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Biomedical subjects

S L Hansen

Publications and source records attributed to S L Hansen.

At least 37 records · Page 2Linked to original sources
PubMed1990

Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology.

Charts from patients admitted from April 1976 to March 1986 to the departments of neurology, neurosurgery, ophthalmology and pediatrics serving a population of 615,000 inhabitants in Copenhagen County were surveyed. We then examined patients with coexisting headache and ophthalmoplegia at follow-up. Many diseases may mimic a single attack of ophthalmoplegic migraine. We found 4 cases of ophthalmoplegic migraine, i.e. an annual incidence of 0.7 per million inhabitants. We added another 4 cases from the same area, but diagnosed before or after the study period. Only in 2 of the 8 cases did the ophthalmoplegic episodes fulfil criteria for pain and associated symptoms required for migraine without aura (common migraine). In contrast, the clinical characteristics of the attacks are typical of the Tolosa-Hunt syndrome. When this inflammatory disease strikes a migraineur it is likely to elicit headache with migrainous features. We postulate that such cases have been diagnosed as ophthalmoplegic migraine, whereas the proper diagnosis of Tolosa-Hunt syndrome has been made in non-migraineurs.

Adolescent↗
PubMed1989

[Whipple's resection in cancer of Vater's ampulla and the pancreatic head].

A review is presented of 62 Whipple's resections between 1962 and 1984 for adenocarcinoma of the choledocho-duodenal junction (CDJ) and pancreatic head (PH). The operation was radical in 17 patients with CDJ (94%) and in 34 patients with PH cancer (77%). The cumulative 5-year survival rates were 22% and 9%, respectively. The overall perioperative mortality was 23%, but was lowered to 11% during the last five years. Histology, size of tumour and age also influenced survival. Sixteen of the 32 radically operated patients who survived more than three months had a period without pain. Whipple's resection is still the only hope for cure in otherwise fit patients with CDJ or PH cancer, estimated to be radically resectable by pre- and peroperative investigations. The operation should be centralized in a few departments.

Adenocarcinoma↗
PubMed1989

Treatment of solitary enchondromas in fingers.

The results after operative treatment of 21 solitary enchondromas of finger bones are described. 15 cases were treated by curettage and cancellous bone grafting, five by curettage alone, and one with amputation. One case did not heal after curettage and grafting. When symptoms are present or the cortical strength is decreased, we recommend operation. We find that the eccentric type of enchondroma can be treated adequately by curettage alone, while curettage and filling of the cavity with cancellous bone should be preferred in the central and polycentric forms. It is important that all material is removed from the cyst, which has to be packed completely with bone chips. The possibility of malignant change in enchondromas should be borne in mind, but we did not see this.

Adolescent↗
PubMed1989

Stress response and platelet function in minor surgery during epidural bupivacaine and general anaesthesia: effect of epidural morphine addition.

In a randomized study, thirty patients submitted to transarthroscopic meniscectomy were allocated to general or epidural anaesthesia with or without epidural morphine. Threshold concentration of collagen for platelet aggregation did not differ between the groups, but showed a similar pattern of increase, which was significant in the general anaesthesia group. Collagen-induced thromboxane-B2 synthesis was significantly lower in the epidural anaesthesia groups compared with the general anaesthesia group, and the addition of morphine caused a significant fall in thromboxane-B2 synthesis. The mean serum cortisol concentration increased in the general anaesthesia group, and decreased in the epidural groups. The difference between the groups was significant. Epidural morphine administration significantly decreased serum cortisol. During operation a thigh tourniquet was used. The removal of the tourniquet did not influence any of the measured variables. It can be concluded that the adrenocortical system is activated during general and inhibited during epidural anaesthesia. The addition of morphine during epidural anaesthesia further decreases the activity of the adrenocortical system, and the combined regime has an inhibiting effect on platelet function.

Adult↗
PubMed1987

Dual-photon absorptiometry of the proximal tibia.

