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Biomedical subjects

H Poulsen

Publications and source records attributed to H Poulsen.

At least 55 records · Page 3Linked to original sources
PubMed1987

Hydatidiform mole: genetic markers in diploid abortuses with macroscopic villous enlargement.

In a series of diploid abortion specimens with gross villous enlargement the parental origin was determined by chromosomal heteromorphisms, HLA typing, and enzyme analysis. Diploid androgenesis was the mechanism in 33 cases; in 28 cases the most likely origin was by duplication of a haploid sperm after fertilization of an anucleated ovum, whereas heteromorphisms in five cases indicated a dispermic origin. In one macroscopically complete molar specimen all marker techniques applied indicated a normal conception. In two homozygous specimens a second cell line with both maternal and paternal contributions indicated a twin gestation, whereas, in four conceptuses twinning was suggested solely by HLA determination or ultrasound scan. The observation of a heterogeneous origin of diploid moles, as indicated by three marker systems studied simultaneously, emphasizes that additional information about the frequency of different types of molar conceptions may be obtained by this approach.

Abortion, Induced↗
PubMed1987

Portal tract lipogranulomas in liver biopsies.

Portal lipogranulomas in liver biopsy specimens were investigated. The incidence of biopsies containing portal lipogranulomas was 2.4%. Out of 20 biopsies with lipogranulomas 10 biopsies contained only one lipogranuloma. Portal lipogranulomas show a distinctive morphology with fat vacuoles surrounded by macrophages. They are consistently found together with parenchymal steatosis and probably originate from parenchymal fat being transported to portal tracts. Portal lipogranulomas are of importance in the differential diagnosis from other granulomas.

Biopsy↗
PubMed1986

Updating prognosis and therapeutic effect evaluation in cirrhosis with Cox's multiple regression model for time-dependent variables.

A multivariate Cox regression analysis with time-dependent variables has been performed on the data of 415 patients with cirrhosis included in a controlled clinical trial of 10-15 mg prednisone daily versus placebo. The analysis showed that a poor prognosis was associated with a low prothrombin index, marked ascites, GI bleeding, high age, high daily alcohol consumption, high bilirubin and alkaline phosphatase and low albumin values, little liver connective tissue inflammation, and poor nutritional status. Prothrombin index and ascites showed significant interaction with the treatment in such a manner that high prothrombin index and absence of ascites were associated with a beneficial effect of prednisone, whereas low prothrombin index and presence of ascites were associated with a harmful effect of prednisone treatment. The final model was validated in independent patients by comparing their actual survival with that predicted from the model, using a split-sample testing technique. The prognostic factors were combined with an index that can be used to update prognosis whenever changes occur in the clinical status of a patient during the course of the disease. The probability of surviving the next 3 or 6 months can be estimated from the prognostic index at any time during the course. The index may be of value for the correct timing of special therapeutic procedures such as liver transplantation.

Adult↗
PubMed1985

A therapeutic index that predicts the individual effects of prednisone in patients with cirrhosis.

Our aim was to construct an index that accurately predicts the degree of benefit or harm that prednisone therapy holds for patients with liver cirrhosis. The admission and survival data of 488 patients with cirrhosis who participated in a controlled clinical trial of prednisone in a dosage of 10-15 mg daily (251 patients) versus placebo (237 patients) and who were observed for up to 12 yr were analyzed using Cox's multiple regression model. Four variables each provided significant therapeutic information: antinuclear factor (p = 0.02) and large piecemeal necroses (p = 0.02) were associated with a beneficial effect, whereas ascites (p = 0.0004) and large regenerative nodules (p = 0.0007) were associated with a harmful effect of prednisone. From these four variables a therapeutic index was constructed. For a given patient the therapeutic index is a measure of how big the effect will be if prednisone is given. The gain in survival time obtained by administering prednisone according to the therapeutic index was estimated to be 349 yr, mainly confined to 217 patients with a significant positive (121) or negative (96) therapeutic index. The therapeutic index may prove useful for the optimal administration of prednisone treatment in new patients with cirrhosis.

Antibodies, Antinuclear↗
PubMed1985

Changes in liver histology during methotrexate therapy of psoriasis correlated to the concentration of methotrexate and folate in erythrocytes.

To investigate, whether an assessment of the folate and methotrexate concentrations in erythrocytes could be used to indicate incipient histological liver changes, these 2 parameters were related to liver histology in series of liver biopsies (means 4.3 biopsies) from 31 long-term methotrexate-treated psoriasis patients. Logistic regression analysis showed that the probability of changes in liver histology during methotrexate therapy increased significantly with increasing erythrocyte methotrexate concentrations and with decreasing erythrocyte folate concentration. The application of these variables as a decisive criterion when to institute liver biopsy surveillance needs further studies, but can probably help reduce the number of liver biopsies to be taken during long-term methotrexate therapy considerably.

