Biomedical subjects
Publications and source records attributed to T Steen.
The authors consider various types of seizures and their medico-legal consequences in connection with motor vehicle driving. Epilepsy, syncope, transitory ischemic attacks, migraine, electrolyte disturbances, hypoglycaemia, hypersomnia, and alcohol-induced fits are discussed in brief. The authors also discuss risk of recurrence, the seizure-free interval before driving can be resumed, and possible mitigating factors.
There are health requirements for acquiring and renewing a driver's license. Physicians are legally obliged to inform the local health authorities when a patient no longer meets these health requirements. This paper describes the current Norwegian legislation, formalities of administration, and practice of traffic medicine. Visual acuity, field of vision, seizures, heart disease, diabetes mellitus, abuse of alcohol and drugs, psychiatric disorders, aging and dysfunction of the locomotor system are discussed in brief.
The minimum visual acuity for obtaining a driver's licence for smaller vehicles in Norway is 0.5 (5/10). However, visual acuity is not routinely tested on application for the licence. Among 720 conscripts examined by a draft board, five (0.694%) had a visual acuity of less than 0.5, and did not have spectacles or lenses. The estimated standard deviation is 0.31%. The upper 95% one sided confidence limit was estimated to be 1.46% (Poisson-distribution). It is concluded that checking the vision of all applicants for a driver's licence would have only a marginal effect on safety.
Monoclonal antibodies (MAbs) were produced against pneumococcal capsular polysaccharides after subcutaneous immunization of BALB/c mice with a 23-valent vaccine (Pneumovax N, Merck, Sharp & Dohme). Selected antibodies were tested in ELISA against individual polysaccharides from 23 different pneumococcal types and in a dot blot assay with heat-killed whole bacteria adhered to nitrocellulose paper. Three MAbs (isotype IgM) were found to be specific for types 4, 8 and 22F, respectively, whereas one (isotype IgA) reacted both with 19A and 19F. Very mild acid hydrolysis of the capsular polysaccharides resulted in loss of reaction with the antibodies.
The performance of oral, electronically measured body temperature with Craftemp (Astra Meditec) in routine use in medical wards was investigated. Rectal measurement with conventional Hg-thermometer was used as a reference method. The Craftemp method turned out to be unacceptably inaccurate: 30.8 per cent of the measurements of rectal-oral temperature difference were subject to a variation around the mean larger than +/- 0.4 degree C. The standard deviation of the rectal-oral temperature differences was 0.51 degree C, and the range -1.2 degrees C to +3.0 degrees C. Until an alternative method for measurement of body temperature is proven accurate in the clinical routine, the established method of rectal measurement should not be abandoned.
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The pulmonary venous flow (PVQ) pattern usually has two antegrade flow waves, corresponding to ventricular systole and diastole, respectively, and is used to assess left atrial pressure. To study the effects of atrioventricular conduction (AVD) and heart rate (HR) on the PVQ pattern, transthoracic pulsed Doppler recordings of pulmonary venous, transmitral, and aortic flow were made in five healthy subjects with dual-chamber pacemakers. Recordings were made at HRs of 80, 100, and 120 beats/min, with AVDs of 75, 150, and 220 msec at each HR. When the AVD was increased, the biphasic PVQ changed to a monophasic pattern in which a single flow wave covered the transition between ventricular diastole and systole. There was a shift of flow from ventricular systole to diastole. When HR was increased, the systolic fraction of the PVQ increased as a result of an increase in the relative duration of systole. In conclusion, AVD and HR influenced the PVQ pattern in subjects without signs of ventricular dysfunction. This may be a limitation to the use of the flow pattern to assess left atrial pressure.