Biomedical subjects
Publications and source records attributed to L Eriksen.
An increasing number of young people in the Nordic countries try to commit suicide. Some of these attempts could perhaps be prevented if there was widespread knowledge of several characteristic features of such youngsters, and if we sought to give them attention and assistance.
An outbreak of listeric meningo-encephalitis occurred in a population of 1800 fallow deer (Dama dama) in a park during the winter and early spring of 1985 to 1986. Listeriosis was diagnosed in 41 of 42 fallow deer that showed the typical central nervous system signs of circling disease or were found dead. The diagnosis was verified by bacteriological examination of the brains of 35 animals. In five of the seven remaining cases listeriosis was diagnosed by histological examination, and in one animal by clinical signs alone. Listeria monocytogenes was isolated in three of 23 soil samples taken from the park. In addition, L monocytogenes was isolated from the intestinal contents of apparently normal fallow deer. Fifty isolates from animals and soil were serotyped and all of them belonged to serovar 4b except one from brain (serovar 1/2b) and three from intestinal contents (serovar 1/2a). In phage typing of 54 isolates, the 35 isolates from the brain and spleen of diseased animals belonged to the same lysovar, as did most isolates from other sources, but strains from intestinal contents belonged to three other phage types. No external source of L monocytogenes was demonstrated in the outbreak and stress due to the poor beech-mast crop, an increased stocking rate and a sudden change in the weather are suspected as predisposing factors.
Pleomorphic adenoma of the human breast is a rare, benign tumor for which the literature is sparse. A local recurrence has been reported only once before. The diagnostic challenge of this cancer-imitating lesion is emphasized in this report. Although local excision of the tumor is the treatment of choice, almost 50% of the patients reported have undergone fairly extensive surgery, i.e., simple or radical mastectomy. A paraffin secretion of the excised tumor is mandatory to confirm the benign nature of the lesion to avoid an unnecessary mastectomy for a benign condition.
At an Alcoholism Treatment Center which was under restructuring, the Ward Atmosphere Scale (WAS) was used to study the effect of changes on the climate of two wards. Before implementation, after the first phase of changes one year later, and after the second phase changes a year later, patients (n1 = 19, n2 = 16, n3 = 23) and staff members (n1 = 21, n2 = 24, n3 = 25) filled out WAS forms. The patients were divided into two groups according to a quasi-experimental design. In a Short-term intensive inpatient unit all of the restructuring was implemented, whereas only some were in a Half-way house. The Short-term intensive patients reported significant improvements between the second and the third assessment (p less than .05) and between the first and the third year (p less than .02), but not from the first to the second year. The Half-way house patients showed no significant improvements. The patients altogether reported significant improvements in six subvariables of the eight hypothesized. The total WAS score of the staff increased significantly each year (p less than .01), and there was a clear improvement between the first and third assessment (p less than .001). The staff reported significant improvements from the first to the third assessment in seven subvariables of the eight hypothesized.
We studied whether gut mucosal IgA antitoxin production as well as the acquired protection against cholera toxin (CT) after oral immunization with CT are both thymus-dependent immune manifestations. In contrast to normal BALB/c mice, nude, athymic mice did not respond to oral immunizations with CT with either IgA antitoxin-producing cells (SFC) in the lamina propria or protection against challenge with CT in ligated intestinal loops. However, when nude mice were first reconstituted by grafting of syngeneic thymus glands, both IgA antitoxin SFC in the lamina propria and protection were stimulated by oral immunizations with CT and the response were of similar magnitude to those of normal mice after immunizations. During in vitro culture, isolated lamina propria lymphocytes from immunized but not from control mice concomitantly and proportionally produced IgA antitoxin and CT-neutralizing activity. We conclude that intestinal antitoxin formation and protection against toxin challenge after oral immunization with CT are both critically thymus-dependent and therefore likely to be under T-cell control.
