Biomedical subjects
Publications and source records attributed to H S Hansen.
A case of missed first time bilateral anterior dislocation of the shoulders caused by a grand mal seizure is presented. The lack of asymmetry of the shoulders is stressed as a potential pitfall in the clinical evaluation of patients with this condition.
Thirty-seven patients with malignant tumours in the ear treated at Rigshospitalet, Copenhagen in the period 1.6.1983-1.6.1993 were retrospectively reviewed. There were 20 males and 17 females. The average age was 67 years. Twenty-four patients had tumours involving the middle ear and 13 patients had tumours located only in the external auditory canal. Eighty-four percent had squamous cell carcinoma. In 61% of the patients with squamous cell carcinoma, chronic infection of the ear preceded the malignant process. Overall control of disease for the 37 patients was 49%. The total actuarial crude survival was 33%. For the nine patients who had squamous cell carcinoma located only in the external auditory canal, the control of disease was 89%. Twenty-two patients had squamous cell carcinoma involving the middle ear. Most of these patients underwent radical mastoidectomy and step-wise removal of gross tumour followed by radiotherapy. Six had radiotherapy alone. The control of disease in this group was 32%. It is concluded that tumours involving only the external auditory canal have a good prognosis. If the tumour involves the middle ear, the prognosis falls dramatically.
It is well established that marine n-3 fatty acids measured in erythrocyte phospholipids of non-pregnant subjects reflect the subjects' intake of these fatty acids. In 135 pregnant women in the 30th week of gestation we compared intake of marine n-3 fatty acids and energy, estimated by a combined dietary self-administered questionnaire and interview, with fatty acids measured in erythrocyte phospholipids. Daily intake (g/d) and nutrient density of marine n-3 fatty acids (mg/MJ) correlated with the n-3 fatty acid: arachidonic acid ratio (FA-ratio) with correlation coefficients of 0.48 and 0.54 respectively. In a linear regression model with three frequency questions about marine sandwiches, marine cooked meals and fish oil as explanatory variables, and the FA-ratio as dependent variable, the multiple correlation coefficient was 0.46. Conclusions from the study were (1) levels of erythrocyte fatty acids in pregnant women may be employed as a qualitative method to rank subjects according to intake of marine n-3 fatty acids; (2) with respect to the power to explain FA-ratio variability, three simple marine food frequency questions were comparable with intake of marine n-3 fatty acids assessed by an elaborate semiquantitative dietary method involving an interview.
It has been hypothesized that marine n-3 fatty acids ingested during pregnancy prolong duration of pregnancy and increase fetal growth rate in humans. By a combined self-administered questionnaire and interview applied in the 30th week of gestation we assessed dietary intake of marine n-3 fatty acids and energy in a population-based sample of 965 pregnant Danish women; in a random 14% subsample we also measured marine n-3 fatty acids relative to arachidonic acid (FA-ratio) in erythrocytes. Mean intake of marine n-3 fatty acids was 0.25 (95% range 0-0.75) g/d. We could detect no association between n-3 fatty acid intake and FA-ratio on the one hand, and gestation length, birth weight and birth length on the other. The analyses were adjusted for maternal height, prepregnant weight, parity and smoking. The conclusion from the study was that within the intake range of this population, marine n-3 fatty acids ingested in the weeks prior to the 30th week of pregnancy seem not to be a predictor of gestation length or fetal growth rate.
