Search PubMedSearch

Biomedical subjects

J Wilske

Publications and source records attributed to J Wilske.

At least 19 recordsLinked to original sources

Vitamin D status, parathyroid function and femoral bone density in an elderly Swedish population living at home.

The aim of this study was to determine vitamin D status and bone mineral density (BMD) in elderly, independent Scandinavians. A cross-sectional examination was conducted in a sample of 104 subjects (mean age 84.5 years), for possible correlations among anthropometric data, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, intact parathyroid hormone (PTH) and femoral neck BMD. Daily dietary calcium and vitamin D intakes were below the recommended levels. Five percent of the subjects were taking calcium, and 30% vitamin D supplements. Previous fragility fracture was reported in 30% of the men, and 55% of the women. Higher mean values of serum 25-hydroxyvitamin D (p = 0.03) and femoral neck BMD (p = 0.03) were recorded in subjects spending > or = 3 hours outdoors weekly. Independently of time spent outdoors, subjects taking daily supplements of vitamin D (on average 5 micrograms) had higher 25-hydroxyvitamin D (p < 0.001) levels, without significant changes in femoral neck BMD values. Serum levels of intact PTH (reference range 8-51 ng/L) were elevated in 41%, of which 5% had mild primary hyperparathyroidism. Serum levels of 25-hydroxyvitamin D (reference range 10-65 ng/mL) and 1,25-dihydroxyvitamin D (reference range 15-55 pg/mL) were below the reference ranges in 4% and 5% of the subjects, respectively. When serum levels of 25-hydroxyvitamin D were lower than approximately 30 ng/mL, the serum intact PTH values began to increase from a level of 43 pg/mL. This threshold most probably reflected a more relevant value of vitamin D insufficiency, indicating that 45% of our subjects rather than 4% actually had hypovitaminosis. Multiple regression analysis demonstrated femoral neck BMD to be significantly and positively associated with higher body mass index, male gender, no history of fragility fracture and 25-hydroxyvitamin D (R2 = 0.39). It is concluded that in this sample of healthy elderly people who regularly spend time outdoors, vitamin D levels leading to secondary hyperparathyroidism seem to be a major cause of osteoporosis. Correcting chronic dietary calcium deficiency is likely to eliminate another factor contributing to poor bone health.

Absorptiometry, Photon

Blood lead in Uruguayan children and possible sources of exposure.

Blood samples and questionnaire background data were collected from 96 children (age 2-14 years) living in urban, suburban, or rural areas with varying traffic intensity and industrial lead pollution in Uruguay. Spot samples of tap water were collected from the homes of 44 children, and samples of top soil were taken from seven areas. Samples of air-borne dust were collected in central and suburban Montevideo. Blood lead concentrations (B-Pb) in children ranged between 47 and 191 (mean 96) micrograms/L and exceeded in 36% of the children 100 micrograms/L, the intervention level adopted by the United States Centers for Disease Control. Lead in tap water ranged from 0.2 to 230 (mean 15) micrograms/L and exceeded in 39% of the samples the maximum level recommended by WHO, 10 micrograms/L. Lead pipes were used in parts of the water supply systems. Lead in air varied between different locations from 0.15 to 1.7 micrograms/m3, highest in the very center of Montevideo. The median soil lead ranged from 6 to 2100 micrograms/g and was highest in industrially polluted areas. At multiple regression analysis, B-Pb was significantly associated only with age (P = 0.032) and traffic intensity at school (P = 0.045). No significant impact on B-Pb of lead in water or soil could be established.

Adolescent

Seasonal variation in vitamin D metabolites in southern elephant seal (Mirounga leonina) females at south Georgia.

Southern elephant seals spend two periods on land each year, during breeding and moult, exposed to intensive UV radiation. The time between periods on land are spent at sea, with little exposure to the sun. A study of serum 25-OH-D3 and 1,25(OH)2-D3 on southern elephant seals was carried out at South Georgia. Samples were collected on four different occasions: early and late breeding, and early and late moult. The levels of 25-OH-D3 increased when seals were on land, and decreased when at sea. Two annual peaks of 25-OH-D3 were found, both of which immediately followed periods of intensive exposure of UV radiation. 1,25(OH)2-D3 levels showed a seasonal variation, but no significant changes while being on land were detected. The diving behaviour at sea for southern elephant seals and no detectable change in 25-OH-D3 indicates that the seals feed on prey containing vitamin D.

Animals

Bone mineral and related biochemical variables in patients with Kock ileal reservoir or Bricker conduit for urinary diversion.

