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Biomedical subjects

B Petersen

Publications and source records attributed to B Petersen.

At least 19 recordsLinked to original sources
PubMed2007

Lund Stroke Register: hospitalization pattern and yield of different screening methods for first-ever stroke.

OBJECTIVES: To explore case ascertainment, hospitalization, characteristics of both hospitalized and non-hospitalized patients in a population-based group of stroke patients. MATERIALS AND METHODS: One-year screening in Lund-Orup district for first-ever strokes using multiple prospective and retrospective methods. RESULTS: A total of 456 patients with first-ever stroke (n = 412 prospective screening methods, n = 17 primary care, n = 12 hospital registers, n = 10 death register, n = 2 autopsy registers, n = 3 other). Hospitalization proportion within 14 days was 84%. Patients sent home from emergency unit (n = 36) were often males (75%), had low 28-day case-fatality (0%), and less severe strokes (median National Institute of Health Stroke Scale score 2 vs 4 for all). Patients managed solely within primary care (n = 18) were elderly (median age 89 vs 77 years for all), resided in nursing homes (86% vs 8% for all) and had high 28-day-case-fatality (61%). CONCLUSIONS: Hospitalization was lower than expected. Two main categories of patients were not hospitalized: elderly patients at nursing homes with high case-fatality and patients with mild stroke.

Adolescent↗
PubMed2006

Inhibition of porcine endogenous retroviruses (PERVs) in primary porcine cells by RNA interference using lentiviral vectors.

A potential risk in pig-to-human xenotransplantation is the transmission of PERVs to human recipients. Here we show for the first time the inhibition of PERV expression in primary porcine cells by RNA interference using lentiviral vectors. Cells were transduced with lentiviral vectors coding for short hairpin (sh) RNAs directed against PERV. In all primary porcine cells studied and in the porcine kidney cell line PK-15, expression of PERV-mRNA was significantly reduced as measured by real-time PCR. Most importantly, expression of PERV proteins was almost completely suppressed, as shown by Western blot analysis. Thus, lentiviral shRNA vectors could be used to knockdown PERV expression and create transgenic pigs with a reduced risk of PERV transmission during xenotransplantation.

Animals↗
PubMed2006

How high should total pain-relief score be to obviate the need for analgesic remedication in acute pain? Estimation using signal detection theory and individual-patient meta-analysis.

BACKGROUND: A pain relief score 50% of the maximum is often used as a clinically meaningful outcome in meta-analyses of analgesic trials. This arbitrary value requires validation. OBJECTIVE: To determine the optimum pain relief score for predicting pain relief sufficient to obviate the need for analgesic remedication in acute post-surgical pain. DESIGN: Individual-patient meta-analysis of randomized controlled trials and use of signal detection theory to identify the optimum cut-off point on the total pain relief score (TOTPAR). Analgesic remedication was used as the clinical outcome. DATA SOURCES: Seven parallel-group, active and placebo-controlled trials of minor analgesics. RESULTS: The predictive value of the TOTPAR score [expressed as a percentage of the maximum score (%maxTOTPAR)] for remedication was excellent for all the trials. The pooled estimate of the area under the receiver operating curve, an index of discriminative power, was outstanding 0.96 (95% CI 0.95-0.97). The pooled estimate of the optimal %maxTOTPAR for predictive purposes was 44.11 (95% CI 44.00-44.23). CONCLUSION: The analysis suggests that the arbitrary 50% cut-off point TOTPAR score often used in meta-analyses of analgesic trials in dental pain is reasonably acceptable. This is different to the 33% cut-off point reported for analgesic trials of acute breakthrough cancer pain and some chronic pain states such as diabetic neuropathy and postherpetic neuralgia. These differences deserve careful consideration when reading reports of analgesic trials and meta-analyses. Remedication itself should be considered as the preferred outcome measure for analgesic trials.

Acetaminophen↗
PubMed2004

Primary stenting of subclavian and innominate artery occlusive disease: a single center's experience.

