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Biomedical subjects

J Pedersen

Publications and source records attributed to J Pedersen.

At least 55 records · Page 3Linked to original sources
PubMed1998

Transurethral incision versus resection of the prostate for small to medium benign prostatic hyperplasia.

OBJECTIVE: To compare the effects of transurethral incision and resection of the prostate in patients with small to medium benign prostatic hyperplasia. PATIENTS AND METHODS: Patients were assessed preoperatively using the Madsen-Iversen symptom score, post- void residual urine volume, urinary flow and cystoscopy. Those eligible for the study were randomized to undergo either transurethral incision or resection of the prostate. Follow-up visits were scheduled at 2-3.6, 12, 24 and 60 months post-operatively with an assessment by symptom score and urinary flow rate; most patients also underwent cystoscopy at 24 and 60 months. RESULTS: The maximum urinary flow rate was significantly higher in those undergoing resection than incision at all but the last follow-up visits. Cystoscopy 24 months after surgery showed adhesions between the lateral lobes, closed incisions or obstructing prostatic lobes in most of the patients undergoing incision, but not in those resected (P < 0.001, chi-square test). During follow-up, a second transurethral procedure was carried out for persistent or recurrent symptoms, combined with a maximum urinary flow rate of < 10.0 mL/s, in 10 patients who underwent incision and in three who were resected (P = 0.039, chi-square test). CONCLUSION: Transurethral resection is preferable to transurethral incision of the prostate in the treatment of small to medium benign prostatic hyperplasia.

Aged↗
PubMed1998

Percutaneous dilatational tracheostomy versus conventional surgical tracheostomy. A clinical randomised study.

BACKGROUND: As no clinical randomised studies have previously been performed comparing complications with the Ciaglia Percutaneous Dilatational Tracheostomy Introducer Set (PDT) and conventional surgical tracheostomy (TR), we designed a study with the aim of comparing the efficacy and safety of the two techniques. METHODS: Sixty patients selected for elective tracheostomy were randomised for either PDT (30 patients) or TR (30 patients). All patients had general anaesthesia and were ventilated with 100% oxygen. Furthermore, lidocaine with epinephrine 1% (3-5 ml) was used for local analgesia and to minimise bleeding during the procedure. RESULTS: The median time for insertion of the tracheostomy tube was 11.5 min (range 7-24 min) in the PDT group and 15 min (range 5-47 min) in the TR group (P<0.01). Complications during the procedure were cuff puncture of the endotracheal tube in 5 cases in the PDT group. Minor bleeding was encountered in 6 cases in the PDT group as opposed to 24 cases in the TR group (P<0.01), major bleeding in none versus 2 cases, respectively. In 8 cases in the PDT group, increased resistance to insertion of the tracheostomy tube was met by further dilatation. During the post-tracheostomy period, complications occurred with minor bleeding in 2 cases in the PDT group as opposed to 9 cases in the TR group (P<0.05), and major bleeding was encountered in 1 case in each group. Minor infections were encountered in 3 cases in the PDT group as opposed to 11 cases in the TR group (P<0.01). Major infection was encountered in none versus 8 cases, respectively (P<0.01). CONCLUSION: Our results indicate that the percutaneous dilatational tracheostomy technique performed with the Ciaglia Introducer Set is effective, safe and superior to conventional surgical tracheostomy as immediate complications as well as complications with the tracheostomy tube in situ are fewer and of less severity.

Adolescent↗
PubMed1998

Modified ultrafiltration in paediatric cardiac surgery.

