Dissection of vertebral artery after cervical trauma.
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Adult↗
Biomedical subjects
K Hansen
Publications and source records attributed to K Hansen.
Peritoneal fluid from patients with endometriosis decreases sperm binding to the zona pellucida in the hemizona assay: a preliminary report.
OBJECTIVE: To evaluate the effect of peritoneal fluid (PF) from patients with endometriosis on gamete interaction under hemizona assay (HZA) conditions. DESIGN: The HZA was used to study the effect of PF from patients with endometriosis on sperm binding to the zona pellucida using media and normal PF as controls. SETTING: The patients were collected from a university hospital infertility clinic. PATIENTS: Peritoneal fluid from 16 women being evaluated for infertility or sterilization who were found to have endometriosis at surgery was used. Three normal patients, who were being sterilized, had PF that was used as a control. RESULTS: Results suggest that there is a significant reduction in the number of tightly bound sperm to the zona surface in endometriosis specimens as reflected in the hemizona index and that this effect is directly related to the stage of the disease. CONCLUSIONS: Although the sample is small, this methodology may help to elucidate one of the mechanisms responsible for endometriosis-associated infertility.
Ascitic Fluid↗
The clinical and epidemiological profile of Lyme neuroborreliosis in Denmark 1985-1990. A prospective study of 187 patients with Borrelia burgdorferi specific intrathecal antibody production.
This prospective study reports the clinical and epidemiological features of 187 consecutive patients with neuroborreliosis recognized in Denmark over the 6-yr period, 1985-1990. Only patients with intrathecal Borrelia burgdorferi specific antibody synthesis were included. In 1990 regional incidences varied between 5.7 and 24.1 per million. Ninety-four percent of the patients had early (second stage) neuroborreliosis. The most common manifestation was a painful lymphocytic meningoradiculitis (Bannwarth's syndrome) either with paresis (61%) or as a radicular pain syndrome only (25%). Central nervous system (CNS) involvement in early neuroborreliosis was rare; 4% had signs of myelitis and only one patient had acute encephalitis. Children showed a different course of the disease. Six percent of the patients suffered a chronic course with a disease duration between 6 mths and 6 yrs either as chronic lymphocytic meningitis (1.6%) or as third stage chronic encephalomyelitis (4.3%). Meningeal signs were rare despite pronounced inflammatory cerebrospinal fluid (CSF) changes (median cell count 160/microliters; median protein concentration 1.13 g/l). High dose i.v. penicillin G was administered to 91% of the patients. Based on the clinical outcome and normalization of CSF no treatment failures were recognized. The final morbidity after a median follow-up of 33 mths was low; disabling sequelae were reported in nine patients, mainly those with previous CNS involvement. We conclude that neuroborreliosis is a common and characteristic neurological disorder. The diagnosis should be based on the demonstration of inflammatory CSF changes and B. burgdorferi specific intrathecal antibody production.
Aged↗
Long-term effects of Herbst treatment in relation to normal growth development: a cephalometric study.
The aim of this study was to evaluate the short- and long-term effects of Herbst appliance treatment in relation to normal growth and development. The sample consisted of 32 subjects (16 boys and 16 girls) with a Class II, division 1 malocclusion treated successfully with the Herbst appliance for an average period of 7 months. The patients were reinvestigated 6 months post-treatment when the occlusion had settled and at the end of the growth period, an average of 6.7 years (SD = 1.1 years) after therapy. The control group comprised of 32 subjects (16 boys and 16 girls) with excellent occlusion (Bolton Standards). Sagittal, skeletal, and dental changes occurring during three observation periods were evaluated on lateral cephalograms in centric occlusion. On a long-term basis, Herbst treatment improved the sagittal jaw base relationship, but did not normalize it. The sagittal dental arch relationship, on the other hand, was almost normalized.
Activator Appliances↗
Detection of Borrelia burgdorferi DNA in urine samples and cerebrospinal fluid samples from patients with early and late Lyme neuroborreliosis by polymerase chain reaction.