Dual-photon absorptiometric bone-mineral assay, penetration tests, and axial compression tests of the proximal tibial epiphyses were carried out in 18 human cadaver knees. The reproducibility of bone mineral assay was within +/- 12% (95% tolerance limits). Linear regression analysis with bone-mineral content as the independent variable showed a good correlation to the ultimate force obtained from the compression tests on the medial (r = 0.81) and the lateral (r = 0.90) condyles. The correlation between bone mineral content and an average of three condylar penetration tests was somewhat weaker (medical condyle: r = 0.65, lateral condyle: r = 0.62). It is concluded that dual-photon absorptiometric bone-mineral assay may be a suitable noninvasive alternative to bone-strength measurement and thus suitable for monitoring the changes in tibial condylar bone during follow-up studies.

Humans↗
PubMed1987

Prospective microbiologic surveillance in control of nosocomial methicillin-resistant Staphylococcus aureus.

A prospective microbiological surveillance (PMS) program was developed in a comprehensive hospital-wide effort for control of nosocomial methicillin-resistant Staphylococcus aureus (MRSA). This PMS program entailed: active identification of colonized and infected patients; application of a screening microbiologic system for MRSA; isolation of colonized and infected patients; antibiotic decolonization of MRSA; and educational efforts. The PMS program was studied over three and one half years for its contribution to infection control of MRSA, early identification of nosocomial MRSA outbreaks, use of the highest yield surveillance culture sites, and cost effectiveness. Following initiation of the PMS program in December 1982, during an MRSA outbreak, the frequency of new MRSA cases declined from 14 to none by the end of a 3-month pilot study. The frequency of new MRSA cases stabilized at approximately 2 per month until October 1983, when the PMS system allowed prompt detection of a new outbreak of 11 cases. Following isolation and antibiotic decolonization, the frequency of cases again declined to 3 per month. A third outbreak in December 1985 again was promptly detected and controlled. Infection to colonization ratio decreased from a maximum of 1.5 during outbreaks to a minimum of 0.17 after outbreaks. Wounds and tracheostomy sites provided the greatest yield of detection of new cases of MRSA. During one 15-month period, 35 of the 43 new cases were detected initially at wounds and tracheostomy sites. No new MRSA cases were detected by a positive axillary or nares site alone. The estimated quarterly cost of outbreaks and infection paralleled the quarterly frequency of new MRSA cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost-Benefit Analysis↗
PubMed1987

Collaborative investigation of the accuracy and reproducibility of Sceptor Breakpoint susceptibility panels.

A combination Sceptor Breakpoint/ID panel (Johnston Laboratories, Inc., Towson, Md.), which determines interpretive susceptibility results (susceptible, moderately susceptible, and resistant) using two to three selected concentrations of antimicrobial agents, was tested in comparison with full-range Sceptor microdilution MIC panels. The inter- and intralaboratory interpretive reproducibilities for 24 control strains tested in three laboratories on three consecutive days were 97.0 and 95.7%, respectively. The equivalency of breakpoint results to category results obtained by the microdilution MIC procedure for 10,368 control organism-antimicrobial agent comparisons was 94.1%. The level of interpretive agreement between breakpoint and MIC category results using 101 fresh clinical isolates was 97.0% for 51 gram-negative and 50 gram-positive bacteria. Among the total 4,872 clinical organism-antimicrobial agent comparisons, major and very major discrepancies were seen in 0.2% of gram-negative bacteria and very major discrepancies were seen in 0.9% of gram-positive bacteria. All very major discrepancies with gram-positive organisms were associated with trailing endpoints using trimethoprim or sulfisoxazole and staphylococci. The breakpoint concept of testing selective antimicrobial agent concentrations was highly reproducible and accurate and allows for placement of more antimicrobial agents into a panel than is possible with full-dilution MIC testing.

Bacteria↗
PubMed1987

Detection of intrinsically resistant (heteroresistant) Staphylococcus aureus with the Sceptor and AutoMicrobic systems.

