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Biomedical subjects

M B Jensen

Publications and source records attributed to M B Jensen.

At least 55 records · Page 3Linked to original sources

Morphological and immunophenotypic microglial changes in the denervated fascia dentata of adult rats: correlation with blood-brain barrier damage and astroglial reactions.

The reactions of microglial and astroglial cells to anterograde axonal degeneration were studied in the fascia dentata of adult rats from 1 to 42 days after removal of the entorhinal perforant path projection. The observations focused on the kinetics of glial activation in terms of induction of immunomolecules on the glial cells and the possible correlation between these changes and lesion-induced extravasation of plasma constituents. Normal and activated microglial cells were identified by immunohistochemical visualization of the constitutively expressed complement type 3 receptor (CR3/CD11b). Activated microglial cells were stained immunohistochemically for the inducible major histocompatibility complex (MHC) antigen class I and class II and the leukocyte common antigen LCA/CD45). Astroglial cells were identified by immunohistochemical staining for glial fibrillary acidic protein (GFAP). Blood-brain barrier (BBB) conditions were primarily evaluated by immunohistochemical staining for extravasated Immunoglobulin G (IgG), but also by intravenously injected horseradish peroxidase (HRP) and Evans Blue. Twenty-four hours after entorhinal cortex ablation, microglial cells in the perforant path terminal zones displayed an increase in CR3 immunoreactivity, changes of morphology and an induced expression of MHC antigen class I. At the same time there was a hitherto undescribed leakage of IgG through the BBB (albeit without detectable extravasation of HRP and Evans Blue). One day later microglial cells also expressed LCA, but MHC antigen class II was not induced under these degenerative conditions. The activation of microglial cells occurred prior to a noticeable hypertrophy of astroglial cells and increase in GFAP immunoreactivity, as this first became evident on Postlesional Day 2. From the results we conclude (1) that perforant path axonal degeneration induces an endothelial transcytosis of blood-borne IgG by mechanisms which cannot be envisioned by conventional HRP tracer methods and (2) that the early activation of both microglial cells and astroglial cells is likely to be initiated and later influenced by both axonal degeneration and extravasated plasma constituents. The demonstration of an early induction of immunomolecules on activated microglial cells and extravasation of blood borne molecules might moreover form the basis for a correspondingly early intervention aiming to regulate microglial immunomolecule, cytokine, and growth factor gene expression in the affected areas.

Animals↗

Components of variance when assessing the reproducibility of body composition measurements using bio-impedance and the Hologic QDR-2000 DXA scanner.

This study evaluated the reproducibility of measuring lean tissue mass (LTM), fat mass(FM(DXA)), bone mineral content (BMC) and density (BMD) with a Hologic QDR-2000 DXA scanner, and both fat free mass (FFM(bio)) and fat mass (FM(bio)) with an impedance meter. Furthermore, the study aimed to assess whether sheets and pillows significantly altered the DXA results. Fifty-one healthy volunteers aged 20-61 years were examined before and after repositioning (n = 20), removal of the sheets (n = 10), addition of two foam pillows (n = 11) or a regular pillow (n = 10). One to 7 days later a re-examination was performed (n = 35). Eight surgical patients were also scanned twice 1-7 days apart. The day to day coefficients of variation were about 1% for most measurements, though more than 2% for FM(DXA), and FM(bio). For total tissue mass, LTM, and BMC there was a significant biological day to day variance whereas for the other measurements the day to day variation could be accounted for by just measurement variance. Pillows systematically changed the estimates of bone mineral and soft tissue, but sheets did not.

Journal Article↗

Dietary supplementation at home improves the regain of lean body mass after surgery.

Little is known about nutritional intake after discharge though it takes months to regain preoperative weight after gastrointestinal surgery. We studied whether a 4-mo intervention with dietary advice and protein-rich supplements would increase nutritional intake and gain in lean body mass (LBM) in patients who had undergone gastrointestinal surgery. Patients admitted for gastrointestinal surgery were randomized at discharge to serve as control patients (n = 47) or to receive intervention (n = 40). One month after discharge, the control patients had a nutritional intake (3-d diet record) comparable with the intake of the general population that did not increase further. During the 4 m, the intervention patients had an increased intake of protein (+22%) and energy (+16%), and an enhanced gain of LBM after 2 mo (control 0.8 kg versus intervention 2.1 kg; P = 0.009). After the 4-mo intervention, both LBM and fat were gained (control 1.7 kg LBM and 0.2 kg fat versus intervention 3.1 kg LBM and 1.5 kg fat; LBM: P = 0.029 and fat: P = 0.056). At discharge patients should increase protein intake to 1.5 g.kg-1.d-1 for 2 mo, e.g., by taking protein-rich liquid supplements.