The purpose of the study was to examine the value of a commercial immunoradiometric (IRMA) method for measuring serum thyroglobulin as a tumor marker after treatment for differentiated thyroid carcinoma. A prospective analysis of consecutive serum samples from 53 patients was performed using the IRMA method and a traditional double antibody radioimmunoassay (RIA). The results were compared with those of 100 healthy control subjects and furthermore the method was validated by investigating sera from 24 patients with Hashimoto's thyroiditis positive for thyroglobulin autoantibodies. Finally, in vitro studies of the influence of thyroglobulin autoantibodies on the method were done. The IRMA method had an acceptable analytical precision and was more sensitive than the RIA. It was furthermore less sensitive to the presence of thyroglobulin autoantibodies but it was affected by them, and it showed less unspecific serum effect. Both methods had limitations as tumor marker when the patients had a thyroid remnant, when serum thyrotropin was not suppressed, and in cases of local recurrence. The highest predictive value was found in patients with distant metastases. Thus, in cases of only slightly elevated serum thyroglobulin, the strongest indication for recurrence is still an increasing serum thyroglobulin level within the same patient rather than a single value.
The prognostic significance of lymph node metastases was evaluated in an unselected material of 427 oropharyngeal cancer patients treated primarily with radiotherapy. At first referral, palpable lymph node metastases were present in 60% of the patients. After irradiation, 60% of all palpable nodes had disappeared. As many as 50% of the nodes initially palpable in N3 patients vanished after irradiation. Recurrences were significantly increased in patients primarily with lymph node metastases (N1-3) compared with N0 patients; recurrences in the primary tumour site were (56% vs. 43%) in neck lymph nodes (40% vs. 9%) and in distant metastases (14% vs. 5%). Surgery was performed in 98 of 256 patients (38%) with recurrent or metastatic disease. The 5-year disease-free survival rate after radiotherapy for N0 patients was an improvement (44%) on that of N1-3 patients (23%). The N-stage is an important prognostic factor for oropharyngeal cancer patients.
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A review of anaesthesia for gynaecologic laparoscopic surgery is given. Special criteria are needed for selection of patients, choice of anaesthesia and intraoperative monitoring. The cardiovascular and respiratory system are affected by tension from the pneumoperitoneum, absorption of CO2 and Trendelenburg position. Gas insufflation can provoke venous gas embolism, pneumothorax, pneumomediastinum, pneumopericardium and subcutaneous emphysema. The introduction of laparoscopic instruments may result in unintentional injuries to intra-abdominal organs. The possibility that the procedure may have to be converted to open laparotomy needs to be considered. Bowel burns may result in perforation, peritonitis and sepsis. Laparoscopy is contraindicated in patients with serious cardiac disease, extensive bowel adhesions or intestinal obstruction. General anaesthesia with muscle paralysis, tracheal intubation and controlled ventilation is the preferred technique in these cases. Short acting anaesthetics are preferred in day case laparoscopy. Central neural blockade or infiltration anaesthesia supplemented with sedation and analgetics can be used for short laparoscopic procedures. The electrocardiogram, noninvasive arterial pressure monitor, airway pressure monitor, intra-abdominal pressure monitor, pulse oximeter and CO2 monitor are used routinely. Antiemetics and analgetics may be needed postoperatively.
It is possible to screen for medullary thyroid cancer (MTC) with biochemical tests, imaging and genetic testing in families with multiple endocrine neoplasia type 2. The recommendation is based on a consensus statement made by the Members of the European Community concerted action for MTC. The prognostic characteristics are based on 117 patients with MTC diagnosed in Denmark between 1970-1991. Twenty percent of all MTC patients were members of families with two or more thyroid cancer patients. More than half of all MTC patients had neck lymph node involvement at the time of diagnosis. The frequency of neck lymph node involvement was however only 20% amongst those with familiar MTC.
It was hypothesised from previous observational studies in the Faroes and Denmark that dietary marine n-3 fatty acids would prolong the duration of pregnancy and thereby increase the birth weight, by influencing the production of prostaglandins involved in the process of parturition. Five hundred and thirty-three healthy Danish women were randomly assigned in the 30th week of pregnancy to fish oil (2.7 g n-3 fatty acids (4 1-g capsules Pikasol oil) per day), olive oil (4 1-g capsules per day) or no oil supplementation. The three groups differed in mean gestational age at birth (ANOVA, p = 0.006), with the fish oil group ranking highest and the olive oil group lowest. Babies born to women allocated fish oil had on average 4.0 (95% confidence interval 1.5;6.4) days higher gestational age and 107 (95% confidence interval 1;214) g higher weight at birth than babies born to women allocated olive oil; the difference in gestational age depended on the level of fish intake at enrollment, with a low fish intake enhancing the difference. Fish oil supplementation in the third trimester seems to prolong gestation while allowing continued growth of the foetus; this effect seems to explain the difference between the Faroes and Denmark in pregnancy duration.
