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Biomedical subjects

H Kelbaek

Publications and source records attributed to H Kelbaek.

At least 109 records · Page 6Linked to original sources
PubMed1985

Pericardiocentesis in patients with and without incipient cardiac tamponade due to pericardial effusion. An easy and safe bedside approach.

Fourteen patients with pericardial effusion of various origins underwent pericardiocentesis on 16 occasions. Incipient cardiac tamponade was present on 19 occasions in 12 patients. Pericardiocentesis was carried out bedside under sterile conditions by a trained cardiologist. In case of impaired central circulation, drainage was sufficient to stabilize the clinical condition haemodynamically, and no adverse events occurred during pericardiocentesis. Fenestration of the parietal pericardium was necessary in 5 patients because of rapid regeneration of the fluid and in one patient due to pyopericardium with cardiac constriction. Pericardiocentesis is recommended in incipient cardiac tamponade. In the hands of experienced cardiologists the drainage procedure can be carried out safely without sophisticated equipment.

Adult↗
PubMed1985

Anal abscess imaged with 99mTc-labeled leukocytes. Case report.

Abscess imaging with leukocyte scintigraphy is described in a case report. Autologous leukocytes were separated from whole blood in a patient with localized inflammation in the perineal region and labeled with 99mTc, an ideal radionuclide for clinical examination with gamma camera. Scintigraphic investigations demonstrated a deep-lying anal abscess. The procedure may prove useful for detection of occult infections and may provide a new diagnostic approach in fever of unknown origin.

Abscess↗
PubMed1985

Technetium-99m labeling of polymorphonuclear leukocytes: preparation with two different stannous agents.

A technique for in vitro labeling of human polymorphonuclear leukocytes with Tc-99m is described. Titration of stannous fluoride and stannous pyrophosphate concentrations for pretinning was performed, and optimal amounts of the stannous agents were added to polymorphonuclear leukocytes efficiently isolated from 100 ml of blood. Labeling with 10-15 mCi Tc-99m resulted, after three washings of cell suspensions, in yields of 1.6-4.8 mCi, corresponding to 20.5-33.5% of added tracer. Cell-bound activity in the final cell suspensions was 92.3% +/- 1.9 of the added dose. Cell function was not impaired by the labeling technique. Sterility and exclusion of bacterial endotoxins in the final cell suspensions were demonstrated. The method may prove of diagnostic value in the isolation, labeling, and reinjection of autologous leukocytes for scintigraphic imaging of acute inflammatory lesions.

Cell Separation↗
PubMed1985

Sterile isolation of polymorphonuclear leukocytes from large blood volumes.

A method for preparation of pure polymorphonuclear leukocyte populations from large blood volumes is described. Methyl cellulose sedimentation and hypotonic haemolysis resulted in an efficient removal of erythrocytes. Subsequent separation with sodium metrizoate/Ficoll (density 1.077) gave rise to a preparation containing 95% polymorphonuclear leukocytes with a recovery of 56% and complete exclusion of red cell ghosts. The granulocyte function expressed by chemotaxis to the standard attractant casein and by trypan blue exclusion was not influenced by the separation procedure, which may be applied prior to granulocyte labeling for studies of cell kinetics and inflammatory disease.

Cell Separation↗
PubMed1984

Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver.

Twenty patients with biopsy-proved alcoholic cirrhosis of the liver and no cardiac symptoms entered a noninvasive investigation program in which cardiac performance was evaluated. One patient was excluded from the study because of a significant ethanol content in the serum at the time of investigation and 4 patients were excluded because of significant electrocardiographic ST-segment changes during exercise testing. Fifteen patients (12 men, 3 women, median age 47 years) who had abstained from alcohol drinking for at least 2 months were studied by exercise testing, echocardiography, measurement of systolic time intervals and left ventricular (LV) radionuclide ejection fraction (EF) at rest and during submaximal exercise. Twelve healthy persons of the same age served as control subjects. Heart rate at rest was significantly elevated in the patient group, median 90 beats/min (range 62 to 128) vs 73 beats/min (range 61 to 89) (p less than 0.02). No significant differences were found in physical work capacity and systolic time intervals, and echocardiographic parameters did not differ with the exception of left atrial dimension (median 36 mm [range 22 to 47] in the patient group and 31 mm [range 17 to 38] in the control subjects, p less than 0.05). No significant difference was found in LVEF at rest. During exercise, however, the median LVEF increased only 6% in the patients versus 14% in the control subjects (p less than 0.05). The results of this study suggest that patients with alcoholic liver cirrhosis, although free of cardiac symptoms, may have a latent or preclinical cardiomyopathy that is manifest during physical stress.

