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J F Larsen

Publications and source records attributed to J F Larsen.

At least 19 recordsLinked to original sources
PubMed1999

[Laparoscopic cholecystectomy as a same-day surgical procedure].

The aim of this study was to describe the results of laparoscopic cholecystectomy as an outpatient procedure in a prospective, consecutive, descriptive study. The study included 50 patients selected in the period from April to December 1997, who accepted the outpatient procedure. Preoperative complications, morbidity during hospital stay, length of hospital stay, frequency of readmission and the satisfaction of the patients were registered. In our investigation we found a risk of preoperative complications of 6% (severe 0%), a morbidity during hospital stay of 6% (severe 2%) and an incidence of readmission of 4%. A total of 74% of the patient went home on the same day as the procedure, and 90% of all patients had been discharged 24 hours later. The patients showed a high degree of satisfaction. In conclusion laparoscopic cholecystectomy as an outpatient procedure may be performed with a low risk of complications, a low incidence of readmission, a high degree of satisfaction in patients, but with a high frequency of primary admission (26%).

Adolescent↗
PubMed1999

[Early medical abortion. An update].

Early medical abortion was introduced in Denmark in 1998. In countries in which this practice has been in use for several years, clinical studies have identified an effective and at the same time gentle regimen. For the time being, this regimen is a combination of the antiprogestogen "mifepristone" and a prostaglandin E1 analogue. Among women with pregnancies up to eight weeks of gestation, 95% will have a complete abortion on a regimen of 600 mg oral mifepristone combined 24 hours later with 1 mg vaginal gemeprost. About five percent will undergo evacuation due to incomplete abortion or heavy bleeding. Although many women experience moderate or severe pain, nausea or vomiting, the tolerability is generally good. Complications wuch as infection or excessive bleeding occur in less than one percent. It is concluded that medical abortion is a good alternative to surgical abortion, and that women who wish an abortion have to be referred to hospital as early as possible in order not to pass the time limit of medical abortion.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

[The first 100 early medical abortions].

Early medical abortion was introduced in Denmark in 1998. This article describes our experiences with the first 100 patients at Herlev University Hospital. The regimen was 600 mg mifepriston (RU486) given orally on day one. All women had an ultrasound examination before RU486 was given in order to ensure an intrauterine pregnancy and a gestationel age of eight weeks or less, and all had a quantitative P-hCG. On day three the patients received 1 mg gemeprost as vagitory as well as a paracetamol/-codein suppository. They were observed in the department for four hours, and were thereafter discharged no matter whether a complete abortion had occurred ot not. On day 14 a new P-hCG was taken. All women in whom the hCG value was not reduced to one half of the initial value or less underwent a new ultrasound examination. All women were given a questionnaire. The effectivity was 96%. Four of 100 women were evacuated: one due to severe vaginal bleeding four hours after application of gemeprost, two because of womiting soon after having taken RU486 and one due to incomplete abortion. Half of the women began to bleed before application of gemeprost, and 91% had bleeding for more than six days. One half had no side effects to mifepristone, the other half had mild nausea. Nine of ten patients were sufficiently relieved of pain without opioids, whereas 10% were insufficiently pain relieved. Eight of ten patients would choose the same method again, in case of a future need for an induced abortion. The reason for not preferring a medical abortion among the remaining 20% was primarily pain. Early medical abortion should be offered to all women referred for induced abortion with a gestational age of eight weeks or less.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

Coagulation and fibrinolysis during laparoscopic cholecystectomy.

Laparoscopic surgery appears to be less traumatic to the patient than open surgery, but its influence upon coagulation and fibrinolysis is incompletely elucidated. Our aim was to measure markers of coagulation and fibrinolysis before, during. and after laparoscopic cholecystectomy (LC). Blood samples drawn on admission, on four occasions during operation as well as 2 hours after operation and on the first postoperative day in 50 patients undergoing elective LC were analyzed for prothrombin fragment 1+2 (F1+2), soluble fibrin (SF), D-dimer (DD), fibrin degradation products (FbDP), tissue-type plasminogen activator (tPA) activity and antigen, and plasminogen activator inhibitor (PAI) activity and antigen. F1+2, SF, DD, and FbDP levels increased significantly after LC. Differences between pre- and postoperative PAI and tPA levels were not significant apart from a transient increase in tPA antigen levels. tPA activity was significantly increased during operation.

