Magnetic resonance imaging. A national survey.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to S Jensen.
Explore the source record for details and available documents.
Fatigue, a universally reported symptom, may be one of the most prevalent feelings of people suffering 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 caregiver. The purpose of this article 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 the duration of caregiving. However, a significant relationship was found between fatigue and the impact of care on the daily schedule. This finding has strong implications for the oncology nurse, because the more the caregiver's schedule is a burden, the greater will be the fatigue experienced.
Cerebral blood flow and the cerebral metabolic rate of oxygen were measured in 30 patients during craniotomy for supratentorial cerebral tumours by a modification of the Kety-Schmidt technique using Xenon 133 intravenously. Anaesthesia was induced with midazolam 0.3 mg/kg, fentanyl and pancuronium, and maintained with midazolam as a continuous infusion, fentanyl, pancuronium and nitrous oxide in oxygen or oxygen in air. The concentration of midazolam in the blood of 10 patients was about 300 ng/litre during two measurements; the patients' lungs were ventilated with N2O in oxygen. The concentration of midazolam in the blood of another 10 patients was doubled to about 600 ng/litre during the second flow measurement; the patients' lungs were ventilated with N2O/O2. The concentration of midazolam in the blood of the third group of 10 patients was doubled to 600 ng/litre during the second flow measurement; the patients' lungs were ventilated with oxygen in air. No relationship was found between the dose of midazolam and cerebral blood flow or oxygen consumption. Nitrous oxide in combination with midazolam also had no effect on these variables.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Nine patients with primary hyperparathyroidism were studied to investigate the renal tubular reabsorption of calcium and sodium. Fasting serum and urine samples were analysed, and the glomerular filtration rate and the renal plasma clearance of lithium were determined simultaneously. Comparison was made with 9 age- and sex-matched normocalcemic controls. In the proximal tubule, there was a significantly higher absolute reabsorption of calcium in patients than in controls, whereas the fractional reabsorption rate of calcium did not differ between the two groups. In the distal tubule, the absolute calcium reabsorption rate was significantly higher in the patients, whereas the fractional reabsorption rate of calcium was significantly lower than in controls. In the patient group there was a significantly positive linear correlation between the increased tubular capacity for calcium reabsorption and the absolute proximal calcium reabsorption rate, but not between the increased capacity and the absolute distal calcium reabsorption rate. No significant differences were found in the renal tubular handling of sodium between patients and controls. Our results suggest that the increased capacity for tubular calcium reabsorption in primary hyperparathyroidism mainly is localized in the proximal tubule, and that the renal tubular handling of calcium and sodium in this disease differs from that in familial hypocalciuric hypercalcemia.
Mental illness is quite prevalent in the nursing home population. The Omnibus Budget Reconciliation Act of 1987 (OBRA), as it relates to nursing homes, has many facets including preadmission screening, periodic assessment, formalized patient rights, and gives reviewers a broader list of sanctions for offending facilities. OBRA does away with the designation of skilled and intermediate levels of care. It provides for evaluation of special needs of the mentally retarded and developmentally disabled and expects relocation of residents in need of specialized treatments. Similarly, it requires evaluation of the mentally ill in nursing homes for appropriateness of placement and discourages admission of potential nursing home residents with mental illness. This last aspect of OBRA and its potential effect of the long term care system, the mental health system, and the budget of the state of South Dakota are the subject of this paper.
The polyglandular autoimmune syndrome type II, (Schmidts syndrome), is defined as coexistence of two of the diseases: Addison's disease, insulin dependent diabetes mellitus and autoimmune thyroid disease. The first endocrine deficiency state typically develops after the age of twenty and in most cases it is Addison's disease. The prevalence is approximately 5 per 100,000. The syndrome occurs within families in half of the cases. The immunological mechanism is not finally determined, but both the humoral and cellular systems seem to be involved and furthermore there is an association with the major histocompatibility complex. Whereas treatment of the components in polyglandular autoimmune syndrome is straightforward, diagnosis may be troublesome: Patients with Addison's disease may be biochemically hypothyroid the first months of corticosteroid treatment. Patients with myxedema show decreased urine excretion of 17-ketosteroids until thyroid substitution treatment is sufficient. A decreased insulin requirement or increased frequency of hypoglycaemic attacks may be the first sign of an adrenocortical hypofunction in diabetic patients. Patients with one autoimmune disease and their relatives are predisposed to (other) autoimmune diseases.
