[Total hip replacement. A cost-effectiveness analysis].
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Biomedical subjects
Publications and source records attributed to K M Pedersen.
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In the Randers area of Denmark urinary iodine excretion (which reflects iodine intake) was found to be much lower than recommended intake levels, both in women in late pregnancy [52(23-118) micrograms iodine/g creatinine, median, range, n = 20] and in non-pregnant controls [42(23-71), n = 20]. Serum thyroglobulin which is high in iodine deficiency was 32.5 micrograms/l (median) (range 10.5-78.0) in the control women and considerably higher in the pregnant women [67.0 micrograms/l (9.0-385)]. This increase was probably due to the extra iodine requirement of pregnancy which was not satisfied with an adequate increase in iodine intake. The results may suggest that pregnant women in this area should receive iodine supplementation and that a general program of iodine supplementation should be considered.
A sensitive assay for thyroglobulin autoantibodies (Tg-ab) is described. The assay is based on prolonged incubation of [125I]Tg with serum followed by precipitation of antibody bound [125I]Tg by polyethylene glycol (PEG). The PEG concentration was chosen to give a low precipitation of free [125I]Tg while effectively precipitating Tg-ab-bound [125I]Tg. The lowest reference employed contained 19.5 MRC U/l Tg-ab. This was always different from an incubate without Tg-ab. Tg standard added to samples interfered in the assay giving spuriously low Tg-ab values as in other Tg-ab assays. Tg-ab added to samples was recovered quantitatively. The interassay coefficient of variation was 19.8% and the intra-assay coefficient of variation 11.3%. Only eight of 66 serum samples with various amounts of Tg-ab, measured with the new assay, had levels of Tg-ab detectable by the passive haemagglutination test.
This paper analyses the question whether minor trauma should be treated in hospital or general practice. It shows what kind of data are necessary and that this data can be obtained from different countries, with basic similarities in their health care system. In a period of tight budgets there is a tendency to focus on a narrow economic analysis. This article, however, shows the complexity of the simple question of where minor trauma should be treated and stresses other important aspects which should supplement an economic analysis. These aspects are illustrated with data from different investigations in Denmark and the United Kingdom.
A Danish study allocated at random 30,970 persons to screening with Hemoccult-II and 30,968 as controls in a population of 140,000 between 45 and 74 years old. Persons with known colorectal cancer, adenoma, and distant spread from all types of cancer were excluded. The test was completed in 20,672 persons from August 1985 to September 1986, and 215 (1%) were found to be positive. Colonoscopy in 203 and double-contrast barium enema in 6 detected 37 persons with cancer and 86 with adenomas. Dukes A cancer was detected in 19 in the screening group, in contrast to 2 among controls. Synchronous adenomas were found in 23 with a positive test and 10 controls. Interval cancer was found in nine persons within 1-11 months after a negative test. Eighteen persons got cancer before invitation and six defectors as well. In all, colorectal cancer was detected in 70 persons in the screening group and in 38 controls; the figures for adenomas alone were 103 and 38, respectively. The study is designed to detect a possible reduction in mortality from colorectal cancer of 25% within 5 years after three screenings with intervals of 2 years. The second screening will begin in September 1987. It remains to be shown whether a reduction may be obtained both in mortality and in incidence of colorectal cancer.
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A new thyroglobulin (Tg) assay employing polyethylene glycol (PEG) for separation of free and antibody bound [125I]Tg is described. By choosing a suitable PEG concentration the non-specific precipitation of free [125I]Tg was kept low while both [125I]Tg bound to rabbit anti-Tg immunoglobulins and to human Tg autoantibodies were precipitated. For all sera a 'blank' incubation with no rabbit anti-Tg immunoglobulins was run in parallel with the assay tubes. Hence any interference of Tg autoantibodies would be detected. A two-phase incubation gave a very low detection limit of 0.2 microgram/l. The inter-assay coefficient of variation was 9.4% and the intra-assay coefficient of variation was 5.6%. Dilution curves of normal sera were parallel to the standard curve and Tg standards added to normal sera were recovered quantitatively. Twelve out of 60 normal sera from the Randers area contained Tg autoantibodies. The average serum Tg in the 48 sera without antibody was 44.6 +/- 5.2 micrograms/l (SEM).
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Glycogen synthase I was purified from bovine polymorphonuclear leucocytes (PMNs) by a procedure involving concanavalin A-Sepharose affinity chromatography. The purified glycogen-bound glycogen synthase I had a specific activity of 9.83 U/mg protein and the glycogen free enzyme 21 U/mg protein. Molecular ratio of the native enzyme and the subunit were 340 K and 85 K respectively. After phosphorylation by the catalytic subunit of cAMP-dependent protein kinase the phosphorylated sites were studied using high-performance liquid chromatography (HPLC) of the tryptic 32P-peptides. The enzyme was phosphorylated at three different sites with retention times identical to site 1a, site 1b, and site 2 from rabbit skeletal muscle glycogen synthase.
A method for the isolation of an enriched population (greater than 96%) of bovine polymorphonuclear leucocytes (PMNs) from 70 liters of blood was developed using a two-step procedure involving separation of the blood, in a packed red blood cell fraction containing the PMNs and a plasma fraction, by continuous flow blood separation. Hypotonic lysis of erythrocytes was then followed by centrifugation at 200 g sedimenting the PMNs. The yield was 93 +/- 30 g, the recovery was 62 +/- 20%, viability was greater than 95%. Since bovine blood can be obtained in unlimited amounts, the procedure described here can be applied to obtain large amounts of bovine PMNs for incubation studies and large-scale purification of intracellular enzymes suitable for biochemical characterization.
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