Biomedical subjects
Publications and source records attributed to S Jensen.
We describe two cases of aplastic crisis of unknown origin, occurring within one week in a 49-year old man and his 20 year old son. They both had undiagnosed hereditary spherocytosis, and both of them had earlier had a B19-parvo infection without having symptoms of aplastic crisis at the same time. Chronic haemolytic anaemia should be considered in adult patients with acute severe anaemia caused by aplastic crisis.
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.
Neutropenic enterocolitis is a necrotising colitis, which most often develops in the setting of severe neutropenia. The symptoms are non-specific and among the differential diagnoses are appendicitis, ischaemic colitis and pseudomembranous enterocolitis. In practice neutropenic enterocolitis is seen in oncological, especially haematological, patients during chemotherapy induced neutropenia. The condition has a potentially lethal course and both medical and surgical treatment is possible; clinically controlled investigations on methods of treatment have not been available. Two cases are reported.
Fatigue, a universally reported symptom, may be one of the most prevalent feelings of people suffering from physical or mental diseases. An understanding of the factors leading to fatigue in the caregiving population can contribute to better care and support of both the cancer patient and the caregiver. The purpose of this discussion is to investigate and describe the experience of fatigue among caregivers of cancer patients in relation to caregiver age, employment status, number of hours of care provided daily, duration of caregiving, and the impact upon the caregiver's schedule. A sample of 248 caregivers of cancer patients, participating in the Family Homecare Cancer Study, were surveyed regarding fatigue related to their caregiving roles. No relationship was found between severity of fatigue experienced by the caregiver of the cancer patient and caregiver age, employment status, the number of hours of daily caregiving, or its duration. However, a significant relationship was found between fatigue and the impact of care on the daily schedule. This finding has strong implications for the health-care provider, because the more the caregiver's schedule is a burden, the greater will be the fatigue experienced.
In Denmark a new trend concerning the abuse of codeine has been observed. Danish drug abusers have discovered that codeine is easily separated from certain drugs containing acetylsalicylic acid and codeine. When separated the codeine can be used either orally or intravenously. Three different drugs combining acetylsalicylic acid and codeine are available in Denmark, but codeine is only easily separable from one of these. Applying the same procedure to the two other drugs produces unpredictable or unfavourable ratios of codeine to acetylsalicylic acid. In several countries, however, similar drugs combining acetylsalicylic acid and codeine are available. It is not possible from a list of constituents to predict how easily codeine can be separated from a particular drug. Therefore it is strongly recommended that relevant drugs are tested at local forensic laboratories. In case codeine is found to be very easily separated from a product appropriate action should be taken.
Changes in the plasma concentrations of interleukin-1 beta (IL-1 beta), tumour necrosis factor alpha (TNF alpha), interleukin 2 (IL-2), and lymphocyte subsets were investigated in 19 persons with newly diagnosed (type 1) insulin-dependent diabetes mellitus (IDDM) from admission to hospital prior to insulin treatment and following 1 week and 1 month of treatment. Furthermore, the cytokines were measured 16-28 months after the presentation of IDDM. The mean TNF alpha values were all within the normal range, but demonstrated a slight increase in all the samples taken (Friedman 0.06). The mean plasma IL-1 beta value was initially at the upper normal limit, but gradually increased significantly from admission to hospital to 1 week, 1 month, and 16-28 months afterwards (Friedman 0.031). No IL-2 activity was detectable in the majority of the samples. No significant changes in total leukocyte and lymphocyte counts were found. The lymphocyte subsets (CD5+, CD8+, CD4+, CD16+, CD20+, HLA-DR+) did not show any significant changes from admission to after the start of insulin treatment. It is concluded that the gradual increase in IL-1 beta and TNF alpha plasma levels may reflect an ongoing autoimmune inflammatory reaction at the onset of IDDM.