Age Factors↗

Discrimination of people by dairy cows based on handling.

This study examined whether dairy cows could distinguish among people based on the treatment received, whether cows used color as a cue to make this discrimination, and whether cows generalized their discrimination to other locations. Twelve cows were each repeatedly treated in a special treatment stall by two people wearing red or yellow overalls. One person always treated the cows aversively, and the other always treated them gently. The distance between each person and each cow in the home stall and in the treatment stall was scored during tests. Before treatment, the distances that cows maintained from the two people were uncorrelated, and the distances that they maintained in the treatment stall were uncorrelated with those in the home stall. Before and after treatments, the cows stood further from the handlers in the treatment stall than in the home stall, regardless of color of the overalls. Defecation and urination were more frequent during aversive treatments. After treatment, the cows stood further from the aversive handler than from the gentle handler in both stalls, and distance from the aversive handler was positively correlated with distance from the gentle handler. The cows did not discriminate when the aversive and gentle handlers wore blue overalls (as worn by the usual barn handlers), when two unfamiliar people wore the same color overalls as the handlers, or when the cows were shown photographic slides of the two handlers. In conclusion, the cows learned to discriminate among the handlers, partially based on the color of the clothes worn. This discrimination was generalized to another location.

Analysis of Variance↗

Randomization to nutritional intervention at home did not improve postoperative function, fatigue or well-being.

BACKGROUND: Postoperative fatigue and deterioration in functional capacity have been correlated to postoperative weight loss. This suggested that nutritional support to enhance the regain of weight might improve upon the convalescence. METHODS: Patients were allocated randomly at discharge to standard management or to dietary advice and protein-rich supplements for 4 months. The convalescence of 32 patients admitted electively for colorectal surgery and of 21 operated on for acute obstruction or severe peritonitis was studied. RESULTS: The intervention substantially increased protein intake, gain in body-weight and lean body mass, especially in the legs as shown by dual-energy X-ray absorptiometry. Changes in work capacity, hand grip and pinching strength, fatigue and quality of life were similar in patients in control and intervention groups and had returned to preoperative values 1-2 months after operation, although fatigue was increased at 2-3 months. CONCLUSIONS: This study did not support the hypothesis that changes in weight were important for the changes in function and fatigue in patients with small to moderate weight loss.

Body Composition↗

[Treatment of primary breast cancer. Consequences of mammographic screening in the municipality of Copenhagen].

In order to analyse changes in the pattern of primary treatment of breast cancer after introduction of mammography screening in the Copenhagen municipal area every second year, retrospective analyses of data from the Danish Breast Cancer Cooperative Group were performed. Newly diagnosed patients with breast cancer of the age of 50-69 years from the Copenhagen municipal area (1040 patients) were compared to a similar group of patients from the rest of Denmark (7353 patients). Parameters such as tumour size, lymph node status, grade of anaplasia, frequency of breast preserving surgery and adjuvant treatment were analysed. Introduction of mammography screening resulted in almost a doubling of newly diagnosed patients with invasive breast cancer during the prevalence phase, and a significant increase in the number of patients with tumour size < or = 1 cm without metastases to the axillary nodes. The frequency of breast preserving surgery increased from 5 to 45% in the municipality of Copenhagen compared to 6 to 19% in the rest of the country. Ratio between low-risk versus high-risk patients increased from 1.0 before screening to 2.7 in the following prevalence phase and 2.5 in the first year of the subsequent incidence phase, while the ratio in the rest of Denmark was the same throughout the whole study period. It can be concluded that the introduction of mammography screening resulted in significant changes in the treatment pattern of patients with primary breast cancer.

Aged↗

[Prognosis for patients admitted to intensive care units with acute renal failure requiring dialysis].

