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Biomedical subjects

M K Jensen

Publications and source records attributed to M K Jensen.

At least 37 records · Page 2Linked to original sources

Metabolic cobalamin deficiency in patients with low to low-normal plasma cobalamins.

Over a 2-year period, we examined 48 patients with P-cobalamin levels in the difficult "grey zone" at the lower reference limit detected by a competitive protein binding assay using intrinsic factor as binder. In 21 of 30 patients (70%) with low P-cobalamins we could not establish the diagnosis of metabolic cobalamin deficiency, but 1 of 18 patients (6%) with low-normal P-cobalamin values was confirmed metabolically cobalamin-deficient. Half of these 30 patients with low P-cobalamins had neuropsychiatric disorders, but only one-third of the latter patients had metabolic cobalamin deficiency. Ten of the remaining 15 patients (67%) were characterized as non-deficient. In patients with low-normal P-cobalamin level, we found neuropsychiatric disorders in 5 of the 18 (28%), but none of these had metabolic cobalamin deficiency. We conclude that P-cobalamins below the reference interval combined with typical neuropsychiatric symptoms or findings are not diagnostic of cobalamin deficiency and that further analyses are necessary.

Adult↗

EBV-positive primary central nervous system lymphomas in monozygote twins with common variable immunodeficiency and suspected multiple sclerosis.

Common variable immunodeficiency represents the most frequently occurring primary immunodeficiency disorder and is usually detected sporadically in patients with no family history of immunodeficiency. We present the case stories of two monozygote twins, who following a period of decreasing serum immunoglobulins developed primary central nervous system lymphomas. One twin had clinical and paraclinical features mimicking multiple sclerosis. Immunohistochemical investigations on biopsy tissue showed expression of the bcl-2 and p53 gene products, and Epstein-Barr virus (EBV) encoded small RNA's (EBER) indicating latent infection were detected in lymphoma cells using in situ hybridisation techniques. The pathogenetic role of EBV in oncogenesis is discussed.

Adult↗

[Primary cerebral non-Hodgkin's lymphomas and primary malignant brain tumors in a well-defined geographical area. Population-based data from the registry of non-Hodgkin's lymphoma in western Denmark, LYFO and the cancer registry, Kraeftens Bekaempelse].

In a Danish population-based non-Hodgkin's lymphoma (NHL) registry (LYFO) representing a population of 2.7 million all new cases of NHL were registered from 1st January 1983 to 31st May 1994. Incidence data of primary malignant tumours of the brain and central nervous system in western Denmark for the period 1971-1990 have been obtained from the Danish Cancer Registry. During the approximate 11-year period 3124 new cases of NHL were registered. Of these, 1152 (37%) were extranodal and 48 were non-AIDS related primary central nervous system lymphomas (PCNSL) accounting for 4.2% of extranodal NHL and 1.5% of all NHL, respectively. The average annual incidence rate of non-AIDS related PCNSL during the period was 1.56 cases per million population (age range: 15-85 yrs, median: 62 yrs, M/F ratio: 1). In a 23-year period there was no trend towards an increasing incidence of non-AIDS related PCNSL in a well-defined population. PCNSL accounted for 1.7% of all primary malignant brain tumours. Incidence of primary malignant brain tumours was stable, except for age ranges over 70 years. Histologically, 85% were high grade, centroblastic diffuse (60%) and immunoblastic lymphoma (13%) (Kiel classification). No T-cell lymphomas were detected. Treatment included surgical resection, whole brain irradiation (WBRT) and chemotherapy. Median survival for those receiving either WBRT or WBRT and chemotherapy was eight months and 20 months, respectively (p = 0.78). Overall survival was 53%, 38% and 26% at one, two and five years. Cox-regression analysis identified only one factor having independent impact on survival in performance score > or = 2 (PCNSL p < 0.001, RR = 5.8).

Adult↗

[Primary cerebral non-Hodgkin's lymphoma. Intensive chemotherapy supported by crania radiotherapy].

Four cases of primary central nervous system lymphomas treated with high dose cytosine arabinoside and high dose methotrexate prior to cranial irradiation are described. All patients achieved a complete clinical and radiological remission following treatment with chemotherapy alone. Three patients are alive with a follow-up period of 60, 45 og 24 months, respectively. One patient died 12 months after diagnosis at another hospital. Autopsy was not performed.

