Biomedical subjects

G Jacobsen

Publications and source records attributed to G Jacobsen.

At least 91 records · Page 5Linked to original sources

PubMed1994

Herpes simplex encephalitis in the temporal cortex and limbic system after trigeminal nerve inoculation.

Herpes simplex virus type 1 causes an encephalitis in humans that is primarily restricted to the temporal lobe and limbic system. The distribution of lesions suggests that virus enters the brain from a single site and then spreads transneuronally to infect connected structures. Two obvious sites of potential viral entry are the olfactory and trigeminal nerves. Trigeminal nerve entry is more likely because it innervates the oral cavity, a common site of initial infection, and the trigeminal ganglion is the most common site of viral latency. In previous reports, however, experimental trigeminal nerve infection has never led to the pattern of disease observed in humans. By directly inoculating virus into the murine tooth pulp, the mandibular division of the trigeminal nerve was selectively infected. This division, which innervates the oral cavity, is the one most commonly infected in humans. Intrapulp inoculation led to an encephalitis primarily affecting the temporal cortex and limbic system. Thus, spread via the trigeminal nerve provides an explanation for the distribution of herpes simplex virus observed in the human encephalitis.

Animals↗

PubMed1994

Body composition and gonadal steroids in older white and black women.

Obesity offers protection against osteoporosis in older women. The mechanisms are not well understood, but relate in part to increased aromatization of adrenal androgens to estrone in peripheral fat and muscle tissue. Two hundred and one white and 77 black women previously reported to be free of skeletal disease and to have normal bone mass had measurements of total body bone mineral (TBBM), fat mass (TBFM), and lean mass (TBLM) performed by dual energy x-ray absorptiometry. Serum estrone, androstenedione, and dihydroepiandrostenedione sulfate were measured on the same day. Body weight, body mass index, TBFM, and TBLM were all significantly higher in the black women. However, proportionately, there were no differences in body composition between the two groups. This suggests that the black women were not more obese despite their greater body mass index, and that future studies on the health impact of obesity in older black women should take this into consideration. Despite the greater TBFM and TBLM in the black women and no difference in serum androstenedione levels, the serum estrone level was not higher in the black women, and the higher bone mass in blacks was not related to serum estrone. In both ethnic groups, TBBM was significantly related to body weight (white, r = 0.80; black, r = 0.85; P < 0.001 for both). Both TBFM and TBLM were significantly related to TBBM in both ethnic groups. Serum estrone was significantly related to all measures of body mass in the white women, but to no measures of body mass in the black women, indicating apparent differences in the metabolism of estrone between older white and black women.

Adipose Tissue↗

PubMed1994

General practitioners' compliance with guidelines for antenatal care.

OBJECTIVE: To assess general practitioners' compliance with Norwegian guidelines for antenatal care issued in 1984 and to identify characteristics of physicians with low compliance. SETTING: Routine clinical practice in primary care. STUDY POPULATION: All women permanently residing in the county of Oppland who gave birth during a 12-month period 1988-89 and the general practitioners who provided their antenatal care. METHODS: The content of the care was assessed from nine procedures, the selection of which was based on a previous perinatal audit. A 'compliance score' was established and logistic regression analysis was used to estimate pregnant women's odds for a low score by characteristics of their care-providing GPs. RESULTS: GPs' compliance with the guidelines was lower for procedures which required recording of a clinical judgment. The odds for a low score increased significantly if the doctor was a male or worked in a single rather than a group practice. There was no association between compliance score and fetal outcome, or between compliance score and the effectiveness of antenatal care measured as the detection of major obstetric disorders. CONCLUSION: The gender specific differences in GPs' antenatal care performance were the same as those reported by others. These findings warrant further research.

Adolescent↗

PubMed1994

[Misconduct in medical research. A questionnaire survey among project leaders in health region 4].

During the period 1986-92, a questionnaire survey was conducted among research project administrators whose study protocols were assessed by the ethical committee for biomedical research in Health region 4 (Central Norway). The questions referred to the scientists' attitudes towards medical research ethics in general, and their views on the work of the committee. They were also asked to comment on seven statements about scientific fraud and misconduct. This paper presents data on misconduct from the 119 scientists who completed the questionnaire, i.e. 70 percent of the 159 recipients. Some 40 percent claimed that scientific fraud is a problem in Norway, but 46 percent maintained that it is less so than in other countries. More than every fourth researcher (27 percent) knew of one or more cases of scientific misconduct, 42 percent stated that their knowledge was not publicly known, 18 percent felt that they had been exposed to misconduct themselves. A majority (60 percent) stated that a better system is needed to investigate claims of scientific fraud. The authors discuss these findings in relation to the personal characteristics and scientific qualifications of the researchers, and the current knowledge about the extent of scientific fraud in medicine.