The effect of modified ultrafiltration (MUF) after cardiopulmonary bypass for paediatric cardiac surgery was evaluated in 138 children with moderate to severe congenital heart disease. The median age was 0.4 years (0 days to 6.5 years), and the weight 5.3 kg (2.2-20 kg). The operation was discontinued in six cases, three because of technical problems and three because of unstable circulation. One-hundred-and-thirty-four patients were ultrafiltrated for a median of 12 min (2-27 min) with an ultrafiltrate of median 44 ml/kg (6-118 ml/kg). Haematocrit was significantly increased from 28% (20-39%) to 36% (26-51%) and systolic arterial pressure from 56 mmHg (30-85 mmHg) to 74.0 mmHg (32-118 mmHg). Furthermore arterial oxygenation was significantly increased from 30.8 kPa (4.8-70.4 kPa) to 34.1 kPa (4.9-80.6 kPa), and arterial carbon dioxide tension from 4.8 kPa (3.1-7.3 kPa) to 5.1 kPa (3.1-7.6 kPa). Heart rate was significantly reduced from 145 beats/min (92-201 beats/min) to 136 beats/min (88-200 beats/min). There were no significant differences in central venous pressure, left atrial pressure and base excess before and after MUF. MUF increases systolic blood pressure, haematocrit, arterial oxygen and carbon dioxide tension coming off bypass in paediatric cardiac surgery and reduces heart rate and postoperative fluid overload.

Cardiac Surgical Procedures↗
PubMed1997

[Percutaneous dilatation tracheostomy. A preliminary study].

Fifteen patients electively selected for percutaneous dilatational tracheostomy as performed with the Ciaglia Percutaneous Tracheostomy Introducer Set are reported in this preliminary study. The median time for insertion of the tracheostomy tube was 13.1 min. Complications were cuff puncture of the translaryngeal tube at an early stage of the procedure in one case, and minor bleeding controllable by the compressible effect of the dilatational procedure in three cases. During the posttracheostomy period complications included one case of minor bleeding controllable by digital compression and one case of minor infection, i.e. cellulitis in a few millimetres around the stoma without purulent secretion. Our preliminary results indicate that the technique as performed with the Ciaglia Introducer Set is effective and safe with only minor complications. Furthermore, we now use it as a bed-side procedure in the ICU, thus avoiding the transportation of critically ill patients to the operating theatre. A conclusion on the superiority of percutaneous tracheostomy to dissectional tracheostomy has to await clinical randomized studies including more patients.

Adult↗
PubMed1997

Behavioral aspects of infantile autism: an ethological description.

Eighteen children classified in four diagnostic groups--Infantile Autism, Full Syndrome Present (IA), Infantile Autism, Residual State (IA-R), Hyperkinetic Syndrome (HYPER), and Mental Retardation (MR)--were mutually compared on the basis of their behavior in a free child-adult interaction. An ethological analysis of 80 behavioral elements was performed, aiming at describing this interaction in detail. The analysis demonstrated that the autistic children with full syndrome present stayed closer to the adult and that they were more inclined to decrease the interpersonal distance than the children in the three other groups. Moreover, this group was often engaged in bodily contact with the adult. However, their facial orientation towards the adult was poorly developed, in fact they usually turned away their faces. Visual attention to the adult and manipulated objects was relatively low. Hand and head gestures were rare, but facial expressions occurred very frequently. Speech was seriously impaired, but probably counterbalanced by nonarticulated sounds. Finally, the adult seemed to have modified her behavior on a par with the child she was interacting with. From a behavioral point of view the autistic group with full syndrome present was clearly distinguishable from the three comparison groups, including the group with residual state autism.

Adolescent↗
PubMed1997

Increased intramuscular concentration of bradykinin increases the static fusimotor drive to muscle spindles in neck muscles of the cat.