PURPOSE: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. METHODS: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. RESULTS: Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. CONCLUSION: Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions.

Adult↗
PubMed2003

Rapsyn N88K is a frequent cause of congenital myasthenic syndromes in European patients.

BACKGROUND: Mutations in various genes of the neuromuscular junction may cause congenital myasthenic syndromes (CMS). Most mutations identified to date affect the epsilon-subunit gene of the acetylcholine receptor (AChR), leading to end-plate AChR deficiency. Recently, three different mutations in the RAPSN gene have been identified in four CMS patients with AChR deficiency. OBJECTIVE: To perform mutation analysis of the RAPSN gene in patients with sporadic or autosomal recessive CMS. METHODS: One hundred twenty CMS patients from 110 unrelated families were analyzed for the RAPSN mutation N88K by restriction fragment length polymorphism and sequence analysis. RESULTS: In 12 CMS patients from 10 independent families, RAPSN N88K was identified either homozygous or heteroallelic to another missense mutation. Symptoms usually started perinatally or in the first years of life. However, one patient did not show any myasthenic symptoms before the third decade. Clinical symptoms typically included bilateral ptosis, weakness of facial, bulbar, and limb muscles, and a favorable response to anticholinesterase treatment. Crisis-like exacerbations with respiratory insufficiency provoked by stress, fever, or infections in early childhood were frequent. All RAPSN N88K families originate from Central or Western European countries. Genotype analysis indicated that they derive from a common ancestor (founder). CONCLUSIONS: The RAPSN mutation N88K is a frequent cause of rapsyn-related CMS in European patients. In general, patients (RAPSN N88K) were characterized by mild to moderate myasthenic symptoms with favorable response to anticholinesterase treatment. However, severity and onset of symptoms may vary to a great extent.

Adolescent↗
PubMed2002

Plasma haptoglobin concentration in swine after challenge with Streptococcus suis.

Eight 15-week-old pigs, reared under specific pathogen-free conditions, were inoculated with Streptococcus suis serotype 2. The animals were monitored before and after challenge by measuring rectal temperature, recording specific clinical symptoms and collecting blood samples for haptoglobin determination. Twenty-four hours after infection, the average haptoglobin plasma concentration of the animal group increased significantly and reached a maximum 4 days post-inoculation, followed by a constant mean level until the end of the trial on day 10. In spite of individual differences between the animals, an increase in haptoglobin concentration of at least 2.5 times above normal was observed in all infected pigs 1 day after challenge. Twenty-four hours after challenge, lameness was observed in five animals and an elevated body temperature was observed in seven of the eight experimental infected animals. These are the classical clinical symptoms of streptococcal infection. Haptoglobin was shown to increase in acute S. suis infection in pigs.

Animals↗
PubMed2002

Computed tomography perfusion imaging in acute stroke.

The development of thrombolytic and neuroprotective agents for the treatment of acute stroke has created an imperative for improved imaging techniques in the assessment of acute stroke. Five cases are presented to illustrate the value of perfusion CT in the evaluation of suspected acute stroke. To obtain the perfusion data, a rapid series of images was acquired without table movement following a bolus of contrast medium. Cerebral blood flow, cerebral blood volume and mean transit time were determined by mathematically modelling the temporal changes in contrast enhancement in the brain and vascular system. Pixel-by-pixel analysis allowed generation of perfusion maps. In two cases, CT-perfusion imaging usefully excluded acute stroke, including one patient in whom a low-density area on conventional CT was subsequently proven to be tumour. Cerebral ischaemia was confirmed in three cases, one with an old and a new infarction, one with a large conventional CT abnormality but only a small perfusion defect, and one demonstrating infarct and penumbra. Perfusion CT offers the ability to positively identify patients with non-haemorrhagic stroke in the presence of a normal conventional CT, to select those cases where thrombolysis is appropriate, and to provide an indication for prognosis.

Acute Disease↗
PubMed2002

Anoxic activated sludge monitoring with combined nitrate and titrimetric measurements.