When highly unsaturated fatty acids are added to cell cultures, it can become important to include antioxidants in the culture medium to prevent cytotoxic peroxidation. To find an optimal antioxidant for this purpose, the effect of 50 microM alpha-tocopherol, gamma-tocopherol, alpha-tocopheryl acetate, alpha-tocopheryl acid succinate, or alpha-tocopheryl phosphate, or of 1 microM N,N'-diphenyl-1,4-phenylenediamine, was investigated with respect to the agent's ability to prevent lactate dehydrogenase leakage in long-term rat hepatocyte cultures supplemented with 0.5 mM highly unsaturated fatty acids. Formation of thiobarbituric acid reactive substances in the cultures was also measured. alpha-Tocopheryl acid succinate was found to be the most effective cytoprotective compound, followed by N,N'-diphenyl-1,4-phenylenediamine, alpha-tocopherol, gamma-tocopherol and alpha-tocopheryl acetate, and alpha-tocopheryl phosphate was without effect.
The results of the present study point to phosphatidic acid (PtdOH) as a possible intracellular messenger, which might be involved in local modulation of testicular testosterone production in vivo. Propranolol (27-266 microM) induced an increased level of [3H]PtdOH in isolated rat Leydig cells, prelabeled with [3H]myristate, and at the same time a strong dose-dependent inhibition of the acute testosterone production stimulated by luteinizing hormone (LH). The inhibition was not bypassed by the addition of dibutyryl-cAMP but was overcome, when 22(R)-hydroxycholesterol was added as a direct substrate for cytochrome P-450 side chain cleavage enzyme. Thus, the inhibition appears to be exerted at a point distal to cAMP-generation but before the first enzyme in the testosterone synthetic pathway. Treatment with other agents (4 beta-phorbol 12-myristate 13-acetate (PMA), A23187, and sphingosine) giving rise to increases in the PtdOH-level resulted in the inhibition of the LH-induced testosterone formation as well, thus indicating a connection between the two effects. Furthermore, we were able to demonstrate a highly significant correlation between the PtdOH-increase and the inhibition of the LH-stimulated testosterone production. This may suggest a causal relationship between these two parameters.
Four new findings of the biochemistry and biology of the essential n-6 and n-3 fatty acids have recently been demonstrated. These findings will augment current knowledge as to the role of the essential fatty acids in human health.
The validity of peak expiratory flow (PEF) recordings and the sensitivity of PEF variability indices in asthma and asthma-like conditions were examined in an adolescent population. Recordings from 245 randomly selected subjects and from an additional 181 subjects reporting or considered at risk for developing asthma were analyzed. Subjects recorded PEF twice daily for 2 wk using Mini-Wright meters, completed a symptoms questionnaire, and were tested for airway responsiveness to methacholine. The first three recording days showed significant accumulation of lowest PEF values recorded (41%) and were excluded from further analysis. Among nine PEF variability indices, the Two-lowest%mean (the mean of the two lowest PEF values as a percentage of the period mean) had the best sensitivity for physician-diagnosed asthma (28%). The sensitivity of the methacholine dose-response slope (DRS) was 69%. Combining these indices, a sensitivity of 77% for diagnosed asthma was obtained. Among subjects with asthma-like symptoms but no diagnosis of asthma, 14% had increased Two-lowest%mean and the DRS was increased in 17%, but only 3% were identified by both tests. In conclusion, inhomogeneity of PEF data could be corrected by disregarding the first three recording days. PEF variability indices identified some diagnosed asthmatics, and particularly some symptomatic "nonasthmatics," not identified by the DRS, suggesting that the combined use of these indices might be helpful.