The aim of the present study was to investigate if increased intramuscular concentrations of bradykinin (BK) in one muscle influence the activity in primary and secondary muscle spindle afferents (MSAs) originating from both ipsi- and contralateral muscles, via fusimotor reflexes. The ipsilateral trapezius (TR) and the splenius (SP) muscles were subjected to sinusoidal stretches and 2-3 MSAs were simultaneously recorded from these muscles. Responses of 29 MSAs (15 SP and 14 TR) were registered in five adult cats anaesthetised with alpha-chloralose. Intramuscular injections of 0.5 ml BK (6-86 micrograms/ml) were administered to both the ipsi- and contralateral SP and TR muscles. Similar doses of BK (5-10 micrograms) have been shown to induce muscle pain when injected into the temporal muscle in man. The responsiveness of the MSAs to the injections of BK was 86% and 87.5% from the contralateral TR and SP muscles, respectively. The effects were predominantly static onto the MSAs. The duration of the effects was on average 3.5-4 min, however some effects lasted for more than 15 min. The effects were always abolished after cutting the nerve to the injected muscle. The large majority of the spindle afferents were unresponsive to i.m. Tyrode injections (23 of 29). For the afferents that were responsive to injection of Tyrode, the effects were always considerably smaller and with shorter duration than those evoked by BK injections. Thus, increased intramuscular concentrations of BK may excite primary and secondary MSAs from ipsi- and contralateral muscles, via fusimotor reflexes evoked most probably by activity in chemosensitive muscle afferents. The results are discussed in relation to a recent hypothesis on pathophysiological mechanisms behind genesis, spread and perpetuation of muscle tension and pain in chronic musculoskeletal pain syndromes.

Animals↗
PubMed1997

Molecular determination of dermatophyte fungi using the arbitrarily primed polymerase chain reaction.

Dermatophytes are keratinophilic fungi capable of causing dermatophytosis (commonly known as tinea or ringworm) in humans and animals. Previously, we reported the differentiation of the common dermatophytes Trichophyton rubrum, T. mentagrophytes and T. tonsurans using a random primer 5'-ACCCGACCTG-3' (OPAA11) in the arbitrarily primed polymerase chain reaction (AP-PCR). In the present study, by examining additional dermatophytes including eight Microsporum spp., 16 Trichophyton species/subspecies and Epidermophyton floccosum using both OPAA11 and a second random decamer 5'-GAGAGCCAAC-3' (OPD18) in AP-PCR, we show that except for T. rubrum and T. gourvilli, and three T. mentagrophytes varieties, most of the dermatophyte fungi investigated formed distinct DNA band patterns on gel electrophoresis. The amplification of specific DNA bands in AP-PCR appeared to be independent of culture variations shown by dermatophyte isolates. These results provide the basis for the rapid identification of dermatophytes at the genetic level, supplementing existing laboratory methods and improving the diagnosis of human dermatophytosis.

Arthrodermataceae↗
PubMed1997

PCR identification of Trichophyton mentagrophytes var. interdigitale and T. mentagrophytes var. mentagrophytes dermatophytes with a random primer.

Dermatophytes are a group of keratinophilic fungi falling within the genera of Epidermophyton, Microsporum and Trichophyton. The genus Trichophyton is particularly important and complex; it comprises at least 15 recognised species. In addition, there are several different variants in the species T. mentagrophytes, which occur both in man and animals. The current methods of determining T. mentagrophytes varieties may require several different culture media and time-consuming procedures, as well as specialist skills. This study used a random primer, 5'-GAGCCCGACT-3', in the arbitrarily primed polymerase chain reaction (AP-PCR) and showed that the two common T. mentagrophytes varieties (var. interdigitale and var. mentagrophytes) can be clearly identified on the basis of their characteristic DNA band patterns. The relative reproducibility, ease of use and precision of this method make the AP-PCR a valuable tool in the laboratory diagnosis of human dermatophytosis.

DNA Primers↗
PubMed1997

A retrospective study of the inheritance of peromelia in Angora goats.

Peromelia, agenesia of the distal parts of the limbs, has been reported as a congenital defect in several animal species. In Angora goats, cases occur in a familiar pattern consistent with an autosomal recessively inherited defect. To obtain further evidence on the inheritance of peromelia in Angora goats, breeding results for goats being daughters of known carriers and which were then mated to a known carrier were analysed. Of 45 kids born in 1993 and 1994, five kids had peromelia. This corresponded to the expected 7:1 segregation. The difference between the number of affected male and female kids was not statistically significant. Peromelia affected kids occurred significantly more frequently among goats selected in the breeding study than among other goats in the respective herds. The study demonstrated that peromelia is inherited as an autosomal recessive defect. Based on knowledge obtained in a previous study, the genotype probably has varying degrees of expressivity.