An experimental procedure for anoxic activated sludge monitoring with combined nitrate and titrimetric measurements is proposed and evaluated successfully with two known carbon sources, acetate and dextrose. For nitrate measurements an ion-selective nitrate electrode is applied to allow for frequent measurements, and thereby the possibility for detailed determination of the denitrification biokinetics. An internal nitrate electrode calibration is implemented in the experiments to avoid the often-encountered electrode drift problem. It was observed that the best experimental design was with the carbon source in excess, since excess nitrate provoked nitrite build-up thereby complicating the data interpretation. A conceptual model could quantitatively describe the experimental observations and thus link the experimentally measured proton production with the consumption of electron acceptor and carbon source during denitrification.

Calibration↗
PubMed2001

Activated sludge monitoring with combined respirometric-titrimetric measurements.

A short review of different respirometric methods is presented, and advantages and disadvantages of different principles are discussed. In this study a combined respirometric-titrimetric set-up was applied to monitor the degradation processes during batch experiments with activated sludge. The respirometer consists of an open aerated vessel and a closed non-aerated respiration chamber. It is operated with two oxygen probes resulting in two sources of information on the oxygen uptake rate; both collected at a high frequency. The respirometer is combined with a titrimetric unit that keeps the pH of the activated sludge sample at a constant value through the addition of acid and/or base. The cumulative amount of added acid and base serves as a complementary information source on the degradation processes. Interpretation of respirometric data resulting from validation experiments (additions of acetate and urea as ammonium source) showed that the set-up provided reliable data. Data interpretation was approached in two ways: (1) via a basic calculation procedure, in which the oxygen uptake rates were obtained by an oxygen mass balance over the respiration chamber, and (2) via a model-based procedure in which substrate transport was included for a more accurate data interpretation. Simulation examples showed that the presence of substrate transport in the model may be crucial for a correct data interpretation, since experimental conditions (e.g. low flow rate) and/or the biodegradation kinetic parameters (e.g. high Ks) may otherwise lead to data interpretation errors. Earlier studies already pointed out that titrimetric data can be related to nitrification, and this was also confirmed in this study. However, in addition, it was shown here for experiments with acetate that the amount of acid dosed was clearly related to the amount of acetate degraded. This indicates that the titrimetric data can be used to study the carbon source degradation. For the titrimetric data in this study, a model-based analysis was however only applied for the nitrification process. For an experiment with ammonium, it was illustrated that the estimation of biodegradation kinetics on a combined respirometric-titrimetric data set significantly improves confidence intervals of the parameters compared to the parameter estimation based on respirometric or titrimetric data separately.

Biodegradation, Environmental↗
PubMed2001

Intravascular US-guided direct intrahepatic portacaval shunt with a PTFE-covered stent-graft: feasibility study in swine and initial clinical results.

PURPOSE: To determine the feasibility of the creation of a direct intrahepatic inferior vena cava (IVC)-to-portal-vein shunt with puncture guided by a transfemorally placed intravascular ultrasound (IVUS) probe and use of a polytetrafluoroethylene (PTFE)-covered stent-graft. MATERIALS AND METHODS: In five swine, transjugular access was used to perform a direct puncture from the IVC to the portal vein with use of a modified Rosch-Uchida Portal Access set directed with real-time IVUS (9 MHz) introduced from a transfemoral venous approach. The direct intrahepatic portocaval shunt (DIPS) was then created with single or overlapping PTFE-covered Palmaz stents placed through a 10-F sheath and dilated to a diameter of 8 mm. Follow-up was performed with transhepatic portography at 2, 4, and 8 weeks. Animals were killed when shunts occluded or at the termination of the study at 8 weeks. Gross and microscopic histologic study was performed on sacrificed animals. A similar technique was used to create DIPS in five patients with intractable ascites, with follow-up by US and venography. RESULTS: All experimental DIPS created in swine were created without complications. Portal vein punctures were achieved in four of five swine on the first or second pass of the needle. Follow-up transhepatic portography at 2 weeks demonstrated occlusion of two shunts, both explained by technical reasons at sacrifice. At 4 and 8 weeks, the remaining three shunts were patent on portography. Histology showed a thin neointimal lining with no significant tissue ingrowth or hyperplasia. Clinically, in five patients, successful puncture of the portal vein from the IVC was achieved in one to three passes. Creation of DIPS led to a reduction of mean portosystemic gradient from 18-29 mm Hg (mean, 24 mm Hg) to 9-10 mm Hg (mean, 9 mm Hg). One patient died of liver failure 2 days after creation of DIPS. The other four patients were doing well 2-15 months (mean, 8 months) after the procedure, with patency confirmed by US and venography. CONCLUSION: Creation of DIPS is technically feasible, and the direct IVC-to-portal-vein puncture can be done accurately with real-time IVUS guidance. Further studies and longer follow-up are necessary to determine if the short length of the PTFE-covered stent-graft and avoidance of the hepatic vein will increase the long-term patency compared to standard transjugular intrahepatic portosystemic shunt creation.