A polymerase chain reaction (PCR) was developed for use in the identification of a 248-bp fragment of the Borrelia burgdorferi flagellin gene in urine and cerebrospinal fluid (CSF) from patients with Lyme neuroborreliosis. The specificities of the PCR products were confirmed by DNA-DNA hybridization with an internal probe. The assay had a detection limit of 10 in vitro-cultivated B. burgdorferi. The PCR assay seemed to be species wide as well as species specific, since DNA from all 21 B. burgdorferi isolates from humans tested but not from Borrelia hermsii or Treponema pallidum could be amplified. We tested 10 consecutively diagnosed patients with untreated neuroborreliosis. There was lymphocytic pleocytosis and intrathecal B. burgdorferi-specific antibody synthesis in the CSF of all patients. Urine and CSF samples were investigated by PCR before, during, and up to 8.5 months after therapy. B. burgdorferi DNA was detected in urine samples from nine patients; five patients, including two patients with chronic neuroborreliosis, were PCR positive prior to treatment, whereas urine samples from the remaining four patients obtained 3 to 6 days after the onset of therapy became PCR positive. All urine samples obtained greater than 4 weeks after therapy were negative by PCR. PCR of CSF was less sensitive, and samples from only four patients, including one with chronic neuroborreliosis, were positive. We conclude that urine is a more suitable sample source than CSF for use in B. burgdorferi DNA detection by PCR. Normalization of inflammatory CSF changes and the negative PCR results during follow-up even in patients with chronic neuroborreliosis do not point to a persistent infection. The future role of PCR as a diagnostic tool for Lyme neuroborreliosis is still uncertain.
Adolescent↗
Measurements of tooth length in panoramic radiographs. 1. The use of indicators.
The aim of this study was to investigate both the actual and the radiographic tooth lengths of the maxillary first molar and second premolar and the mandibular premolars in panoramic radiographs. The actual length of 64 extracted teeth was measured. Steel balls were then attached to the cusp and apex and the teeth embedded in plastic moulds. Each pair of plaster casts with their set of teeth was radiographed with an Orthopantomograph twice at an interval of 1 month. The actual and the radiographic tooth length was measured twice by one observer. The mean tooth length of the molar was shorter than that of the premolars. The mean difference between the repeated measurements of the actual tooth length was small and ranged between 0.47 and 1.16% of the tooth length. The mean difference between repeated measurements of the radiographic tooth length was also small, with a method error of 0.13-0.21 mm. The vertical magnification in panoramic radiography was lower for mandibular premolars (13-15%) than for the maxillary second premolar and first molar (17-28%). The palatal root of the maxillary first molar had the highest vertical magnification (28%). Following the second set of radiographs, the mean difference between the measurements was small, except for the palatal root of the maxillary first molar (P < 0.001). Radiographic measurements of this root should therefore be used with caution. The results for the other roots examined indicate that these could be measured with high reproducibility.
Humans↗
Measurements of tooth length in panoramic radiographs. 2: Observer performance.
Observer performance in tooth-length measurements in panoramic radiography has been examined. Sixty-four teeth, evenly distributed between maxillary first molars, second premolars and mandibular first and second premolars, were fixed in plastic moulds. Each cast was radiographed with an Orthopantomograph, twice with steel balls indicating the cusps and apices of the teeth and once without them. One observer measured the radiographic tooth length twice in both radiographs with indicators in order to estimate the true radiographic tooth length and the repositioning error, and twice in the radiographs without indicators. Seven other observers measured the tooth length on the radiographs without indicators, twice applying their own criteria and twice using defined criteria. The accuracy of the tooth-length measurements was calculated by comparing the true radiographic tooth length with the measurements of the seven observers. The intra-observer variation was defined as the difference between two measurements on the same radiograph. The accuracy and the precision of the tooth-length measurements were highly influenced by the observer performance. The mean radiographic tooth length of the seven observers was closer to the true radiographic tooth length when the observers applied the defined criteria. The inter- and intra-observer variation was higher for the measurements of the maxillary teeth (0.3-1.9 mm) compared with the mandibular teeth (0.3-0.9 mm) for most observers. The highest intra-observer variation was found for the palatal root of the maxillary first molar. The intra-observer variation of four observers decreased somewhat when the defined criteria were used; for the other three observers, however, the variation increased.(ABSTRACT TRUNCATED AT 250 WORDS)
Humans↗
Roxithromycin in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans.