Adult↗
PubMed1984

In vitro labeling of human polymorphonuclear leukocytes with 99mTc.

Preliminary experience with 99mTc labeling of isolated polymorphonuclear leukocytes is reported. Leukocytes efficiently purified from 100 ml peripheral blood were labeled in vitro with 99mTc after pretreatment with small amounts of a stannous agent to reduce pertechnetate. A labeling yield of 1.3 mCi equivalent to 12.5% of the added dose of 99mTc and a cell binding efficiency of more than 90% was achieved under sterile conditions. Viability assays showed no influence of the labeling procedure on cell function. The technique may prove a valuable alternative for assessment of local leukocyte accumulation by scintigraphy.

Cell Survival↗
PubMed1984

Right and left ventricular ejection fraction and left ventricular volume changes at rest and during exercise in normal subjects.

The effect of exercise upon right and left ventricular ejection fractions (RVEF and LVEF) as well as the changes upon left ventricular end-diastolic and end-systolic volume indices (LVEDVI and LVESVI) were investigated. Twenty-two normal subjects were studied at rest and during upright submaximal exercise. RVEF was determined using a first-pass method. LVEF was measured using multiple gated blood pool imaging. During the exercise test ECGs remained normal. HR and BP increased significantly (P less than 0.01). RVEF increased from 44% +/- 4 (mean +/- SD) to 60% +/- 6 (P less than 0.001). LVEF increased from 62% +/- 6 to 76 +/- 5 (P less than 0.001). A wider scatter was observed in delta RVEF than in delta LVEF. There was a 14% increase in LVEDV-index and a 14% decrease in LVESV-index (P less than 0.001). A multiple regression analysis with delta RVEF as the dependent variable and delta HR, delta systolic BP, delta LVEF, delta LVEDV-index and LVESV-index as independent variables showed a significant correlation between delta RVEF and delta LVEF and delta systolic BP (P less than 0.05). Our data provide insight into the mechanisms by which the pump performance is increased in normal subjects. The central mechanisms observed are the Starling effect and an increase in contractility of the myocardium. This is connected in the general circulation to an increase in afterload, indicating a redistribution of blood from the vascular beds to the muscles and to the heart.

Adult↗
PubMed1984

Cholecystokinin-stimulated and postprandial serum concentrations of bile acids in alcoholic liver cirrhosis.

This investigation was undertaken to examine the alterations in serum bile acid concentration after intravenous administration of cholecystokinin and a standard meal in 13 patients with alcoholic cirrhosis. Total 3 alpha-hydroxy bile acids in serum (SBA) were monitored for 2 h after injection of cholecystokinin and for 3 h after the standard meal. The median fasting value of SBA was 39.9 mumol/l (range, 3.2-148 mumol/l). The increase in SBA after cholecystokinin started earlier and lasted shorter than after standard meal stimulation (median, 30 min and 120 min, respectively). The appropriate relative peak levels of SBA were 173% and 212% of the fasting value. The increments were significant (P less than 0.01) within groups but insignificant between groups. Day-to-day variation of postprandial SBA was more pronounced than after cholecystokinin stimulation. The difference, however, was insignificant. An inverse correlation was detected between both fasting and stimulated peak levels of SBA and P-coagulation factors 2, 7, and 10.

Adult↗
PubMed1983

Diagnostic values of fasting and postprandial concentrations in serum of 3 alpha-hydroxy-bile acids and gamma-glutamyl transferase in hepatobiliary disease.

Fasting and postprandial concentrations in serum of 3 alpha-hydroxy-bile acids and gamma-glutamyl transferase were measured in 138 consecutive patients, 62 with (D) and 76 without (D) hepatobiliary disease. The maximum efficiencies of the three tests--that is, the fractions of patients allocated correctly to the D or D group at the optimum discrimination values--were 0.85, 0.84, and 0.83, respectively. Furthermore, the predictive values and nosographic sensitivities and specificities were rather similar. When the three tests were combined, the nosographic sensitivity increased significantly to a value of 0.84, and the corresponding specificity was 0.91. The diagnostic value of the absolute postprandial increase in serum bile acid concentration was slightly inferior to the diagnostic values of the fasting and postprandial serum bile acid concentrations and, finally, the relative postprandial serum bile acid increase was of no diagnostic value at all.

