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Biomedical subjects

A Rasmussen

Publications and source records attributed to A Rasmussen.

At least 91 records · Page 5Linked to original sources

Bladder neck mobility evaluated by vaginal ultrasonography.

Factors involved in monitoring bladder neck mobility were studied by means of vaginal ultrasonography. Thirty-three continent, 28 incontinent and 39 patients who had undergone surgery for incontinence were examined in the supine and sitting positions during rest, the Valsalva manoeuvre and withholding urine. Bladder neck mobility can be described as a semicircular movement with the tip of the symphysis pubis as the centre and a line from the tip to the bladder neck as the radius (BS). Movement can be measured by 2 independent factors: BS distance and size of the angle between the BS line and the midline of the symphysis, at rest, during the Valsalva manoeuvre and withholding urine. The continent controls were characterised by a 90 degrees angle at rest, a long BS (2.4 cm) and a fixed bladder neck. The incontinent patients had a shorter BS (2.1 cm), angles at rest of approximately 100 degrees--the angle increased with the grade of incontinence--and a mobile bladder neck. If 2 of the 3 criteria (angle at rest > or = 95 degrees, BS < or = 2.3 cm and mobility > or = 20 degrees) are regarded as diagnostic of incontinence, diagnostic sensitivity was 84% and specificity 82%. In the surgical group, patients who failed to respond to treatment had a shorter BS, larger angles and greater bladder neck mobility than their successfully treated counterparts.

Adult↗

Clinical applicability of the immunomagnetic beads technique for serological crossmatching in renal transplantation.

The aim of the present prospective study was to investigate the clinical applicability of the immunomagnetic (IM) beads technique for serological crossmatching (XM) in renal transplantation. The IM XM were read after various periods of incubation, and the results were compared with those obtained by the conventional Kissmeyer-Nielsen (KN) technique. A total of 132 sera from 96 potential recipients were tested against cells from 62 donors. Eight-nine KN T-cell XM-negative renal allograft transplantations were performed, and the IM XM results were related to clinical 3-month follow-up data (incidence of primary non-function, never functioning grafts, graft losses and rejection episodes). The IM technique was clearly more sensitive than KN, and sensitivity increased markedly with increasing duration of incubation. KN-, IM+ reactions were predominantly found among sera from patients with panel-reactive antibodies (PRA, 2p less than 0.01), and thus probably caused by HLA antibodies. However, positive IM XM, appearing after more than 35 min of incubation, did not influence the overall clinical outcome in the observation period. With reading after exactly 35 min of incubation, XM results obtained by IM and KN techniques correlated well. Thus, we believe, that the IM XM technique will be as safe and effective in avoidance of hyperacute rejections as the conventional assay. In the present material, the incidence of primary nonfunction was significantly (2p = 0.0023) higher among PRA+ recipients compared to PRA- patients. To conclude, we recommended the IM technique with reading after exactly 35 min of incubation for easy, fast (70 min) and reliable XM, that is always possible to perform using peripheral blood.

Cell Separation↗

Stretch reflex variation in the relaxed and the pre-activated quadriceps muscle of normal humans.

The stretch reflex to patellar tendon taps was quantified by force measurements at the ankle in 7 normal subjects. In each experiment the stretch reflex was elicited from 14 consecutive stretches by two types of hammers (an ordinary hand-held hammer and a motorized hammer) in the relaxed and the pre-activated quadriceps muscle. The coefficient of variation for the 14 stretch reflexes fell from 54% in the relaxed muscle to 39% in the contracting muscle (p less than 0.05). The stretch reflex varied less between the different levels of active contraction than between the relaxed state and the contracted level (p less than 0.05). The experiment was repeated in all subjects and at all contraction levels. The coefficient of variation of the mean for the two experiments fell non-significantly from a mean value of 27% in the relaxed muscle to 14% in the contracting muscle. The coefficients of variation for the two hammers were almost identical. It is concluded that quantification of the stretch reflex can be made more precisely in the contracting muscle.

Adult↗

[Acute iliofemoral venous thrombosis. 26 cases treated with thrombectomy, temporary arteriovenous fistula and anticoagulants].

