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K S Johansen

Publications and source records attributed to K S Johansen.

At least 37 records · Page 2Linked to original sources
PubMed1991

Big ticket health technology: is rational utilization possible?

Medical technologies that have high initial and operating costs are commonly labeled 'Big Ticket Technologies'. However, technologies with lower initial and operating costs, but which are utilized extensively in patient care, should be considered Big Ticket as well. Some of these technologies are product innovations, because they represent a new product or service. Others are process innovations because they provide an alternative way of delivering health care. Radiology and radiation oncology offer many examples of Big Ticket technologies in medicine, including CT scanners, MRI units and linear accelerators. Other examples include extracorporeal shock wave lithotripsy and resuscitation and intensive care technologies. Differences in the availability of these technologies in various countries reflects financial incentives and disincentives at work in the countries, expectation levels for health care in the countries, and the degree to which the diffusion and use of medical technologies are regulated. Evidence of the cost-effectiveness of medical technologies, and the impact of their use on health outcomes, is rapidly being added as an additional criterion for evaluation of the usefulness of medical technologies in health care.

Cost-Benefit Analysis↗
PubMed1983

Effect of temperature on polymorphonuclear leukocyte function.

The effect of temperature on the function of polymorphonuclear leukocytes (PMN) has been investigated in vitro. Increases in temperature from 37 degrees C to 40 degrees C progressively increased chemiluminescence (CL) responses by PMN after stimulation by Staphylococcus aureus, zymosan or phorbol myristate acetate (PMA) while increases above 40 degrees C decreased these functions. Temperature increases from 37 degrees C to 40 degrees C also produced increased PMN bactericidal activity against S. aureus. In contrast, similar increases in temperature did not change superoxide production by PMN stimulated by PMA. Incubation of PMN at the various temperatures did not cause release of LDH indicating that damage to PMN was not the cause of reduced PMN chemiluminescence and bactericidal activity seen within the temperature range studied. The discrepancy between the influence of temperature on PMN chemiluminescence and bactericidal activity of PMN compared to superoxide anion production by PMN suggests that superoxide anion production may not be solely, or at least directly, responsible for killing of bacteria. Careful temperature control is needed when assaying PMN function. Febrile responses up to 40 degrees C may play a beneficial role in host defense.

Adult↗
PubMed1983

Effect of sodium benzoate on polymorphonuclear leukocyte function.

Sodium benzoate is widely used as a food preservative and reputed to be a scavenger of hydroxyl radical (.OH). The effects of sodium benzoate on the function of polymorphonuclear leukocytes (PMN) stimulated by S. aureus or the chemical agent, phorbol myristate acetate (PMA) were examined in vitro using assays of chemiluminescence (CL), total bactericidal activity, intracellular recovery of bacteria, as well as release of lactate dehydrogenase (LDH), lysozyme and superoxide anion (O2(-)). Sodium benzoate decreased chemiluminescence, superoxide anion and lysozyme release by PMN stimulated with S. aureus but did not similarly affect these responses of PMN to the chemical agent, PMA. The ability of PMN to kill S. aureus was also impaired by sodium benzoate and associated with a reduced number of intracellular bacteria recovered after 90 minutes incubation. LDH release from PMN was not demonstrable at concentrations of sodium benzoate below 100 mM indicating that damage can not account for these findings. The underlying mechanism of the altered bactericidal function of PMN treated with sodium benzoate appears to be a result of decreased uptake of S. aureus.

Adult↗
PubMed1983

Nitroblue tetrazolium slide test. Use of the phorbol-myristate-acetate-stimulated NBT-reduction slide test for routine and prenatal detection of chronic granulomatous disease and diagnosis of heterozygous carriers.

