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Biomedical subjects

M Hansen

Publications and source records attributed to M Hansen.

At least 307 records · Page 17Linked to original sources
PubMed1986

The family conference: what do patients want?

This study investigated patients' desire for family conferences in a variety of clinical situations encountered in family practice. Two hundred seventy-six family practice center patients were given a questionnaire in which they indicated the likelihood that they would want a family conference in 21 clinical situations. Patients' past experiences with family conferences as well as demographic information were obtained. For serious medical problems and some behavioral problems, patients indicated a high likelihood of wanting a family conference. They showed moderate to low interest in such conferences for guidance for family developmental stages, health promotion, and minor acute problems. Demographic factors and previous experiences with family conferences did not predict patients' interest in future conferences.

Attitude↗
PubMed1985

Cerebrospinal fluid ACTH as a marker of central nervous system metastases from small cell carcinoma of the lung.

Adrenocorticotrophic hormone (ACTH) concentrations were measured in the plasma and cerebrospinal fluid (CSF) of 107 consecutive patients with known or suspected central nervous system (CNS) metastases secondary to small cell carcinoma of the lung. The combined results of computerized tomography scans, neurologic examination, and autopsy were used to determine the presence or absence of CNS metastases. On the basis of such an assessment, definitive conclusions were possible in 77 patients. CNS metastases were present in 52 cases and absent in 25. The median CSF ACTH level was 30 ng/ml in both groups. None of five patients with very high CSF ACTH concentrations had elevated ACTH concentrations in plasma. Considering the 95th percentile of patients without CNS metastases as the upper limit of normal, 12 patients with metastases and one without had an elevated CSF ACTH value. Eleven patients with leptomeningeal carcinomatosis (MC) did not constitute a special subgroup in this respect. The median ratio of CSF ACTH and plasma ACTH was 1.0 in patients with CNS metastases and 0.4 in those without (P less than 0.05). Patients with MC had a median ratio of 1.3, which was significantly different from that of both of the other groups (P less than 0.05). Ten patients with CNS metastases (one with MC) and one without exceeded the upper 95th percentile of the CSF/plasma (ACTH) ratio in patients without CNS metastases. The significance levels of these findings disappeared, however, when patients with signs of an elevated ACTH concentration in plasma were excluded. Patients with ectopic ACTH production into CSF do not necessarily have ectopic ACTH production outside the CNS, despite the presence of extracerebral metastases. With the criteria employed in this study, an elevated level of CSF ACTH diagnosed too few patients for the authors to recommend its determination as a single test in diagnosing CNS metastases or MC secondary to small cell carcinoma of the lung.

ACTH Syndrome, Ectopic↗
PubMed1985

Characterization and immunohistochemical localization of rat salivary cobalamin-binding protein and comparison with human salivary haptocorrin.

Rat saliva contains a cobalamin-binding protein that binds cobalamin as well as cobinamide. The protein binds cobalamin with an affinity constant of 8 X 10(10) l X mol-1, and it binds cobalamin over a more narrow pH range (pH 7.5-10) than does human haptocorrin. It has a Stokes radius of 2.45 nm as compared to the Stokes radius of 4.50 nm for human haptocorrin. Upon isoelectricfocusing it dissociates into four strong bands with pI between 7 and 8, while human haptocorrin dissociates into acid isoproteins. Since human haptocorrin binds to concanavalin A while rat haptocorrin does not, we suggest that rat haptocorrin lacks carbohydrate. The substance concentration of rat saliva haptocorrin is 0.04-12.9 nmol X l-1 (median 7.5 nmol X l-1, n = 9) for control animals. After stimulation with isoproterenol, a beta-adrenergic agent, the substance concentration is 46.4-96.6 nmol X l-1 (median 69.7 nmol X l-1, n = 8). Immunohistochemical studies show haptocorrin in the secretory acini of the submandibular and parotid glands of the rat. In the human submandibular gland, the protein is detected both in the mucous secretory acini and in the intercalated ducts.

Animals↗
PubMed1985

Cobalamin binding proteins (haptocorrin and transcobalamin) in human cerebrospinal fluid.