Animals↗
PubMed2001

Bifurcated drum occluder endograft for treatment of abdominal aortic aneurysm: an experimental study in dogs.

PURPOSE: To evaluate a new, low profile, home-made, bifurcated drum occluder endograft (BDOEG), designed for percutaneous, transcatheter treatment of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: AAA was created in 10 dogs with over-dilated Palmaz stents. To prevent back filling, the lumbar arteries, inferior mesenteric artery, and common internal iliac arteries were embolized. The BDOEG was constructed of a drum occluder device and two PTFE endografts. The drum device consisted of a modified Z stent with Dacron stretched across and held within the ends of the stent, each with two 8 x 6-mm slits through which PTFE endografts were delivered. The PTFE endografts were 8 mm in diameter and 9.5 cm in length. Preloaded, the BDOEG was delivered through a 10-F sheath from both femoral arteries in a three-step procedure. All 10 animals were treated with BDOEG. Aortography was performed immediately, 6 weeks, and 12 weeks after stent-graft placement. Five animals were killed at 6 weeks and five were killed at 3 months. Gross and histologic evaluation was performed. RESULTS: The infrarenal aortic diameters and both external iliac arteries ranged from 8.0 mm to 10.3 mm (mean, 9.4 mm +/- 0.6) and from 5.2 mm to 6.8 mm (mean, 5.8 mm +/- 0.5), respectively. Creation of the AAA was successful in all 10 dogs. AAA diameters ranged from 13.7 mm to 15.9 mm (mean, 14.9 mm +/- 0.7). Complete exclusion of the AAA was achieved immediately after BDOEG placement and aneurysms remained excluded without perigraft leak to the time of killing in all 10 animals. There was a high incidence of aortoiliac limb occlusion. Occlusion of 12 aortoiliac limbs (60%) caused by intimal hyperplasia at the distal end of the endografts in iliac arteries developed in nine animals (90%). In six animals (60%), one limb occluded and, in three animals (30%), there was occlusion of both limbs. CONCLUSION: This study suggests a new approach for treatment of AAA. BDOEG use reduces sheath size for endograft delivery and may eliminate the need for a surgical cut down on femoral arteries. Tapering of the iliac ends of endografts to the size of the artery will be needed to prevent distal intimal hyperplasia.

Animals↗
PubMed2001

The processing and utilization of hepatocyte growth factor/scatter factor following partial hepatectomy in the rat.