Adult↗

Justifying and implementing an ophthalmic pharmacy practice.

The justification for and implementation of an ophthalmic care satellite pharmacy at the eye center of a university hospital are described. A pharmacy dedicated to ophthalmic care was developed in conjunction with a new eye care center. The eye center pharmacy staff, in consultation with other members of the pharmacy department, determined the services to be provided: preparing pharmaceuticals for operating room and clinic use, performing medication evaluations for all patients undergoing surgery, taking and documenting medication histories, providing distributive services, counseling surgical patients about their prescriptions and the care of their eyes after surgery, and checking on patients after discharge. Services were implemented after feedback was received from ophthalmology department physicians and from eye care pharmacies at other institutions. Before working in the eye center pharmacy, pharmacists received inservice instruction. To assist in its medication evaluation and counseling efforts, the pharmacy introduced a medical information form, which is used for both surgical and clinic patients. An adverse drug reaction-reporting program was also introduced. Establishment of a satellite pharmacy specializing in ophthalmic care resulted in improved outpatient and surgical pharmacy services and better provision of information on ophthalmic pharmaceuticals.

Humans↗

Suspected malignant lymphoma presenting with widespread granulomatous lesions in bones and lymph nodes and responding to combination chemotherapy.

A 61-year-old man presented with widespread granulomatous lesions of lymph nodes and bones, constitutional symptoms and various abnormal laboratory tests. An extensive investigation for the etiology including several biopsies, all showing granulomatous lesions, failed to reveal any specific underlying illness. A tentative diagnosis of sarcoidosis was made. However, corticosteroid therapy only temporarily improved the symptoms. Subsequently, standard chemotherapy for Hodgkin's disease induced complete clinical and biochemical remission. Rarely, the diagnosis of a lymphoma may be obscured by the presence of extensive granulomatous lesions. In these cases combination chemotherapy directed towards a malignant lymphoma may be justified in patients failing to respond to corticosteroid treatment.

Antineoplastic Combined Chemotherapy Protocols↗

Expression of Na(+)-K(+)-ATPase in the brown trout, Salmo trutta: in vivo modulation by hormones and seawater.

Expression of the Na(+)-K(+)-ATPase alpha-subunit was investigated in the gill and trunk kidney of Salmo trutta. Groups of freshwater (FW) fish were treated with various hormones [cortisol: 3 x 4.0 micrograms/g; recombinant salmon growth hormone (rsGH): 3 x 0.25 micrograms/g; salmon prolactin (sPRL): 3 x 0.25 micrograms/g; recombinant bovine insulin-like growth factor-I (rbIGF-I): 2 x 0.01 micrograms/g; or 2 x 0.1 micrograms/g] or transferred to 25 parts per thousand seawater (SW) and sampled after 1, 2, 3, and 50 days. Total RNA was analyzed by Northern blotting using Xenopus laevis Na(+)-K(+)-ATPase alpha-subunit cDNA as probe. The probe detected a 3.8-kb transcript. Relative to untreated FW control fish, the abundance of alpha-subunit Na(+)-K(+)-ATPase mRNA in gill tissue increased 1.7-to 2.5-fold after treatment with cortisol, rsGH, and rbIGF-I and after transfer to SW. Na(+)-K(+)-ATPase enzyme activity was also significantly stimulated in these groups, except at 0.01 micrograms/g rbIGF-I. sPRL was without effect. In the kidney, alpha-subunit mRNA level and Na(+)-K(+)-ATPase activity were unaffected by hormone treatment and SW transfer. The results indicate that an increased abundance of alpha-subunit mRNA is part of the molecular mechanism behind the increased gill Na(+)-K(+)-ATPase activity induced by SW transfer, cortisol, GH, and IGF-I.

Animals↗

Clinicopathological features, survival and prognostic factors of primary central nervous system lymphomas: trends in incidence of primary central nervous system lymphomas and primary malignant brain tumors in a well-defined geographical area. Population-based data from the Danish Lymphoma Registry, LYFO, and the Danish Cancer Registry.