The mortality of critically ill patients who develop acute renal failure (ARF) is persistingly high. We reviewed all patients who developed ARF that required dialysis in a single intensive care unit (n = 167) during the period 1977 to 1989, in order to identify variables with possible influence on outcome. Overall mortality within hospital was 75%. Age above 60 (p < 0.02), requirement for mechanical ventilation (p < 0.0005), requirement for inotropic drugs (p < 0.0005) and increased levels of P-bilirubin (p < 0.005) had negative impacts on survival. Mortality increased significantly from 63% in the early period (1977-1985) to 84% in the late period (1986-1989) (p < 0.001), a rise that could not be explained by a single variable. The patients in the later period were, though, characterized by a higher morbidity with a higher frequency of additional organ failure.

Acute Kidney Injury↗

Parental origin of the X chromosome, X chromosome mosaicism and screening for "hidden" Y chromosome in 45,X Turner syndrome ascertained cytogenetically.

Our study confirms the finding that about 85% of X chromosomes in Turner girls are maternally derived. A new observation is the detection of a high frequency of mosaicism (15%) in Turner girls who by cytogenetic analysis were thought to have a pure 45,X karyotype. DNA examination of the material was done by hybridization with digoxigenin labelled, non-radioactive probes, and PCR products for microsatellite analysis were run on polyacrylamide gels. We screened for the presence of "hidden" Y chromosome mosaicism, using the primers SRY, ZFY, DYZ3, DYZ1 and DYS132. Contrary to other reports using the PCR technique to unravel "hidden" Y chromosome mosaics, we did not find any positive cases. A precise technical protocol for these new techniques is given, and the advantages are discussed.

Chromosome Banding↗

Microglial and astroglial reactions to anterograde axonal degeneration: a histochemical and immunocytochemical study of the adult rat fascia dentata after entorhinal perforant path lesions.

The reaction of microglial and a stroglial cells to anterograde axonal degeneration was studied in the fascia dentata of adult rats at various timepoints after removal of the entorhinal perforant path projection. Microglial cells were identified by histochemical staining for nucleoside diphosphatase (NDPase) at light and electron microscopical levels. Astroglial cells were stained immunocytochemically for glial fibrillary acidic protein (GFAP). Activated astroglial cells and some microglial cells also stained immunocytochemically for the intermediate filament protein vimentin. Phagocytotic activity was detected by histochemical staining for acid phosphatase. The postlesional connective reorganization of the cholinergic septohippocampal projection was monitored by histochemical staining for acetylcholinesterase. Twenty-four hours after entorhinal cortex ablation, microglial cells in the perforant path zones of the fascia dentata and the adjacent neuropil reacted by shortening and coarsening of processes and an increase in NDPase reactivity. These changes occurred prior to a noticeable increase in GFAP immunoreactivity and hypertrophy of astroglial cells (first evident on postlesional day 2) or sprouting of cholinergic septohippocampal fibres (first evident on day 3). There was evidence of an early, local proliferation of microglial cells in the denervated perforant path zones and migration into these zones of microglial cells from adjacent intact areas. The specific accumulation of strongly stained microglial cells within the denervated parts of the dentate molecular layer persisted for at least 4 weeks, while the astroglial reaction subsided at 3 weeks. The results demonstrate an early activation of microglial cells by axonal degeneration, and indicate that these cells may play a pivotal, inductive role in the subsequent glial and neural events.

5'-Nucleotidase↗

[Surgical treatment of cardiovascular manifestations of Marfan syndrome].

Thirteen patients with cardiovascular manifestations of Marfan's syndrome (MS) were admitted to the Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, during an 11-year period (1981-92). One patient died preoperatively. Fifteen operations were performed in 12 patients. Four operations were elective, 11 were acute. Dilatation of the aorta (> 5 cm) accompanied by insufficiency of the aortic valve was the most frequent cardiovascular pathology, (13/13 (100%)). Aortic dissection was present in 8/13 (62%) patients. At the primary operation seven patients had the ascending aorta and the aortic valve replaced by a composite graft. Two of these also had the mitral valve replaced. Four patients had the aortic valve replaced and three patients underwent CABG (coronary artery bypass grafting) due to dissection into the coronary arteries. Three patients underwent a second operation. Two of these had composite grafts implanted, the last underwent CABG. The operative mortality at the primary operation was 17%, at re-operation it was 33%. This report illustrates the high risk of acute complications in patients with MS and emphasizes the importance of an early diagnosis of the syndrome, subsequent examination of the cardiovascular system and prophylactic elective surgery. Control of blood pressure and monitoring of aortic dilatation and valve function is recommended.