Modified procedures for the Sceptor Gram-Positive MIC Panel and the Vitek AutoMicrobic System GPS-M Card were evaluated for their ability to detect methicillin-resistant (heteroresistant) Staphylococcus aureus. A total of 398 clinical isolates (including 222 methicillin-resistant S. aureus) obtained from 10 hospitals were tested. Both systems had 2% NaCl in the oxacillin wells. Sceptor MIC panels were inoculated with an organism suspension prepared from an 18- to 24-h blood agar plate and were inoculated for a full 24 h at 35 degrees C before MICs were read. All methicillin-resistant S. aureus isolates were detected as resistant to oxacillin at greater than or equal to 8 micrograms/ml by the Sceptor method and at greater than 2 micrograms/ml by the Vitek method. All 176 oxacillin-susceptible, methicillin-susceptible S. aureus isolates were correctly distinguished from methicillin-resistant S. aureus isolates by Sceptor. However, with the Vitek system 29 methicillin-susceptible S. aureus isolates tested as falsely resistant to oxacillin and four isolates tested as falsely resistant to vancomycin. The modified testing procedure with the Sceptor system can be used reliably for accurate susceptibility testing of methicillin-resistant and methicillin-susceptible S. aureus. The Vitek GPS-M card does not accurately discriminate between methicillin-resistant and methicillin-susceptible S. aureus with an oxacillin breakpoint of greater than 2 micrograms/ml.

Amoxicillin↗
PubMed1986

Novobiocin and rifampicin in combination against methicillin-resistant Staphylococcus aureus: an in-vitro comparison with vancomycin plus rifampicin.

Novobiocin and rifampicin were evaluated in vitro as a possible new antibiotic combination against methicillin-resistant Staphylococcus aureus. An evaluation of 20 strains of methicillin-resistant Staph. aureus using microdilution checkerboard techniques at 10(5) cfu/ml showed neither synergy nor antagonism between novobiocin and rifampicin or between vancomycin and rifampicin. Agar surface inoculation of six strains of methicillin-resistant Staph. aureus showed increased synergy with increased inocula (10(6)-10(9) cfu) for novobiocin plus rifampicin compared to vancomycin plus rifampicin. Time-kill curves showed indifference at 6h for all combinations, whereas, at 24 and 48 h, they generally showed indifference, occasionally synergy, but never antagonism. The 'synergy' between novobiocin and rifampicin at higher inocula of methicillin-resistant Staph. aureus appears to be due to prevention of emergence of resistant organisms and may have clinical relevance. The combination of novobiocin-rifampicin merits further investigation.

Drug Combinations↗
PubMed1986

Subchondral bone strength in arthrosis. Cadaver studies of tibial condyles.

We measured the axial penetration strength of subchondral cancellous bone in a close, regular pattern at the tibial resection surface of five valgus and seven varus human, cadaveric knees. The strength patterns obtained were illustrated by pseudo-three-dimensional reconstructions of strength values as a function of the location on the resection surface. The varus knees had high strength values towards the medial margin of the medial condyle. Three qualitatively different strength patterns were distinguished in the valgus knees: two knees showed a near normal strength distribution with higher peak values medially; two knees with centrolateral bony attrition had high bone strength values at the center of the lateral condyle; and one knee with moderate posterolateral bony attrition showed a high strength area at the posterolateral aspect of the lateral condyle. In both types of malalignment, there was a decrease of bone strength with the depth from the resection surface.

Aged↗
PubMed1985

Trabecular bone strength patterns at the proximal tibial epiphysis.

The longitudinal compressive strength of trabecular bone from the human proximal tibial epiphysis was investigated in 12 autopsy specimens using multiple penetration tests with a small diameter indentor. Strength profiles were visualized by three-dimensional computerized reconstruction as a function of location on the resection surfaces. There were large variations of the maximal values between individuals, but the patterns obtained were remarkably uniform. The medial condyle showed the highest peak value in all but one knee with a mean medial-to-lateral peak value-ratio of 1.7. At the medial condyle the high strength area was relatively large with peak values being obtained centrally and anteriorly; the lateral condyle showed a more restricted, posteriorly localized area of high strength. Beneath the menisci, bone strength gradually decreased toward the margins of the condyles; likewise, bone strength decreased to reach very low values at the intercondylar region. There was a significant reduction of bone strength with the distance from the subchondral resection surface. This reduction was most pronounced at the high strength areas.

