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Biomedical subjects

M Ostensen

Publications and source records attributed to M Ostensen.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Hip prostheses in women of fertile age. Consequences for sexuality and reproduction].

About 6,000 patients undergo total hip replacement in Norway each year. 2.2% of them are women of fertile age, and 14% of them need hip replacement because of inflammatory rheumatic disease. Female patients may wish to know about possible consequences of hip arthroplasty on sexual activity or pregnancy and delivery. An inquiry on these issues was carried out among Norwegian orthopaedic surgeons and obstetricians. The results of the inquiry and a review of the literature can be summarized as follows: Uncomplicated total hip replacement does not preclude normal delivery nor interfere with sexual activity. Some restrictions as regards sexual activity may be advisable during the first three months after hip arthroplasty. Patients with widespread joint or muscle involvement due to inflammatory arthritis need individual counselling. As a rule, pre- and postoperative information to female patients undergoing total hip replacement should take up the possible consequences for sexual activity and reproduction.

Adult↗
PubMed1991

[Cartilage changes in arthrosis--do non-steroidal antiphlogistics have positive or negative effects?].

The use of nonsteroidal anti-inflammatory drugs in the treatment of osteoarthritis has been disputed recently because of possible inhibition of cartilage matrix synthesis. The present article reviews the structure of articular cartilage and the pathogenesis of osteoarthritis. It includes a critical analysis of the experimental and in vivo data on nonsteroidal anti-inflammatory drugs and their effect on cartilage repair. So far, investigations using cell or tissue culture, animal models or human cartilage do not support the concept that any nonsteroidal anti-inflammatory drug administered in therapeutic doses accelerates human osteoarthritis. In lack of convincing clinical evidence of detrimental or "chondroprotective" properties, nonsteroidal anti-inflammatory drugs can still be regarded as useful agents in the treatment of osteoarthritis.

Animals↗
PubMed1991

Pregnancy in patients with a history of juvenile rheumatoid arthritis.

The present investigation was undertaken to study the relationship between pregnancy and juvenile rheumatoid arthritis (JRA), with regard to possible reactivation of the disease, complications at delivery, and postpartum complications. Data on 76 pregnancies in 51 JRA patients were collected retrospectively. Comparison of pre-pregnancy disease activity with the course during gestation showed that pregnancy did not cause reactivation of the symptoms of quiescent JRA. Patients with minor symptoms at conception and the majority of those with active inflammation experienced improvement or total remission in the second half of gestation. Four JRA patients with active anterior uveitis had active eye disease during pregnancy also. Seventy-four of the pregnancies resulted in births of infants that were healthy and of normal birth weight; 1 infant had low birth weight and 1 was stillborn. Twenty children were delivered by cesarean section, and in 15 cases this was related to sequelae of JRA. A flare 3-6 months postpartum was reported after 45 pregnancies. However, in none of the patients whose disease was quiescent before or during pregnancy did this cause permanent reactivation of the JRA. Comparison of these 51 patients with 45 age-matched female patients without children revealed that disease severity and functional impairment were the limiting factors in the decision for or against having children.

Adolescent↗
PubMed1991

Responses of normal and rheumatic human articular chondrocytes cultured under various experimental conditions in agarose.

The purpose of the present study was to test if agarose could support the maintenance of normal and arthritic human chondrocytes in culture, and under which experimental conditions they could be successfully grown. Cultures of chondrocytes isolated from articular cartilage from patients with rheumatoid arthritis (RA), juvenile rheumatoid arthritis (JRA), and healthy controls were assessed by light microscopy, alcian blue staining, formazan uptake and incorporation of radiosulfate into the extracellular matrix. The results showed that both normal and arthritic chondrocytes proliferated, and synthesized proteoglycan (PG) in agarose in short term and long term culture. Proliferation and PG synthesis occurred at a slower rate in chondrocytes from adult rheumatic patients than from healthy controls. Supplements to the medium influenced chondrocyte proliferation, PG synthesis and release into the medium. Serum from RA patients stimulated chondrocyte responses more than normal human serum (NHS), and NHS promoted PG synthesis more than fetal calf serum (FCS). Exposure to inflammatory synovial fluid (SF) enhanced PG synthesis of healthy chondrocytes, but suppressed it in arthritic chondrocytes. We conclude that species-specific serum is optimal for chondrocyte cultures, and that disease related culture conditions change the chondrocyte response. As metabolic responses of human chondrocytes are maintained in agarose, this culture system appears as a suitable in vitro tool for further studies of human joint disease.

Adolescent↗
PubMed1991

Counselling women with rheumatic disease--how many children are desirable?

