Biomedical subjects
Publications and source records attributed to J Jensen.
An 18-year-old male giraffe developed a verrucous lesion, 50 cm in diameter, on a flank. Some areas of the lesion were histologically typical of a viral verruca with papillomatosis, prominent hypergranulosis, and inclusion bodies. The bulk of the mass was a well-differentiated verrucous type of squamous cell carcinoma. It may be that the virus of the verruca also caused the verrucous carcinoma.
To determine the relationship between malnutrition and immune status in older and younger outpatients, we assessed 179 outpatient men according to nine markers of malnutrition and assigned them to a well nourished or a malnourished group. Immune status was measured by mixed lymphocyte culture, lymphocyte response to three mitogens, neutrophil chemotaxis, and immunoglobulin levels. Each group was further divided into those 65 years and older (28%) and those younger than 65 years (72%). Malnutrition was present in 29% of the younger group and 38% of the older. Malnourished patients had less lymphocyte response to allogeneic cells and to phytohemagglutinin, but more response to pokeweed and higher IgA levels. In the younger group chemotaxis results showed that malnourished persons had higher responses than well nourished; the trend was opposite in the older group. More differences in immune status were found between malnourished and well nourished than between old and young, but more unfavorable responses were found in the older malnourished than in any other group. The study suggests that malnutrition is common among outpatients and that depressed immune responses associated with malnutrition can lead to disease, particularly in the elderly.
One hundred and fourteen in- and out-patients from a department of internal medicine were interviewed, on the basis of a questionnaire with the following key questions: 1) Their attitudes to medical trials with man as the subject. 2) Their emphasis on informed consent. 3) Their attitudes to inclusion of patients not being able to give informed consent. 4) Their attitudes to tentative participation in 4 concrete projects. In all, 98% considered doctors' and patients' collaboration on new therapeutical methods both necessary and desirable. Eighty-eight per cent considered information of patients participating in trials a prerequisite. Eighty-six per cent accepted participation in scientific trials based on the guarantee of the doctors responsible. Of these 86%, 58% felt that a scientific-ethical committee's accept of the project implied an extra element of security. Seventy-five per cent replied that patients not being able to give informed consent themselves could be included in scientific trials. The majority, 77%, added that patients' relatives would then have to accept, 20% that such trials could be based on the participating doctors' responsibility, and only 2% that such a responsibility was to place on scientific-ethical committees. In the 4 concrete projects, answers followed a uniform trend: full information of patients was demanded by approximately 80%, and acceptance of participation resting with responsible doctors in more than 80%. Less than half of these 80% felt that evaluation by a scientific-ethical committee would add to patients' security.
Using a rate-dialysis technique at 0-2 degrees C, the affinities of Na+ and K+ for the sodium pump of pig kidney outer medulla were determined from their effects on the binding of ADP to the enzyme. Since all experiments were carried out in the presence of Tris, the enzyme in absence of its specific ligands was assumed to be in a 'sodium-like' conformation. The model used in the analysis of the results assumed the enzyme to be a dimeric structure with two identical high-affinity nucleotide-binding sites. It is concluded from the data that the effects of Na+ and K+ on the binding of nucleotide to either subunit of a nucleotide-free enzyme are identical. The two subunits, taken together, have five identical and non-interacting K+-binding sites (Kdiss = 0.5 mM) whose occupation antagonizes nucleotide binding. The binding of a nucleotide molecule to a nucleotide-free enzyme results in the abolition of K+ binding to two of the five K+-binding sites. The binding of the second molecule of nucleotide prevents the binding of three more K+ ions to the enzyme. These results can explain the K+-induced curvature observed in nucleotide-binding isotherms in Scatchard plots. The two subunits, taken together, have five identical and non-interacting Na+-binding sites (Kdiss = 0.5 mM) whose occupation antagonizes the effects of K+ on nucleotide binding, but does not affect nucleotide binding directly. A few experiments carried out at 18 degrees C indicate that the model applies also at this temperature. It is likely that the cation sites investigated are intracellular ones and it is concluded that the binding of each cation to its site induces a specific conformational change in the neighbourhood of the site itself without affecting the regions around the remaining cation binding sites.
