was no statistically significant different between progabide 11.4-20.2 mg/kg X day (median 14.2 mg/kg X day) and placebo in tremor score and tremor amplitude. However, there was a definite placebo and period effect with reduction of tremor score and tremor amplitude during the second period of treatment compared to the first period of treatment, regardless of the treatment regime. This was presumably a result of prolonged treatment and habituation to the test situation and not an effect of the active drug. No side-effects were registered and no laboratory abnormalities were seen.

Adult

Immunological parameters in multiple sclerosis patients with special reference to the herpes virus group.

A group of multiple sclerosis (MS) patients (n = 50), most of them in a stable or slightly progressive phase was studied together with a group of neurological control (NC) patients with CNS lesions (n = 38) comparable in age and disability and an age matched group of healthy persons (n = 46). On stimulation of lymphocytes with herpes simplex virus (HSV), cytomegalovirus (CMV) and varicella zoster virus (VZV) a significantly lower interferon production was found in MS patients compared with the NC patients and the healthy controls; when the NC patients were compared with the healthy controls a significantly lower production was also found. The lymphocyte transformation reaction in seropositive MS patients was significantly lower than that seen in the seropositive control groups when HSV was used as antigen. Lower responses, although insignificant, were found when CMV and VZV were used as antigens. There were no differences among the three groups when Con A was used as mitogen in three different concentrations. Likewise spontaneous lymphocyte transformations were equal. The lower interferon production and the lower transformation reactions in MS patients could not be correlated to age, duration of disease, disability, disease activity or impairment. No significant differences in humoral immunity to HSV, CMV and VZV were found in the three groups, a few MS patients were 'true' seronegative to HSV type 1 and 2. Suppressor cell activity induced by Con A and measles virus was comparable in the three groups, although a few MS patients in an active relapsing phase were found to have low suppressor cell activity. Natural killer cell activity against two different cell lines was found equal in the three groups, and there was no difference in the potentiating effect of interferon.

Adult

Familial progressive myoclonic epilepsy. A clinical, genetical, biochemical and patho-anatomical study of a family with a 6-year follow-up.

Six siblings, including 4 cases of myoclonic epilepsy, their parents and 2 grandmothers were subjected to systematic investigation, and the patients were followed-up. The genetic studies revealed in the mother's family a patient with Lafora bodies demonstrated at autopsy. No chromosome abnormalities were found nor any linkage to the HLA system. The affected family members were characterized biochemically by an increased excretion of total glycosaminoglycans and/or an abnormal electrophoretic pattern of urinary glycosaminoglycans with an increased proportion of low-sulfated glycosaminoglycans. In the healthy family members this pattern of electrophoresis could also be demonstrated in the father and the paternal grandmother. Based on the biochemical results and the genetic studies it is suggested that the family members with progressive familial myoclonic epilepsy present a combination of at least 2 hereditary defects. The course of the disease has been relatively benign and treatment with sodium valproate, baclofen and clonazepam has shown quite satisfying results. In consequence of the biochemical findings combined treatment with A and E vitamins has been initiated.

Adolescent

Anal sphincter responses after perianal electrical stimulation.

By perianal electrical stimulation and EMG recording from the external anal sphincter three responses were found with latencies of 2-8, 13-18 and 30-60 ms, respectively. The two first responses were recorded in most cases. They were characterised by constant latency and uniform pattern, were not fatigued by repeated stimulation, were most dependent on placement of stimulating and recording electrodes, and always had a higher threshold than the third response. The third response was constantly present in normal subjects. It had the longest EMG response and the latency decreased with increasing stimulation to a minimum of 30-60 ms. This response represented the clinical observable spinal reflex, "the classical anal reflex". The latencies of the two first responses were so short that they probably do not represent spinal reflexes. This was further supported by the effect of epidural anaesthesia which left the first responses unaffected but abolished the classical anal reflex. The origin of the two first responses is discussed and models involving antidromal impulse propagation in the efferent fibre as the afferent limbs of the responses are proposed.

Anal Canal