Manic-depressive illness (MDI), also known as "bipolar affective disorder," is a common and devastating neuropsychiatric illness. Although pivotal biochemical alterations underlying the disease are unknown, results of family, twin, and adoption studies consistently implicate genetic transmission in the pathogenesis of MDI. In order to carry out linkage analysis, we ascertained eight moderately sized pedigrees containing multiple cases of the disease. For a four-allele marker mapping 5 cM from the disease gene, the pedigree sample has > 97% power to detect a dominant allele under genetic homogeneity and has > 73% power under 20% heterogeneity. To date, the eight pedigrees have been genotyped with 328 polymorphic DNA loci throughout the genome. When autosomal dominant inheritance was assumed, 273 DNA markers gave lod scores < -2.0 at recombination fraction (theta) = .0, 174 DNA loci produced lod scores < -2.0 at theta = .05, and 4 DNA marker loci yielded lod scores > 1 (chromosome 5--D5S39, D5S43, and D5S62; chromosome 11--D11S85). Of the markers giving lod scores > 1, only D5S62 continued to show evidence for linkage when the affected-pedigree-member method was used. The D5S62 locus maps to distal 5q, a region containing neurotransmitter-receptor genes for dopamine, norepinephrine, glutamate, and gamma-aminobutyric acid. Although additional work in this region may be warranted, our linkage results should be interpreted as preliminary data, as 68 unaffected individuals are not past the age of risk.
The study analyses the role of salicylic acid (SA) in fatal intoxications with special reference to potentially avoidable, accidental poisonings. The study indicates a relation between SA intoxication and the presence of an infection of the respiratory tract. All deaths in Denmark in the period 1980 through 1989 registered as caused by SA were analysed as were all deaths submitted to forensic toxicological examination in a defined region of Denmark in the years 1985 through 1989. During the decade 1980 through 1989 the number of fatal intoxications due to SA increased from approx. five per year to approx. 23 per year. During the same period the sales of SA decreased. Many deaths in the material were registered as accidental, and an increasing frequency of accidental deaths was seen with a lower social level. Frequently, an infection of the respiratory tract was either indicated in a hospital case record or a police report, or found at autopsy.
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Post-traumatic myocardial infarction is a well-known although rare complication of blunt chest traumas. In cases of proximally located damage to the coronary arteries, modern vascular surgery such as bypass operations may be lifesaving. In this paper we describe a case, where a healthy 35-year-old man developed a lethal myocardial infarction 8 days after a chest trauma caused by a moped. The ECG obtained 4 h after the accident showed extensive transmural ischemia of the anterior wall. At autopsy a hematoma originating from a side branch was found to compress the left anterior descending coronary artery immediately distal to its origin from the main stem. This finding suggests that bypass surgery could have saved the life of this young man. Patients with evidence of myocardial ischemia following chest traumas should be transferred to a cardiac center as early as possible.
We investigated the interaction between human lung cancer cells, laminin, and several differentiating agents. When grown on laminin coated substrate eight out of 11 small cell lung cancer (SCLC) cell lines exhibited attachment to laminin and three had extensive outgrowth of long neurite-like processes. Of seven non-small cell lung cancer cell lines, selected for their in vitro anchorage-independent growth, attachment was observed in only three cell lines, and process formation was far less extensive than in SCLC cell lines. Among several differentiating agents, only dcAMP, which alone induced attachment and some process formation, increased laminin-mediated attachment and process formation of two SCLC cell lines, NCI-N417 a variant cell line, and NCI-H345, a classic cell line. The expression of several neuroendocrine and neuronal markers was investigated in these two SCLC cell lines. The expression of the light subunit of neurofilaments increased in NCI-N417 within 3 to 4 days of seeding, while NCI-H345 exhibited approximately 5 fold increase in expression of the GRP gene and a 3 fold increase expression of the beta-actin gene. The expression of a number of other neuroendocrine and neuronal markers did not change following growth on laminin. The doubling times remained unchanged independent of the presence of and attachment to laminin while topoisomerase II gene expression levels in NCI-N417 cells decreased approximately 5 fold when cells were growing on laminin.