Adult↗

Microglial and astroglial reactions to ischemic and kainic acid-induced lesions of the adult rat hippocampus.

The aim of this study was to characterize the microglial and astroglial reactions to degeneration of (a) hippocampal CA1 pyramidal cells and dentate hilar neurons induced by cerebral ischemia and (b) CA3 pyramidal cells and dentate hilar neurons induced by intraventricular injections of kainic acid (KA). The microglial reactions to ischemia, as monitored by histochemical staining for the enzyme nucleoside diphosphatase (NDPase) and immunohistochemical staining for the complement type 3 receptor (CR3), could be divided into (1) initial and generalized, but transient, reactions which also included areas devoid of subsequent neural degeneration and (2) protracted, degeneration-specific reactions in the areas with neural degeneration. Due to more widespread hippocampal involvement a similar distinction was not possible after KA lesions. After both ischemia and KA application the protracted degeneration-specific reactions were characterized by increased NDPase/CR3 reactivity and prominent morphological changes. In the dentate hilus, reactive microglial cells clustered around the degenerating hilar neurons. In stratum radiatum of CA1, reactive microglial cells transformed into either (1) "rod cells," aligned along the postischemic, degenerating pyramidal cell dendrites, followed by subsequent transformation into ameboid-like cells, or (2) "bushy" cells, in response to degeneration of Schaffer collaterals induced by KA lesioning of CA3 pyramidal cells. Within stratum radiatum of the KA-lesioned CA3, where both dendrites and axons were degenerating, the microglial cells developed into stellate cells with thickened, retracted processes and plump cell bodies. These cells were supplemented by rounded macrophage-like cells. Astroglial reactions, monitored by immunohistochemical staining for the intermediate filament proteins glial fibrillary acidic protein (GFAP) and vimentin (VIM), and the normal plasma constituent immunoglobulin G (IgG), showed an initial and generalized astroglial immunoreactivity for IgG, which paralleled the initial and transient microglial reactions, while the reactive changes in GFAP and VIM immunohistochemistry paralleled the protracted, degeneration-specific reactions with regard to timing, strength, and distribution. In the KA-lesioned CA3, the most prominent finding was a prompt loss of astroglial GFAP immunoreactivity corresponding to the degenerating pyramidal cell layer and the adjacent mossy fiber layer. The results strongly indicate that stimuli other than neural degeneration initiated the activation of both microglial and astroglial cells, which then upon further activation by actual neuronal damage and degeneration adjust according to which neuronal structures were undergoing degeneration.

Acid Anhydride Hydrolases↗

Accuracy of 94 anaesthetic agent vaporizers in clinical use.

Using the Brüel & Kjaer Anaesthetic Gas Monitor type 1304, we have monitored the output of 94 anaesthetic agent vaporizers (Fluotec 3:58, Enfluratec 3:24, Isotec 3:12), in seven departments of anaesthesia, at different dial settings and flow rates. The range of output, for one type of vaporizer and dial setting (flow: 6 litre min-1) was largest with the Fluotec 3 (0.85-1.55% when dial set to 1%) and smallest with the Isotec 3 (0.85-1.15% when dial set to 1%). In determining the number of vaporizers with unacceptable inaccuracy, we applied acceptance limits of +/- 15% relative on each vaporizer and each dial setting. Using a flow of oxygen 6 litre min-1 17% of Fluotec 3.8% of Isotec 3 and 71% of Enfluratec 3 vaporizers had outputs outside those limits. Even when some specific conditions (vaporizers giving output beyond the limits at any two or more dial settings; output beyond the limits in the clinically relevant range (0.5-2%)) were added, a substantial number of vaporizers did not perform within the limits. We found a significantly greater accuracy of the vaporizers after 3-monthly calibration checks (P < 0.05) compared with vaporizers undergoing service and calibration only annually. Using a questionnaire, we found that fewer than 30% of the anaesthetists using the vaporizers would accept aberrance beyond +/- 10% relative of the dial setting.