Immunocytochemical staining of cells in sputum by rat monoclonal antibody 624H12 detects lung cancer 2 years prior to its detection by conventional diagnostic techniques. The antigen recognized by antibody 624H12 is a sugar sequence in the glycosphingolipid difucosylneolactonorhexaosylceramide (V3FucIII3FucnLc6Cer) whose structure is (formula see; text) Both fucosyl residues are required for high affinity binding by the antibody. The antigen was expressed in 35 of 45 specimens of cancer tissue from patients with early stage non small cell lung cancer. There was no correlation between antigen expression and patient survival.
Flumazenil (Lanexat) is the first specific benzodiazepine-antagonist for clinical use. In several controlled investigations, a significant rapidly commencing antagonistic effect on the central effects of benzodiazepines has been demonstrated. Flumazenil possesses only slight side effects which may easily be treated. The immediate indications for employing flumazenil are reversal of the sedation caused by benzodiazepines in outpatients and treatment of cases of poisoning. In addition, flumazenil could be employed to reverse sedation produced by benzodiazepines during general anaesthesia and prolonged sedation in intensive care units. The following should be observed on employing flumazenil: 1. Flumazenil should be administered by slow meticulous titration. 2. The relatively short half-life of flumazenil provides the possibility for partial return of CNS depression. 3. In cases of mixed poisoning, flumazenil may unmask the effects of possible seizure-producing drugs. 4. Care should be employed in using flumazenil in chronic benzodiazepine abusers.
On account of the therapeutic consequences, it is important to determine whether a case of torticollis is oculogenic. This may involve problems as shown by the case reported here. Bielschowsky's head-inclination test is an important method of diagnosing paresis of the superior oblique muscle. In cases of paresis of this muscle, good cosmetic results can frequently be obtained by operative intervention.
Embryonic mouse hippocampi (E17) were placed in the anterior eye chamber of young adult rats. The transplants were photographed twice a week. Initially the transplants increased in size, thereafter focal bleeding occurred and later regression of the transplants was seen. Regression continued until the transplants were no longer macroscopically visible. At this time the eyes were prepared for histological examination. Comparison of these transplants with immature rat hippocampi transplanted to the anterior eye chamber of rats, and with mouse-rat in vitro co-cultures suggests that the regression is a result of an immunological response.
Using radioimmunoassays specific for essential processing sites of human progastrin in combination with chromatography before and after cleavage with trypsin and carboxypeptidase B, we have examined antral biopsy specimens and serum from 10 hypergastrinemic patients with fundic atrophic gastritis and 7 normal control subjects. Four types of processing were studied: N-terminal proteolysis (at the N-terminus of component I, gastrin 34, and gastrin 17); C-terminal proteolysis (at the C-terminus of the amide donor, glycine93 in preprogastrin); alpha-carboxyamidation (of phenylalanine92); and O-sulfation (of tyrosine87). The results show that progastrin during permanent G-cell hypersecretion is less completely processed with respect to C-terminal proteolysis, alpha-amidation, and tyrosine-sulfation. In contrast, the degree of N-terminal proteolysis is normal. Thus, the processing of progastrin adjacent to the active site of gastrin is more restrictively controlled than N-terminal processing during G-cell hypersecretion associated with pernicious anemia.