Adult↗
PubMed1999

Presence of uterine pinopodes at the embryo-endometrial interface during human implantation in vitro.

In order to study changes occurring on the surfaces of human endometrial epithelial cells in the presence of an implanted blastocyst, we used scanning electron microscopy for investigation of five endometrial biopsies and three human implantation sites obtained in vitro. All specimens showed areas with endometrial pinopodes, separated by cells displaying microvilli or cilia at the apical surface. Pinopode formation was more pronounced in endometrial biopsies than in cell cultures. All blastocysts adhered to pinopode presenting cells. Endometrial surface changes were not seen around the blastocysts. The results of this study demonstrate that cultured endometrial epithelial cells are capable of pinopode formation. Furthermore, endometrial epithelial pinopodes, generally considered as a marker of endometrial receptivity, seem to be directly involved in the adhesion of the blastocyst to the endometrial surface.

Blastocyst↗
PubMed1998

[ERCP and laparoscopic cholecystectomy].

The use of perioperative endoscopic retrograde cholangiopancreatography (ERCP) for suspected common bile duct stones (CBDS) was investigated retrospectively in 153 of 477 patients undergoing laparoscopic cholecystectomy (LC). Pre- and postoperative ERCP was performed in 141 patients (29.6%) and 12 patients (2.5%), respectively. Successful cannulation of the CBD was achieved in 95%. Preoperative CBDS were found in 40/141 patients (28%), of whom 65% were successfully retracted during one session and 35% during two sessions. Twelve patients underwent postoperative ERCP of whom eight patients had CBDS. The complication rate of preoperative ERCP was 9.9%. There was no mortality. Prediction of CBDS diagnosed by preoperative ERCP, using history, liver biochemistry, ultrasonography and combination of biochemistry and ultrasonography showed values of 2.2%, 37.5%, 33.3% and 55.6%, respectively. The diagnostic and therapeutic success rate of ERCP is acceptable. However, the low rate of CBDS in patients undergoing ERCP preoperatively calls for a more selective use of ERCP in patients undergoing LC. History, liver biochemistry and ultrasonography are inefficient methods of patient selection.

Adolescent↗
PubMed1997

Co-ordinated expression of MMP-2 and its putative activator, MT1-MMP, in human placentation.

The spatial expression of mRNA for matrix metalloproteinase 2 (MMP-2), its putative activator, the membrane-type 1 matrix metalloproteinase (MT1-MMP), and the MMP-2 substrate type IV collagen was investigated in human placentas of both normal and tubal ectopic pregnancies and in cyclic endometrium using in-situ hybridization. Cytokeratin staining applied to adjacent sections was used to identify epithelial and trophoblast cells. In both normal and tubal pregnancies MT1-MMP, MMP-2 and type IV collagen mRNA were highly expressed and co-localized in the extravillous cytotrophoblasts of anchoring villi, in cytotrophoblasts that had penatrated into the placental bed and in cytotrophoblastic cell islands. In addition, the decidual cells of normal pregnancies in some areas co-expressed MT1-MMP and MMP-2 mRNA, with moderate signals for both components. Fibroblast-like stromal cells in tubal pregnancies were positive for MMP-2 mRNA but generally negative for MT1-MMP mRNA. The consistent co-localization of MT1-MMP with MMP-2 and type IV collagen in the same subset of cytotrophoblasts strongly suggests that all three components co-operate in the tightly regulated fetal invasion process. The co-expression of MT1-MMP and MMP-2 mRNA in some of the decidual cells indicates that these cells are also actively involved in the placentation process.

Chorionic Villi↗
PubMed1996

[Improved prenatal diagnostic possibilities for congenital abnormalities and chromosomal disorders. Advantages and disadvantages of screening and diagnostic methods].

Significant progress has taken place in recent years regarding prenatal screening and diagnosis of severe foetal malformations and chromosomal disorders. This review describes blood sample screening in 15-16 week of pregnancy compared with the other prenatal examinations such as amniocentesis and chorionic villus sampling. Serological screening of all pregnant women based on a blood sample taken at 15-16 weeks of pregnancy would lead to identification of about 70% of the screened women having to undergo a conclusive investigation i.e. either a thorough ultrasound examination or an amniocentesis. This is compared with the present Danish prenatal program, where invasive examinations are carried out in about 13% pregnant women without a high detection rate for malformations and chromosome disorders. The Danish National Health Board has recently published new guidelines where the blood test is primarily offered to pregnant women over 34 years of age and not to all pregnant women as in many other countries.