PURPOSE: Bone material content was studied with single photon absorptiometry and dual energy x-ray absorptiometry , and the various biochemical parameters related to bone metabolism in patients with Kock reservoirs or Bricker conduits for urinary diversion. MATERIALS AND METHODS: We examined 34 patients with Kock ileal reservoirs to the skin (29) or urethra (5) and 14 with Bricker conduits 2 to 17 years after urinary diversion. Bone mineral density was measured in the radius with single photon absorptiometry, and in th femur, lumbar spine and whole body with dual x-ray absorptiometry. Serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium were determined. Arterial blood gases were analyzed. RESULTS: The mean values for bone mineral density did not differ from age-matched controls in either group and no signs of decrease were observed with followup. Vitamin D serum concentration values remained within normal limits in all patients. Most patients had normal blood gas values. Mean values for osteocalcin, parathyroid hormone, bone specific alkaline phosphatase and ionized calcium also were within normal limits, although a few patients had elevated osteocalcin values indicating increased bone turnover. CONCLUSION: Urinary diversion with a Kock reservoir or Bricker conduit did not cause bone demineralization of significant changes in different markers of bone metabolism in patients examined 2 to 17 years after urinary diversion.

Absorptiometry, Photon

Serum intact parathyroid hormone in a random population sample of men and women: relationship to anthropometry, life-style factors, blood pressure, and vitamin D.

Intact parathyroid hormone (PTH) in serum was determined in a random population sample and was related to age, sex, body composition, life-style factors, blood pressure, blood lipids, plasma fibrinogen, and serum IGF-1, osteocalcin, and vitamin D. Within the framework of the WHO MONICA Project in the city of Göteborg, Sweden, 181 men and 166 women aged 25-64 years were studied. Intact PTH concentrations varied with age but were similar in both sexes (range 4-82 ng/liter) [mean (+/- SD) 23.8 +/- 10.4 ng/liter in men and 25.1 +/- 10.6 ng/liter in women]. Intact PTH concentrations increased with increasing age, body mass index, systolic blood pressure, and 1,25(OH)2D3 and decreased with increasing 25(OH)D3 in all subjects. Additionally, in men, intact PTH correlated positively to diastolic blood pressure and negatively to coffee consumption. In women, PTH also correlated negatively to smoking and IGF-1. In a multivariate analysis including all variables, age lost its significance. In both sexes there were independent positive relations between intact PTH and body mass index and 1,25(OH)2D3, and negative relations between PTH and smoking habits as well as 25(OH)D3; among men there was also negative relations between PTH and coffee consumption. The results indicate that life-style factors such as smoking and coffee consumption decrease the serum concentration of intact PTH, and the same effect is seen in individuals with low body mass index. Coffee intake, smoking, and low body mass index are also known to adversely affect bone mineral content, highlighting the relationship between PTH and bone metabolism.

Adult

Sunlight increases serum 25(OH) vitamin D concentration whereas 1,25(OH)2D3 is unaffected. Results from a general population study in Göteborg, Sweden (The WHO MONICA Project).

OBJECTIVE: To determine serum 25-hydroxyvitamin D3 [25(OH)D3] and its 1-hydroxylated metabolite [1,25(OH)2D3] and relate them to anthropometric data, life-style habits, blood pressure and selected biochemical analytes. DESIGN: Random population samples of men and women. SETTING: Göteborg, Sweden, population size 450,000 inhabitants. The study was performed within the framework of the WHO MONICA Project. SUBJECTS: 2000 randomly selected subjects were invited to the main MONICA screening. Out of those 1421 (71%) participated. Fifty individuals in each of four age-groups, 25-64 years, were selected at random for the present analyses (184 men and 198 women). RESULTS: The concentration of 25(OH)D3 was similar in both sexes whereas 1,25(OH)2D3 concentration was higher in women than in men (P = 0.01). 25(OH)D3 correlated positively to sun exposure, physical activity and negatively to intact parathyroid hormone (PTH) in both sexes, and also negatively to blood pressure in men. The remaining significant relationship for 25(OH)D3, when age and sun exposure were taken into account in multivariate analyses, was a negative correlation to intact PTH in both sexes. 1,25(OH)2D3 correlated positively to intact PTH in both men and women, negatively to height in men, positively to fibrinogen in men and positively to psychological stress and osteocalcin in women. When all variables were included in multivariate analyses 1,25(OH)2D3 concentration correlated negatively to age and positively to intact PTH and osteocalcin in both sexes together. CONCLUSIONS: Sunlight was the only external factor that influenced 25(OH)D3 concentration whereas 1,25(OH)2D3 was unaffected by sun exposure. 1,25(OH)2D3 was not related to environmental or life style factors but declined by age and correlated positively to intact PTH and osteocalcin. SPONSORSHIP: Grants from the Swedish Medical Research Council and the Swedish Heart and Lung Foundation.