During a period of two years, 26 patients with acute iliofemoral venous thrombosis were treated with venous thrombectomy, establishing of a temporary arteriovenous fistula and anticoagulants as thrombolytic treatment was not possible. Twenty-five patients were followed-up after an average of 20 months with clinical examination, phlebography, venous strain-gauge pletysmography and vein-pump examination. At follow-up examination, 68% of the patients were free from symptoms, in 54% vein-pump function was normal and 79% had normal venous strain-gauge pletysmographic findings. One patient had venous claudication. Thrombectomy with temporary arteriovenous fistula formation offers a possibility of ensuring normal venous drainage from the lower limbs in patients with contraindications to thrombolysis.

Acute Disease↗

The development of an observer-scale for measuring social dysfunction and aggression.

Scales for measuring aggressive cognitions and behaviour have mainly been administered by nursing-staff or been self-ratings. During recent years we have made an attempt to construct an observer-scale for aggression analogous to the Hamilton scale for depression. The Social Dysfunction and Aggression Scale (SDAS) consists of 9 items (SDAS-9) covering outward aggression and 2 items (SDAS-2) covering inward aggression. The inter-observer reliability of the SDAS has been found adequate in terms of intra-class coefficients. In a pilot study on 82 inpatients from different centres in Denmark and Sweden the SDAS was compared to three-item scales for outward and inward aggression and to a global scale for outward aggression. The results showed that the SDAS-9 correlated positively with the other outward observer-scales, and the SDAS-2 with the other inward scale. A divergent validity was seen between the outward and inward scales, indicating that it is necessary to measure both dimensions. Preliminary ranks-according-to-frequency scores showed the following order of the nine outward items: irritability, dysphoric mood, social disturbances, nondirected verbal aggressiveness, negativism, directed verbal aggressiveness, physical violence towards staff, physical violence towards things, and physical violence towards persons other than staff.

Aggression↗

Acquired haemolytic anaemia due to isohaemagglutinins of donor origin following ABO-minor-incompatible kidney transplantation.

Of 1041 renal allograft transplantations performed in our centre, 142 (13.6%) were carried out with ABO-minor-incompatible kidneys. Anti-recipient ABO antibodies were found in two of 34 patients treated with cyclosporin. These two cases of severe but self-limited haemolysis due to anti-A1 and anti-B, respectively, are reported in detail. Among 108 azathioprine-treated patients no evidence of the disorder was found. The condition should be suspected in any recipient with an unexpected reduction in haematrocrit or other signs of haemolysis after ABO-minor-incompatible organ transplantation.

ABO Blood-Group System↗

Ciclosporin-induced immunosuppression in vitro. II. Variation in sensitivity and binding capacity.

The purpose of the present study was to analyse and correlate variations in lymphocyte sensitivity to, and binding of, ciclosporin (CsA) in vitro. Peripheral blood lymphocytes from healthy individuals were harvested over a 5-week period and activated with purified protein derivative (PPD) or alloantigens in the presence or absence of CsA (1 microgram/ml). Sensitivity to CsA was expressed as the ability of the drug to suppress cell proliferation ([3H]thymidine incorporation) and high-affinity interleukin-2 receptor (IL-2R) expression. Binding capacity was tested in a [3H]CsA binding assay. A significant variability in both sensitivity and binding capacity was recorded between individuals (P less than 0.001). There was no correlation between high sensitivity and high binding capacity. The intraindividual day-to-day variability did not differ significantly from the experimental (intra- and interassay) variability. The CsA-induced suppression of high-affinity IL-2R expression varied between 57.1 and 98.9%, while suppression of [3H]thymidine incorporation varied between 81.0 and 97.4%. Specific binding of 10 nM [3H]CsA at 37 degrees C varied between 5.4 and 10.7%.

Analysis of Variance↗

Postoperative and glucose-induced hypophosphatemia in relation to adenosine triphosphate and 2,3-diphosphoglycerate in erythrocytes.