Hepatocyte growth factor/scatter factor (HGF/SF) is a pluripotent growth factor capable of acting as a motogen, a morphogen, and a mitogen. Originally, HGF/SF was found as a blood-borne mitogen for hepatocytes and has since been determined to be very important in liver repair. Previous studies have established that HGF/SF must be proteolytically cleaved to elicit its effects. After liver injury by toxins such as carbon tetrachloride or after surgical resection, partial hepatectomy (PHX), HGF/SF concentrations increase in the blood. The aims of this study were to examine (1) which form of HGF/SF is present in the normal liver, (2) which form is present in the regenerating liver after PHX, and (3) if the HGF/SF used after PHX is derived from existing liver reservoirs. Both single-chain HGF/SF and active two-chain HGF/SF are present in normal liver, with the former being the dominant form. After PHX, the liver can be described as having two phases with regard to the use of endogenous HGF/SF. The first phase from 0 to 3 hours is the consumptive phase and is characterized by a decrease in both single-chain HGF/SF and active two-chain HGF/SF. The second phase is the productive phase. It is characterized by a pronounced reappearance of both single-chain HGF/SF as well as two-chain HGF/SF. The activation index shows a 5-fold increase over sham operations during the productive phase. The use of radiolabeled HGF/SF showed that during the first 3 hours, HGF/SF is used in part from hepatic stores. Furthermore, during the first 3 hours after PHX, only active two-chain HGF/SF is seen in the plasma.

Animals↗
PubMed2001

Practical identifiability of model parameters by combined respirometric-titrimetric measurements.

An earlier study on theoretical identifiability of parameters for a two-step nitrification model showed that a unique estimation of the yield YA1 is possible with combined respirometric-titrimetric data, contrary to the case where only one type of measurement is available. Here, the practical identifiability of model parameters was investigated via evaluation of the output sensitivity functions and the corresponding Fisher Information Matrix (FIM). It appeared that the FIM was not sufficiently powerful to predict the practical identifiability of this case with combined measurements as parameters could indeed be identified despite the fact that the FIM became singular. The accuracy of parameter estimates based on respirometric and titrimetric data and combination thereof was also investigated. Estimation on titrimetric data (Hp) was very accurate and a fast convergence of the objective function towards a minimum was obtained. The latter also holds for estimation on oxygen uptake rate data (rO), however with a lower accuracy. Parameter estimation based on oxygen concentration data (SO) was more complex but resulted in a higher accuracy. Thus, when the highest accuracy is needed it is recommended to estimate parameters initially on Hp and/or rO data, and to subsequently use these parameters as initial values for final, and more accurate estimation on SO data.

Equipment Design↗
PubMed2001

Monitoring of denitrification performance with combined nitrate and titrimetric measurements.

A sensor based on on-line measurement of nitrate and acid/base titration is proposed for anoxic activated sludge monitoring. The data probed from the preliminary experiments with denitrifying activated sludge samples using anoxic-titrimetric sensor are information-rich with high data frequency that can be used further in model-based data interpretation and parameter estimation of denitrification process. Moreover, the sensor was able to detect intermediate accumulation, which is an often-observed phenomenon during the denitrification process. It therefore offers the possibility for use in overall performance evaluation of biological nutrient removal plants.

Biosensing Techniques↗
PubMed2000

The incidence of positive margins with breast conserving therapy following mammotome biopsy for microcalcification.

BACKGROUND AND OBJECTIVES: The ability to achieve clean margins with breast conserving therapy varies greatly even when the diagnosis of carcinoma is known beforehand. Although several reports reveal that the incidence of positive margins decreases after stereotaxic core biopsy of nonpalpable lesions and fine-needle aspiration biopsy of palpable lesions, the data on the results following mammotome biopsy (mmbx) is scanty. METHODS: Two hundred and ninety-eight biopsy specimens for mammographically indeterminate microcalcification from 1/97 through 3/30/98 were reviewed. Biopsies were performed using the biopsys method utilizing an 11-gauge multidirectional, vacuum-directed device. RESULTS: Ten percent (n = 31) of the mammotome biopsies were atypical and 9% (n = 27) were malignant. These 58 cases (19%) were recommended for surgical excision. The incidence of positive margins in this subset was determined. Of patients who underwent lumpectomy as their initial surgical procedure 69% had negative surgical margins. Seventy-seven percent of patients with carcinoma diagnosed by mammotome biopsy had definitive initial surgery with a single surgical procedure. CONCLUSIONS: Mmbx facilitates fewer surgical procedures to achieve negative margins, and thus provides a better cosmetic result.

Adult↗