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Seventeen detoxified alcoholics were randomly assigned to a waiting list group or an inpatient treatment group. The waiting list group members were informed that they had to wait some time until there was a vacant place. By their discharge from the Detoxification Unit they were told to complete a self-report form every day with regards to drinking, working, sleeping home and use of disulfiram orally. Two weeks later they had an outpatient appointment in which the self-reports were collected and reviewed. This was repeated once for everybody so that they all had to wait 4 weeks. By discharge from further inpatient treatment, the inpatient treatment group was instructed to record the same four behaviors daily as the waiting list group did, and they, too, got an outpatient appointment with a 2 week interval. No significant differences between the groups were observed in the three main variables of drinking, working and sleeping home, but the waiting list group used significantly more disulfiram than the inpatient treatment group.
In an experimental comparison, 24 inpatients at an Alcoholism Treatment Center with the DSM-III diagnosis alcohol dependence (alcoholism) were randomly assigned to a Social Skills Training Group (SSTG) or a Control Group (CG). Both groups received, in addition, the traditional treatment program at the institution. Self-report questionnaires, as well as questionnaires for significant others, were used to get biweekly information after discharge on current drinking habits, working days, and nights slept home. A lottery procedure ensured an extremely high return rate of questionnaires during 1 year follow-up (23 of 24 clients returned all questionnaires). SSTG clients drank on the average 2/3 of the amount of pure alcohol or its equivalent (740 cl, that is 14.2 cl/week) that the CG clients did (1196 cl, that is 23.0 cl/week) during 1 year follow-up after discharge. SSTG clients had twice as many sober days (281 or 77% compared to 116 or 32%) and working days (223 or 97% compared to 104 or 45%). The average length of abstinence period after discharge were 51.6 days for SSTG and 8.3 for CG clients. All SSTG clients had drunk after 143 days, and all CG clients after 31 days. During drinking days, however, SSTG had drunk almost twice as much as CG clients. The average number of nights slept home were 345 (95%) for the SSTG versus 316 (87%) for the CG. In addition to group data, detailed individual data are also presented.
A novel procedure to obtain high rates of follow-up information is presented in this study. After discharge, 24 alcohol abusers were asked to complete and mail a self-report information sheet every other week. To check the reliability of the data obtained, significant others in the clients' environment were asked to report on the same behaviors. The clients and the significant others were informed that every returned information sheet was a lottery ticket. There were two prizes of 1000 NOK ($ 150), one every 6 months. The 1-year follow-up results show that 96% of the clients' self-report sheets were returned. The lottery procedure therefore seems an inexpensive and easy way to ensure the receipt of follow-up data and consumes little time.
The existence of conditioned abstinence symptoms in 16 abstinent alcoholics was investigated by comparing their subjective, physiological, and behavioral responses while viewing slides of alcohol-related and non-alcohol-related stimuli. The alcoholics were randomly assigned to one of two groups. The first group viewed a set of six alcohol-related slides the first day and a set of six non-alcohol-related slides the following day. The second group looked at the same slides, but the order of presentation was reversed. Alcohol-related slides produced significantly greater increases in subjectively reported alcohol craving and anxiety scores. There were no differences between the two sets with regard to physiological measures or subjective reports of heart rate. The global observations showed significant differences between the alcohol-related and non-alcohol-related slides.
A 5-year-old girl with the classical clinical features of congenital erythropoietic porphyria (CEP) is described. Different types of CEP are discussed based on varying excretion patterns of porphyrins.
The present study shows that oral inoculation with infective A. suum eggs or 3rd stage larvae in pigs aged 5-16 weeks induces resistance against oral challenge with infective A. suum eggs. Acquired resistance is reflected by an adaptive type of host response as measured by increased pathological, serological and hematological responses and decreased recovery of worms from lungs and small intestine. Although based on a limited number of experimental pigs, the results of the present experiments suggest that resistance to A. suum may be induced both when the parasites are introduced directly into the digestive tract as 3rd stage larvae, i.e. without a previous migration through the liver and lungs, and when given as infective eggs.