Anesthesia, Inhalation↗

[Pulmonary arteriovenous malformations and fistulas].

Pulmonary arteriovenous malformations are often associated with the Rendu-Osler-Weber-syndrome (40-65%) and involve high risks of serious complications, especially of cerebral character. Operative treatment minimizes morbidity and mortality, but presents problems in cases with multiple, bilateral lesions. Embolotherapy seems promising as an alternative to surgery in cases of widespread lesions. Based on the literature, active therapy is recommended to all patients with pulmonary arteriovenous malformations and fistulas. The only exception may be asymptomatic patients with small lesions who have no evidence of the Rendu-Osler-Weber-syndrome.

Arteriovenous Fistula↗

Aneurysm of the ductus arteriosus in the neonate: three case reports with a review of the literature.

Ductus arteriosus aneurysm was demonstrated in three neonates by echocardiography. One case was already diagnosed in utero. One patient needed surgical resection, whereas in one case the aneurysm of the ductus arteriosus regressed spontaneously. In the third case the patient died of associated lesions. In a review of the literature, 61 previous cases of ductus aneurysm in infants less than 2 months were found. Ductus arteriosus aneurysm may be diagnosed by echocardiography both pre- and postnatally. A ductus aneurysm should be monitored closely by echocardiography. Since a high incidence of complications is reported, surgical resection is indicated if the aneurysm does not regress within a few days.

Adult↗

Aneurysm of the ductus arteriosus. A review of the literature and the surgical implications.

One hundred and forty-four cases of aneurysms of the ductus arteriosus (DAA) have been reported in the literature of which 106 appeared spontaneously and 38 followed surgical treatment of a patent ductus arteriosus (PDA). Within the last few years there has been an increasing number of reported spontaneous DAA. However, the real incidence is presumably still underestimated. Aortography is a well established diagnostic method. In neonates, transthoracic echocardiography has shown convincing potential, whereas in older children and adults, transoesophageal echocardiography has yielded very promising results. Serious complications following spontaneous DAA are rupture, erosion, infection and thromboembolism. In infants younger than 2 months of age, the complication rate is 31%, in children between 2 months and 15 years, 66%, in adults, 47%. The rate of complications following postoperative DAA is even higher: 91% of the unoperated cases died due to rupture or infection. The operative mortality in children older than 2 months and adults is low. In the neonate group, 2 of 8 died during operation. The operative mortality in patients with postoperative DAA was 26%. Based on information from the literature, we suggest prompt surgical treatment of all spontaneous DAA in patients older than 2 months of age, and in all patients with postoperative DAA. In infants, a DAA should be closely followed with echocardiography, as spontaneous regression has been reported in this age group. If no regression is seen within a few days, it should be surgically corrected.

Adult↗

A double staining technique for simultaneous demonstration of astrocytes and microglia in brain sections and astroglial cell cultures.

We developed a double staining technique for simultaneous demonstration of astrocytes and microglial cells in histological brain sections and cell cultures. The procedure included a histochemical stain specific for microglial cells and an immunocytochemical stain specific for astroglial cells, with postponement of the final visualization of the staining products until both reactions had been performed. First, microglial cells were specifically but invisibly labeled by histochemical reaction for nucleoside diphosphatase (NDPase). Then the astroglial cells were labeled by performing the first parts of the immunocytochemical reaction for glial fibrillary acidic protein (GFAP). Finally, in a series of intervening steps, the NDPase reaction product was visualized and stabilized by treatment with ammonium sulfide and silver nitrate, while the 1-naphthol basic dye method was used to visualize the GFAP immunoreactive product. As an end product, the NDPase-positive microglial cells were brown and the GFAP-reactive astroglial cells blue. The two types of glial cells were clearly distinguishable in vibratome sections of rat brain tissue and in primary astroglial cell cultures, and we never observed cells that stained for both NDPase and GFAP. When the GFAP antibody was replaced by the OX-42 antibody, which recognizes microglial cells and macrophages, double staining of microglial cells was observed. The staining protocol has wide applications in studies of the functional interactions between microglial and astroglial cells in the normal brain and in different pathological states with neuronal or axonal degeneration, just as it can be used for experimental studies in cell cultures.

Acid Anhydride Hydrolases↗