It has been claimed that Primary Central Nervous System Lymphomas (PCNSL), a rare neoplasm accounting for only a small fraction of malignant brain tumors and extranodal non-Hodgkin lymphomas (NHL), occur with increasing frequency in immunologically normal as well as in immunocompromised individuals. In an attempt to characterize the clinicopathological features, outcome and prognostic factors of PCNSL we here report our experience in a large unselected series of patients from a well-defined region. In addition, we present data on trends in incidence of PCNSL and primary malignant brain tumors in a well-defined geographical area. In a Danish population-based NHL registry (LYFO) representing a population of 2.7 million all new cases of NHL were registered during the approximate 11-year period from 1st January 1983 to 31st May 1994. Incidence data of primary malignant tumors of the brain and central nervous system in western Denmark for the period 1971-1990 have been obtained from the Danish Cancer Registry. During the approximate 11-year period 3124 new cases of NHL were registered. Of these, 1152 (37%) were extranodal and 48 were non-AIDS related PCNSL accounting for 4.2% of extranodal NHL and 1.5% of all NHL, respectively. The average annual incidence rate of non-AIDS related PCNSL during the period was 1.56 cases per million population (age range: 15-85 yrs, median: 62 yrs, M/F ratio: 1). In a 23-year period there was no trend towards an increasing incidence of non-AIDS related PCNSL in a well-defined population. PCNSL accounted for 1.7% of all primary malignant brain tumors. Incidence of primary malignant brain tumors was stable, except for age ranges over 70 years. However, diagnostic artifacts might be responsible for this apparent increase. Histologically, 85% were high grade. Using the Kiel classification centroblastic diffuse (60%) and immunoblastic lymphoma (13%) were the most common subtypes. Forty-three patients had B-cell lymphoma and no T-cell lymphoma was detected. Forty-seven cases were diagnosed pre mortem. Treatment included surgical resection (26 patients), whole brain irradiation (WBRT) (43 patients) and chemotherapy (28 patients). Median survival for those receiving either WBRT or WBRT and chemotherapy was 8 months and 20 months, respectively (p = 0.78). Overall survival was 53%, 38% and 26% at 1, 2 and 5 years. Cox-regression analysis identified only one factor having independent impact on survival in PCNSL: performances score > or = 2 (p < 0.001, RR = 5.8).

Adolescent↗

[Pseudocroup. Treatment in hospital].

Although croup is the most common form of airway obstruction in small children, there is debate as to the correct medical care for the hospitalized patient. A critical review of published articles was performed. It was found that a scoring system was essential for observation. There is only little information concerning the use of humidified air. Inhaled racemic epinephrine has a well-demonstrated effect. New studies indicate that L-epinephrine is as effective and safe as racemic epinephrine. Dexamethasone in doses greater than 0.6 mg/kg is effective in decreasing the length and the severity of respiratory symptoms associated with croup. When intubation is necessary steroids reduced the duration of intubation and the need for reintubation.

Child, Preschool↗

[Treatment of acute myeloid leukemia in the elderly with low-dose cytosine arabinoside].

We report the outcome of 95 patients older than 60 years with de novo acute non-lymphocytic leukaemia (ANLL), treated in two institutions during a 10 year period. Thirty-two patients, mean age 78 years, did not receive any chemotherapy, and their median survival was 38 days. Five patients in good clinical condition, aged 60-63 years, were treated conventionally with an anthracycline and cytarabine, and three patients obtained a complete remission (CR) lasting 73, 417, and 1050 days. Fifty-eight patients were treated with low-dose cytarabine (LDC) for remission-induction and maintenance. Eighteen patients obtained CR, yielding a remission rate of 31%. The median duration of remission was 380 days and median survival of the same group was 498 days. LDC is valuable in the treatment of ANLL in the elderly. Controlled studies are warranted to define the indications for LDC versus conventional therapy in the large grey zone of elderly patients.

Age Factors↗

[The role of social factors in the place of death of cancer patients in the county of Nordjylland].

The purpose of this study was to evaluate the importance of social factors on whether cancer deaths occurred at home or in hospitals. The study was based on questionnaires to the patient's general practitioner and to the home nursing service. The study included 241 patients with terminal cancer who were all identified by death certificates via the Department of Public Health in the period of the 1st February, 1992 to the 31st April, 1992. The study demonstrated that significantly more patients died in their own homes when a contact to the home nursing service had been established. The same tendency could be observed for patients with relatives being reimbursed for loss of income while providing care in the home. Significantly more patients died at home in municipalities where 24-hour nursing facilities could be offered. No association between age, sex, or whether the patient lived alone or lived cohabitantly were observed. The study suggest that an intensification of the home nursing facilities would give a greater number of terminal cancer patients the option of dying in their own homes. The possibility of relatives being reimbursed for loss of income while providing care in the home has a positive influence on the development of the number of cases home nursing.