Chronic granulomatous disease (CGD) in utero has recently been detected by a new qualitative nitro blue tetrazolium (NBT) reduction slide test using phorbol-myristate-acetate (PMA) as a stimulus. The technique is simple and inexpensive and requires only a few microlitres of blood. Reported here is an evaluation of this method as applied to routine clinical diagnosis. The blood granulocytes from 300 normal individuals and 49 CGD patients and their relatives were tested and the results compared to the conventional in vitro function tests. In normal individuals the number of abnormal cells was very low never exceeding 2% of granulocytes. CGD patients (14 out of 15) diagnosed by conventional functional tests showed no positive cells in the NBT-PMA test. One patient diagnosed by functional tests had 4% positive cells. Thirty-four relatives of these patients were tested and eleven were found to have fewer positive cells than normal in the NBT-PMA slide test ranging from 16-88% of all granulocytes. These are presumably carriers, a finding supported by granulocyte function tests. All these individuals were female, mothers, sisters or maternal aunts of male CGD patients, thus presumably X-linked heterozygote carriers of CGD. An example of successful prenatal diagnosis using the PMA-NBT test is described. The results show that the PMA-NBT test provides a simple and reproducible method for routine diagnosis of CGD and CGD X-linked heterozygote carriers.

Female↗
PubMed1982

Antibody response and opsonization afer pneumococcal vaccination in splenectomized children and healthy persons.

A significant rise in antibody against pneumococcal types 3, 6A and 25 after pneumococcal vaccination could be demonstrated in 26 of 30 individuals (87%) using an enzyme-linked immunosorbent assay. Similar geometric mean antibody fold increases were found in splenectomized children, non-splenectomized children and healthy adults for types 6A and 25. Splenectomized children exhibited a somewhat lower, but not statistically significant, geometric mean antibody fold increase against type 3 (p = 0.10), as compared to non-splenectomized children. For the whole group a negative correlation could be demonstrated between prevaccination antibody concentration and antibody fold increase after vaccination. After vaccination an enhanced serum opsonic activity against type 3 was found by granulocyte glucose-l-14C oxidation for the whole group of 30 patients (p less than 0.05) but nine individual patients (30%) failed to exhibit an increase. No differences between the three patient groups were demonstrable. Changes in serum opsonic activity could not be detected by a pneumococcal bactericidal assay.

Adolescent↗
PubMed1981

Discoid lupus erythematosus-like lesions and stomatitis in female carriers of X-linked chronic granulomatous disease.

The skin and oral mucosa were studied in an unselected series of carriers of x-linked chronic granulomatous disease, a hereditary condition in which phagocytic cells display a pronounced functional defect. Three carriers had discoid lupus erythematosus (DLE)-like skin lesions which histopathologically were consistent with DLE of the hypertrophic and profundus type. Four patients had experienced photosensitivity in childhood. Seven patients had recurrent aphthous-like stomatitis which should be distinguished from the recurrent aphthous stomatitis seen in otherwise healthy individuals. The remarkably high incidence of DLE-like symptoms in heterozygous carriers might be related to the presence of mixed populations of defective and normal phagocytes. The variable expression of skin symptoms may be related to uneven distribution of abnormal and normal phagocytes. Female patients with these clinical symptoms, especially the combination of DLE-like skin lesions and aphthous-like stomatitis, should be suspected of being carriers of chronic granulomatous disease and studies of phagocyte function in vitro should be performed, since the diagnosis of the carrier state is of utmost importance for genetic counselling before pregnancy.

Adult↗
PubMed1981

Effect of in vitro X-irradiation on lymphocyte and granulocyte function.

Granulocyte transfusions have been complicated by graft-versus-host disease (GVHD) in the recipients. This risk can be eliminated by irradiation of the cell product. The effect of in vitro irradiation on elements of lymphocyte and granulocyte function was therefore studied in order to determine the dose of irradiation which blocked lymphocyte function without affecting the function of granulocytes. Lymphocyte blast transformation after stimulation with mitogens was reduced by 90% after irradiation with 1500 rad and by 97% after 5 000 rad. The response to microbial agents and allogeneic cells was far more radio-sensitive, being completely abolished after irradiation with 1 000 and 500 rad, respectively. Mobility was the function of polymorphonuclear leucocytes (PMN) most affected by irradiation, being slightly but significantly reduced after irradiation with 10 000-20 000 rad. The bactericidal activity was reduced only after irradiation with 40 000 rad or more, while the hexose monophosphate shunt activity and the myeloperoxidase activity were largely unaffected by irradiation with doses of up to 120 000 rad. Hence the results indicate that the irradiation of leucocytes intended for transfusion with a dose of 2 000 rad is likely to prevent GVHD without causing any apparent damage to the PMN.

Chemotaxis, Leukocyte↗