Attitude↗

PubMed1993

[Dishonesty in medical research. A questionnaire study among project administrators in Health Region 4].

During the period 1986-92, a questionnaire survey was conducted among research project administrators whose study protocols were assessed by the ethical committee for biomedical research in Health region 4 (Central Norway). The questions referred to the scientists' attitudes towards medical research ethics in general, and their views on the work of the committee. They were also asked to comment on seven statements about scientific fraud and misconduct. This paper presents data on misconduct from the 119 scientists who completed the questionnaire, i.e 70% of the 159 recipients. Some 40% claimed that scientific fraud is a problem in Norway, but 46% maintained that it is less so than in other countries. More than every fourth researcher (27%) knew of one or more cases of scientific misconduct, 42% stated that their knowledge was not publicly known. 18% felt that they had been exposed to misconduct themselves. A majority (60%) stated that a better system is needed to investigate claims of scientific fraud. The authors discuss these findings in relation to the personal characteristics and scientific qualifications of the researchers, and the current knowledge about the extent of scientific fraud in medicine.

Adult↗

PubMed1993

Routine ultrasonography in utero and subsequent growth during childhood.

The study was performed to investigate any associations between routine ultrasonography during pregnancy and subsequent growth during childhood. A follow-up was carried out of children born to women who took part in two randomized, controlled trials of ultrasonic screening during pregnancy. From a total of 2428 eligible children, 2140 (88%) were followed up with measurements of growth at Norwegian maternal and child health centers. The body weight and height were recorded at birth and at 3, 6 and 12 months of age; and subsequently at 2, 4 and 7 years of age. A repeated-measures analysis of growth was carried out, stratified by maternal smoking in a subsample of 1201 children. No significant differences between ultrasound-screened children, and their controls, were found in mean body weight, or height, at birth and at all the subsequent visits to the health centers. However, the repeated-measures analysis of variance in the subsample indicated that growth from birth to 7 years of age differed significantly (p = 0.02) between screened and control children of mothers who reported smoking at the first antenatal visit. We conclude that children who were routinely exposed to ultrasonography in utero showed no statistically significant differences in growth during childhood compared to control children.

Journal Article↗

PubMed1993

Mutants of Dictyostelium discoideum with defects in the regulation of discoidin I expression.

Discoidins are proteins, coded by a multigene family, which are regulated by extracellular factors during growth and development of Dictyostelium discoideum. In this paper we describe the isolation and characterization of mutants which misregulate the expression of the discoidin I subgroup. One mutant (III29) induces discoidin I during late growth phase but does not express it during development. Another mutant (VI41) has significantly reduced discoidin levels under all conditions tested, while two mutants (VI88 and X27) express discoidin early during exponential growth and accumulate more discoidin protein than the wild type. The defects are due to abnormal regulation of transcription in all mutants except VI41. Experiments in which mutants and wild type are mixed suggest that the mutant phenotypes are not caused by changes in extracellular signals. Since multiple members of the multigene family are affected, it can be concluded that the intracellular signals regulating discoidin expression are changed rather than the genes themselves. The mutants are thus likely to have defects in the reception or intracellular processing of environmental signals.

Animals↗

PubMed1993

Mouse hepatitis virus and herpes simplex virus move along different CNS pathways.

The spread of mouse hepatitis virus, strain JHM and herpes simplex virus type 1 in the central nervous system after inoculation into the nares and main olfactory bulb has been examined. The results show that each virus infects a subset of the possible connections of the olfactory bulb and that the subset infected by each virus is different. Thus, both viruses will be useful for studying the neuroanatomic connections of the olfactory bulb, and possibly for functional analyses as well.

Administration, Intranasal↗

PubMed1993

Prediction of high birthweight from maternal characteristics, symphysis fundal height and ultrasound biometry.

The possibility to predict a large infant during pregnancy was assessed using data from a prospective cohort study of 537 singleton pregnancies with term deliveries. Maternal characteristics, symphysis fundal height and ultrasound measurements were used in multivariate analyses for the prediction of an infant with a birthweight of > or = 4,500 or > or = 4,000 g. The positive predictive value was 55% for a birthweight > or = 4,000 g when only maternal characteristics were used, and increased slightly when symphysis fundal height was added. The corresponding value for a single ultrasound measurement at 37 gestational weeks was 52%. Using all available clinical data, positive predictive values of 45 and 80% could be achieved for birthweights of > or = 4,500 and > or = 4,000 g, respectively.

Adult↗

PubMed1993

Pre-pregnancy risk factors of small-for-gestational age births among parous women in Scandinavia.