Animals↗
PubMed1997

Expression and localization of activin subunits and follistatins in tissues from men with high grade prostate cancer.

Activins are growth and differentiation factors that have growth inhibitory effects on LNCaP and DU145, but not PC3, human prostate tumor cell lines. Activin-binding proteins, follistatins, block the inhibitory actions of exogenously added activins on LNCaP and DU145 tumor cell lines. Based on these in vitro observations using human prostate tumor cell lines, the aims of this study were to determine whether activins and follistatins are expressed in the human prostate in tissues from men with high grade prostate cancer. The expression and cellular localization of these proteins in malignant and nonmalignant regions of these tissues were compared to determine whether any changes occur with progression to malignancy. The results demonstrate that activins and follistatins are synthesized in tissues from men with high grade prostate cancer, and that messenger ribonucleic acid (mRNA) and protein for the activin beta A- and beta B-subunits and follistatin is expressed and localized to poorly differentiated tumor cells. In the nonmalignant regions, activin beta A and beta B subunit mRNA and proteins are predominantly localized to the epithelium. Follistatin mRNA was expressed in the basal epithelial cells and in the fibroblastic stroma; however, the localization of follistatin proteins using two specific antisera demonstrated a difference between the follistatin isoforms expressed in basal cells and the stroma. In the progression to malignancy, the colocalization of follistatin and activins to the tumor cells in vivo implies that resistance to the growth inhibitory effects of activin may be conferred by follistatins.

Activins↗
PubMed1997

Autonomic innervation of vas deferens after autotransposition. A functional study in the rat.

In order to investigate the nerve-mediated response of vas deferens subjected to autotransposition, muscular strips were taken from various segments of rat vas. Electrical field stimulation (EFS) was applied and frequency-response curves were determined. After autotransposition the neural function was preserved, albeit the amplitude of the contractile response to EFS was smaller than in controls. Further, a reduced contractile response was noted in the vas segments proximal, as well as distal, to the transposed segment, probably due to secondary reactions to the surgical trauma. Noradrenaline and ATP seem to act as transmitter substances in the transposed vas segments because the results show a reduction of the contraction after pretreatment with prazosin or chi, beta-methylene ATP. However, the reduction recorded was less pronounced in transposed segments of vas compared with controls, indicating that other transmitter substances may contribute. No difference in contractile response could be seen between segments from fertile rats and segments from infertile animals and it is concluded that factors other than the intrinsic neural response determine fertility after autotransposition of vas.

Adenosine Triphosphate↗
PubMed1997

Perforation of continent urinary reservoirs. Scandinavian experience.

In a questionnaire survey of urological departments in Sweden, Denmark, Finland and Norway, 20 episodes of perforation of continent urinary pouches were found to have occurred in 18 patients, representing an incidence of 1.5%. This complication occurred with ileal as well as colonic segments, without predilection. In one case there was perforation of an appendiceal outlet. Noticeable findings were (a) a long delay (median 10h) to treatment and (b) that investigational procedures such as enterocystography and enterocystoscopy were not commonly employed. Treatment of this potentially lethal complication was by oversewing the perforation, and there were no subsequent major complications. This complication should be strongly suspected if a patient with continent urinary reconstruction presents with acute abdominal pain.

Abdominal Pain↗
PubMed1996

[Pregnancy and occupational environment. Counseling of pregnant women in the department of occupational medicine during the period 4 January--31 December 1992].