Adult

Increase of calcitriol during treatment with protein-reduced diet in patients with renal failure.

Vitamin D metabolites 25-OH-D3 (calcifediol) and 1,25-(OH)2-D3 (calcitriol) were measured in plasma in 16 patients with advanced chronic renal failure during treatment with a protein-restricted diet for 6 months. The glomerular filtration rate (GFR) decreased only marginally, from 8.3 to 7.9 ml/min, during the study while there was a significant decrease of serum urea levels after the initiation of the protein-reduced diet. Calcitriol levels rose significantly (p < 0.05) after 3 months from 17.1 to 27.7 pg/ml but fell after another 3 months to nearly their initial values, 15.3 pg/ml. The serum phosphate levels changed during the same periods from 1.99 to 1.67 to 1.93 mmol/l. There were significant inverse correlations between the calcitriol and phosphate levels at the start and after 3 months but not after 6 months. There was also a significant correlation between the changes in calcitriol and initial GFR. A subgroup of patients with decreased or unchanged calcitriol concentrations during dietary treatment had significantly higher serum phosphate and creatinine and significantly lower standard bicarbonate concentrations. Multivariate regression analysis for the pooled set of data with calcitriol as the dependent variable showed significant values for GFR (p < 0.02), body mass index (p < 0.02), and serum phosphate concentrations (p < 0.04). These results show the importance of phosphate control and renal function for the regulation of calcitriol synthesis.

Adult

[Penetrating injuries of the orbital roof caused by the point of an umbrella].

Two lethal cases of penetration injury of the orbita are reported. The injuries were caused directly by the point of an umbrella (accident or homicide), leading to canalicular destruction of the frontal lobe of the cerebrum. The mechanism of injury with cerebral involvement was not determinable except by autopsy, and the importance of a thorough clinical examination is therefore emphasized.

Adult

Analysis of the immunohistochemical localization of collagen type III and V for the time-estimation of human skin wounds.

Collagen type III and V were visualized immunohistochemically in 79 surgically treated human skin wounds with a wound age between 8 h and 2.5 months. Network-like structures positively staining for collagen type III and associated with fibroblastic cells in the wound area were first detectable in a 2.5-day-old skin lesion and occurred regularly in wounds more than 5 days old. Collagen type V appeared first in the wound area after about 3 days, slightly later than collagen type III, and was detectable regularly in wounds with a survival time of 6 days or more. The immunohistochemical detection of collagen type III or type V thus indicates a wound age of at least 2-3 days. The lack of a positive reaction in a sufficient number of specimens indicates a wound age of less than 6 days. Even though both collagen types could also be detected in older wounds (wound age 2.5 months), further information for the time-estimation of older skin wounds cannot be given due to the observation that the time period during which reparative processes can be observed depends on the extent of the wound area.

Collagen

Immunohistochemical localization of collagen types I and VI in human skin wounds.

A total of 74 human skin wounds were investigated and collagen types I and VI were localized in the wound area by immunohistochemistry. Collagen type I appeared in the form of ramifying string-like structures after approximately 5-6 days, but positive reactions in the form of a spot-like staining around isolated fibroblasts also occurred in a skin wound aged 4 days. Collagen VI was detectable after a post-infliction interval of at least 3 days showing a strongly positive reacting network associated with fibroblasts in the wound area. Both collagens appeared almost constantly after a wound age of 6-7 days and could also be found in wounds aged a few months. Therefore, although a positive reaction for collagen type I in the form of string-like and ramifying structures around wound fibroblasts indicates a wound age of at least 5-6 days, a spot-like positive staining for collagen type I cannot exclude a wound age of at least 4 days. A positive staining for collagen type VI represents a post-infliction time of 3 days or more. The almost constant appearance of these collagen types suggests that negative results in a sufficient number of specimens indicate a wound age of less than 6-7 days, but cannot completely exclude longer post-infliction intervals. Since collagen type I and VI are also found in the granulation/scar tissue of lesions with advanced wound age, the immunohistochemical analysis of these proteins provides no further information for an age determination of older skin wounds.

Adult

The time-dependent localization of Ki67 antigen-positive cells in human skin wounds.

