[Training in gynecologic-obstetric ultrasonic diagnosis].
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Denmark↗
Biomedical subjects
T Larsen
Publications and source records attributed to T Larsen.
[Doppler ultrasound: its use in obstetrics?].
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Denmark↗
Acute growth hormone injection reduced gastrointestinal and increased hepatic oleic acid oxidation in swine.
Gastrointestinal, hepatic, and hindleg oxidation of 3H-labelled oleic acid and 14C-labelled glucose based on arterial-venous differences in 3H2O and 14CO2 were studied before and after an intravenous injection of 24 IU of growth hormone in 10 piglets. Hepatic oleic acid oxidation increased transiently while gastrointestinal oleic acid oxidation decreased correspondingly, maintaining a constant splanchnic oleic acid oxidation. Administration of a growth hormone led to a transient, parallel decrease in both hepatic and gastrointestinal glucose oxidation. We conclude that, in contrast to the growth hormone effect on splanchnic glucose oxidation, growth hormone effect on splanchnic fat oxidation appears to be organ specific.
Animals↗
Growth hormone, insulin-like growth factor I and its binding proteins 1 and 3 in last trimester intrauterine growth retardation with increased pulsatility index in the umbilical artery.
OBJECTIVE: The interrelationships between maternal hormone levels and placental dysfunction in mothers bearing children with intrauterine growth retardation remain unclear. We have examined some endocrinological aspects of intrauterine growth retardation and, in particular, tested whether low levels of GH and IGF-I in maternal serum are associated with direct evidence of placental dysfunction. DESIGN: Prospective, descriptive and comparative. PATIENTS: Women with singleton pregnancies: 48 with a small for gestation fetus (SGA) (estimated fetal weight less than -1.5 standard deviation scores) and 28 with an appropriate for gestation fetus (AGA). MEASUREMENTS: Maternal serum GH, IGF-I, IGFBP-1 and 3 were determined, and fetal weight and umbilical artery pulsatility index (PI) was estimated by ultrasonography and Doppler ultrasound at 33 weeks gestational age. RESULTS: Serum IGF-I was lower in the SGA group (246 vs 297 micrograms/l, P = 0.03) but GH and IGFBP-1 and -3 did not differ between the groups. In the 16 SGA pregnancies with increased PI, IGF-I concentration was low (218 micrograms/l, quartiles 149-265), whereas in the 32 with normal PI, IGF-I was 269 micrograms/l, quartiles 219-382. Serum IGFBP-1 was increased in the high PI group compared to the normal PI group (161 micrograms/l vs 113, P = 0.05). CONCLUSION: Maternal serum IGF-I concentration was lower in small for gestational age pregnancies with increased pulsatility of the umbilical artery blood flow, compared to small for gestational age pregnancies with normal umbilical blood flow, which in turn was close to the IGF-I concentration in appropriate for gestational age pregnancies. Growth hormone concentrations did not differ among the groups.
Female↗
Intrauterine growth curves based on ultrasonically estimated foetal weights.
Available standard intrauterine growth curves based on birthweights underestimate foetal growth in preterm period. New growth curves are presented based on data from four Scandinavian centres for 759 ultrasonically estimated foetal weights in 86 uncomplicated pregnancies. Mean weight of boys exceeded that of girls by 2-3%. A uniform SD value of 12% of the mean weight was adopted for the standard curves as the true SD varied non-systematically between 9.1 and 12.4%. Applied to an unselected population of 8663 singleton births, before 210 days of gestation, 32% of birthweights were classified as small-for-gestational age (SGA; i.e. below mean - 2 SD); the corresponding figures were 11.1% for gestational ages between 210 and 258 days, and 2.6% for ages of 259 days or longer. The new growth curves reveal better the true distribution of SGA foetuses and neonates, and are suggested for use in perinatological practice.
Anthropometry↗
Resistance of Streptococcus sanguis biofilms to antimicrobial agents.