The interaction of pregnancy and the rheumatic diseases has been described for most of the inflammatory joint disorders. However, the patient response to the challenge of motherhood and child rearing has seldom been taken into consideration. The current study presents data derived from a patient inquiry on these issues. The results demonstrate that while a wish for children is present even in disabled patients, the number of children regarded feasible depends largely on coping strategies, external help and the patient's own resources. Information before pregnancy is crucial, but often insufficient. Counselling should rely not only on medical facts, but also on patient experience.

Adult↗
PubMed1991

The L1 protein as a new indicator of inflammatory activity in patients with juvenile rheumatoid arthritis.

L1 is a major granulocyte and monocyte protein with Mr 36.5 kDa. It is released during leukocyte activation and detected in plasma by use of an enzyme immunoassay. In our study, L1, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), orosomucoid and haptoglobin were analyzed in 127 patients with juvenile rheumatoid arthritis (79 pauci, 33 poly and 15 systemic). L1, ESR and the acute phase proteins were all found to have positive correlations with the clinical joint assessments, with L1 having the strongest correlations. High correlation coefficients were found between L1 and orosomucoid (r = 0.83), ESR (r = 0.72), haptoglobin (r = 0.71) and CRP (r = 0.65), with p less than 0.001 for all the correlations.

Antigens, Surface↗
PubMed1989

Identification of antihistone antibodies in subsets of juvenile chronic arthritis.

Antihistone antibodies (AHAs) as measured by an enzyme linked immunosorbent assay (ELISA) were detected in the sera of 58 (48%) of 121 unselected patients with juvenile chronic arthritis (JCA). AHAs were found in 28 (93%) of 30 patients with JCA with uveitis but in only 30 (33%) of 91 patients with JCA without uveitis. AHA positivity was unrelated to the type of joint involvement, disease activity, and drug regimen. When the AHA positive group was divided into 28 patients with JCA with uveitis and 30 patients with JCA without uveitis a distinct response pattern of AHA was detected in each group. Anti-H3 dominated in the JCA/uveitis group, whereas a more heterogeneous AHA pattern was shown in the group without uveitis. The results indicate that subtyping for AHA reactivity may define patients who are highly susceptible for the development of anterior uveitis.

Adolescent↗
PubMed1989

Ankylosing spondylitis and pregnancy.

In contrast to what is known for RA, pregnancy does not improve the symptoms of AS. The majority of women with AS has unchanged or temporarily aggravated disease activity during pregnancy. AS associated with other inflammatory states like psoriasis, IBS, or peripheral small joint arthritis, may benefit from pregnancy. Women with AS can expect to have the same rate of fertility, course of pregnancy, and normal delivery as the healthy female population. In general, female AS patients have healthy babies. However, the chance for their offspring to develop AS later in life is slightly increased.

Anti-Inflammatory Agents↗
PubMed1988

Piroxicam in breast milk after long-term treatment.

The presence of piroxicam in breast milk was determined by HPTLC during initial and long term dosing in 4 women treated for arthritis. Piroxicam appeared in breast milk at about 1-3% of the maternal plasma concentration. No accumulation of piroxicam occurred in milk relative to that in plasma up to 52 days of treatment. Neither piroxicam nor its conjugates were detectable in the urine of one breast-fed infant. The daily dose ingested by the infant was calculated to average 3.5% (maximum 6.3%) of the weight-related maternal dose of piroxicam. It is concluded that a breast-fed infant will be exposed to a very small amount of piroxicam.

Adult↗
PubMed1988

Regulation of human natural killer (NK) cell function: induction of killing of an NK-resistant renal carcinoma cell line.

Natural killer (NK)-like activity against a renal carcinoma cell line, Cur, was assessed. There was no spontaneous killing of Cur cells by human peripheral blood mononuclear cells in 4-hr assays. Cur killing was observed in 18-hr assays, but the magnitude of killing was variable and always markedly less than that against K562. Cur killing was mediated by a nonadherent, nonphagocytic lymphocyte, the activity of which could be modulated both positively and negatively by monocytes or their products. Preincubation of effectors with monocyte supernatant, interleukin 1 (IL-1), alpha-interferon (alpha IFN), or interleukin 2 (IL-2) greatly increased the magnitude of Cur killing and accelerated the kinetics of lysis. The addition of prostaglandin E2 (PGE2) during in vitro activation of NK by IL-2 profoundly inhibited subsequent Cur lysis, whereas only minimal inhibition of K562 lysis was noted. However, following activation with IL-2, lysis of Cur targets was less sensitive to the inhibitory effects of PGE2. Removal of Leu 11b(+), OKM1(+), or L-leucyl-leucine methyl ester-sensitive cells markedly decreased both Cur and K562 lysis. Moreover, CD16(+) cells purified with the fluorescence-activated cell sorter were found to mediate Cur killing. Whereas Cur and K562 lysis is mediated by phenotypically similar effector cells, the present studies demonstrate that the cytotoxic functions defined by the ability to lyse these two targets differ in response to a variety of immunoregulatory stimuli.