Adult↗
PubMed1985

The Mini-Cap. External immobilization of facial fractures.

A method is described for external immobilization of the facial skeleton. The method is only indicated in a few cases. By means of Vitallium screws and a small head cap of plaster of Paris it is possible to achieve stiff, external immobilization of facial fractures, even when they are situated in the frontal bones. The Mini-Cap permits the patient to rest comfortably and costs very little.

Adolescent↗
PubMed1984

Abnormal bile duct epithelium accompanying septicaemia.

A 56-year-old female without previous hepatobiliary disease developed a severe obstructive cholestasis following E. coli urinary tract infection with septicaemia. Liver biopsy showed cholangitis and a unique abnormality of almost all the interlobular bile ducts; the epithelium was irregular with polymorphic, angular, and hyperchromatic or pyknotic nuclei. Some ducts were ectatic , others narrowed due to protrusion of proliferating epithelium. In some areas the ducts were blurred or completely destroyed. Cholangitis or granulomas were, however, not present. Abnormal interlobular bile ducts have to our knowledge not previously been described in septicaemia. The lesion is morphologically distinguishable from other types of abnormal bile ducts. It is considered to be caused by endotoxaemia and seems to be reversible. The cholestasis may be due to endotoxic alteration of biliary secretion, bacterially induced inspissation of bile, and/or mechanical obstruction to the bile duct lesions.

Bile Ducts, Intrahepatic↗
PubMed1983

Carrier detection and X-inactivation studies in the fragile X syndrome. Cytogenetic studies in 63 obligate and potential carriers of the fragile X.

Cytogenetic investigations by three different lymphocyte culture methods in 63 obligate and potential carriers of the fragile X [fra(X)] are reported. A difference was observed between normal and retarded carriers in the manifestation of the fra(X). An inverse relationship between percentage positive cells and age was demonstrated in normal carriers, whereas retarded carriers generally showed higher percentages at all ages. X-inactivation studies in retarded carriers compared with normal carriers showed a tendency towards a skewed inactivation pattern with an excess of early replicating fra(X) in both groups when carriers expressing high percentages of fra(X) positive cells were compared. In normal carriers with low percentage expression the tendency was apparently reversed. The relationship between the replication pattern of the fragile X and the mental status of the individual is more complicated than suggested by previous studies.

Adolescent↗
PubMed1983

Liver biopsy in chronic aggressive hepatitis. Diagnostic reproducibility in relation to size of specimen.

For the purpose of evaluating the reproducibility of the main diagnosis in liver needle biopsies and estimating the size of the specimen for an acceptable accuracy, 100 liver specimens selected from the daily routine, all 25 mm or more in length, were investigated. The material consisted of specimens from 50 patients with chronic aggressive hepatitis (CAH; including 37 without and 13 with suspicion of cirrhosis), 6 with macronodular cirrhosis, 5 with micronodular cirrhosis, 10 with acute viral hepatitis (including 3 with suspicion of chronicity), 10 with primary biliary cirrhosis, 6 with chronic persistent hepatitis, and 13 with other diagnoses. The specimens were investigated without knowledge of clinical data in five sessions with an increasing amount of tissue made visible. The predictive value of a diagnosis present (diagnostic specificity) and a diagnosis absent (diagnostic sensitivity) was used in evaluating the efficiency of the diagnosis made on the visible part of the biopsy. For CAH (with and without suspicion of cirrhosis) the number of biopsies with the correct diagnosis increased significantly with increasing amounts of tissue visible (p less than 0.01), and the required length for an acceptable accuracy of CAH was 15 mm. The diagnostic sensitivity for CAH was very high (94%) with only 5 mm tissue available and constant through all sessions.

Biopsy, Needle↗
PubMed1983

Main causes of death in cirrhosis.

The main causes of 436 deaths among 532 patients with cirrhosis followed up for up to 16 years constituted liver failure (24%), liver failure with gastrointestinal bleeding (13%), gastrointestinal bleeding (14%), primary liver cell carcinoma (4%), other liver-related causes (2%), infections (7%), cardiovascular diseases (22%), extrahepatic malignancies (9%), and other non-liver-related causes (5%). Totally, 57% died of liver-related causes. A high frequency of liver-related death was found among patients with a short observation time, high biochemical activity, pronounced change in liver architecture, ascites, and other signs of a poor prognosis at the time of diagnosis. The findings favoured the hypothesis that cirrhosis of the liver is a disease with an initial active and a subsequent inactive phase. Half of the patients were treated with prednisone, but this had no detectable influence on the distribution of causes of or on the frequency of single causes of death as infections or gastrointestinal bleeding. The group of patients responding favourably to prednisone treatment with regard to survival (non-alcoholic women without ascites) showed causes of death not different from those of the total material.