Low red-cell concentrations of 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) with resulting increased oxygen affinity of hemoglobin is one of the mechanisms by which hypophosphatemia exerts clinically detrimental effects. The possibility that obligatory post-traumatic and/or glucose-induced hypophosphatemia leads to changes in red-cell 2,3-DPG and ATP concentrations was investigated in patients undergoing elective colonic surgery. In addition to standardized intravenous fluids postoperatively, one (randomized) patient group received continuous glucose-saline infusion, which is specially associated with hypophosphatemia, while another group was given the same amount of glucose/24 hours, but in a 5-hour infusion. Serum phosphate fell significantly in both groups, mainly in the former, but unaccompanied by change in red-cell 2,3-DPG or ATP concentration. During the 5-hour glucose infusions significant hypophosphatemia appeared, but without reduction of 2,3-DPG or ATP. Thus neither the obligatory hypophosphatemia after elective surgery nor the further fall during postoperative glucose infusion altered the red-cell concentration of 2,3-DPG or ATP.

2,3-Diphosphoglycerate↗

Venous thrombosis after abdominal surgery. A comparison between subcutaneous heparin and antithrombotic stockings, or both.

In an open controlled study, 248 consecutive patients (age more than 40 yrs) admitted for major abdominal surgery were randomized to one of three prophylactic antithrombotic treatments. Eighty-five patients received subcutaneous heparin, 74 patients had graduated compression stockings to the knee (TED stockings), and 89 patients had both subcutaneous heparin and stockings. Treatment began on the evening before operation and continued to complete mobilization, or for not less than five days postoperatively. On the fourth or fifth postoperative day, the patients underwent a 99mTc-plasmin test of the lower limbs as a test for deep vein thrombosis. There were 29.7% positive tests in the stocking group, 29.4% in the group with heparin prophylaxis, and 25.8% in the combined group. Differences between treatments were not statistically significant.

Abdomen↗

Distinction by radioisotope technique of a subgroup with increased thrombophilic potential among patients submitted to major abdominal surgery.

Deep vein thrombosis (DVT) detectable by the 99mTechnetium-labeled plasmin test developed in 13 (37%) of 35 sequentially studied patients, all above 40 years, undergoing elective major abdominal surgery. Ten of the 13 patients with DVT had an abnormal pulmonary perfusion scintigram, suggesting pulmonary embolism (PE), but only three had clinical evidence of thrombotic disease.

Abdomen↗

The effect of preoperative nutrition on the immune system.

In many surgical departments it has been common practice to give patients with weight loss pre-operative parenteral nutrition before major surgery. The purpose of the present study was to elucidate the value of intravenous pre-operative nutrition in relation to the immune system. The study comprised 10 patients undergoing total gastrectomy. All patients had a weight loss of 15% of body weight or more within 6 months or 10% within 3 months. Before operation they all received parenteral nutrition for 1 week. They all had 1.5 g of protein per kg per day and energy corresponding to the basal metabolic rate + 50% as Vamin, Intralipid, and carbohydrate solutions. Before and after this treatment blood samples were taken to estimate neutrophil function (the rate of oxygen consumption and superoxide liberation, phagocytosis and intracellular lysis of Candida albicans, the concentration and consumption rate of ATP during phagocytosis, and chemotaxis) and immune globulins (IgG, IgM, & IgA). Cellular immunity (CMI) was estimated by intradermal application of seven different antigens. We found a significant increase in response to the intradermal antigens (p < 0.01) but no difference in any of the parameters expressing leukocyte function or immune globulins.

Journal Article↗

Abnormal vascular function and morphology in pre-eclampsia: a study of isolated resistance vessels.

In order to obtain direct information about vascular changes associated with pre-eclampsia, the morphological and functional characteristics of isolated omental resistance vessels from 11 women with pre-eclampsia, 10 normotensive pregnant women and eight normotensive non-pregnant women were determined. In vessels from the women with pre-eclampsia, the ratio of media thickness to lumen diameter was increased, compared with that in vessels from the other two groups. The vessels from the women with pre-eclampsia had an increased responsiveness to angiotensin II and a decreased rate of relaxation, but only when compared with the vessels from the normotensive pregnant women. However, no difference in responsiveness to noradrenaline was found between any of the groups. The angiotensin II responsiveness of the vessels from the women with pre-eclampsia and from the non-pregnant women were similar, suggesting that pre-eclampsia is associated with an absence of the change in vascular function which normally occurs during pregnancy. The study provides direct evidence for an involvement of vascular abnormalities in the pathogenesis of pre-eclampsia.

Adult↗