To study the etiology and consequences of intrauterine growth retardation (IUGR), a prospective study was organized by the National Institute of Child Health and Human Development, NIH, with the Universities of Trondheim and Bergen in Norway, Uppsala in Sweden, and Alabama in the United States. This paper reports on the Scandinavian portion of the study. 6,354 women were referred to the study and 5,722 women, who were expecting their second or third child between January 1986 and March 1988, were eligible and made their first appointment for the study. Of these, 1,945 women and their births were selected for follow-up at four prenatal visits, delivery, and during the first year of life. This report analyzes the relative impact of various maternal pre-pregnancy risk factors associated with SGA birth. For example, mothers who smoked cigarettes around the time of conception, but who had none of the other major risk factors, nearly doubled their risk of SGA birth. A previous low birth weight (LBW) delivery increased the risk nearly two and a half times among non-smokers. If a mother both smoked and had a previous LBW, the relative risk rose to nearly five and a half. Low maternal pre-pregnancy weight (< 50 kg) increased the risk of SGA birth almost twofold among non-smokers, while low pre-pregnancy weight and smoking together increased the risk of SGA birth fourfold. A low weight mother who smoked and also had a previous LBW delivery, had a risk of SGA birth that was nearly six times that of a mother without those characteristics.

Adult↗

PubMed1992

Prognostic significance of DNA quantitation in stage D1 prostate carcinoma with the use of image analysis.

BACKGROUND: A characteristic feature of prostatic adenocarcinoma is its great variation in biologic behavior. This variation and the observation that most carcinomas are of intermediate grade make standard histologic grading of limited value in determining the prognosis of a patient. METHODS: DNA quantitation with the use of computer-assisted image analysis on Feulgen-stained nuclei was performed on the metastatic lymph nodes from patients with Stage D1 prostate carcinoma to determine whether ploidy was a useful predictor of survival or progression. The Gleason histologic score of the primary tumor, the number and extent of lymph node metastases, and the progression and survival intervals were documented. Treatment modalities included pelvic lymph node dissection, radical prostatectomy, external beam radiation therapy, and iodine 125 implantation. RESULTS: DNA ploidy quantitation showed that 65% (33 of 51) of cases were aneuploid, 2% (1 of 51) were tetraploid, and 33% (17 of 51) were in the diploid range. Progression to Stage D2 disease occurred in 76% of the patients with aneuploid cases and 53% of those with cases in the diploid range. CONCLUSION: There was a significant difference in progression between the two ploidy groups (Cox regression analysis, P less than 0.05).

Combined Modality Therapy↗

PubMed1992

Routine ultrasonography in utero and subsequent vision and hearing at primary school age.

The study was performed to investigate any associations between routine ultrasonography during pregnancy and subsequent reduced vision and/or hearing among children. A follow-up was carried out of primary school children born to women who took part in two randomized, controlled trials of routine ultrasonography during pregnancy. Of 2428 eligible singletons, 2161 (89%) were followed up with a parental questionnaire and with information from maternal and child health centers. Parents assessed vision and hearing in their children and reported their observations in questionnaires. At the age of 7 years, the children were also screened with bilateral visual acuity tests and pure tone audiometry at public maternal and child health centers. No significant differences between ultrasound-screened children and their controls were found in the parental assessment of vision or hearing. The objective tests did not show any significant differences between children in the two groups with regard to visual acuity or hearing. The risk of reduced vision or hearing was no greater for children of mothers who had been offered routine ultrasonography during pregnancy than for those whose mothers had not received that offer.

Journal Article↗

PubMed1992

Effect of steroids or tissue precooling on edema and tissue thermal coagulation after CO2 laser impact.

The carbon dioxide laser is frequently used in laryngeal microsurgery. Some surgeons have empirically used preoperative steroids or precooling with ice prior to laser impact to limit the resultant tissue thermal coagulation and/or edema. An animal model was designed to quantitatively test these effects. Depillated areas of rat skin were exposed to a CO2 beam of 1 mm diameter at 15 W for 0.1 sec after either administration of Decadron (0.25 mg/kg) immediately prior to impact or precooling more than 10 degrees C below basal body temperature. Measurement of edema was quantitated as extravasation of Evans's blue dye that had been injected intravenously. Tissue thermal coagulation was measured on hematoxylin and eosin stained histologic sections. In comparison to controls, statistically significant reduction in edema was seen only at the 24 hour time period after laser exposure for the steroid group (P less than .002) but not for the precooling group. Tissue thermal coagulation was significantly smaller for both the steroid and the ice group (P less than .006 and P less than .001, respectively) when compared to controls.

Animals↗

PubMed1992

The utility of a double-lumen tube for one-lung ventilation in a variety of noncardiac thoracic surgical procedures.

