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Biomedical subjects

B Andersen

Publications and source records attributed to B Andersen.

At least 109 records · Page 6Linked to original sources

Dissociation of changes in plasma cholesterol and hepatic cholesterol synthesis, assessed by precursors in bile, after jejunoileal bypass with 3:1 and 1:3 jejunoileal ratio.

Hepatic cholesterol synthesis, assessed by the biliary content of post-squalene cholesterol precursors relative to cholesterol, was related to fasting plasma cholesterol fractions in obese patients before (n = 7) and after jejunoileal bypass surgery with either a 3:1 ratio (n = 15) or a 1:3 ratio (n = 14) between jejunum and ileum left in function. The content of precursors increased after bypass surgery, and more so with a 3:1 than with a 1:3 jejunoileal ratio. However, the two types of bypass resulted in similar reductions in plasma concentrations of total cholesterol and low-density lipoprotein cholesterol. Within the unoperated group and the 3:1 bypass group the precursor content and plasma cholesterol levels were, as expected, inversely correlated, but within the 1:3 bypass group there were either weaker or even positive correlations. These findings suggest that the link between stimulation of hepatic cholesterol synthesis and reduction in plasma cholesterol may depend on the length of jejunum and ileum left in function.

Bile↗

Endoscopic suspension of the bladder neck by the Stamey method for urinary incontinence.

Eighteen women with stress incontinence underwent endoscopic suspension of the bladder neck by the method of Stamey. The procedure was carried out in a department of general surgery. Pre- and postoperatively the patients were evaluated by pelvic examination with stress test, colpo-cysto-urethrography, urinary flow rate measurement, cystometry, and culture of the urine. Fifteen became fully continent at once, another two after having been treated further by posterior colpoperineorraphy, while one remained incontinent. The median postoperative follow-up was 27 months. Complications were rare and mild. It is concluded that the method is applicable in departments of general surgery and that the result can be improved in selected patients by posterior colpoperineorraphy.

Adult↗

Cyclic AMP and phorbol esters interact synergistically to regulate expression of the chorionic gonadotropin genes.

Previous studies have shown that activators of the protein kinase A pathway increase transcription of the genes encoding the alpha- and beta-subunits of human chorionic gonadotropin (hCG) in choriocarcinoma cell lines. Here, we show that treatment of choriocarcinoma cells with activators of protein kinase C, such as phorbol myristate acetate (PMA) and dioctanoylglycerol, increases accumulation of the mRNAs for both subunits of hCG by 3-4-fold. In contrast, a phorbol ester which fails to activate protein kinase C, phorbol 12 beta,13 alpha-didecanoate, has no effect on hCG mRNA levels. To test the possibility that these two major intracellular signaling pathways interact, we treated choriocarcinoma cells with PMA, forskolin, or PMA and forskolin together. Treatment with either agent led to a 2-3-fold increase in hCG mRNA levels, whereas treatment with both agents resulted in a 9-fold increase. This synergistic response also occurred when choriocarcinoma cells were treated with PMA and 8-Br-cAMP. Furthermore, PMA did not increase intracellular cAMP levels, suggesting that these two pathways interact subsequent to cAMP generation. PMA also increased transcription of the hCG alpha- and beta-genes by 2-3-fold. Whereas transcription of the alpha subunit gene increases synergistically after treatment with both PMA and forskolin, transcription of the hCG beta-gene was limited to the increase caused by either agent alone. This latter result suggests that regulation of hCG beta mRNA accumulation is more complex than that of alpha-subunit mRNA and probably involves both transcriptional and post-transcriptional components.

8-Bromo Cyclic Adenosine Monophosphate↗

Polyamines control human chorionic gonadotropin production in the JEG-3 choriocarcinoma cell.

The effect of inhibition of ornithine decarboxylase with difluoromethylornithine (DFMO) and the resultant lowering of polyamine levels upon human chorionic gonadotropin (hCG) production in JEG-3 choriocarcinoma cells was investigated. DFMO (10 mM) totally inhibited ornithine decarboxylase activity. In DFMO-treated cells, cellular spermidine concentrations fell to nondetectable levels (less than 1% of control values) within 24 h and spermine concentrations were reduced to 41.9% of controls over 6 days. DFMO caused a 70-80% inhibition of hCG production. Levels of mRNA for both the alpha and beta subunits of hCG were also inhibited relative to mRNA for tubulin. Exogenous putrescine normalized hCG production in a dose-dependent manner. Other diamines, including cadaverine, 1,3-diaminopropane, 1,6-diaminohexane, and 1,7-diaminoheptane, were ineffective in reestablishing hCG production in DFMO-treated cells. Dibutyryl cAMP (1 mM) stimulated hCG production and increased levels of mRNA for the alpha and beta subunit 5-40-fold in both DFMO-treated and control cells. Polyamines appear to have a fundamental role in hCG production in JEG-3 choriocarcinoma cells. However, dibutyryl cAMP can partially overcome or circumvent the requirement for polyamines in hCG biosynthesis.

