Biomedical subjects
H E Hansen
Publications and source records attributed to H E Hansen.
HLA-DR matching: the impact on cadaveric renal transplantation. A single-center study.
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Distorted HLA segregation or biased ascertainment?
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[Are you planning long-term treatment with lithium?].
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Lack of correlation between the incidence of rubella antibody and the distribution of HLA antigens in a Danish population.
The frequencies of HLA antigens among children (2.5-5 years, n = 71) and adults (ave. age 27 years, n = 154) with a strong Rubella specific antibody, and adults (n = 28) without Rubella specific antibody were investigated. No significant correlations were found. A total of 997 persons were included in the study.
Assessment of renal concentrating ability in lithium-treated patients. Comparison of long-term dehydration with administration of a vasopressin analogue.
In patients given long-term treatment with lithium maximum urine osmolality was measured after 26 h of dehydration and after intranasal administration of desamino-8-D-arginine vasopressin (DDAVP). A high correlation was found between the results of the two tests suggesting that the DDAVP test is a suitable method of assessing renal concentrating ability in lithium-treated patients.
The predictive value of percutaneous biopsies from human renal allografts with early impaired function.
A semiquantitative histological analysis was performed on 84 percutaneous biopsies 0-60 days post transplant from 66 grafts with clinical rejection, decreasing graft function of unknown etiology or persisting anuria. The presence of 1 or more of 3 histological lesions was associated with 100% graft loss within 1 year. The lesions were: infarction, glomerular capillary thrombosis, and arterial/arteriolar thrombosis. Since the detection of these severe lesions only permitted prediction of an unfavourable course in 72% of all grafts that were subsequently lost, a system was elaborated utilizing the sum of scores of 12 histological and 4 clinical parameters. This system failed to improve the prognostic value of the biopsy since diagnostic specificity as well as sensitivity was slightly lower by this method. The conclusion is that a graft biopsy performed during early graft failure has a high predictive value for graft loss if infarction, arterial thrombosis or glomerular capillary thrombosis is present; however the predictive value of a negative test is low.
1 alpha-hydroxy vitamin D3 treatment of non-dialyzed patients with chronic renal failure. Effects on bone, mineral metabolism and kidney function.
Nine non-dialyzed patients with creatinine clearance below 20 ml/min and histological and biochemical signs of renal osteodystrophy received 1 alpha-hydroxy vitamin D3 for 6 months in a mean daily dosage of 0.9 microgram. The serum concentrations of calcium and phosphate increased, and the serum concentrations of alkaline phosphatase and parathyroid hormone decreased during treatment. Quantitative histological examination of iliac crest bone biopsies showed a marked improvement of uremic bone changes, including normalization of the initial low mineralization rates evaluated by tetracycline uptake in bone. No significant change was seen in bone mineral content in the forearm measured by photon absorptiometry. An accelerated loss of kidney function was observed during the treatment period with 1 alpha-OH-vitamin D3 as compared with control periods before and after the treatment.
[Clinical significance of acute and chronic nephrotoxicity of lithium].
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Renal function and plasma aldosterone during acute lithium intoxication.
Studies on plasma aldosterone, total serum protein, electrolytes, osmolal concentrations in serum and urine, creatinine, lithium and osmolal clearances were carried out on 14 patients suffering from lithium intoxication. The determinations were done on samples obtained on admission and during the following twelve days of treatment with hemodialysis, sodium chloride loading, or forced diuresis. Plasma aldosterone and total serum protein were increased; serum sodium concentrations and creatinine clearances were decreased on admission. Serum osmolality was normal; urine osmolal concentration was just above that in plasma. The results showed that the lithium intoxicated patients were moderately depleted of sodium and water on admission. Plasma aldosterone, total serum protein and serum sodium were normalized during treatment. Creatinine clearance increased but did not normalize in all patients. Renal concentrating tests were performed in five patients three to four weeks after lithium intoxication. The renal concentrating ability was reduced in all. The elevated plasma aldosterone seen in lithium intoxication might have been a result of sodium and water depletion. It is suggested that impaired renal concentrating ability induced by lithium may make some patients more susceptible to conditions which can lead to sodium and water loss, and thereby to lithium intoxication.
HLA--typing of a dead man by a microabsorption method: solution of a paternity case.
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HLA--A, B haplotype frequencies in 5,202 unrelated Danes by a maximum-likelihood method of gene counting.
A population sample of 5,202 persons comprising normal, healthy individuals from three laboratories in Copenhagen was used for estimating HLA-A, -B antigen, gene, and haplotype frequencies, besides delta-values and their standard errors. The serum panels used allowed the determination of a total of 273 HLA-A, -B haplotypes, and the most significant delta-values were in agreement with those found in other Caucasian populations. The methods used for the calculations of frequencies, delta-values, and standard errors are described.
