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Biomedical subjects

B Petersen

Publications and source records attributed to B Petersen.

At least 37 records · Page 2Linked to original sources
PubMed2000

Unusual pattern of leukoencephalopathy after morphine sulphate intoxication.

We report a 14-year-old girl with an unusual pattern of leukoencephalopathy after intentional intoxication with morphine sulphate tablets. Toxicological analysis showed exceedingly high levels of morphine and its metabolites. MRI disclosed a leukoencephalopathy with high signal from the centrum semiovale, corpus callosum and cerebellar white matter on T2-weighted images. These findings could be only partially explained by a hypoxic-ischaemic event; neurotoxic effects must be considered in this atypical leukoencephalopathy.

Adolescent↗
PubMed2000

Combination therapy with carvedilol and amiodarone in patients with severe heart failure.

BACKGROUND: Carvedilol and at least in some studies, amiodarone have been shown to improve symptoms and prognosis of patients with heart failure. There are no reports on the outcome of combined treatment with both drugs on top of angiotensin-converting enzyme inhibitors (ACEI), diuretics and digitalis. METHODS AND RESULTS: In 109 patients with severe heart failure submitted for heart transplantation at one single center between the years 1996 and 1998 [left ventricular ejection fraction (LVEF) 24.6+/-11%, 85% males, 52% idiopathic dilated cardiomyopathy (DCM), mean observation time 1. 9+/-0.4 years] a therapy with low-dose amiodarone (1000 mg/week) plus titrated doses of carvedilol (target 50 mg/day) was instituted. In addition, patients received a prophylactic dual chamber pacemaker (PM) in order to protect from bradycardia and for continuous holter monitoring. The devices were programmed in back-up mode with a basal rate of 40 i.p.m. with a hysteresis of 25%. Significantly, more patients were in sinus rhythm after 1 year than at study entry (85% vs. 63%, P<0.01). In 47 patients, under therapy over at least 1 year, the resting heart rate fell from 90+/-19 to 59+/-5 b.p.m. (P<0.001). Ventricular premature contractions in 24-h holter ECGs were suppressed from 1.0+/-3 to 0.1+/-0.3%/24 h (P167 b.p.m. detected by the pacemaker (1.2+/-2.8 episodes/patient/3 months vs. 0.3+/-0.8 episodes/patient/3 months after 1 year (P<0.01). The LVEF increased from 26+/-10 to 39+/-13% (P<0.001). NYHA class improved from 3. 17+/-0.3 to 1.8+/-0.6 (P<0.001) as well as right heart catheterization data. From the total cohort, seven patients (6%) developed symptomatic documented bradycardic rhythm disturbances requiring reprogramming of their pacemakers to DDD(R)/VVI(R) mode with higher basic rates. Two of these patients developed AV block, four sinu-atrial blocks or sinus bradycardia and one patient had bradycardic atrial fibrillation. During the observation period five patients died (3 sudden, 1 due to heart failure and 1 due to mesenteric infarction). Two patients had undergone heart transplants. The 1-year survival rate (Kaplan-Meier) without transplantation was 89%. Compared to historic control patients with amiodarone only (n=154) or without either agent (n=283) this rate was 64 and 57% (P<0.01). CONCLUSIONS: Heart failure patients benefit from a combined therapy with carvedilol and amiodarone resulting in a markedly improved NYHA stage, an increase in LV ejection fraction, a stabilization of sinus rhythm, a significant reduction in heart rate, a delay of electrical signal conduction and a suppression of ventricular ectopies. Approximately 6% of patients under such a regime became pacemaker-dependent in the first year. Compared to historic controls prognosis was better and the need for heart transplantation was lower. The exact role of either agent in combination or alone should be clarified in larger randomized studies.

Adrenergic beta-Antagonists↗
PubMed2000

An unusual FGFR1 mutation (fibroblast growth factor receptor 1 mutation) in a girl with non-syndromic trigonocephaly.

Non-syndromic trigonocephaly is a heterogeneous entity; in most cases the origin is unknown. Rare cases with autosomal dominant and recessive inheritance exist. Here the mutational screening of ten patients in the FGFR1, 2, and 3 genes and the TWIST gene causative of autosomal dominant craniosynostosis syndromes was reported. In one girl an unusual FGFR1 mutation was found.

Adult↗
PubMed2000

The concept of hereditary impairment of brain maturation.