Adult↗

Crystallization on intraocular lens surfaces associated with the use of Healon GV.

OBJECTIVE: To describe a series of patients who had visually significant crystalline deposits on their intraocular lenses during cataract surgery with the use of Healon GV (a high concentration and high molecular-weight hyaluronate sodium). METHODS: Patients were examined for crystalline deposits on their intraocular lenses. These deposits were compared with intraocular lens type, viscoelastic solutions, any other intraocular substance used, type of surgery, and perioperative medications. RESULTS: In the 11 patients with documented changes (six photographically), the only consistent finding was the use of Healon GV. Furthermore, since we discontinued the use of Healon GV, we have not seen a recurrence of these deposits in more than 500 consecutive patients. The deposits could last a long time (at least 6 months) if sequestered by the posterior capsule, and they are believed to be visually significant at times (Snellen visual acuity of 20/40 or worse). CONCLUSION: Healon GV use is associated with a new clinical finding of crystalline deposits on intraocular lenses. These deposits can be clinically significant.

Aged↗

Incidence, clinicopathological features and outcome of primary central nervous system lymphomas. Population-based data from a Danish lymphoma registry. Danish Lymphoma Study Group, LYFO.

BACKGROUND: Primary Central Nervous System lymphomas (PCNSL), a rare neoplasm accounting for only a small fraction of malignant brain tumors and extranodal non-Hodgkin's lymphomas (NHL), seems to occur with increasing frequency in immunologically-normal as well as immunocompromised individuals. In an attempt to characterize the clinicopathological features, incidence rate and outcome of PCNSL, we here report our experience in a large unselected group of patients from a well-defined region. PATIENTS AND METHODS: In a Danish population-based NHL registry (LYFO) representing a population of 2.7 million, all new cases of NHL were registered during the 10-year period from 1st January 1983 to 31st December 1992. The number of malignant brain tumors reported to the Danish Cancer Registry from the region covered by LYFO, during the 7-year period from 1st January 1983 to 31st December 1989, is compared to the number of PCNSL. RESULTS: During the 10-year period 2687 new cases of NHL were registered. Of these, 1004 (37%) were extranodal and 42 were non-AIDS-related PCNSL, accounting for 4.2% of extranodal NHL and 1.6% of all NHL, respectively. The incidence rate for PCNSL during the ten-year period (age range: 21-85 yrs, median: 62 yrs, M/F ratio: 0.9) was 15.6 cases per million population. Eighteen and 24 cases were diagnosed during the first and the second 5-year period, respectively (p > 0.05). During the 7-year period 1866 primary malignant brain tumors were registered in the region covered by the LYFO study group. In the same period 30 cases of PCNSL were detected. Thus, PCNSL accounted for 1.6% of all primary malignant brain tumors diagnosed in Western Denmark. Histologically, 83% were high-grade. Using the Kiel classification centroblastic diffuse (62%) and immunoblastic lymphoma (12%) were the most common subtypes. Thirty-seven patients had B-cell lymphoma; no T-cell lymphomas were detected. Forty-one cases were diagnosed pre mortem. Treatment included surgical resection (23 patients), whole brain irradiation (WBRT) (37 patients) and chemotherapy (22 patients). Median survival for those receiving either WBRT or WBRT and chemotherapy was 7.5 months and 12 months, respectively (p > 0.05). Survival was 43.9%, 31.7% and 7.3% at 1, 2 and 5 years.

Adult↗

Salvage therapy with low-dose cytosine arabinoside in refractory or relapsed acute non-lymphocytic leukaemia: a report on 25 patients.

Thirteen patients with de novo acute non-lymphocytic leukaemia (ANLL) refractory to standard chemotherapy for remission induction and 12 patients with ANLL in relapse were treated with low-dose cytosine arabinoside (LD ara-C) 10 mg/m2 subcutaneously every 12 hours for 21 days. Five of 13 patients (38%) and 6 of 12 patients (50%), respectively, obtained a complete remission (CR). Of these, 7 patients subsequently relapsed after 2-76 months, while 4 patients remain in CR after 7-131 months. Compared to standard intensive regimens treatment with LD ara-C was rather non-toxic, requiring platelet transfusions and antibiotics in only 6 and 13 cases, respectively. Three patients (12%) died during induction therapy with LD ara-C; 2 had a cerebral haemorrhage and 1 developed anuria following a staphylococcal septicaemia. In conclusion, therapy with LD ara-C may be preferable to more intensive and toxic regimens in the treatment of patients with relapsed or refractory ANLL.