A total of 77 human skin wounds with a post-infliction interval between 3 h and 7 months were investigated and the proliferation marker antigen Ki67 was visualized in paraffin sections using a specific monoclonal antibody (MIB). The re-built epidermal layer covering the former lesional area showed only a few basal cells positively staining for Ki67 antigen. No enhanced reactivity was found when compared to uninjured skin. In basal cells of the epidermis adjacent to the wound area, however, varying numbers of positive cells occurred, but no information useful for a reliable time estimation of skin wounds could be obtained due to the considerable variability in the number of Ki67 positive epidermal basal cells found in non-damaged skin. Fibroblastic cells in the wound area revealed an increased number of Ki67-positive sites which could first be detected in a 1.5-day-old skin lesion. Positive results could be obtained in every specimen investigated after a post-infliction interval of 6 days up to 1.5 months. Only the scar tissue of the oldest wound examined (wound age 7 months) revealed no increase in the number of positively staining fibroblasts. Therefore, positive results indicate a wound age of at least approximately 1.5 days and the lack of an increased number of positive fibroblastic cells in a sufficient number of specimens indicates at a wound age of less than 6 days, but cannot totally exclude longer post-infliction intervals.

Adult

The immunohistochemical localization of alpha 1-antichymotrypsin and fibronectin and its meaning for the determination of the vitality of human skin wounds.

A total of 39 vital human skin wounds (20 cases with short survival times ranging from a few seconds to approximately 30 min and 19 cases with wound ages between 50 min and 13 days) were investigated. Alpha 1-antichymotrypsin (A1-ACT) was visualized by immunohistochemistry. Additionally, fibronectin was localized in 13 of these wounds (8 cases with short and 5 cases with longer survival times). Furthermore, 13 postmortem lesions (stab wounds) were removed from corpses approximately 4 h after infliction and analyzed for A1-ACT and fibronectin. The "vital" reaction previously described for A1-ACT in form of a band-shaped staining pattern at the wound edges was observed in both vital wounds and in most postmortem lesions. A similar reaction was also obtained for fibronectin in wounds inflicted after death, but could be unambiguously distinguished from vital fibronectin staining by morphological criteria. Therefore, it seems questionable that the vitality of skin wounds can be determined by the immunohistochemical detection of A1-ACT and probably other proteinase inhibitors. The meaning of the localization of fibronectin for the determination of the vitality of human skin wounds with a survival time of at least a few minutes could be confirmed.

Fibronectins

The immunohistochemical analysis of fibronectin, collagen type III, laminin, and cytokeratin 5 in putrified skin.

Fibronectin, collagen type III, laminin, and cytokeratin 5 were visualized in normal skin and in skin showing early or advanced signs of autolytic decomposition to prove whether the immunohistochemical analysis of these antigens can provide useful information for an age-estimation of skin wounds obtained from putrified corpses. In cases with early signs of decomposition (visible course of veins, greenish discoloration) and without microscopic alterations like relaxation of the epidermal cell layers or destruction of the blood vessel structures, the staining pattern was identical to that found in normal, non-putrefied skin. In skin already showing microscopic alteration of the tissue structure, fibronectin and collagen type III could not be localized unambiguously. The distribution of laminin and cytokeratin 5, however, was well preserved. In advanced putrefied skin no reliable staining results could be obtained for fibronectin, collagen type III, and laminin. Even though cytokeratin 5 was still detectable in remnants of decomposition-resistant skin appendages, no information useful for an age-estimation of skin wounds can be obtained due to the autolytic detachment of the epidermal layers.

Collagen

Plasma concentrations of 25-hydroxyvitamin-D3 (calcifediol) as an indicator of ultraviolet radiation.

Vitamin D3 is produced in the skin of animals and humans by the sun's ultraviolet rays (UVB region, 290-315 nm). The main metabolite 25-hydroxyvitamin-D3 has a seasonal variation, depending on the ultraviolet radiation. In the Antarctic preliminary investigations on penguins (Pygoscelis papua), female sea elephants (Mirounga leonina), and humans showed that there was an increase in plasma 25-hydroxyvitamin-D3 concentrations during UV-exposure in all three species. This metabolite can therefore be regarded as a molecular indicator of UV radiation. The possibility to use this compound in a long term monitoring program, for UV radiation, is under investigation.

Animals

Immunohistochemical localization of fibronectin as a tool for the age determination of human skin wounds.