The classification of benign partial epilepsies and related conditions includes (besides rolandic epilepsy) atypical benign partial epilepsy, bioelectrical status epilepticus (ESES) and a variety of other syndromes. The broad overlap of the clinical and bioelectrical symptomatology might reflect a pathogenetic background common to these epilepsies. In order to understand the great phenotypic variability, the clinical symptomatology in 56 sibships with focal sharp waves of genetic origin was analyzed. A genetic determination was assumed if, in addition to the index case, at least one sibling or offspring revealed typical focal sharp waves. The 56 index-cases and their 61 sib/offspring/parents showed a broad spectrum of epileptic and non-epileptic conditions ranging from mild selective performance deficits to severe complex mental retardation, from neonatal seizures, febrile convulsions, and simple rolandic epilepsy to severe epilepsies with minor seizures or ESES. The different conditions are not disease entities but sets of variably weighted symptoms of a complex pathogenetic background, in which a genetic disposition to focal anomalies of brain function is of decisive importance. As can be demonstrated by the data, this genetic liability coincides with other widespread genetic traits, expressed in certain EEG patterns, as well as with lesional pathogenetic factors. The biological background of the genetic focal anomaly is currently unknown. The marked age dependence of the symptoms justifies the assumption of an hereditary impairment of brain maturation.

Age Factors↗
PubMed1999

Adrenergic stimulation of hepatocyte growth factor expression.

Hepatocyte growth factor (HGF), a potent mitogen, is released into plasma at increased levels following injury to certain tissues, including the liver. Early increases in plasma HGF are not due to a release from the injured liver, but rather from distal organs, particularly the lung. We have investigated the ability of norepinephrine (NE), which rises rapidly in plasma after liver resection, to trigger elevated production of HGF in MRC-5 human embryonic lung fibroblasts. Levels of HGF released to culture media and of HGF mRNA increased when cultures were exposed to NE, or to other adrenergic agonists. While stimulation of either beta- or alpha(1)-adrenergic receptors increased HGF expression, responses to NE appear to be mediated primarily via beta receptors. Since NE has already been shown to act as a comitogen with HGF, our findings suggest that adrenergic hormones may act both to induce production of HGF at distal sites, and to enhance the response to HGF at target tissues.

Adrenergic alpha-Agonists↗
PubMed1999

Effect of orlistat on blood cyclosporin concentration in an obese heart transplant patient.

OBJECTIVE: We detected markedly decreased cyclosporin blood levels in a heart-transplanted patient after the gastrointestinal lipase inhibitor orlistat was accidentally added to the treatment program to control for his obesity. Therefore, we determined cyclosporin plasma concentration time kinetics with and without orlistat reexposition in this patient. METHODS: Plasma concentration time kinetics of whole blood cyclosporin levels in an obese heart-transplant patient were measured using a standard monoclonal fluorescence polarisation immunoassay. Results were obtained in hourly intervals up to 12 h without and with co-therapy of 3 x 120 mg orlistat (Xenical, Roche Ltd., Switzerland). The orlistat re-exposition was started the day before taking blood samples. RESULTS: Cyclosporin trough levels (98 ng/ml vs 52 ng/ml), maximum concentrations (532 ng/ml vs 74 ng/ml) and the area under the blood drug concentration-time curve (2832 ng h ml-1 vs 700 ng h ml-1) were greatly reduced with orlistat. CONCLUSIONS: Orlistat markedly decreased blood cyclosporin concentrations, possibly due to an interference with its absorption in the small intestine. To avoid potential dangerous under-immunosuppression, orlistat should not be used in patients taking cyclosporin.

Anti-Obesity Agents↗
PubMed1999

Critical illness neuropathy in pediatric intensive care patients.

Critical illness neuropathy is an axonal polyneuropathy recognized more frequently in adult intensive care patients with sepsis and multiple organ dysfunction. In children the diagnosis is rarely made. Within 1 year the authors observed two children with critical illness neuropathy. Both patients, a male 6 years, 6 months of age with a brain contusion and a male 2 years, 6 months of age who underwent craniectomy for Crouzon's disease, required prolonged mechanical ventilation and developed sepsis with multiple organ dysfunction. Three to 4 weeks after successful treatment of the sepsis, a flaccid tetraparesis was noticed in both patients. Laboratory investigations of blood and cerebrospinal fluid and spinal magnetic resonance imaging revealed normal results. Electrophysiologic examinations were indicative of an axonal polyneuropathy. Spontaneous improvement occurred within several months. It is likely that critical illness neuropathy occurs more often in critically ill children than previously thought. Careful neurologic examination and early electrophysiologic investigations are necessary to establish the diagnosis. Important differential diagnoses of acquired lower motor neuron weakness in pediatric intensive care medicine are discussed.

Child↗
PubMed1998

Terminal deletion of the long arm of chromosome 10: a new case with breakpoint in q25.3.

Since the first patient with partial deletion of the long arm of chromosome 10 was described in 1978, another 23 cases have been reported, with the breakpoint ranging from 10q23.3-26.2. To contribute further to the delineation of the monosomy 10qter syndrome, we describe a female child who, at age 3 6/12 years, was diagnosed with a de novo deletion of the long arm of chromosome 10, with a breakpoint in 10q25.3. The phenotypic manifestations in this child are compatible with those of previously reported cases. However, in contrast to most other patients, we found a moderate expression of the syndrome, with no genitourinary or cardiac malformations and with only mild retardation. Based on our observations and those of others, we conclude that a typical craniofacial appearance and varying degrees of psychomotor retardation are always found in patients with 10q- syndrome.