Adolescent↗
PubMed1983

Fasting plasma somatostatin in alcoholic liver disease.

Fasting level of somatostatin-like immunoreactivity (SLI) in plasma was measured by a highly sensitive radioimmunoassay in 36 patients with alcoholic liver disease verified by histopathology (10 patients with steatosis and 26 with cirrhosis of the liver). The median value of SLI was markedly elevated in patients with steatosis of the liver as compared to normal subjects, P less than 0.01, while the median value of SLI in the cirrhotic group was even higher, P less than 0.05, as compared to the steatotic group. Correlations of SLI to se-bilirubin and p-coagulation factors 2, 7 and 10 were significant, P less than 0.001 and P less than 0.01, respectively, whereas no correlation to plasma insulin could be elicited. These results suggest that in alcoholic liver disease fasting plasma somatostatin is correlated to the degree of hepatic failure and indicate that the liver is an important site for clearance of portal vein somatostatin.

Adult↗
PubMed1982

The patterns of glycine and taurine conjugates of bile acids in serum in hepatobiliary disease.

Fasting serum concentrations of glycine and taurine conjugates of cholic, chenodeoxycholic, and deoxycholic acid were measured with a high-pressure liquid chromatography-enzymatic assay in patients with hepatobiliary disease. The total glycine to taurine ratio was significantly lower in extrahepatic cholestasis (median 1.1) than in cirrhosis (median, 2.0) and controls (median, 1.7). In patients with cirrhosis the ratio was significantly correlated with the S-bilirubins, P-coagulation factors (II + VII + X), and S-total conjugated bile acids. Because of large overlaps of the ratio between the groups the glycine to taurine ratio is of hardly any diagnostic value. The ratio of cholic acid conjugates to chenodeoxycholic acid conjugates was over 1.5 in 10 of 12 cholestasis patients and below this value in all but 1 patient with cirrhosis; the separation of the groups was not improved by splitting the ratio in glycine and taurine conjugates. This study does not suggest that separate determination of glycine and taurine conjugates of bile acids in serum adds diagnostic information in hepatobiliary disease.

Adult↗
PubMed1982

Predictive value of the concentration in serum of total 3 alpha-hydroxy bile acids in the diagnosis of hepatobiliary disease.

Fasting serum levels of total 3 alpha-hydroxy bile acids were measured in 163 consecutive patients, who clinically were suspected of having a hepatobiliary disorder. By means of routine biochemical liver tests and paraclinical investigations the clinical suspicion was confirmed in 95 patients and disproved in the other 68 patients. A comparison between this diagnostic grouping and the serum bile acids levels showed that the predictive value of serum concentrations above a discrimination value of 10 mumol/l--that is, the predictive value of a positive test--was 1.0 (0.94-1.0), whereas the corresponding predictive value of a negative test was 0.66 (0.56-0.75). Thus, fasting serum levels of total 3 alpha-hydroxy bile acids may be used as a highly specific and moderately sensitive diagnostic test for hepatobiliary disorders. Furthermore, the study showed that the nosographic sensitivity of total 3 alpha-hydroxy bile acids in patients with verified cirrhosis was significantly greater than that of serum bilirubins and not significantly different from those of the other routine biochemical liver tests.

Adult↗
PubMed1982

[The clinical course as assessment for a diagnostic test].

Investigations assessing the predictive value of diagnostic tests are rarely performed. Several factors may contribute to this matter. Firstly, a diagnostic key is required, secondly a pathoanatomic examination is most often regarded as the true diagnostic key and thirdly, when this demand cannot be met clinical syndromes are created. However, a prediction of the clinical course is of major value to the physician compared to a pathoanatomic diagnosis. Together with the paraclinical data, the clinical course may comprise the diagnostic key in assessing diagnostic probabilities or "probabilities of a certain clinical course", i e the actual predictive probabilities.

Decision Making↗