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K Bjøro

Publications and source records attributed to K Bjøro.

At least 19 recordsLinked to original sources

[Treatment of hepatitis C].

Hepatitis C virus (HCV) has been a major cause of post transfusion hepatitis, and is still an important cause of chronic liver disease throughout the world. How to treat patients with chronic HCV infection has been brought into focus in recent years, and a substantial amount of data has been obtained about the development of hepatitis C with and without treatment. This survey considers the diagnosis of hepatitis C, and present treatment modalities and their potential. The patients most likely to respond to treatment are described, and the authors finally discuss why treatment of hepatitis C still should take place in controlled studies.

Hepatitis C

[Liver transplantation in Norway. Results after 10 years and 114 transplantations].

A total of 114 liver transplantations were performed in 106 patients in Norway during 1984-1994. Survival after one year was 65% and after three years 57%. The most frequent causes of death were infections and rejections. The survival rate improved considerably during the period, and after 1990 the 1 year survival was 70%. Approximately 2/3 of the patients return to work or education. Very few patients die later than 12 months after the transplantation. The most frequent indications were primary biliary cirrhosis, metabolic liver disease, primary sclerosing cholangitis, autoimmune cirrhosis and fulminant liver failure. The number of liver transplantations (approximately 4 per million inhabitants) is lower in Norway than in the other Nordic countries. The number should be increased to 7-8 per million inhabitants.

Adolescent

Effect of phenazone (antipyrine) on the prostanoid formation in human umbilical arteries perfused in vitro.

The influence of phenazone on the production of prostacyclin and thromboxane in human umbilical arteries was investigated by in vitro perfusion. With perfusate concentrations ranging from 10(-7) to 10(-4) M a decrease in the formation of both prostanoids was observed. The inhibitory effect of phenazone on prostanoid formation was found to be equal to that of indomethacin.

Antipyrine

D-penicillamine inhibits the action of reactive oxygen species in the pig pulmonary circulation.

Oxygen radicals produced by the hypoxanthine-xanthine oxidase (Hyp-XO) system potently constrict the pulmonary circulation of pigs. D-penicillamine (DPA) is thought to be a free radical scavenger. In the present work we have studied if DPA may influence the vasoactive action of Hyp-XO in pig lungs. Further, we have measured how this drug influences the output of cyclooxygenase and lipoxygenase products from the left atrium in pigs infused with XO into the pulmonary circulation. Twelve young pigs were divided into two groups. Group 1, the XO group, was infused 1 U/kg XO into right atrium. Group 2, the DPA group, was pretreated with DPA, 100 mg/kg intravenously before XO infusion as in group 1. Pulmonary artery pressure, left atrial pressure, pulmonary artery blood flow and systemic blood flow and pressure were recorded continuously. Plasma tromboxane B2 and prostaglandin (6-keto-PGF1 alpha) were determined with a radioimmunoassay method. Cysteinyl containing leukotrienes LTC4, LTD4, and LTE4, were measured together by RIA analyses of plasma samples, using a monoclonal antibody. There was a significant parallel decrease in paO2 and saO2 during the 130 minutes duration of the experiments in both groups without differences between the groups. Pulmonary vascular pressure and resistance increased sharply with a peak found after 25 minutes in the XO group. DPA attenuated the hemodynamic response. DPA inhibited the XO induced pulmonary blood pressure changes with 80% and inhibited the increase in pulmonary vascular resistance 68%. Plasma TXB2 increased two folds in the XO group reaching a maximum after 40 minutes, this effect was completely inhibited by DPA (92% inhibition). DPA also inhibited the XO induced increase in 6-keto-PGF1 alpha, however, not as efficient as with TXB2 (40% inhibition). Plasma cysteinyl leukotrienes increased after XO infusion reaching a peak at 20 minutes. DPA completely abolished this effect (100% inhibition). The study demonstrates that DPA attenuates or even abolishes the hemodynamic effects of XO on the pulmonary circulation in pigs. It seems that DPA inhibits the production of both lipoxygenase and cyclooxygenase products per se, and it is tempting to speculate that the observed DPA effect is caused by its action as an oxygen radical scavenger. It is further speculated that the vasoconstricting effect of XO is due to the fact that oxygen radicals may inactivate nitric oxide (NO), and that DPA stabilizes NO so it more efficiently possess its vasorelaxant activity. We conclude that DPA is an extremely potent inhibitor of XO induced pulmonary vascular effects. The mechanism of action is not fully understood, although its action as an oxygen radical scavenger may explain part of it.

Animals

Monstrous ascites in hereditary haemorrhagic telangiectasia.