Abnormalities, Multiple↗
PubMed1998

Structural analysis of the intact polysaccharide mannan from Saccharomyces cerevisiae yeast using 1H and 13C NMR spectroscopy at 750 MHz.

The mannan from Saccharomyces cerevisiae yeast was studied by high field NMR spectroscopy in an attempt to deduce the structure of the polysaccharide and to assess the ratio of different side chains. The results show that all structural information, agreeing with previously published data, can be extracted by analysis of the NMR spectra of the intact and modified mannan.

Carbohydrate Conformation↗
PubMed1998

Inferior epigastric artery pseudoaneurysm: a complication of paracentesis.

Two patients had inferior epigastric artery pseudoaneurysms after therapeutic paracentesis for ascites caused by portal hypertension. The first patient, a 62-year-old man, had a two-week history of left lower quadrant pain, tenderness, and nonpulsatile mass after a paracentesis for ascites. A left inferior epigastric artery pseudoaneurysm measuring 10 cm in diameter and 20 cm in length was diagnosed by means of Duplex ultrasound and arteriography. The patient was treated with percutaneous embolization, with successful thrombosis of the pseudoaneurysm. The second patient, a 33-year-old woman, had a six-week history of left lower quadrant pain, tenderness, and nonpulsatile mass after a paracentesis for ascites. Computerized tomography and arteriography showed a left inferior epigastric artery pseudoaneurysm, measuring 7 cm in diameter and 9 cm in length. The patient was treated with percutaneous embolization with successful thrombosis of the pseudoaneurysm. Both patients were discharged in good condition 2 days after embolization. Inferior epigastric artery pseudoaneurysm is a complication of paracentesis, and percutaneous embolization may be preferable to surgical repair in patients with chronic liver failure and portal hypertension.

Adult↗
PubMed1998

Perception of treatment need among orthodontic patients compared with professionals.

The aim was to evaluate estimated need for orthodontic treatment, as judged from intraoral photographs, among orthodontic patients and professionals. Twenty consecutive prospective orthodontic patients, 20 consecutive orthodontically treated patients, 10 randomized general dentists, and 10 orthodontists participated. Seventy pairs of anonymous intraoral photographs of dentitions with varying degrees of objective treatment need were randomly arranged in a notebook. The general dentists and orthodontists rated orthodontic treatment need on a visual analog scale in a similar way among themselves and were more reserved than both patient categories, who also scored similarly among themselves. Professional raters also had similar inter- and intra-rater reliability among themselves, and it was higher than in either of the patient categories. Treatment providers appear to be more restrictive, consistent, and reliable in their judgement of orthodontic treatment need from intraoral photographs than the target group, patients positive toward orthodontic treatment.

Adolescent↗
PubMed1998

Nephelometric determination of haptoglobin plasma concentrations in fattening pigs.

The haptoglobin plasma concentrations in 110 fattening pigs living on three commercial farms and in 28 animals on the university pilot farm were measured using a nephelometric detection method based on an immunoassay. Following calibration of the automated analyser (Nephelometer BN 100) with a human haptoglobin standard, the measurements were performed using anti-human antiserum from rabbits. Differences in age, gender or breed of apparently healthy animals seem to have no influence on the plasma concentration of the protein. The average plasma level of haptoglobin in animals suffering from acute respiratory diseases was significantly higher. Furthermore, an increase was observed in animals without clinical symptoms living on a farm characterized by obvious defects in housing conditions. Comparison studies of the nephelometric method by use of a human or porcine standard for calibration and different anti-human or anti-porcine antisera with radial immunodiffusion as a reference method resulted in high correlation coefficients for all variations. Optimal accuracy was obtained by calibrating the analyser with a porcine standard. Haptoglobin determinations have been shown to be a useful tool for health monitoring during the integrated pig-production process, allowing recognition of performance-reducing conditions. The immunonephelometric determination method is suitable for quantifying porcine plasma haptoglobin for routine checks. The use of animal-specific standards for calibration improves the accuracy of this method.

Animals↗
PubMed1998

The Richards Series 2 total hip prosthesis: a 13-year study and radiographic evaluation.