Bucladesine↗

Adrenal function in children with bronchial asthma treated with beclomethasone dipropionate or budesonide.

The effect of inhaled beclomethasone dipropionate and budesonide on the adrenal function was studied in 30 children (aged 7 to 15 years) with mild bronchial asthma. The trial was designed as a prospective double-blind parallel study of the effect of stepwise increase of either beclomethasone dipropionate or budesonide from 200 micrograms through 400 micrograms, to 800 micrograms daily in three consecutive periods of 4 weeks. At the end of each period, the adrenal stress response was evaluated by measurements of serum cortisol and androstenedione during a short adrenocorticotropic hormone test. The unstimulated diurnal production of glucocorticosteroids was assessed by measurements of free cortisol in 24-hour urine samples. Free cortisol in urine was found a valid measure of the total diurnal excretion of cortisol metabolites, since it exhibited a good correlation to the fractional cortisol metabolites measured by gas chromatography. The adrenal response to adrenocorticotropic hormone stimulation was unaffected by treatment or dose. The unstimulated diurnal production of glucocorticosteroids demonstrated a highly significant dose-related suppression in response to the inhaled steroids. No significant difference was found between the two topical steroids (probability value 5.3%), and yet the suppression was apparent in the group of children treated with beclomethasone dipropionate but not in the group of children treated with budesonide. Further studies are desirable in order to ascertain whether budesonide offers an improved ratio between beneficial anti-inflammatory effect and unwanted systemic activity.

Adolescent↗

What do dentists know about statistics?

A multiple choice test with nine statistical questions was sent to a random sample of Danish dentists to assess their knowledge of elementary statistical expressions (SD, SE, P less than 0.05, P greater than 0.05 and r). Of 250 dentists, 129 (52%) answered the questions. The test was also completed by 27 (71%) of 38 dental students immediately after the last lecture in statistics. The median number of correct answers was 2.2 among the dentists and 3.4 among the dental students. It is concluded that the statistical knowledge of most dentists, and to a lesser degree also dental students, is so limited that they cannot be expected to be critically against or to draw the right conclusions from those statistical analyses with which they are confronted. Only 35% of the dentists stated that it is very important that this problem be raised.

Attitude of Health Personnel↗

Prospective study of malabsorption induced risk of gall stone formation in relation to fall in plasma cholesterol.

The relationship between cholesterol in plasma and risk of gall stone formation was investigated in 210 obese patients who underwent jejunoileal bypass surgery and were free of gall stone disease at the time. Among 185, successfully reexamined on average 19 months after surgery, 26 (14%) developed gall stones. The fall in plasma cholesterol after surgery exhibited a U-shaped relation to risk of gall stone formation with a minimum risk around the average fall (2.6 mmol/l). This was confirmed by multivariate logistic regression analysis (p less than 0.01) taking into account other possible determinants. The relation was not significantly dependent on weight loss or ratio between jejunum and ileum left in function. The study suggests that malabsorption induced fall in plasma cholesterol is related to risk of gall stone formation by two oppositely working mechanisms, one enhancing and one reducing the risk.

Adult↗

Serum selenium and zinc concentrations in morbid obesity. Comparison of controls and patients with jejunoileal bypass.

The concentrations of serum selenium and zinc (both in micromoles per litre) were determined in 18 patients 5-12 years after jejunoileal bypass and in 13 controls with untreated morbid obesity. Selenium concentrations were significantly lower in the operated patients than among controls, whereas there was no significant difference with regard to zinc. Ninety-five per cent confidence limits for the median difference between pre- and post-operative concentrations were 0.03-0.41 with regard to selenium and -0.3 to 2.7 with regard to zinc. Even though little is known about the clinical consequences of chronic selenium deficiency, substitution might prove beneficial.

Adult↗

Neutrophil adhesive dysfunction in diabetes mellitus; the role of cellular and plasma factors.