The unsaturated cobalamin binding capacity of transcobalamin and haptocorrin was studied in cerebrospinal fluid (CSF) and plasma (P) from 37 reference individuals. These comprised 27 males and 10 females who underwent minor surgery in spinal anaesthesia. The 5th and 95th percentiles were as follows: P-Transcobalamin 300-870 pmol/l (median 550 pmol/l); CSF-Transcobalamin 90-540 pmol/l (median 194 pmol/l); P-Haptocorrin 75-290 pmol/l (median 159 pmol/l); CSF-Haptocorrin 10-41 pmol/l (median 21 pmol/l). No sex difference was found between the levels of haptocorrin or transcobalamin in plasma or cerebrospinal fluid. A positive correlation between P-Transcobalamin and CSF-Transcobalamin was found, whereas no correlation between P-Haptocorrin and CSF-Haptocorrin values was found. The plasma/CSF ratios of transcobalamin, haptocorrin, albumin and IgG indicated that the binders may be synthetized into the cerebrospinal fluid or are actively being transported into the cerebrospinal fluid.

Female↗
PubMed1985

Experimental transmission of Aleutian disease virus (ADV) to different animal species.

Two animals from each of 8 different species (mink, Finn raccoon, cat, dog, ferret, blue fox, mouse and rabbit) were inoculated with the highly virulent Utah I strain of ADV. Only the mink developed hypergammaglobulinemia. All animals produced antibodies to ADV antigens, but with different titres. Mink sera had much higher antibody titres than the other animal sera. Antibodies to the ADV-coded, non-structural polypeptide (p71) were found in mink, Finn raccoons and dogs only. Presence of this kind of antibodies was taken as evidence of ADV replication, because p71 was not present in the ADV inoculum. The animals were killed 4 weeks after virus inoculation. Homogenates of different organs from mink, Finn raccoons, ferrets, dogs, mice and the cat were shown to infect ADV-negative mink, which developed antibodies to ADV following inoculation. We conclude from the present studies that mink and Finn raccoons are potential threats as ADV transmitters. Cats, ferrets, dogs and mice may be considered potential ADV reservoirs, because they possibly harbour ADV for 4 weeks or longer. Blue foxes and rabbits did not seem to be a risk factor for ADV transmission.

Aleutian Mink Disease↗
PubMed1985

Treatment policy of surgery in small cell carcinoma of the lung: retrospective analysis of a series of 874 consecutive patients.

A therapeutic policy of surgery in the treatment of small cell carcinoma of the lung was evaluated in a retrospective series of 874 consecutive patients. All patients were included in one of six clinical trials of intensive combination chemotherapy and radiotherapy, carried out during 1973-81. General criteria of resectability, including normal appearances at mediastinoscopy, were fulfilled in 33 electively operated patients and in 46 non-operated patients. An elective operation was defined as a thoracotomy performed with the intention of pulmonary resection in a patient known to have small cell carcinoma. Pneumonectomy or lobectomy was performed in 73% of the electively operated patients. Residual macroscopic or microscopic tumour tissue was left after half of these resections. Both operated patients and non-operated patients with operable tumours survived significantly longer than 696 patients deemed to have been inoperable. There was no significant difference, however, in the duration of survival between the two subsets of operable patients. According to this analysis, a treatment policy of surgery for resectable small cell carcinoma does not lead to better overall results than treatment with chemotherapy and radiotherapy alone.

Actuarial Analysis↗
PubMed1985

Variables affecting the decision making of a review panel.

This study was designed to identify the variables that influence a review panel's decision to discharge or detain an involuntary patient. A group of fifty patients consecutively discharged by the review panel of a provincial mental hospital were compared according to thirty-five variables, with a group of forty-five patients consecutively detained by the panel. The variable set included information on the patient's psychiatric history, current hospitalization and treatment as well as ratings of dangerousness, insight and psychopathology, as reflected in the attending physician's case summary prepared for the review panel. The released and detained groups were found to be remarkably similar. They differed on ten of the thirty-five variables measured, but they did not differ on some variables that one would expect to form the basis of the panel's decision, including diagnosis and a history of suicide attempts. On the other hand, when the predictive value of the variable set as a whole was examined using discriminant analysis, the results indicated that there was a substantial amount of predictability to the review panel process. The group membership of 77.5% of the patients can be predicted from only nine variables that contribute to the discriminant function. The results will be of interest to clinicians who deal with review panels on a regular basis and the findings have implications for other practical issues including discharge planning and readiness for community living.