This retrospective long-term study analyzes the clinical function, failures, and radiographic status of 131 Richards Series 2 prostheses in total hip arthroplasties (THAs) performed during 1981 and 1982. After a minimum follow-up period of 11 years, the results were evaluated. Sixty two (54%) patients with 71 THAs were available for follow-up; 44 (38%) patients with 49 THAs had died. Three patients with three THAs were lost to follow-up, and seven patients with eight THAs were unable to participate in the examination due to causes not related to their present hip status. Ten patients underwent revision THA during the observation period. The median hip functional index (HFI) was 8.6 preoperatively and 15.8 at follow-up. Hip functional index correlated to radiographic signs of loosening. With revision as endpoint, the Kaplan-Meier survivorship for all 131 hips was 93% after 10 years and 91% after 12 years. The radiographic examination at follow-up revealed 5 (8%) definite loose cups and 12 (19%) definite loose stems. Including the number of aseptic loosened cups and stems confirmed at revision, aseptic loosening was found in 6% of all cups and 13% of all stems. This radiographic evaluation confirmed that lack of containment of the cup and varus position of the stem were factors influencing the long-term stability of the prostheses, whereas etiology, type of arthritis, and ectopic ossification did not. A fixation and stability score that was modified for cemented prostheses was developed and was of value in detecting the prostheses at risk. The long-term results of the Richards Series 2 THA are acceptable and comparable with other long-term studies on conventional prosthetic designs. Ten percent to 20% revision THAs due to aseptic loosening can be expected. In addition, patients younger than age 60 at surgery and especially men were found to belong to a high-risk group with regard to revision THA. These patients must be evaluated carefully so that revision THA can be performed before the bone bed is destroyed.

Aged↗
PubMed1997

Ictal and interictal ECD-SPECT for focus localization in epilepsy.

Forty-one ECD (Technetium-99m-ethyl cysteinate dimer) SPECT investigations were undertaken in the course of a presurgical diagnostic work-up in 23 patients with pharmacoresistant focal epilepsy. In 21 patients, both an ictal and interictal SPECT were conducted. In the patients receiving ictal SPECT the tracer was injected between 7 and 30 s after the seizure onset. Of the interictal SPECTs 17 of 23 showed focal hypoperfusion which was consistent in 17 cases (74%) with the area of the electrophysiological focus (EF) and 6 patients had a normal interictal SPECT. Of the ictal SPECTs 18 of 21 (86%) showed regional hyperperfusion, 18 of them in the same location as the EF. Ictal SPECT showed a hypoperfusion similar to that in interictal SPECT in another 3 patients. In these cases seizure duration was short (28-54 s), so that the tracer reached the brain postictally. Our results show that ictal ECD-SPECT is an effective method for demonstrating an epileptogenic focus. Possible reasons for false-negative ictal SPECT results are discussed.

Adolescent↗
PubMed1997

A survey of bovine, bubaline and swine sarcocystosis in the Philippines.

In a survey conducted from January to December, 1994, muscle tissues in 12 out of 22 slaughtered carabaos ages 8-17 years old and obtained from the Food Terminal Inc, Abbatoir in Laguna showed numerous white and creamy elliptic-shaped soft bodied macrocysts in the throat muscles. Microscopic examination of the throat and cardiac muscle tissues revealed the presence of fusiform-shaped microcysts. Our observations are consistent with previous reports incriminating Sarcocystis fusiformis as the most important etiologic agent of bubaline sarcocystosis in the country. In a survey of bovine sarcocystosis in muscle tissues of imported Australian cattle (Brahman Breed) and native cattle obtained from various slaughter houses in Manila and suburbs, prevalence rates of 17% (98/577) and 3% (1/31) were noted, respectively. Sarcocysts were predominant in skeletal muscles and to a lesser extent in cardiac, esophageal and diaphragm muscle tissues. Light microscopic examination of sarcocysts morphology suggests Sarcocystis cruzi (= Sarcocystis bovis), and Sarcocystis hominis (= Sarcocystis bovihominis) or Sarcocystis hirsuta (= Sarcocystis bovifelis) as the likely etiologic agents of bovine sarcocystosis in the country. Of the 225 swines examined, only muscle tissues from a 6-month old swine revealed very young sarcocysts (= metrocytes). A review of available documented studies on sarcocystosis suggests that to date, our findings may represent the first data on the prevalence of bovine and swine sarcocystosis in the Philippines.

Animals↗
PubMed1996

Chronic treatment with citalopram induces noradrenaline receptor hypoactivity. A microdialysis study.

To investigate whether chronic citalopram administration influences the cyclic AMP (cAMP) synthesis in vivo, microdialysis was used to assess citalopram-induced alterations in extracellular concentrations of cAMP in the dorsal hippocampus of freely moving rats. Citalopram administration for 4 weeks (40 mg/kg p.o. daily) did not affect the baseline levels of cAMP but decreased the noradrenaline-induced enhancement of cAMP levels. No change in forskolin-induced enhancement of cAMP levels was observed. Citalopram in situ did not exert any effect on the cAMP levels. These data support the hypothesis that chronic administration of antidepressants alters the function of noradrenergic receptors.

Animals↗