A new semisynthetic macrolide roxithromycin was evaluated for its potential use in the treatment of Lyme borreliosis. Using a macro-dilution broth technique, Borrelia burgdorferi was shown to be susceptible to roxithromycin with a minimal bactericidal concentration (MBC) of 0.06-0.25 microgram/ml. A systemic B. burgdorferi infection was established in gerbils; a dosage of greater than or equal to 25 mg/kg/day roxithromycin for 10 days eliminated the infection. A single blind, randomized multicenter study was performed to evaluate the efficacy of roxithromycin 150 mg b.i.d. versus phenoxymethyl-penicillin 1 g b.i.d. for 10 days in patients with uncomplicated erythema migrans. The study was interrupted when 19 patients had enrolled because of five treatment failures. All 5 patients had received roxithromycin; three patients had persisting or recurrent erythema migrans, one developed a secondary erythema migrans-like lesion and severe arthralgia and one developed neuroborreliosis. B. burgdorferi was isolated from skin biopsies after roxithromycin therapy from two patients with persistent erythema migrans and both isolates were still highly susceptible to roxithromycin (MBC = 0.03 microgram/ml). No treatment failures were seen in 10 patients treated with phenoxymethyl-penicillin. Roxithromycin is thus not recommended for treatment of Lyme borreliosis.
Adult↗
Morning stiffness and nightime pain in ankylosing spondylitis. A comparison between enteric-coated and plain naproxen tablets.
Thirty-nine patients with ankylosing spondylitis participated in a randomized, double-blind, double-dummy, multi-cross-over study with enteric-coated (ECT) and plain (PT) naproxen tablets. The duration of the study was 24 days with 6 treatment periods of 4 days. The majority of the patients were taking 750 mg naproxen daily. The mean plasma concentration of naproxen in the morning was 36% higher with ECT (p < 0.001). No significant differences regarding duration of morning stiffness and night time pain were found in this patient category. The mean duration of morning stiffness was 116 minutes (ECT) and 125 minutes (PT). We were not able to show correlation between plasma concentration of naproxen and duration of morning stiffness.
Adolescent↗
Post-treatment effects of the Herbst appliance. A radiographic, clinical and biometric investigation.
The treatment effects of continuous bite jumping with the Herbst appliance in the correction of Class II malocclusions have been analysed in previous investigations. The purpose of this study was to investigate the post-treatment effects of the appliance as well as to compare various mandibular anchorage systems. The total patient sample consisted of 108 malocclusion cases treated with the Herbst appliance. The subjects in the various parts of this study were selected from the total sample according to different criteria. The study included analyses of lateral cephalometric radiographs in centric occlusion and with the mouth wide open, lateral tomograms of the temporomandibular joints, growth records and dental casts. A clinical examination of the patients and a questionnaire at the time of follow-up was also included. During Herbst appliance therapy, all subjects were treated to a Class I or overcorrected Class I relationship. During the post-treatment period of 12 months, the occlusion settled into Class I, mainly as a result of relapsing (recovering) maxillary and mandibular tooth movements. Ninety per cent of the dental changes occurred during the first 6 months post treatment. The anterior movement (proclination) of the mandibular teeth during treatment could not be prevented even if the anchorage system was increased by incorporating more dental units. In the long-term perspective (5-10 years after treatment), it was found that Herbst treatment improved the sagittal jaw base relationship but without normalising it. The sagittal dental arch relationship, on the other hand, was almost normalised. The growth period in which the subjects were treated did not seem to have any impact on the long-term result. Furthermore, Herbst appliance therapy did not seem to have any long-term adverse effects on the craniomandibular system.
Activator Appliances↗
The effect of alcohol consumption on body weight among Wisconsin adults.
It is a common perception that alcohol use increases body weight. In fact, people are often advised to reduce their drinking if they wish to lose weight. To assess the relationship between alcohol use and body weight, we analyzed data from 5,496 Wisconsin men and women. We compared weights of drinkers and non-drinkers and adjusted for potential confounders. For women, there was a strong inverse relationship between drinking and weight. Women who drank any alcohol weighed an average of 2.6 kg (5.6 lbs) less than women who did not drink (p less than .0001). This association was found for all types of alcoholic beverages. No difference in weight was found overall between drinking and non-drinking men, although men who drank wine weighed significantly less (1.8 kg, p less than .05) than non-drinkers. These results, combined with other recent studies, suggest that alcohol use does not lead to increased weight among Wisconsin adults, and may be associated with lower weight among women.