Lithium treatment and kidney function. A survey of 237 patients in long-term treatment.
Kidney function has been examined in 237 patients who in the autumn of 1977 were in lithium treatment at the Psychiatric Hospital in Risskov, most of them as outpatients. The average age was 42 years. The patients had been given lithium treatment for 0.5-17 years, mean duration 5 years. The mean lithium dosage was 33 mmol/day and the mean 12-hour serum lithium concentration 0.85 mmol/l. Glomerular filtration rate was assessed through determination of 24-hour creatinine clearance and serum creatinine, in some cases iothalamate clearance. Water excretion was assessed through determination of 24-hour urine volume and in some cases urine osmolality after 26 hours of fluid deprivation. Creatinine clearances, serum creatinine concentrations, and urine volumes were subjected to multiple regression analysis with various clinically relevant predictor variables. Affection of glomerular filtration rate was only moderate and progressed slowly. The data indicate that the risk of renal insufficiency and terminal azotemia is remote even when lithium is given for many years. A large number of the patients had altered water excretion with polyuria or lowered urine concentrating ability or both. Due to the extra fluid loss these patients are apt to develop dehydration, and they may then be in danger of lithium poisoning. We hypothesize that lithium-induced changes of kidney function may become less frequent and less pronounced if patients are maintained at serum lithium levels somewhat lower than those employed in the group studied here. We recommend careful monitoring of serum lithium levels, regular control of kidney function, and extra caution when physical illness or additional drug treatment may lead to disturbance of fluid and electrolyte balance.
A study of the linkage relations of epidermolysis bullosa dystrophica.
Two large families from the Faroe Islands presenting epidermolysis bullosa of the dystrophic type were subjected to extensive linkage analyses with 22 serological markers. No significant evidence in support of linkage with any of these loci was provided. It was found to be very unlikely that the gene or genes causing the present types of epidermolysis bullosa belong to the EBS1 locus known to be closely linked to the GPT locus.
HLA-GLO linkage analysis in 57 informative families.
The HLA-GLO linkage relationship was investigated among 37 single backcross families with 97 children and 20 double intercross families with 51 children. For the total number of families the value Zmas = 14.600 for theta = 0.060 was found. A total of 11 cross-overs between HLA and GLO were found leading to a recombination fraction of 0.067. 221 unrelated haplotypes were examined for linkage disequilibrium between HLA and GLO, and no disequilibrium was found.
Peritoneal transport of vancomycin during peritoneal dialysis.
The peritoneal transport of vancomycin during peritoneal dialysis was studied in 11 uremic patients following intravenous and intraperitoneal administration of vancomycin. The half-life of vancomycin was about 18 h and the clearance of vancomycin 6.1 ml/min (range 4.2--9.8) during the period of dialysis. Following intraperitoneal administration of vancomycin 50 micrograms/ml of dialysate, serum concentrations from 5.1 to 21.5 micrograms/ml were obtained and 35% of the instilled amount of vancomycin was absorbed during 15 h of dialysis. The peritoneal transport of vancomycin indicates that the dosage should be increased during peritoneal dialysis. Peritonitis caused by Staphylococcus aureus may be treated by peritoneal dialysis with vancomycin added to the dialysate.
Bone maturation in children with chronic renal failure. Effect of 1 alpha-hydroxy vitamin D3 and renal transplantation.
In 8 of 11 children with terminal chronic renal failure, bone age was retarded 6 months to 3 years. During hemodialysis the bone maturation rate decreased. 1 alpha-OH vitamin D3 treatment and renal transplantation normalized the bone maturation rate.
Comparison of a new parallel-flow, plate dialyser and a hollow fibre dialyser.
A new, low-price, parallel-flow, plate dialyser--the LPP dialyser--has been compared with a hollow fibre dialyser--the C-DAK dialyser. At dialysate flows of 510-680 ml/min and blood flows 140-200 ml/min the clearances of urea, creatinine and uric acid were 30-40 ml/min greater in the C-DAK dialyser. In the patients the mean creatinine at end of dialysis increased 1.7 mg% during treatment with the LPP dialyser. The ultrafiltration rate was found to be greater in the LPP dialyser than in the C-DAK dialyser. No membrane ruptures were observed in 200 LPP dialysers compared to 2 of 1200 C-DAK dialysers. The mean residual blood volume was 6.4 ml in the LPP dialyser + blood lines and 5.3 ml in the C-DAK dialyser + blood lines. The difference is insignificant. The LPP dialyser may be useful when dialysis is carried out frequency and when overhydration is a major problem.