Bacterial Infections↗
PubMed1982

Martin-Bell syndrome fra(X) (q28) in a Sri Lankan family.

The Martin-Bell syndrome was observed in a family with six mentally retarded males, born to three sisters, who were of more than average intelligence. The males showed large ears, macrotestes, they were delayed in their development and had speech retardation. Five were pleasant and co-operative, while one had severe temper tantrums. The fra(X)(q28) was observed in the three males cytogenetically examined and in two of the three female potential carriers, who could be studied. It was expressed in 17-36% of the cells in the males cultured in 199 and in 5% and 39% in the two female carriers, studied under addition of methotrexate.

Adult↗
PubMed1982

Prednisone treatment of chronic liver disease. I. Chronic aggressive hepatitis as a therapeutic marker.

A liver biopsy material comprising 477 biopsies from 477 patients included in a prospective, unblinded, randomized trial of treatment of cirrhosis with prednisone has been re-evaluated using new and more restrictive histological criteria for the diagnosis of cirrhosis and chronic aggressive hepatitis (CAH). The material was divided according to the likelihood of cirrhosis being present: (A) cirrhosis (287 patients), (B) probably cirrhosis (101 patients) and (C) compatible with but not diagnostic for cirrhosis (89 patients). Each group was further divided according to the presence (I) or absence (II) of CAH. A total of 98 patients fulfilled the histological criteria for CAH. The effect of prednisone concerning survival was evaluated in each group. In the total group of patients with CAH a significant beneficial effect of prednisone was found (p = 0.04). Among these patients the subgroup with cirrhosis in addition (group I A) also showed a significant effect of prednisone, while groups I B and I C only had a trend towards a beneficial effect (p = 0.44 and p = 0.36, respectively). In patients without CAH in the biopsy (Group II, A + B + C), no effect of prednisone was seen although a trend towards a harmful effect was found in patients with cirrhosis (Group II A). Control patients with CAH in all three subgroups had an insignificantly shorter survival than patients without CAH. All the CAH groups significantly more often included female patients with no history of alcoholism and a lower frequency of spider naevi. In addition, the CAH groups were more active as judged by biochemical and histological variables. It was further disclosed that the presence of large piecemeal necroses indicated a favourable effect of prednisone treatment, while alcoholism, ascites and male sex acted as indicators for an unfavourable treatment effect.

Biopsy↗
PubMed1982

Prednisone and chronic liver disease. II. Clinical versus morphological criteria for selection of patients for prednisone treatment.

A prospective, unblinded, randomized trial of treatment of cirrhosis and chronic aggressive hepatitis (CAH) with prednisone included 484 patients who were divided using both the clinical criteria: non-alcoholic females without ascites, and the morphological criterion: presence of a liver biopsy showing CAH. A total of 164 patients (34%) satisfied the three clinical criteria and biopsies from 95 patients (20%) showed CAH. By a cross-tabulation method between the two sets of criteria, four groups were formed. Evaluation of the treatment effect by means of relative death rate showed that the clinical criteria identified both a group of patients with a beneficial effect of prednisone (p less than 0.05) and a group with a harmful effect of the treatment (p less than 0.05). Patients with CAH also had a significant beneficial treatment effect, but patients without CAH showed only an insignificantly harmful effect of treatment. Patients fulfilling both sets of criteria had a beneficial effect of prednisone (p less than 0.05) and patients lacking both sets had a significantly harmful treatment effect. A significantly better survival was found in patients satisfying the clinical criteria without CAH in the biopsy than in patients with CAH and not fulfilling the clinical criteria (p = 0.03). In both the groups of patients with disagreement between the two sets of criteria, a trend towards a beneficial effect of prednisone was found. It is concluded that the simple clinical criteria in comparison with the histological criteria identify a larger group of patients with a beneficial effect of treatment.

Chronic Disease↗
PubMed1982

Hypospadias repair: with construction of a fossa navicularis.

Acceptable results can be achieved in the treatment of hypospadias by the use of Denis Browne's method. However, the condition is not completely normalized, as the external orifice of the urethra is most frequently situated in the neighbourhood of the coronal sulcus and the orifice itself open. The distance to the normal urethral mucosa is thus short with the consequent increased risk of contamination. In order to ensure normalization of the condition, Denis Browne's method was supplemented by the construction of a fossa navicularis in 74 patients with hypospadias. The results of this construction were satisfactory in the great majority of cases.

Adolescent↗