Bacteria living in biofilms as dental plaque on tooth surfaces are generally more resistant to antimicrobial agents than bacteria in batch culture normally used for in vitro susceptibility testing. In order to compare the resistance of free-living and surface-grown oral bacteria, the MIC of Streptococcus sanguis 804 and ATCC 10556 to amoxicillin, doxycycline and chlorhexidine was determined by a broth dilution method. Subsequently, S. sanguis biofilms established in an in vitro flow model were perfused with the antimicrobial agents for 48 h at concentrations equal to and up to 500 times the MIC, and biofilm cell number was determined during this period. The antibiotics at the MIC did not affect the cell number of S. sanguis biofilms compared to the starting point, and only after 48 h at 500 times the MIC were the biofilm bacteria eliminated. At intermediate concentrations biofilm cell number gradually decreased. Chlorhexidine also gradually reduced biofilm cell number, but was inhibitory at concentrations closer to the MIC than was the case for the antibiotics. Thus S. sanguis in biofilms survived up to 500 times the MIC found in batch culture for up to 48 h.
Amoxicillin↗
The capsid size-determining protein Sid forms an external scaffold on phage P4 procapsids.
Although the phages P2 and P4 build their capsids from the same precursor, the product of the P2 N gene, the two capsids differ in size: P2 builds a 60 nm, T = 7 capsid from 420 subunits, whereas P4 makes a 45 nm, T = 4 capsid from 240 subunits. This difference leads to substantial changes in shell geometry and subunit interactions. Previous results have demonstrated that the P4 sid gene is responsible for the assembly of P4-sized shells. We have used cryo-electron microscopy and image reconstruction to determine the structure of a putative assembly intermediate of P4 capsids, produced in vivo from cloned genes. We demonstrate that Sid forms a P4-specific scaffold with icosahedral symmetry on the outside of the procapsid-like particles. The Sid molecules (60 or 120 copies) form lofty arches that interact with the gpN hexamers on the icosahedral 2-fold axes, and connect as trimers over the 3-fold axes, forming a continuous dodecahedrally shaped outer cage. The gpN shell inside the Sid cage is approximately 40 nm wide, consistent with the previously suggested maturational expansion. The main difference with respect to the mature P4 capsids is found in the hexamers, which appear strongly elongated and more protruding than in the mature shell. These and previous results are discussed in the light of a model for regulation of capsid size.
Amino Acid Sequence↗
Prediction of birth weight by ultrasound-estimated fetal weight: a comparison between single and repeated estimates.
OBJECTIVES: Ultrasound estimation of fetal weight is used for diagnosing intrauterine growth retardation. The aim of the present study was to assess the accuracy of birth weight prediction by use of a single or repeated estimations of fetal weight in the third trimester. STUDY DESIGN: 1000 pregnant women considered at risk were scheduled to ultrasound estimation of fetal weight, using Warsof's formula, at 28, 31, 34 and 37 weeks of gestation. The 421 pregnancies with term delivery and complete set of ultrasound examinations and 57 pregnancies with preterm delivery with ultrasound examination at 16 and 28 weeks and once more before delivery were included in the present analysis. RESULTS: The accuracy of birth weight prediction improved significantly for every three weeks from 28 to 37 weeks of gestation in the term infants. Prediction based on the average of repeated weight estimates or linear extrapolation from two estimates or extrapolation by a second order polynomium fitted to four estimates did not improve accuracy compared to prediction based on the last estimate before delivery. CONCLUSION: When more than one ultrasound estimation of fetal weight are available, prediction of birth weight in relation to gestational age should be based on the last ultrasound examination only.
Birth Weight↗
Parental origin of the X chromosome, X chromosome mosaicism and screening for "hidden" Y chromosome in 45,X Turner syndrome ascertained cytogenetically.