Adult↗
20-epi-vitamin D3 analogues: a novel class of potent regulators of cell growth and immune responses.
The 20-epi-vitamin D3 analogues are a novel class of vitamin D3 derivatives, structurally related to 1 alpha,25-dihydroxycholecalciferol (1 alpha,25(OH)2D3). They are characterized by an altered stereochemistry at carbon 20 in the side-chain. In vitro, these new analogues were found to be considerably more potent as regulators of growth and differentiation in the human histiocytic lymphoma cell line U 937 than 1 alpha,25(OH)2D3, despite a practically unchanged calcemic activity in vivo. The most potent analogue, KH 1060, inhibited cell proliferation by 50% at 10(-12) M (14,000 times more active than 1 alpha,25(OH)2D3). At the same time, KH 1060 induced cell differentiation at concentrations as low as 10(-14)M. In addition, the 20-epi-vitamin D3 analogues were found to be very potent inhibitors of T-lymphocyte proliferation induced by interleukin-1 or alloantigen. In this respect, they were several orders of magnitude more active than the potent immunosuppressive agent cyclosporin A (CyA). KH 1060, the most potent analogue, inhibited interleukin-1-induced mouse thymocyte proliferation by 50% at 3 x 10(-16) M and allogeneic stimulation of mouse spleen lymphocytes at 5 x 10(15) M. These effects were considered to be mediated by inhibition of interleukin-2 release from activated T-lymphocytes. The new analogues are of potential interest in the prevention of graft rejection and in the treatment of psoriasis, cancer and auto-immune diseases.
Calcitriol↗
[Extracorporeal membrane oxygenation. A therapeutic alternative in acute heart and/or pulmonary failure?].
Extracorporeal membrane oxygenation was introduced as a supplement ot mechanical ventilation in the treatment of two patients with severe acute respiratory failure and as heart assist in one patient with acute refractory cardiac failure after open heart surgery. The system includes a membrane oxygenator and a roller pump. The whole circuit is coated with partially degraded heparin covalently bound to the surface (Carmeda Bioactive Surface), reducing the need of systemic heparinization to a minimum. In the first case of acute respiratory failure a veno-venous bypass was employed, with cannulas in the right atrium and the femoral vein. Given a blood flow through the circuit of 2.5 l/min, ventilator settings could be favourably reduced. The patient was weaned off the bypass system after six days, off the ventilator after 120 days, and recovered completely. In two cases the system served as partial venoarterial bypass, and blood was returned to the ascending aorta. A 31 year-old male victim of a smoke inhalation lung injury was on bypass for four and a half days. He recovered completely after another 17 days of mechanical ventilation. A 68 year-old man with pump failure after cardiac surgery needed extracorporeal support as heart assist for seven days. On the eighth day he was weaned off intra-aortic balloon-pumping as well. Unfortunately, he died of septicemia, with multiple organ failure, 13 days later. The heparin-coated extracorporeal membrane oxygenation system may represent a major advancement in the treatment of critically ill patients in need of cardiopulmonary assist.
Acute Disease↗
Lyme neuroborreliosis: a new sensitive diagnostic assay for intrathecal synthesis of Borrelia burgdorferi--specific immunoglobulin G, A, and M.
An antibody capture enzyme-linked immunosorbent assay was developed to measure directly intrathecal immunoglobulin (Ig) G, A, and M synthesis specific for Borrelia burgdorferi. Purified, biotin-avidin-peroxidase-labeled B. burgdorferi flagella was used as test antigen. Paired cerebrospinal fluid and serum specimens from 100 patients with clinically definite neuroborreliosis and 35 control subjects with neurological diseases were examined. Significant B. burgdorferi-specific intrathecal IgG, A, and M production was found in 89%, 65% and 67% of patients with neuroborreliosis. Local synthesis of specific IgA was only seen in patients with significant local IgG synthesis. Antibody production in cerebrospinal fluid began by 2 weeks after onset of neurological symptoms. At the end of the second week specific IgM, IgG, or both, was detected in 88% of the patients. Specific IgG synthesis was present in all patients by 6 weeks after onset. Specific local IgM synthesis usually disappeared by 3 to 6 months after therapy, whereas specific IgG synthesis persisted after recovery. Even in patients with a severely altered blood-brain barrier, the assay discriminated between intrathecal antibody synthesis and antibody leakage from serum. The assay makes diagnostic measurement of B. burgdorferi-specific intrathecal antibody synthesis reliable, rapid, and accessible as a routine serological test.