To determine the utility of one-lung ventilation (OLV) in a variety of noncardiac thoracic surgical procedures, 200 patients were studied to document the ease of double-lumen tube (DLT) placement, associated complications, intraoperative respiratory changes, and methods for managing hypoxic events. Most tubes could be placed, repositioned when necessary, and secured within 12 minutes. By defining tube position with fiberoptic bronchoscopy, auscultatory assessment of placement was found to be incorrect in 38.0% of patients. The tip occluded the respective upper lobe orifice in 40.5% of this subgroup, the endobronchial cuff was at or above the carina in 38.7%, and in the wrong mainstem bronchus in 20.8%. During OLV, PaO2 initially fell to approximately 200 mmHg in most patients but gradually rose during the balance of the operation. Hypoxia (PaO2 less than 80 mmHg) during OLV developed in 28.5% of patients. Preoperative spirometry and arterial blood gases had no predictive value for this complication. Pulse oximetry values between 95% and 100% reliably reflected systemic arterial oxygen saturation. Hypoxia occurring during OLV was successfully reversed in 40.0% of instances by positive end-expiratory pressure (PEEP) to the ventilated lung. The addition of continuous positive airway pressure (CPAP) to the nonventilated lung reversed persistent hypoxia in virtually all cases. There was no difference in oxygenation, carbon dioxide elimination, airway pressures, or intraoperative complications noted between right and left double-lumen tubes. In conclusion, a DLT for OLV can expeditiously and safely be placed. Because auscultation for tube position is unreliable, bronchoscopic assessment of final position should be performed in every instance. Hypoxia during OLV can be detected reliably by pulse oximetry.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1992

Prediction of fetal growth deviations by use of symphysis-fundus height measurements.

The development of various symphysis fundus (SF) growth charts and the use of SF height measurements in the diagnosis of small-for-gestational-age (SGA) births and the prediction of newborn complications are reviewed. Measurement precision and accuracy are also discussed. It is concluded that further research of this simple, low cost, harmless, and widespread technology to detect fetal growth disturbances in routine prenatal care is warranted.

Embryonic and Fetal Development↗

PubMed1992

Detection of intrauterine growth deviation. A comparison between symphysis-fundus height and ultrasonic measurements.

Efficacy of ultrasonography to detect fetal growth retardation is reviewed. Ultrasound dating is held as a prerequisite. Abdominal anthropometry is reported to reflect fetal growth best. Efficacy of symphysis-fundus (SF) height measurements is reviewed similarly. Proposed protocols that include ultrasound and SF height measurements and other maternal characteristics with known prognostic properties are reported. Preferably, both kinds of measurements should be analyzed longitudinally.

Embryonic and Fetal Development↗

PubMed1992

KTP/532 laser laparoscopy in the treatment of endometriosis-associated infertility.

OBJECTIVE: To determine the clinical effectiveness of the KTP/532 laser in treating endometriosis-associated infertility and to analyze the impact of additional infertility factors on outcome. DESIGN: Prospective cohort analysis of 74 consecutive patients followed up to 24 months after surgery. SETTING: Tertiary institutional infertility clinic. MAIN OUTCOME MEASURES: Cumulative pregnancy rates (PRs), monthly fecundity rates, monthly probability of pregnancy, crude PRs, and cure rates. RESULTS: Thirty-eight percent (28) of patients conceived with a mean +/- SE time to conception of 7.2 +/- 0.8 months. The cure rates were 74% for the total patient sample, 51% for stage I, 69% for stage II, and 64% for stage III disease. Patients who had a cervical factor (P = 0.05), who underwent intrauterine insemination (P = 0.03), who received human menopausal gonadotropin (P = 0.03), or who had additional infertility factors (P = 0.02) had significantly lower crude PRs. The presence of additional infertility factors (P less than 0.02) and intrafimbrial adhesions (P less than 0.01) had a significant impact on cure rates. In the absence of additional factors, 60% (12) of patients with stage I and II conceived. When additional factors were excluded, the overall cure rate was 80%. CONCLUSION: The results indicate that the KTP/532 laser is an effective tool for the treatment of endometriosis-related infertility. The high prevalence of subtle adhesions may lend further impetus to operative laparoscopy for stage I and II disease. Additional infertility factors may adversely affect outcome.

Adult↗

PubMed1991

[The physician's choice of a specialty].

This study included 1,416 graduates from the four medical schools in Norway, during the period 1978-81. The purpose was to determine which factors potentially influence choice of specialty. There were some differences in choice of specialty between physicians from different universities. Choice of specialty also varied with sex, age, and examination performance. Female physicians took no more time than their male colleagues did to become specialists. It is also concluded that the quality of the undergraduate teaching of the different specialties had little or no impact on future choice of career.

Decision Making↗