We analyzed the distribution of fibronectin in routinely embedded tissue specimens from 53 skin wounds and 6 postmortem wounds. In postmortem wounds a faint but focal positive staining was exclusively found at the margin of the specimens which did not extend into the adjacent stroma. Vital wounds were classified into 3 groups. The first comprising lesions with wound ages ranging from a few seconds to 30 min, the second comprising those with wound ages up to 3 weeks, and the third group with lesions more than 3 weeks old. Ten out of 17 lesions with a wound age up to 30 min showed a clear positive reaction within the wound area. Three specimens in this group were completely negative, while in 4 additional cases the result was not significantly different from postmortem lesions. These 7 cases were characterized by acute death with extremely short survival times (only seconds). In wounds up to 3 weeks old fibronectin formed a distinct network containing an increasing number of inflammatory cells corresponding to the wound age. In 2 cases with a survival time of 17 days and in all wounds older than 3 weeks fibronectin was restricted to the surface of fibroblasts and to parallel arranged fibers in the granulation tissue without any network structures. We present evidence that fibronectin is a useful marker for vital wounds with a survival time of more than a few minutes. Fibronectin appears before neutrophilic granulocytes migrate into the wound area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Comparison of the solophenyl-red polarization method and the immunohistochemical analysis for collagen type III.

In the present study, we have compared the staining pattern of the Solophenyl-Red 3 BL-method for the visualization of collagen type III with the immunohistochemical staining in serial sections from 7 skin wounds (wound age 3 days up to 4 weeks) to elucidate the specificity of the histochemical staining method. Large amounts of collagen type III were clearly detectable in the investigated wounds using the immunohistochemical technique. In the sections stained with Solophenyl-Red, however, only 3 out of 7 skin lesions showed a significant positive red staining at the wound margin or in the granulation tissue, while the adjacent normal connective tissue revealed a typical intensive staining. Using polarization microscopy no characteristic bright green fibrils, as reported for collagen type III, could be seen in the wound areas without positive Solophenyl-Red staining. Since the localization of collagen type III detected by immunohistochemistry and the presumed distribution of this collagen type by the Solophenyl-Red method was not identical, the histochemical polarization method has to be regarded as non-specific for visualization of this collagen type.

Adult

Time-dependent pericellular expression of collagen type IV, laminin, and heparan sulfate proteoglycan in myofibroblasts.

Human skin wounds (n = 62) with a wound age between 5 h and 6 weeks were investigated. The appearance of cell-associated pericellular basement membrane components collagen type IV, laminin and heparan sulfate proteoglycan (HSPG) in myofibroblasts was evaluated by immunohistochemistry. Laminin and HSPG were first detectable around myofibroblasts approximately 1.5 days after wounding. Collagen type IV did not appear before the 4th day after wound infliction. In wounds more than 7 days old, 94% of the cases showed fibroblastic cells positively staining for laminin, 70% of the wounds contained fibroblastic cells positive for HSPG and in 63% a positive reaction for collagen type IV was obtained around these cells. The numbers of the cases as well as of the cells positively stained for laminin exceeded the corresponding values for HSPG and especially for collagen type IV. The pericellular appearance of laminin or HSPG around myofibroblasts, therefore, indicates a wound age of at least approximately 1.5 days. The pericellular localization of collagen type IV indicates a survival time of approximately 4 days or more. Since these proteins are still detectable in the pericellular region of myofibroblasts in skin wounds with advanced wound age (6 weeks) further information for the time-estimation of older human skin lesions cannot be obtained. A semiquantitative analysis revealed no significant correlation between the number of positively stained cells and the wound age, rendering this parameter unsuitable for a practicable time-estimation of human wounds.

Collagen

The time-dependent rearrangement of the epithelial basement membrane in human skin wounds--immunohistochemical localization of collagen IV and VII.

In 62 human skin wounds (surgical wounds, stab wounds and lacerations after surgical treatment) we analyzed the immunohistochemical localization of collagen IV in the epithelial basement membrane. In 27 of these wounds the distribution of collagen VII, which represents a specific component of the basement membrane of stratified epithelia, was also analyzed. We were able to demonstrate a virtually identical co-distribution of both collagen IV and VII in the wound area with no significant time-dependent differences in the appearance of both collagen types. Fragments of the epithelial basement membrane could be detected in the wound area from as early as 4 days after wounding and after 8 days a complete restitution of the epithelial basement membrane was observed. In all cases with a wound age of more than 21 days the basement membrane was completely reformed over the former lesional area. The period between 8 and 21 days after wounding was characterized by a wide variability ranging from complete restitution to deposition of basement membrane fragments or total lack of the epidermal basement membrane.

Adolescent