BACKGROUND: Nasopharyngeal carcinoma (NPC) and anaplastic salivary gland carcinoma (SGC), both associated with Epstein-Barr virus (EBV), are common among Inuit from Greenland, Canada, and Alaska. Because immigrant studies have shown that factors acting early in life are important for the development of NPC, the authors interviewed new patients in Greenland with either NPC or SGC about their lifestyles during childhood and additional cases in their families. METHODS: On admission, new patients from Greenland with either NPC or SGC were interviewed about childhood life-style, family size, and other cases of NPC or SGC within the family. Additional cases were confirmed by review of the medical records concerning these patients. RESULTS: During the 11 years from 1980 through 1990, 17 of 63 (27%) cases in Greenland were found in familial clusters among first-degree relatives. There were no differences in the life-styles of multiple-case families and single-case families. CONCLUSIONS: The high rate of familial clusters among natives of Greenland is of interest because EBV is believed to play a role in the origin of these two diseases similar to that of Marek disease in neurolymphomatosis of chickens. Therefore, the familial clustering of NPC and SGC may indicate that an enhanced oncogenic potential of an EBV strain may occur more frequently in Greenland than in other parts of the world.
Rat hepatocyte long-term cultures were utilized to investigate the impact of different polyunsaturated fatty acids (PUFA) on the insulin-induced de novo fatty acid synthesis in vitro. The addition of 0.5 mM albumin-complexed oleic, linoleic, columbinic, arachidonic, eicosapentaenoic or docosahexaenoic acid resulted in a marked suppression of fatty acid synthesis. By evaluation of cell viability (determined as the leakage of lactate dehydrogenase (LDH) it turned out, that the antioxidant used (50 microM alpha-tocopherol phosphate) had a low antioxidant activity, resulting in cytotoxic effects by the peroxidized PUFA. Arachidonic acid and eicosapentaenoic acid showed a dose- and time-dependent cytotoxicity. Two other antioxidants: 50 microM alpha-tocopherol acid succinate and 1 microM N,N'-diphenyl-1,4-phenylenediamine, both proved more efficient than alpha-tocopherol phosphate. There was a significant correlation between LDH-leakage and inhibition of fatty acid synthesis. Lipid peroxidation, measured as thiobarbituric acid-reactive substances, also showed a significant correlation with the degree of inhibition of fatty acid synthesis. Furthermore, PUFA had no inhibitory effect on fatty acid synthesis when peroxidation was minimized by the use of proper antioxidants. These data indicate that PUFA in vitro inhibit the insulin-induced de novo fatty acid synthesis in hepatocytes from starved rats, due to cytotoxic effects caused by lipid peroxidation.
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We have measured the capacity of the sodium-potassium pump, as assessed by 86rubidium uptake and the number of [3H]-ouabain binding sites on white blood cells, in children aged 9-11 years, partly cross-sectionally and partly longitudinally after a physical training programme. Children from a hypertensive subgroup comprising the upper 5% of the blood pressure distribution and children from a randomly selected normotensive subgroup were eligible for the study. In the cross-sectional study 40 children from the hypertensive subgroup and 40 children from the normotensive subgroup were evaluated. A significant increase in 86rubidium uptake was present in boys as compared to girls. After adjustment for differences in sexual maturation the observed significant difference disappeared. Important correlates of pump activity were height, plasma glucose, and physical fitness. In the training study 10 boys from the hypertensive subgroup and 10 boys from the normotensive subgroup were also evaluated after eight months of physical training. A significant fall in 86rubidium uptake was observed. No control group was examined and probably the changes reflect some effects of sexual maturation on cation handling of cells. These results indicate a significant effect of sexual maturation in capacity of sodium-potassium pump in children.