BACKGROUND: Hepatic involvement in hereditary haemorrhagic telangiectasia (HHT) consisting of fibrosis, telangiectases, and cirrhosis, has been reported as a relatively frequent finding. CASE: A 50-year-old man with HHT presented with monstrous ascites. Liver biopsy demonstrated multiple dilated sinusoids but not cirrhosis. There were no findings indicative of portal hypertension or malignant disease. Portal pressure, recorded in hepatic vein wedge position, was normal. Arteriography showed numerous hypervascular lesions throughout the liver. The clinical course has been stable for more than 2 years. CONCLUSION: No other reason for the monstrous ascites could be found. We thus hypothesize that this case of monstrous ascites is due to hepatic involvement in HHT, presenting as numerous vascular lesions throughout the liver.

Ascites

Two dose regimens of recombinant interferon-alpha-2b in chronic hepatitis C virus infection. Biochemistry, hepatitis C virus RNA, and liver histology as response indices.

BACKGROUND: Recombinant interferon remains the cornerstone of treatment of chronic hepatitis C virus (HCV) infection. Still, evaluation of treatment on the basis of response indicators and long-term effect of the treatment raises several questions. METHODS: Seventy-four patients with chronic HCV infection were randomized to a high (3 MIU, 3/7 days) or low (1 MIU, 3/7 days) dose of recombinant interferon-alpha-2b for 48 weeks after a 4-week course of 3 MIU, 3/7 days. Response to treatment was assessed by means of liver enzymes (transaminases), HCV RNA, and liver histology. RESULTS: The higher maintenance dose was associated with a significantly higher rate of sustained alanine aminotransferase (ALAT) response (45% versus 19%) and with a significantly better chance of becoming HCV RNA-negative during therapy (47% versus 23%). In the high maintenance dose group 14 of the 29 (48%) patients with available HCV RNA data were negative at the 3-month follow-up, compared with 4 of 27 (15%) in the low maintenance dose group. Significantly more patients had improved liver biopsy findings after interferon in the high maintenance dose group (79%) than in the low maintenance dose group (36%). There was a close correlation between ALAT response and HCV RNA response. Of 17 patients who were HCV RNA-negative 3 months after the end of treatment, 10 remained HCV RNA-negative 2-4 years later. CONCLUSION: The study demonstrates a higher response rate as assessed by biochemistry, HCV RNA, and liver histology in the higher dose group.

Adult

Hepatitis C infection in patients with primary hypogammaglobulinemia after treatment with contaminated immune globulin.

BACKGROUND: In Scandinavia many patients with primary hypogammaglobulinemia contracted non-A, non-B hepatitis after intravenous treatment with an immune globulin product that was later found to contain a non-A, non-B hepatitis virus. METHODS: We studied the prevalence and clinical course of hepatitis C virus (HCV) infection in a group of 55 Norwegian patients with primary hypogammaglobulinemia and investigated its association with the use of contaminated immune globulin. We used the polymerase chain reaction to detect HCV RNA and performed HCV genotyping. We also analyzed the responses to treatment with interferon. RESULTS: Of 20 patients who received the contaminated immune globulin, 17 were seropositive for HCV RNA: In addition, 1 of 35 patients not exposed to the contaminated immune globulin was HCV RNA--positive. HCV genotype V was found in all 12 patients for whom genotyping was performed, but 8 patients also had genotype II or III, or both. All HCV RNA--positive patients had abnormal results on biochemical liver tests. All liver-biopsy specimens (from 15 patients) were abnormal, with portal inflammation, bile-duct damage, and focal necrosis. In six patients there was cirrhosis. Two patients died of liver failure. In 4 of the 10 patients treated with interferon there were complete, though transient, biochemical responses, but the follow-up biopsy specimens showed evidence of histologic progression. The poorest responses to interferon were among the patients with multiple HCV genotypes. All but one patient remained positive for HCV RNA: CONCLUSIONS: In patients with primary hypogammaglobulinemia there was a high rate of HCV infection after treatment with contaminated immune globulin. In these immunocompromised patients HCV infection has a severe and rapidly progressive course, and responses to interferon are poor.

Adolescent

[Medullary thyroid carcinoma--familial or sporadic disease?].

Medullary thyroid cancer may be autosomal dominantly inherited. Calcitonin is a very sensitive tumour marker in medullary thyroid cancer. It is essential to measure calcitonin in first grade relatives of these patients, in order to expose familial incidents of subclinical disease. In 55 patients with medullary thyroid cancer and no history of familial disease, nine close relatives with elevated calcitonin were identified in four different families. Eight of these nine have been thyroidectomized. Five were found to have medullary thyroid cancer, one had definite C-cell-hyperplasia, and two had equivocal C-cell hyperplasia. The last two, had elevated basal serum calcitonin-levels were increased, but with no further increase after intravenous pentagastrin bolus injection. Thyroidectomy did not modify these results and DNA-analysis may be necessary to draw a conclusion about the hereditary situation of these patients.

Adolescent

[Puerperal infections. From Semmelweis to current problems].