Our study confirms the finding that about 85% of X chromosomes in Turner girls are maternally derived. A new observation is the detection of a high frequency of mosaicism (15%) in Turner girls who by cytogenetic analysis were thought to have a pure 45,X karyotype. DNA examination of the material was done by hybridization with digoxigenin labelled, non-radioactive probes, and PCR products for microsatellite analysis were run on polyacrylamide gels. We screened for the presence of "hidden" Y chromosome mosaicism, using the primers SRY, ZFY, DYZ3, DYZ1 and DYS132. Contrary to other reports using the PCR technique to unravel "hidden" Y chromosome mosaics, we did not find any positive cases. A precise technical protocol for these new techniques is given, and the advantages are discussed.
Chromosome Banding↗
Development of a flow method for susceptibility testing of oral biofilms in vitro.
Bacteria in biofilms are known to be more resistant than bacteria in batch cultures to antimicrobial agents. The purpose of the present study was to develop a flow method for formation of oral biofilms permitting susceptibility testing of plaque bacteria. A brain heart infusion (BHI) Streptococcus sanguis 804 culture was pumped through a modified Robbins Device (MRD) with 25 exchangeable silicone disks at 40 ml/h. After 24-48 h disks were removed and biofilm cells dispersed by vortex mixing and low-output ultrasonication. Colony forming units (cfu)/cm2 were determined after aerobic incubation on blood agar plates. Optimal biofilm formation was found after growth for 48 h at 37 degrees C in BHI + 1% sucrose, using saliva-coated silicone disks in inverted MRDs, yielding on average 4.4 x 10(5) cfu/cm2. Similar results were obtained for S. sanguis ATCC 10556 and five clinical isolates. Testing the susceptibility of S. sanguis to chlorhexidine gluconate showed increased resistance of biofilms compared to batch culture. Thus an appropriate biofilm model for susceptibility testing of oral microorganisms has been established.
Biofilms↗
Antibody and cytokine responses in a mouse pulmonary model of Shigella flexneri serotype 2a infection.
A murine pulmonary model was used to study the mucosal immune response to Shigella flexneri serotype 2a infection. Inoculation of BALB/cJ mice with shigellae via the intranasal route resulted in bacterial invasion of bronchial and alveolar epithelia with concomitant development of acute suppurative bronchiolitis and subsequent development of lethal pneumonia. The pathology of pulmonary lesions resembled the colitis that characterizes shigellosis in humans and primates. Significant protection against a lethal dose of S. flexneri 2a was observed in mice previously infected with two sublethal doses of the homologous strain. Immunity against lethal challenge was associated with decreased bacterial invasion of the mucosal epithelium. Over the course of two sublethal challenges, which constituted primary and secondary immunizations, mice developed pulmonary and serum immunoglobulin G and A antibody recognizing both lipopolysaccharide and invasion plasmid antigens IpaB and IpaC. Immune mice and naive control mice differed in lung lavage cytokine levels following lethal challenge. Immune mice developed significantly elevated levels of pulmonary gamma interferon within 6 h of challenge, while naive control mice developed elevated levels of this cytokine later during the initial 24-h period. Both groups had elevated levels of gamma interferon during the 24- to 48-h period of infection. Both groups also had elevated levels of tumor necrosis factor alpha within 6 h of challenge, but the control mice had significantly higher levels at the 48- and 72-h time points. Elevated levels of interleukin-4 were observed only in immunized mice. This cytokine appeared within 24 h and receded between 48 and 72 h. Fluorescence-activated cell sorter analysis of lung parenchymal cells showed that both groups experienced an initial influx of monocytes, but the proportion of this cell type began to recede in immunized mice after 48 h of infection, while peak levels were maintained in the control animals. These studies suggest that elements of local B lymphocyte activity, as well as Th1 and Th2 lymphocyte activity, may contribute to the survival of immune mice after intranasal challenge with shigellae.
Administration, Intranasal↗
Intransal or intragastric immunization with proteosome-Shigella lipopolysaccharide vaccines protects against lethal pneumonia in a murine model of Shigella infection.