Cell Line↗
PubMed1988

Phagocytic cell activity in pre-eclampsia.

To compare the immune response in normal and pathological pregnancy, some functions of phagocytic cells were studied in 8 women with pre-eclampsia and 7 healthy women matched for age and parity. Free oxygen radical activity determined by chemiluminescence (CL) of polymorphonuclear leukocytes (PMN) and monocytes (MN) during phagocytosis of preopsonized zymosan, and cell migration measured by tube migration of PMN were studied together during and after pregnancy. CL of MN decreased or remained unchanged during normal pregnancy, but a marked increase was observed in pre-eclampsia. CL of PMN increased, too, in the pre-eclamptic patients, but the difference was not significant. Tube migration was enhanced during pregnancy compared with baseline values, but the values were significantly lower in the pre-eclamptic group. Immuno-globulins (Ig G, Ig M and Ig A) were studied in both groups. A decline in Ig G level from baseline to the 3rd trimester was observed in patients. The complement fractions C3 and C4 were not altered during pregnancy in any group. The study indicates a difference in behavior of phagocytic cells in normal vs. pre-eclamptic pregnancy.

Adult↗
PubMed1988

Modulation of human natural killer cell function by cytokines and rheumatic disease.

The activity of natural killer (NK) cells can be modified by a number of factors that either increase or suppress cytotoxicity. We have investigated in detail the cytokine induced killing of a NK resistant renal carcinoma cell line Cur by human NK cells. Preincubation of peripheral blood mononuclear cells with interferon alpha (IFN alpha), interleukin 2 (Il-2), interleukin 1 (Il-1) and tumor necrosis factor alpha greatly increased the rate and magnitude of Cur killing. Positively selected CD16 (+) cells were found to respond to cytokine stimulation and to mediate Cur killing. The effects of Il-2 and IFNa could be upregulated by costimulation of effector cells with Il-1 or TNF alpha. It was shown that TNF alpha induced Il-2 receptor expression on CD16(+) cells alone and even more in combination with Il-2. Studies of NK cell function in various rheumatic diseases revealed reduced NK cytotoxicity in peripheral blood and synovial fluid (SF), both in rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA). By contrast, normal NK function was found in patients with ankylosing spondylitis (AS) and psoriatic arthritis. A discordance with regard to the percentage of Leu 7 positive mononuclear cells and NK function in peripheral blood and SF was demonstrated. Minimal expression of Leu 7 positive cells and cytotoxicity was present in synovial membranes. NK function in rheumatic disease was largely independent of drug therapy. Natural killer (NK) cells are a subset of lymphocytes that mediate spontaneous cytotoxicity against certain tumor and virus infected cells without any known prior sensitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents↗
PubMed1988

Tolerance of cyclosporine A in children with refractory juvenile rheumatoid arthritis.

In an open trial, tolerance and safety of cyclosporine A was studied in 14 patients with refractory juvenile rheumatoid arthritis (JRA). The doses varied from 4-15 mg/kg/day. Treatment lasted for greater than 12 months in 11 and 6 to 9 months in 3 patients. Eleven patients were withdrawn due to lack of efficacy (4) or side effects (7). A drop of greater than 2 g/l in hemoglobin and a marked rise in serum creatinine were the cause of withdrawal in 5 patients. The effect of cyclosporine on disease activity seemed to be mainly symptomatic and temporary. Probably, the dose should be kept below 5 mg/kg/day. Future controlled studies should be aware of a risk of aggravation of anemia in children treated with cyclosporine.

Administration, Oral↗
PubMed1987

The effect of pregnancy on functions of inflammatory cells in healthy women and in patients with rheumatic disease.

Chemiluminescence (CL) after zymosan stimulated phagocytosis of polymorphonuclear granulocytes (PMN) and mononuclear cells (MNC), random migration of PMN and intra- and extracellular activities of nine lysosomal enzymes were assessed serially in 8 healthy women and 10 women with rheumatic disease during and after pregnancy. A gestational increase of lysosomal enzymes in serum and enhancement of PMN random migration was observed in all women. Significant differences between healthy and rheumatic women were found for CL of phagocytic cells. In healthy women, CL of PMN was slightly enhanced, while it remained unchanged in MNC during pregnancy. In patients, CL of PMN was markedly suppressed, while MNC CL increased during gestation. An inverse relationship between CL and intracellular enzyme activities was noted. Thus, the presence of an inflammatory state seemed to influence the gestational behavior of phagocytic cells.

Female↗