The expression of B cell associated and restricted antigens on tumor cells isolated from 138 patients with non-T cell acute lymphoblastic leukemia (non-T cell ALL) was investigated by flow cytometric analysis by means of a panel of monoclonal antibodies. Tumor cells from these patients could be assigned to one of four subgroups: human leukocyte antigen-DR-related Ia-like antigens (Ia) alone (4%, stage I); IaB4 (14%, stage II); IaB4CALLA (33%, stage III); and IaB4CALLAB1 (49%, stage IV). The expression of B cell-restricted antigens (B4 and B1) and rearrangements of Ig heavy chain genes provided strong evidence for the B cell lineage of stages II, III, and IV tumors. The lineage of the Ia alone group is still unknown. The B4 antigen was expressed on approximately 95% of all non-T cell ALLs tested, and given its absence on T cell and myeloid tumors, it appears to be an exceptional marker to define cells of B lineage. The demonstration that Ia alone, IaB4, IaB4CALLA, and IaB4CALLAB1 positive cells can be readily identified by dual fluorescence analysis in normal fetal and adult bone marrow provided critical support for the view that these leukemic pre-B cell phenotypes were representative of the stages of normal pre-B cell differentiation. It was interesting that the IaB4+ cell was more frequently identified in fetal bone marrow than in adult marrow, whereas the predominant cell found in adult marrow expressed the IaB4CALLAB1 phenotype. These data suggest that the leukemogenic event may be random, since the predominant pre-B cell leukemic phenotype appears to correspond to the normal pre-B cell phenotype present in these hematopoietic organs. Our observations provide an additional distinction between adult and childhood ALL, since these studies show that most non-T cell ALLs seen in children less than 2 yr old are of stage II phenotype, whereas the majority of non-T ALLs in adults are of stage IV phenotype. Finally, it should be noted that the present study suggests that the analysis of leukemic B cell phenotypes and their normal counterparts can provide a mechanism for the investigation and orderly definition of stages of pre-B cell differentiation in man.
The consequences of occupational accidents to the injured have been studied in a follow-up investigation of an emergency department material comprising almost 7 000 patients. The accident resulted in sick leave for 51% (on average 14.9 working days), in a reduced income for 31% (on average 2 125 Danish 1982 kroner), in a prolonged physical handicap for 6%, in hospitalization for 4.2% (on average 27 days), and in occupational consequences for 1.5%.
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In a double-blind study 83 patients with duodenal ulcers, initially healed after treatment with either 1 g cimetidine daily or 50 mg trimipramine daily, were allocated by randomization to maintenance treatment with either 400 mg cimetidine daily, 25 mg trimipramine daily, or placebo for 6 months. Monthly clinical interviews were carried out and endoscopy performed whenever the symptoms suggested ulcer relapse. After 6 months the treatment was discontinued, and the patients were observed similarly for another 6-month period. After 6 months of maintenance treatment 88% in the cimetidine group versus 55% in the trimipramine group and 53% in the placebo group remained in symptomatic remission, yielding a significant difference between the cimetidine-treated patients and the two other groups (P less than 0.05). After a further 6 months of drug-free follow-up study, the percentages were 48% versus 29% and 29% in the cimetidine, trimipramine, and placebo groups, respectively (P less than 0.05). Thus maintenance treatment with trimipramine proved no better than placebo in preventing relapses of duodenal ulcers. Second, maintenance treatment with 400 mg cimetidine daily did prevent ulcer relapse, and, third, maintenance treatment with cimetidine for 6 months did not alter the long-term course of the duodenal ulcer disease.
A prospective study of 292 consecutive patients with 303 tumours was performed to appraise the combination of physical examination, mammography and fine-needle puncture (triple test) in the diagnosis of breast tumours. The diagnostic accuracy of the triple test was 100%. Because of its relative smallness, however, the series does not permit the conclusion that a benign result of triple test makes excisional biopsy unnecessary. It is emphasized that a follow-up regimen with participation of radiologists and cytologists is required. Fine-needle puncture with cytologic examination of the aspirate is recommended as a routine procedure in the diagnosis of breast tumours.
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