Adult↗
PubMed1985

Cerebrospinal fluid vasopressin as a marker of central nervous system metastases from small-cell bronchogenic carcinoma.

Vasopressin (ADH) was measured in CSF and plasma in 75 evaluable patients with known or suspected CNS metastases from small-cell bronchogenic carcinoma (SCBC), and in 66 control patients having neither malignant disease nor organic CNS disease. The presence of CNS metastases was confirmed or excluded on the basis of computed tomographic scans, neurologic examination, and autopsy. Twenty-four of the 75 patients had no CNS metastases. Ten of the 51 patients with CNS metastases had leptomeningeal carcinomatosis (MC). CSF-ADH was significantly increased in patients with MC (P less than .05), but not in patients having exclusively parenchymatous CNS metastases. Taking 2 pg/mL (95th percentile of control patients) as the upper limit of normal, 15 SCBC patients had elevated CSF-ADH, including 12 patients with CNS metastases and six patients with MC. The CSF-ADH to plasma ADH ratio was significantly increased in patients with CNS metastases (P less than .05). Patients without CNS metastases had a ratio less than or equal to 0.8 whereas the ratio was greater than 0.8, in 21 of the 51 patients with CNS metastases. The positive and negative predictive values with 95% confidence limits were 84% to 100% and 31% to 59%, respectively. Patients with inappropriate secretion of ADH (SIADH) constituted a significantly greater proportion of patients with elevated CSF-ADH than of patients with normal CSF-ADH levels (P less than .05). In addition, patients with SIADH constituted a significantly greater proportion of patients with MC than of patients with parenchymatous metastases (P less than .05). The diagnostic application of these findings is limited because of the large number of false-negative results, but it may prove to be of value in conjunction with the measurement of other tumor markers.

Carcinoma, Bronchogenic↗
PubMed1985

Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man.

Cooling of the scalp has been found to prevent hair loss following cytostatic treatment, but in order to obtain the hair preserving effect the subcutaneous temperature has to be reduced below 22 degrees C. In order to establish the relationship between epicutaneous and subcutaneous temperatures during cooling and rewarming and to measure the effect of scalp cooling on subcutaneous scalp blood flow, subcutaneous blood flow and epi- and subcutaneous temperatures were measured in the frontal region at the hairline border before and during cooling with a cooling helmet, during spontaneous rewarming of the cooling helmet and after removal of the rewarmed helmet in 10 normal subjects. Subcutaneous blood flow was reduced to about 25% of the postcooling control level during cooling. The flow was constantly reduced until the subcutaneous temperature exceeded 30-32 degrees C. A linear relationship between epicutaneous and subcutaneous temperatures could be demonstrated with the regression equation: s = 0.9 c + 4.9 (r = 0.99). In eight of the 10 subjects the subcutaneous temperature could be reduced below 22 degrees C with the applied technique. It is concluded that the hair preserving effect of scalp cooling during cytostatic treatment is mainly due to the metabolic effect of cooling, and only to a minor extent due to the flow reducing effect.

Adult↗
PubMed1985

Acute nonlymphocytic leukemia, preleukemia, and solid tumors following intensive chemotherapy of small cell carcinoma of the lung.

Six of 796 patients treated with intensive combination chemotherapy for small cell carcinoma of the lung developed overt acute nonlymphocytic leukemia (ANLL) (three patients) or preleukemia with severe refractory cytopenia and clonal cytogenetic abnormalities in bone marrow cells (three patients). The latent period to development of preleukemia or leukemia was less than two years in four of the six patients. The cumulative risk of preleukemia and leukemia according to a Kaplan-Meier estimate was 14.0% +/- 6.9% (mean +/- SE) four years after the start of treatment. The relative risk of overt ANLL was 77, since three cases were observed v 0.039 cases expected, based on the age- and sex-specific incidence of acute nonlymphocytic leukemia in the general Danish population. The risk of secondary solid tumors was not increased. The possible causes of the exceptionally early appearance and very high cumulative risk of leukemic complications found in the present study, as compared to previous experience in other malignant diseases, is discussed, including the implications for future therapy of patients with small cell lung cancer.

Acute Disease↗