The present study shows that N. brasiliensis infection in thymus-bearing mice results in resistance against a subsequent A. suum infection. In contrast thymus-deficient mice do not develop this heterologous resistance. Thymus-deficient mice, on the other hand, develop resistance to homologous challenge although to a lesser degree than thymus-bearing mice. Further, it is shown that A. suum infection in thymus-bearing mice yields resistance against a subsequent N. brasiliensis infection. The underlying mechanism of the cross resistance between A. suum and N. brasiliensis in mice may be both shared antigens and tissue reactions such as fibrosis and macrophage activation.
The excretion of position isomers of type III porphyrins, not only in porphyric disorders in which the enzymatic decarboxylation of uroporphyrinogen III to coproporphyrinogen III is known to or suspected to play a role, but also in normal man and in conditions like erythropoietic protoporphyria and lead-intoxication, in which no such changes have ever been reported, or would be expected for theoretical reasons, has been described. The implications of these and other findings have been discussed and it is suggested that the enzymatic decarboxylation of uroporphyrinogen III to coproporphyrinogen III is normally a random process. It is, however, not excluded that one of the many routes which could be followed might be energetically more favourable than the others and that most of the coproporphyrinogen III which is formed under physiological conditions might be formed via such a 'prefered' pathway.
Liver pathology during experimental Fasciola hepatica infection was compared in thymus-deficient (nu/nu) mice and in thymus-bearing (+/+) mice, (back ground strain to nu/nu mice) and thymus-reconstituted nu/nu mice. Thymus deficiency resulted in unrestricted liver damage during the migration of the parasite in the liver. In nu/nu mice the migratory tracks were infiltrated by very few eosinophils and mononuclear cells, haemorrhages and liver cell necroses were extensive. Portal area reaction and bile duct hyperplasia were depressed. Regeneration of liver tissue, parenchymal and periportal fibrosis and plasma cell proliferation were reduced. The possible causal mechanisms involved in fluke induced liver pathology are discussed. It is suggested that a thymus-dependent cellular reaction modulates the tissue damage produced by F. hepatica.
Experimental oral inoculation of pigs with infective A. suum eggs resulted in eosinophilia in the peripheral blood and a serum antibody response. When pigs were inoculated at 3 days of age the antibody response was depressed which is suggested to be due either to a protective effect of colostral antibodies or to an immunologic incompetence of the young pigs. Despite the use of isolated pens and strict hygienic measures it was difficult to obtain an Ascaris free environment for the experimental animals. The pathogenesis of white spots in the liver is assumed to represent an immune reaction by the host. Multiple white spots were demonstrated when pigs were inoculated with several egg doses provided the livers were examined 1--3 weeks after last inoculation. The rapid healing of white spots implies that the finding of many white spots in the liver at slaughter indicate a recent uptake of infective A. suum eggs. The finding of low intestinal worm burdens in the experimental pigs after repeated oral inoculations indicates a specific, acquired resistance. Resistance to A. suum in pigs is suggested to involve co-operation of the humoral and the cell mediated immune system and the parasite is eliminated both during migration by white spot formation in the liver and during the early prepatent period by expulsion from the gut.
The mouse has been shown to be a suitable experimental host in studies of the resistance to Fasciola hepatica infection. The present experiment compares the course of infection in two different strains of mice, including immunodeficient (congenitally athymic (nude)--(nu/nu)) mice. It was found that the infection was lethal in nu/nu mice, whereas nu/nu mice reconstituted with a neonatal thymus graft reacted as intact mice. The white blood cell picture of nu/nu mice remained unchanged during the infection and between day 24 and 30 after inoculation nearly all nu/nu mice died. Thymus-bearing mice showed blood leucocyte increase and neutrophilia from week 3 after primary inoculation. Furthermore, a marked peritoneal cell reaction occurred 2--4 weeks after primary inoculation. The total number of cells in peritoneal cavity increased approx. 10--15 times and a very remarkable eosinophil peak was seen in week 3 after primary inoculation. In nu/nu mice the peritoneal cell increase was approx. twice that of uninoculated mice and no eosinophil response was observed. When results obtained with the various groups of mice are compared, it appears that resistance to F. hepatica during infection is dependent on a functional thymus.
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