Maternity hospitals began to be established in the middle of the 18th century to relieve the distress of the poor. As the number of lying-in hospitals increased, so did the cases of puerperal sepsis. The death rate from puerperal sepsis in Norway was high and remained so until 1934. Semmelweis studied the maternal mortality rates in two obstetric clinics in Vienna for the years 1841-46. He declared that puerperal fever was transmitted by the doctors who taught in the dissecting room and went straight from there into the labour wards. I 1847 he instructed all doctors or students to scrub their hands in a solution of chloride of lime before they delivered, examined or touched any patient. The haemolytic streptococcus was finally proved to be the cause of puerperal sepsis by Louis Pasteur in 1879. There was a significant drop in mortality rates in maternity hospitals after the introduction of antiseptic and aseptic techniques around 1880. Deaths from puerperal fever paralleled deaths from erysipelas, and both conditions declined after 1934. Puerperal fever and pelvic inflammation is still a clinical problem. The author discusses sexually transmitted diseases and multibacterial causes.

Asepsis

[Hepatitis C virus infections among persons attending special clinics dealing with problems related to social conditions].

We have studied the prevalence of hepatitis C virus antibodies among 526 persons who attended an HIV diagnostic and counselling clinic and a clinic for sexually transmitted diseases in Oslo, Norway, during a 4-month period in early 1990. Possible risk factors for contracting hepatitis C virus infection were analysed and compared with results of the anti-hepatitis C virus test. The over-all prevalence rate of positive anti-hepatitis C virus tests was 7%. The prevalence rate was highest, 70%, among intravenous drug users (26/37). When intravenous drug users were excluded, only 2% of the remaining 484 persons had antibodies to hepatitis C virus. Among persons with no history of intravenous drug use, a positive correlation was found among women between the presence of hepatitis C virus antibodies and previous gonorrhoea. Male homosexual activity did not correlate with the presence of hepatitis C virus infection. Neither the number of heterosexual partners, nor sex with intravenous drug users, correlated with the presence of hepatitis C virus antibodies. Thus, according to our study the overwhelming risk factor for contracting hepatitis C virus infection was intravenous drug use.

Adolescent

Oxygen radicals stimulate thromboxane and prostacyclin synthesis and induce vasoconstriction in pig lungs.

Reactive oxygen species have earlier been shown to induce vasoactive changes. In the present investigation we hypothesized that active oxygen intermediates would stimulate arachidonic acid metabolism and thereby influence the pulmonary circulation. Four groups of 8-week old pigs were studied after infusion of an oxygen radical generator. Haemodynamic changes were recorded, and thromboxane (TX)B2 (the stable metabolite of TXA2) and 6-keto-prostaglandin (PG)F1 alpha (the stable metabolite of prostacyclin, PGI2) measured by a radioimmunoassay technique after infusion of xanthine oxidase (XO) alone or in combination with pharmacological inhibitors. In the XO group pulmonary vascular resistance increased rapidly compared to baseline levels. Maximum resistance increase was 118.4 +/- 27.5%, 25 min after the XO infusion (p < 0.05 compared to baseline). The vasoconstriction was significantly attenuated after pretreatment with the cyclo-oxygenase inhibitor indomethacin. In this group the pulmonary resistance increase was 21.2 +/- 24.3% at 25 min (p < 0.01 vs. XO group). In a group given allopurinol (xanthine oxidase inhibitor), the resistance increased by 44.3 +/- 28.8% (p < 0.02 vs. XO group), and during catalase infusion (hydrogen peroxide scavenger), the increase was 52.9 +/- 24.2% (p < 0.01 vs. XO group). Along with the pulmonary vascular pressure augmentation, we measured 1.9 fold TXB2 and 2.2 fold 6-keto-PGF1 alpha concentration increases in the XO group. However, both TXB2 and 6-keto-PGF1 alpha formation was significantly inhibited by indomethacin (p < 0.01 respectively vs. XO group), allopurinol (p < 0.01 and p < 0.05 respectively vs. XO group) and catalase (p < 0.01 and p < 0.02 respectively vs. XO group).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

External analytical quality assurance for proteins.

In the Nordic Protein Project an external control scheme (external quality assessment) was combined with the two other indispensable aspects of analytical quality, i.e. standardization (with a common high quality calibrator) and specification of needed analytical quality for sharing common reference intervals for nine serum proteins in the Nordic countries. The quality specifications are reliable for the purpose and given in clinical chemical terms--ready for application to the control systems. Further, a control design for disclosing external and internal errors, separately, is designed with respect to calibration and robustness towards analytical interference from turbid patient samples.

Chemistry Techniques, Analytical

A model for quality achievement--the NORDKEM protein project.

UNLABELLED: The Nordic protein project demonstrates a model for the process of achieving analytical quality. GOAL: based on use of common reference intervals leading to the quality specifications. Creation of quality: through common high quality calibrator (with IFCC-values) (external factor) and individual trouble-shooting and guidelines (internal factor). Control of quality: with specially designed set of control samples and problem-related evaluation of control data. Establishing common reference intervals: through associated projects.

Blood Proteins

[Hepatitis C].

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Hepatitis C