Since the new Sickness and Maternity Benefit Act was introduced in Denmark 1981, it has been possible to provide maintenance allowance for pregnant women working under conditions that might be harmful to the unborn child. The assessment of the risk is primarily undertaken by the general practitioner, but in cases of doubt, the pregnant women can be referred to the Department of Occupational Medicine. The assessment at the Department of Occupational Medicine is made one or two weeks after referral. It consists of a careful work history, which includes characterization of exposure, both qualitatively and quantitatively and a decision whether the exposure entails a risk to the foetus and which steps should be taken for the rest of the pregnancy. The purpose of this study was to describe the practice of risk assessment at the Department of Occupational Medicine in Denmark. Over a period of nine months all cases of pregnant women referred to 12 out of 14 departments were reviewed. Out of 60,000 births per year only 250 pregnant women were referred, which is less than 1%. Main risk factors in the assessment were of chemical (80%) or ergonomic (17%) origin. Forty-three percent were advised to leave work on maintenance allowance and 15% were advised to stay at work, on condition that the work environment was changed or they could be moved to a job without risk exposure. The study revealed big differences in referral incidence between the different counties as well as differences in risk assessment practice. It is concluded, that the best way to secure pregnant women and their foetus is by primary prophylactic measures at the workplace. Hopefully the new EU Directive 92/85 will be a step in that direction.

Counseling↗
PubMed1996

Genetic speciation of Candida isolates by arbitrarily primed polymerase chain reaction.

Candida species are opportunistic human pathogens capable of causing a variety of clinical diseases. Rapid and precise identification of Candida to species level is essential for effective treatment and management strategies. Conventional diagnosis of candidiasis is sometimes slow and variable. By using a random primer 5'-ACGGGCCAGT-3' in arbitrarily primed polymerase chain reaction, seven common Candida species (i.e., C. albicans, C. guilliermondii, C. parapsilosis, C. krusei, C. lipolytica, C. tropicalis and C. (Torulopsis) glabrata) produced characteristic DNA band patterns, which enabled rapid determination to species level among them. Further analysis of the nucleotide sequences of Candida specific fragments should improve our understanding of the molecular structures and possible functions of the gene regions involved.

Candida↗
PubMed1996

Ensemble coding of muscle stretches in afferent populations containing different types of muscle afferents.

Ensemble coding of simple mechanical stimuli (small sinusoidal stretches) was studied in simultaneously recorded mixed ensembles of primary- and secondary muscle spindle afferents (MSAs), and Golgi tendon organ (GTO) afferents recorded from L7-S1 dorsal root filaments. The experiments were made on 48 recorded afferents (29 primary MSAs, 6 secondary MSAs and 13 GTO afferents) in chloralose anaesthetised cats. For the analyses, we used a combination of principal component analysis and algorithms for quantification of stimulus discrimination. Mixed ensembles of primary- and secondary MSAs, and GTO afferents, discriminated significantly better between different muscle stretches than ensembles of only one or two types of these afferents. All kinds of ensembles showed a successive increase in discriminative ability with increased ensemble size and this ability seemed to level at larger populations. However, the increase in discriminative ability was significantly greater for the mixed ensembles. It is hypothesised that the main reason for the greater discriminative ability achieved by mixed ensembles, might be that the variation in response profiles (sensitivity tuning) among the individual afferents of the mixed ensemble will be larger than that for ensembles of only one type of afferent. Finally, the results in the present study give experimental support to some of the teleological arguments in favour of the ensemble coding theory.

Animals↗
PubMed1996

Use of arbitrarily primed polymerase chain reaction to differentiate Trichophyton dermatophytes.

Dermatophytes such as Trichophyton species are common human pathogens, the infection of which results in dermatophytosis (also known as ringworm). Several laboratory tests are used routinely for the diagnosis of dermatophytosis, but they are either slow or lacking specificity. Through examination of genomic DNA from Trichophyton dermatophytes and other fungi in arbitrarily primed PCR, it was shown that a random primer 5'-ACCCGACCTG-3' produced bands of 4.3 kb, 1.9 kb, 1.7 kb and 0.7 kb in T. rubrum DNA, bands of 2.5 kb, 1.9 kb and 0.8 kb in T. mentagrophytes var. interdigitale and T. mentagrophytes var. mentagrophytes DNA, and bands of 2.5 kb, 1.9 kb, 1.5 kb and 0.9 kb in T. tonsurans DNA. This primer amplified bands of different sizes in other fungal DNA. Therefore, based on the distinct band patterns observed in arbitrarily primed PCR using this primer, T. rubrum, T. mentagrophytes and T. tonsurans dermatophytes could be rapidly differentiated.

DNA Primers↗