Intravenous infusion of lidocaine has a pain-relieving effect in patients with painful diabetic neuropathy. We measured plasma beta-endorphin (beta-EP), dynorphin immunoreactivity (DYN), and met-enkephalin (MET) before and after lidocaine infusion in 8 patients with painful diabetic neuropathy and in 10 controls. The pretreatment level of beta-EP and DYN was identical in the two groups. After lidocaine, beta-EP increased in diabetic patients from 3.4 to 5.5 pmol/L (median) (p less than 0.02) and in controls from 3.4 to 5.0 pmol/L (p less than 0.02). The concentration of DYN was stable, and MET was undetectable before and after lidocaine. Lidocaine reduced symptoms and pain score in diabetic patients was uncorrelated with the changes in beta-EP. Intravenous lidocaine increased plasma beta-EP and diminished complaints in patients with painful diabetic neuropathy.
In a double-blind, randomized trial, the efficacy and safety of flumazenil, a benzodiazepine antagonist, was evaluated in patients after gastroscopy under midazolam or diazepam sedation. The criteria of efficacy were the degree of sedation and anterograde amnesia. Flumazenil significantly reduced the degree of sedation in both groups without significant intergroup differences. No sign of resedation was found during the observation period of 3 h. The anterograde amnesia was effectively antagonized in both groups. Flumazenil was well tolerated. Flumazenil is a safe and effective benzodiazepine antagonist which makes it possible to reduce the recovery period in outpatients sedated sufficiently with benzodiazepines for gastroscopy.
The sensitizing capacity of 15 commercial colophony products was studied experimentally in guinea pigs. The study included 8 French and 6 American colophony derivatives as well as French tall oil colophony. The results indicate that tall oil colophony is the strongest sensitizing material within the tested group and that the maleic-modified products and the zinc-calcium-resinate are moderate sensitizers. Most of the modified products show a higher sensitizing capacity than the genuine resin acids themselves. Cross-reactions between the resin acids and the derivatives are uncommon. Therefore, patch testing with high concentrations of colophony (e.g., 60%) will not help to detect patients with colophony-derivative allergy.
Mice with the karyotype 39, XO and XX mice with the same genetic background were injected for a six month period with daily subcutaneous doses of 0.5 IU biosynthetic human growth hormone (hGH) or with placebo. The XO mice dosed with hGH obtained a significantly higher body weight and greater final length than the XO mice dosed with placebo (39.2 g versus 29.0 g and 21.1 cm versus 19.2 cm respectively). The body weight remained constant after cessation of dosing. The XX mice became significantly longer but not heavier as a result of hGH dosing. The placebo dosed XO mice became significantly longer than the placebo XX mice but their body weights were comparable. Dosing with hGH caused a significant increase in growth rate in both XO and XX mice, and the ultimate body weight was reached within a significantly shorter time period. In the XO mice the hGH injections increased significantly the length and thickness of the femoral bones and the length of the tibia bones. Stimulated endogenous plasma growth hormone levels were significantly higher in XX mice compared to XO mice. Plasma IGF-I levels were significantly higher in XO compared to XX mice, but the levels were not affected by hGH dosing. XO mice may be useful in future metabolic and hormonal studies.
We performed a follow-up study of the glomerular function in a series of 29 Type 1 (insulin-dependent) diabetic patients who had been studied 18 years previously. Initial median duration of diabetes was 2 years (range 0-9) and at follow-up 21 (17-27) years. At follow-up, 8 diabetic patients exhibited increased urinary albumin excretion rate 515 (32-3234) micrograms/min with glomerular filtration rates significantly lower than 21 diabetic patients with normal urinary albumin excretion (85 vs 126 ml/min/1.73 m2; p less than 0.01). The patients with increased urinary albumin excretion rate also had higher arterial blood pressure (145/90 vs 120/80) mm Hg; p less than 0.02) and increased frequency of proliferative retinopathy (7 out of 8 vs 2 out of 21; p = 0.0001) as compared to the group with normal urinary albumin excretion. However, we found no association of increased urinary albumin excretion rate (incipient or overt nephropathy) to early glomerular hyperfiltration as median initial glomerular filtration rate was 142 ml/min/1.73 m2 in the diabetic patients with increased urinary albumin excretion and 147 ml/min/1.73 m2 in the patients with normal excretion rate (p greater than 0.05).