Adolescent↗

Non-Hodgkin's lymphoma of the gastrointestinal tract: a population-based analysis of incidence, geographic distribution, clinicopathologic presentation features, and prognosis. Danish Lymphoma Study Group.

PURPOSE: To evaluate incidence, time trends, geographic distribution, clinicopathologic presentation features, and prognostic factors for survival and relapse in gastrointestinal (GI) non-Hodgkin's lymphomas (NHLs). PATIENTS AND METHODS: Over a 9-year period (1983 to 1991), 2,446 new NHL cases were recorded in a Danish population-based NHL registry (Danish Lymphoma Study Group [LYFO]). Of these, 306 (12.5%) were GI NHL (175 gastric, 109 intestinal, and 22 both sites). LYFO registry data were used for incidence rate (IR) assessment, and time-trend and geographic distribution analysis. Relative risk (RR) values for survival and relapse were identified by multivariate analysis. RESULTS: The mean annual, age-standardized IRs for gastric and intestinal NHL were 0.71/10(5) and 0.48/10(5) per year, respectively. Age-specific IRs for both localizations showed an exponential increase as a function of age. Time-trend analysis for the period 1983 to 1991 showed stable IRs for both localizations. Intestinal NHL was more frequent in males (male-to-female ratio, 2.0 v 1.3), and had a higher occurrence of disseminated disease, constitutional symptoms, high-grade histology, and T-cell phenotype (10% v 2%). Gastric NHL had more low-grade cases (38% v 19%), and almost all were of the mucosa-associated lymphoid tissue (MALT) type. The cause-specific 5-year survival rate was 63% for gastric NHL and 49% for intestinal NHL. The Musshoff staging system was an excellent discriminator between truly localized (stage I and II1) and disseminated cases (stage II2 to IV), particularly for gastric NHL, for which no survival difference was found between surgically and conservatively stage localized cases. CONCLUSION: (1) No increase in the incidence of GI NHL was found over a 9-year observation period; (2) nonrandom spatial distribution of new GI NHL cases was observed; (3) factors that significantly increased the risk of death in gastric cases were presence of B symptoms (RR = 3.3), clinical stage is more than II1 (RR = 3.0), age more than 72 years (RR = 2.4), and elevated serum lactate dehydrogenase (s-LDH) level (RR = 2.0); and factors that increased the risk of death in intestinal cases were presence of B symptoms (RR = 3.2), age more than 58 years (RR = 2.8), and clinical stage more than I (RR = 2.1); (4) factors that significantly increased the risk of relapse in gastric cases were male sex and no radiotherapy in primary treatment; and in intestinal cases were T-cell phenotype and no surgery in primary treatment; (5) surgical staging, as opposed to thorough noninvasive staging, did not improve staging accuracy and final outcome in localized gastric NHL.

Adolescent↗

[Short-term and long-term effects on glycosylated hemoglobin after transition from conventional insulin treatment to multiple insulin injection regime in a diabetic outpatient clinic].

In order to examine the short- and long term effects of basal/bolus insulin therapy on the metabolic regulation assessed by glycosylated haemoglobin (HbA1c) the first 201 patients in the diabetes out-patient clinic of the Section of Endocrinology, Department of Medicine, Aalborg Hospital, assigned for this treatment were prospectively studied. In all 201 patients a significant decrease in mean HbA1c value was observed after 21 months on multiple injection therapy (8.5% vs 8.1%; p < 0.001). The higher the HbA1c value on conventional therapy, the greater was the observed decrease in HbA1c following six months on basal/bolus therapy (r = 0.57, p < 0.001). According to an anonymous questionnaire completed by the first 140 patients six months after the start of multiple injection therapy, 97% of the patients preferred to continue with basal/bolus therapy with NovoPen, and 87% felt that they had achieved a better general condition and that the basal/bolus regime made their daily life easier. It is concluded that basal/bolus therapy with NovoPen may combine the attainment of improved metabolic control assessed by a decrease in mean HbA1c in many poorly regulated patients and the subjective experience of an improved quality of life.

Adolescent↗