Mice immunized intransally or intragastrically with proteosome vaccines containing either Shigella sonnei or S. flexneri 2a lipopolysaccharide were protected against lethal pneumonia caused by homologous organisms in an experimental murine intranasal challenge model of Shigella infection. Histopathological analysis demonstrated that immunization also protected against the progressive lesions resulting from invasion of the pulmonary mucosa by S. sonnei. These data show that mucosal proteosome-lipopolysaccharide vaccines can protect against lethal bacterial pneumonia and indicate that such vaccines are promising candidates for protection against intestinal shigellosis.
Animals↗
Identity of streptococcal blood isolates and oral isolates from two patients with infective endocarditis.
The purpose of this study was to isolate streptococcal strains from the oral cavities of streptococcal endocarditis patients and compare these strains biochemically and genetically with the corresponding streptococcal blood isolates. Total identity was observed between the blood and oral cavity isolates from the two patients studied.
Aged↗
[Bone metabolism in female runners. Menstruation disorders are frequent among long-distance runners, but the bone mass is not influenced, with the exception of runners with amenorrhea].
The purpose of the study was to investigate the prevalence of exercise-related menstrual and sex hormonal disturbances and the effect of exercise on bone mass and metabolism in female runners at various training levels. Two hundred and five premenopausal women (running 0-140 km a week) were recruited from a large population of female runners, who had responded to a questionnaire regarding exercise habits. Maximum oxygen uptake was determined by treadmill testing. Gynaecological status was assessed on entries in a menstrual calendar and by transvaginal ultrasonography; and sex hormonal status was measured three times with 10-day intervals. Bone mass was measured in the lumbar spine, proximal femurs and total body by dual energy x-ray absorptiometry, and in the forearm by single photon absorptiometry. Bone turnover was assessed by plasma osteocalcin, serum alkaline phosphatase, and urinary calcium and hydroxyproline. The results showed that sex hormonal disturbances were significantly related to training intensity. Compared with the normally active women, the baseline levels and fluctuations of oestradiol and progesterone in the elite runners were reduced by up to 25-44%, (0.01 < p < 0.05). The prevalence of amenorrhoea increased from 1% in the normally active to 11% in the elite runners. No statistically significant relation was found between running activity and bone mass or bone turnover. However, the group of amenorrhoeic runners had a 10% reduction in lumbar bone mass as compared to the normally menstruating runners (p < 0.05), but the bone turnover was similar.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Transabdominal and endoluminal ultrasonic scanning of the lower ureter.
I.v. urography is often insufficient for visualization of the intramural and juxtavesical portion of the ureter. In 30 consecutive patients (July 1st 1993-January 31st 1994) where i.v. urography was inconclusive, but had evoked suspicion of pathology in--or adjacent to--the lower ureter, abdominal ultrasound (including color Doppler) and endoluminal (transrectal or -vaginal) ultrasound were performed. A final diagnosis was obtained in 26: Ureteric stone (14), prostatic cancer (4), bladder cancer (2), stricture of ureteric orifice (1), TURB sequelae (1), ureterocele (1), bladder stone (1), detrusor hypertrophy (1), normal ureter (1). Abdominal ultrasound scanning gave more, same, and less information than i.v. urography in 8, 8, and 10 cases, respectively. In 14 of 22 cases abdominal color Doppler revealed a unilateral abnormal "ureteral jet"--in 13 of the cases on the side with suspected obstruction. Endoluminal ultrasound scanning gave more, same, and less information than i.v. urography in 20, 4, and 2 cases, respectively. The 20 cases where endoscanning gave more information included detection of 14 distal ureteric stones. In 3 cases it identified other types of distal obstruction, in two cases it determined the length of cancer obstruction and in one it detected the presence of ureteral dilatation. It is concluded, that endoluminal ultrasound of the ureter is indicated when i.v. urography evokes suspicion of pathology in the intramural or juxtavesical part of the ureter.
Abdomen↗
[Relevance of cultures for the antibiotic treatment in acute perforated appendicitis].