Biomechanical Phenomena↗
PubMed1985

Wound infection after lower extremity amputation because of ischemia.

The importance of postoperative wound infection in major amputations was elucidated by recording the organisms isolated in preoperatively infected gangrene and in postoperatively infected wounds of patients undergoing lower-limb amputations for ischemia. Sixty-four amputations were performed on 61 patients. The frequency of coexisting diabetes mellitus was 34%. Postoperative infections occurred in nearly two-thirds of the 19 cases of infected gangrene, as compared with less than one-third of cases of noninfected gangrene. The presence of diabetes mellitus did not significantly influence the infection rate. Preoperatively as well as postoperatively, the most frequently isolated bacterium was Staphylococcus aureus. Clostridium perfringens was cultured in four cases. Postoperative wound infection following lower-limb amputation for ischemia is the main reason for reamputation, especially in patients with infected gangrene.

Amputation, Surgical↗
PubMed1985

Activity of novobiocin against methicillin-resistant Staphylococcus aureus.

As infections due to methicillin-resistant Staphylococcus aureus become increasingly prevalent, newer alternative antibiotics, especially those which are orally administered, will be required. In order to provide an in-vitro basis for selecting alternative antibiotics, we studied the susceptibility of 103 strains of methicillin-resistant Staph. aureus from seven institutions to oral antimicrobial agents. Novobiocin, rifampicin, and trimethoprim-sulphamethoxazole had excellent in-vitro activity against virtually all strains of methicillin-resistant Staph. aureus. The MIC90 and MBC90 of novobiocin against methicillin-resistant Staph. aureus were 0.25 mg/l. Since previously reported achievable serum levels with oral novobiocin are 100 to 200 times its MIC90 against methicillin-resistant Staph. aureus, novobiocin should be evaluated further for combination therapy with rifampicin or trimethoprim-sulphamethoxazole.

Humans↗
PubMed1985

Screening method for rapid detection of methicillin-resistant (heteroresistant) Staphylococcus aureus.

A broth screening method was developed to detect methicillin-resistant (heteroresistant) strains of Staphylococcus aureus from primary plates. Lyophilized vials containing cation-supplemented Mueller-Hinton broth, 2% NaCl, and 10 micrograms of methicillin and 6 micrograms of oxacillin per ml were hydrated and tested with 129 methicillin-resistant and 35 methicillin-susceptible strains of S. aureus. With the addition of a tetrazolium indicator after 5 h of incubation, 96.9% of resistant strains were detected. No false-positive results occurred.

Bacteriological Techniques↗
PubMed1985

Sexual life following 'minimal' and 'total' transurethral prostatic resection.

81 otherwise healthy men with an average age of 67 years and verified prostatic hypertrophy were randomized into two groups for either 'minimal' or 'total' transurethral prostatic resection (TUR-P). Interviews on sexual life were made preoperatively and 6 and 12 months postoperatively. 58 men (72%) were prior to the operation sexually active. 18 (31%), mainly men of advanced age, discontinued sexual activity following TUR-P. 40 (69%) remained active. 19 had retrograde ejaculation. No significant difference was found between 'minimal' and 'total' TUR-P concerning the effect on sexual activity and the occurrence of retrograde ejaculation.

Aged↗
PubMed1985

Attitudes of adolescents toward division of labor in the home.

A statewide study of adolescents' attitudes toward division of labor in the home was conducted to determine if adolescents are becoming more egalitarian in their approach to sex roles. This investigation attempted to examine adolescents' attitudes toward household tasks based on gender and maternal employment. A survey-research design was employed to collect data on 893 students in grades 7 to 12 as part of a larger study to develop a profile of today's adolescents. In general, the findings indicated that adolescents' attitudes were still somewhat traditional. Although some variations in sex-role performance of tasks were evident between males and females and students with employed and unemployed mothers, these differences were not significant.

Adolescent↗