We examined neutrophil adherence to bovine aortic endothelial cells in 26 patients with diabetes compared with age- and sex-matched controls. The adherence of chromium 51-labeled neutrophils from patients with diabetes in the basal state and after incubation with phorbol myristate acetate (PMA) but not N-formyl-methionyl-leucyl-phenylalanine (FMLP) was decreased significantly. A subset of 16 of 26 patients demonstrated highly significant decreases in basal adhesion. No significant correlation was found between defective adherence and metabolic control as assessed by plasma glucose level (range 44 to 508 mg/dl) and hemoglobin A1 level (range 7.7% to 17.1%) at the time of study. Plasma from patients with diabetes increased adherence of both diabetic and control neutrophils in the basal state. The adherence-augmenting factor in diabetic plasma was found to be nonfilterable and partially heat labile and to manifest the characteristics of a protein. The adhesive effects of diabetic plasma were mediated through alterations in endothelium rather than neutrophils. Diabetic neutrophil aggregation induced by PMA, FMLP, and calcium ionophore was normal in all patients examined, regardless of the aggregating agent used. Fibronectin release in the basal state and after stimulation with FMLP was found to be comparable in diabetic and control neutrophils. These studies demonstrated intrinsic adhesive dysfunction of diabetic neutrophils and a factor or factors in diabetic plasma that enhanced adherence to endothelium. These cellular and humoral factors may act together to prevent tissue emigration of neutrophils and may contribute to the pathogenesis and susceptibility of infection in diabetes.

Adult↗

Pattern of progression in liver injury following jejunoileal bypass for morbid obesity.

Liver biopsies from 34 patients with morbid obesity, performed before and 5-9 months after jejunoileal bypass, were studied. The patients were divided into four groups according to preoperative findings: A: no or slight steatosis (15 patients), B: moderate-severe steatosis (6), C: steatohepatitis (steatosis + lobular lymphocytic inflammation) (8), D: steatofibrosis (steatosis + pericellular fibrosis) (5). In Group A, 12 patients showed postoperative progression to either moderate/severe steatosis, steatohepatitis, or steatofibrosis. In Group B, all patients progressed to steatohepatitis or steatofibrosis, and one developed septate fibrosis. All patients in Group C progressed to steatofibrosis, and 5 developed septate fibrosis or cirrhosis. In Group D, 3 developed bridging fibrosis. Mallory bodies appeared postoperatively in 11 patients (32%), all of whom preoperatively had either severe steatosis, steatohepatitis, or steatofibrosis. Only patients with postoperative pericellular fibrosis and Mallory bodies developed deranged architecture: 6 septate/bridging fibrosis, and 3 cirrhosis. Five patients, all with deranged architecture, developed reversible liver insufficiency. Progressive liver injury after jejunoileal bypass appears to reflect aggravation of a pre-existing liver lesion. The sequence of events: increasing steatosis, lobular lymphocytic inflammation, pericellular fibrosis, Mallory bodies, and deranged architecture is similar to that of the alcoholic liver lesion, indicating common pathogenetic mechanisms.

Biopsy↗

Fasting and meal-stimulated plasma levels of neurotensin in obese patients after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio.

The functional role of the jejunum and ileum with regard to peripheral plasma levels of intact neurotensin and NH2-terminal immunoreactivity of neurotensin was studied by using jejunoileal bypass as a model. Plasma levels were measured by radioimmunoassay before and after jejunoileal bypass randomized to different jejunoileal ratios. Seven patients were studied before bypass surgery and 28 were examined after end-to-side jejunoileal bypass with 50 cm intestine in continuity and a 3:1 or 1:3 ratio between the length of the jejunal and ileal segments. Fasting levels of intact neurotensin were unchanged by surgery, whereas levels of NH2-terminal immunoreactivity were higher in bypass patients with a long ileal segment (37.5 cm) than in unoperated patients and in those with a short ileal segment (12.5 cm). Meal-stimulated levels of intact neurotensin were higher after 1:3 than 3:1 jejunoileal bypass. The levels of NH2-terminal immunoreactivity in patients with a short ileal segment and in controls were lower than in patients with a long ileal segment. The results show that postprandial levels of both intact neurotensin and NH2-terminal immunoreactivity are related to the length of the functioning ileum and that even a difference in length of 25 cm is reflected in the circulating levels of neurotensin.

Adult↗

A randomized trial of fistulotomy in perianal abscess.

In a randomized trial we compared the treatment of perianal abscess by incision only (18 patients) with that by incision followed by fistulotomy 3 days later (20 patients). All patients were observed for 12 months. There were no differences between the two groups with regard to recurrent abscess/fistula, but the fistulotomy group had a statistically significantly higher prevalence of flatus incontinence. Further, fistulotomy was followed by significantly longer duration of hospitalization and by delayed healing. We recommend that fistulotomy is used only in patients with recurrent abscess.

Abscess↗