We ascertained 8 multigenerational pedigrees afflicted with multiple cases of bipolar and recurrent major depressive disorder. Alterations in dopaminergic and noradrenergic neurotransmission have been implicated in the pathogenesis of this disease, and tyrosine hydroxylase (TH) is the rate-limiting enzyme in the synthesis of these two catecholamines. As TH mutations could underlie susceptibility to manic-depression, we carried out a linkage analysis between this disease in 8 families and two RFLP probes that map to the TH gene region on the short arm of chromosome 11. Evidence of linkage was not found in 7 of 8 kindreds.
Disturbances in dopaminergic activity may play an important role in the pathogenesis of manic depression. The effects of dopamine are mediated by at least five G protein coupled receptors, D1, D2, D3, D4 and D5. Recently, three separate research groups have cloned and characterized the D1 dopamine receptor, which localizes to 5q35.1. We undertook a linkage analysis between the D1 receptor polymorphisms and manic depression in six families in which segregation of the disease was consistent with autosomal dominant inheritance. A highly polymorphic flanking DNA marker, CRI-L1200, was also analyzed as the D1 gene RFLPs were relatively uninformative in our families. Multipoint analyses of manic depression and these DNA markers resulted in lod scores of less than -3.0 at the D1 locus, indicating that the D1 dopamine receptor gene does not confer an inherited susceptibility to manic-depressive illness in the families studied.
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We have marked a cloned Drosophila transposable element--the I element--with an engineered neomycin-containing indicator gene, whose expression is conditioned by passage of the transposon through an RNA intermediate. Mobility of the marked element introduced into Drosophila as a transgene could be detected in vivo, upon in toto selection of developing embryos on G418-containing medium. For resistant individuals, Southern blot analysis and nucleotide sequencing after PCR amplification disclosed transposition of the marked element into new loci, with target site duplications and splicing out of the intron in the indicator gene. It demonstrates that the I element, which is closely related to the widespread mammalian LINEs, transposes through an RNA intermediate, as up to now only conjectured from sequence singularities of this class of 'non-viral retrotransposons'. The developed indicator gene provides a potent new genetic tool for detection and quantitative analysis of retrotransposon mobility and its regulation as it occurs in vivo.
Drugs addicts are commonly brought to casualty wards where they often pose a diagnostic problem. They are typically brought in unconscious with no signs of disease or trauma. The suspicion of poisoning arises by the finding of fresh injection marks. This paper describes a case in which a young male drug addict was dead on arrival in hospital without recognizable recent injection marks but with some old wounds or necroses in both groins. The autopsy and toxicological analyses revealed that death was caused by an overdose of methadone and that the necroses in the groins were fistulas facilitating administration of the drugs directly into larger veins.
Cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) were measured by a modification of the Kety-Schmidt technique using i.v. xenon-133 in 20 patients undergoing craniotomy for supratentorial cerebral tumours. Anaesthesia was induced and maintained with midazolam, fentanyl and nitrous oxide. Pancuronium was given for neuromuscular block. The lungs were ventilated to normocapnia. The first flow measurements were performed approximately 1 h after induction of anaesthesia. At the end of operation the patients were allocated to two groups. Ten patients were given flumazenil 0.01 mg kg-1 and 5 min later the second flow measurement was performed. In the other 10 patients the second flow measurement was performed before the administration of flumazenil. Plasma concentrations of midazolam were measured at the time of each measurement of CBF. There was no difference between the groups in plasma concentration of midazolam, CBF or CMRO2. Flumazenil had no effect on CBF and CMRO2.
This report deals with a case in Denmark in which close cooperation among the local police, the Central Missing and Wanted Persons Search Squad, and the Institute of Forensic Medicine resulted in the positive identification of human remains (part of a skeleton), although the deceased's skull was missing, he had no teeth (but a dental prostheses), and an attempt at blood typing produced a false result. When the remains were found, there was no idea who the deceased might be. The initial forensic examination provided a general description (age, height, and sex), and reconstruction of the vertebral column showed extensive changes caused by arthrosis and changes typical for Scheurmann's disease. The description made on this basis was sent to police stations throughout the country and, far from where the remains were found, a police officer had received the report of a missing person who could have been the deceased. Further investigation was based mainly on the medical history of this missing person and the tracing of the effects found with the remains, and emphasized radiographic comparison.