The case records of 71 patients (31 women and 40 men aged 5-76 years, median age 18) who were registered under the diagnosis of perforated acute appendicitis at the Department of Surgery, Frederikssund Hospital between 1 January 1983 to 31 December 1988 have been reviewed in order to examine the relevance of culturing peritoneal swabs for the antibiotic treatment given. Four antibiotic regimens were used. In 65% of the cases, the cultured bacteria were completely sensitive to gentamycin and metronidazole (82% when cultures where there was no growth are included), the corresponding figure for the treatment given was 48% (65%). Thirty-one percent developed postoperative infections, 20% in the form of abscesses. In four percent of the cases where bacterial resistance to the given antibiotic treatment was found did this result have a consequence in relation to further treatment. The result of culture was on average available 2.1 days after antibiotic treatment had been terminated. The cultures could have greater relevance if 1) the results were communicated to the ward within one to two days 2) bacterial type and pattern of antibiotic sensitivity were registered in such a manner that the effectivity of the standard antibiotic regime could be controlled and 3) if demonstration of possible exogenous contamination were used as a parameter in the department's quality control.
Acute Disease↗
Dephytinization of a rat diet. Consequences for mineral and trace element absorption.
Soaking of a rat diet, high in both plant phytate and phytase, progressively degraded the phytate content with time of soaking. This dephytinization in turn enhanced the digestion of feed organic matter in the animals, and it significantly improved the absorption and retention of minerals and trace elements as observed in balance studies. Incorporation of elements into specific tissues was evaluated as a reflection of bioavailability. Some tissues did reflect the preceding absorption of certain elements; other tissues seemed less suitable as indicators of trace element absorption. Dietary calcium addition in many ways contrasted the soaking procedure: inorganic calcium addition to the feed reduced phosphorus, magnesium, and trace element bioavailability, and interfered with the internal deposition of the elements. The external dephytinization of the feed did not affect the phosphohydrolase activity of the intestinal mucosa as manifested by alkaline phosphatase activity or phytase activity. The mucosal phytase and alkaline phosphatase activities were, however, mutually correlated, supporting the view that "phytase" activity is a less substrate-specific action of alkaline phosphatase activity or a fraction of this activity.
6-Phytase↗
Running induces menstrual disturbances but bone mass is unaffected, except in amenorrheic women.
PURPOSE: To investigate the prevalence of exercise-related menstrual and sex hormonal disturbances and the effect of exercise on bone mass and metabolism in female runners at various training levels. SUBJECTS AND METHODS: Two hundred five premenopausal women (running 0 to 140 km a week) were recruited from a large population of female runners who had responded to a questionnaire regarding exercise habits. Maximum oxygen uptake was determined by treadmill testing. Gynecologic status was assessed on entries in a menstrual calendar and by transvaginal ultrasonography; sex hormonal status was measured three times with 10-day intervals. Bone mass was measured in the lumbar spine, proximal femurs, and total body by dual-energy x-ray absorptiometry, and in the forearm by single-photon absorptiometry. Bone turnover was assessed by measurement of plasma osteocalcin, serum alkaline phosphatase, and urinary calcium and hydroxyproline. RESULTS: Sex hormonal disturbances were significantly related to training intensity. Compared with the normally active women, the baseline levels and fluctuations of estradiol and progesterone in the elite runners were reduced by up to 25% to 44% (0.01 < p < 0.05). The prevalence of amenorrhea increased from 1% in the normally active subjects to 11% in the elite runners. No statistically significant relation was found between running activity and bone mineral measurements or bone turnover. However, the group of amenorrheic runners had a 10% reduction in lumbar bone density as compared with the normally menstruating runners (p < 0.05), but the bone turnover was similar. CONCLUSION: In the large majority of the female runners, no skeletal affection was found despite significant sex hormonal and menstrual disturbances. Only the runners with amenorrhea might be at increased risk of osteoporosis.
Adult↗