Antibodies, Bacterial↗
Echinostoma caproni in rats: worm population dynamics and host blood eosinophilia during primary infections with 6, 25 and 50 metacercariae and resistance to secondary and superimposed infections.
Hooded-Lister rats were inoculated with 6, 25, 50 or 100 metacercariae of the intestinal trematode Echinostoma caproni. Worm establishment and the pattern of egg excretion were followed during the course of primary infections with 6, 25 and 50 metacercariae. Peripheral blood eosinophilia was followed at all infection levels. After 1 month, worm recovery and faecal egg output showed a gradual decline with increasing duration of infection. High worm burdens were expelled later than smaller worm burdens, and egg output persisted longer in animals exhibiting a high initial egg output. The level of blood eosinophilia increased with increasing degree of infection and with the level of egg output. A marked concomitant resistance to superimposed infection was observed on the challenge of rats harbouring 21- and 49-day-old infections with 50 metacercariae. In addition, rats were partially resistant to secondary infection at challenge day 14 following anthelmintic removal of primary 7-day-old infections with 50 metacercariae and were completely resistant at challenge day 7 following elimination of a primary 14-day-old primary infection.
Animals↗
Ten years after cryosurgical treatment of cervical intraepithelial neoplasia.
From 1974 to 1977 we treated 96 patients for grade 2 or 3 cervical intraepithelial neoplasia with cryotherapy. They were monitored for 10 to 14 years with an attendance rate of 98%. Treatment resulted in cure in 92%. Nine patients had persisting lesions, and three patients had a recurrent lesion. The last recurrence was diagnosed 6.7 years after cryotherapy.
Adult↗
Fertility of workers chronically exposed to chemically contaminated sewer wastes.
Few studies have investigated the reproductive effects of exposure to chemical mixtures. The purpose of this study was to assess fertility in males exposed to mixed industrial and domestic wastes. A detailed reproductive history was obtained from the wives of 231 employees in order to evaluate fertility. Daily work records were used to define exposure status. To ascertain problems of infertility, the ratios of observed live births to expected live births (generated from U.S. birth probabilities) for exposed and nonexposed groups were calculated, and the ratios of these Standardized Fertility ratios (SRFs) were compared. Other analyses considered the couples' contraceptive history and preexposure versus postexposure experience. Though multiple statistical approaches were used to examine the data, the conclusion of this study was that exposure to chemical mixtures was not associated with a decrease in the couples' fertility.
Air Pollutants, Occupational↗
[A 3-dimensional reconstructive procedure in lumbar computed tomography].
In this study, 50 patients were examined by a Siemens' "Somatom Plus"; continuous 2 mm sections between the third lumbar and first sacral vertebra were obtained. The accuracy of the 3-D reconstruction software programme was checked by measuring a polyethylene phantom of a second lumbar vertebra. Reconstruction was carried out with a threshold definition of 150 Hu. In each case, four standard projections and medio-sagittal, medio-lateral and coronary sections were reconstructed, photographed and compared with axial CT sections and conventional radiographs. All these imaging procedures were suitable for the diagnosis of osteochondrosis and chondrosis. Spondylosis was diagnosed more frequently on 3-D CT. Spondylarthrosis, with narrowing of the intervertebral foramina and root canals is shown particularly well by 3-D CT, since the entire extent of these structures can be seen. 3-D surface reconstruction of the lumbar spine is useful in the diagnosis of lumbar spondylarthrosis with narrowing of the root canals and of the spinal canal. This method of axial Ct is superior to conventional radiography of the lumbar spine in the usual two planes.
Adult↗