Chromosome Aberrations↗
PubMed1996

Why has conventional intrapartum cardiotocography not given the expected results?

It is probable that conventional electronic fetal monitoring (EFM) has reduced the intrapartum death rate, but the expected dramatic reduction in neurological handicap has not occurred. There are two reasons for this: the majority of infants, who develop neurological problems have been harmed before the onset of labor, and the method of EFM has been more difficult to use in daily routine than expected. However, EFM is the best method we have to monitor high risk cases and the results can be improved by better training of the staff.

Brain Injuries↗
PubMed1996

Plasminogen activators and plasminogen activator inhibitor in portal blood from patients with and without gastric malignancy.

BACKGROUND: Plasminogen activators (PA) may be released by the gut and eliminated by the liver. Patients with liver disorders or malignancy often have abnormal plasma levels of PAs. Some tumours may produce PAs. METHODS: In patients undergoing gastric surgery for malignant (n = 18) or benign (n = 21) disorders., blood drawn from the portal vein and a peripheral vein was analysed for tissue-type plasminogen activator antigen and activity (tPA: Ag, tPA: Act), single-chain urokinase-type plasminogen activator activity (scuPA: Act), and plasminogen activator inhibitor antigen and activity (PAI: Ag, PAI: Act). RESULTS AND CONCLUSIONS: In both groups tPA: Act and scuPA: Act levels were significantly higher in portal blood than in peripheral blood, but tPA: Ag and PAI: Act levels did not differ. PAI: Act levels were significantly lower in patients with malignant disease, but levels of the other markers did not differ in the two groups.

Adult↗
PubMed1995

Ultrastructure of endometrial epithelial cells in a three-dimensional cell culture system for human implantation studies.

PURPOSE: A three-dimensional cell culture system imitating normal uterine endometrium has previously been established. To what degree do cultured epithelial cells retain their morphological characteristics as compared to in vivo material obtained simultaneously from the same tissue donor. RESULTS: We found a high degree of similarity between the in vivo and in vitro situations. The present culture system furthermore imitates the day-to-day morphology of the cycle. CONCLUSIONS: This indicates, that a correct timing of the biopsy tissue is important for future human implantation studies.

Biopsy↗
PubMed1994

Isolation and culture of human endometrial cells in a three-dimensional culture system.

A cell culture system was established in which endometrial stromal cells were embedded in a collagen matrix and separated from the endometrial epithelium by basement membrane material (Matrigel). The epithelium, seeded on top of the collagen matrix, grew in a monolayer. The cultures were evaluated by light microscopy and transmission and scanning electron microscopy. Light and transmission electron microscopy indicated a polarized columnar epithelium in monolayer with basally positioned nuclei. Scanning electron microscopy revealed a confluent epithelium with an abundance of microvilli and cilia, as well as pinopodes on the apical surface. Immunohistochemical staining for cytokeratin confirmed the epithelial origin of the surface cells, and staining for human collagen IV demonstrated its presence underneath the epithelial cells. This culture system represents a three-dimensional system that imitates the normal endometrium.

Biocompatible Materials↗
PubMed1994

Markers of coagulation and fibrinolysis in portal blood from patients with and without gastric malignancy.

BACKGROUND: The origin of coagulation and fibrinolysis abnormalities in cancer patients is unknown. The aim of this study was to measure markers of coagulation and fibrinolysis in portal and peripheral blood from patients with and without gastric malignancy. METHODS: Blood samples were drawn from the portal vein and a peripheral vein in 39 patients undergoing elective gastric surgery, 18 for gastric malignancy and 21 for benign disorders, and analyzed for prothrombin fragment 1 + 2 (F1 + 2), thrombin-anti-thrombin III complex (TAT), fibrinogen and fibrin degradation products (FgDP, FbDP), and fibrinopeptide A (FpA). RESULTS AND CONCLUSIONS: In portal blood, levels of F1 + 2, TAT, FpA, FgDP, and FbDP did not differ in the two groups. In peripheral blood, levels of FpA and FbDP were higher in cancer patients, but in a multiple regression model malignancy did not contribute significantly to variation in peripheral FpA or FbDP levels. In both groups FpA levels were higher in portal blood than in peripheral blood.

Antithrombin III↗