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Biomedical subjects

E S Hansen

Publications and source records attributed to E S Hansen.

At least 91 records · Page 5Linked to original sources

Mortality of mastic asphalt workers.

This study was conducted to investigate the adverse health effects of exposure to bitumen fumes. A cohort of 679 mastic asphalt workers was followed from 1959 to 10 June 1986, during this period 169 deaths occurred. The overall standardized mortality ratio (SMR) was 163 (95% confidence interval (95% CI) 141-190), the SMR was 225 (95% CI 172-288) for cancer and 223 (95% CI 130-358) for external causes. Among persons aged 40 to 89 years, significant increases were seen for lung cancer (SMR 290, 95% CI 188-429), nonpulmonary cancer (SMR 200, 95% CI 141-276), and liver cirrhosis (SMR 467, 95% CI 188-962). Bronchitis, emphysema, and asthma also occurred in excess (SMR 207, 95% CI 95-393). In conclusion, the inhalation of bitumen fumes may have contributed to the elevated mortality from cancer and respiratory diseases among mastic asphalt workers.

Adolescent↗

Gap healing enhanced by hydroxyapatite coating in dogs.

During prosthetic implantation, gaps between the implant surface and the surrounding bone may occur resulting in reduced implant stability. In these instances bone-conductive materials might augment the formation of hosting bone into the pores of the implant and insure earlier implant stabilization and fixation by bony ingrowth. Titanium-alloy cylinders with a porous-titanium-alloy plasma spray coating were implanted into the medial femoral condyles in six mature dogs. In another group of six dogs, matched in age, weight, and gender, hydroxyapatite (HA) coated implants were used. All implants were surrounded by a 1-mm gap. Unilateral osteopenia of the knee, with a 20% reduction of bone density as judged by computed tomography scanning, was induced by 12 weekly intraarticular injections of carrageenin into the right knee before surgery. Four weeks after implantation, the HA-coated implants were compared to the parent porous-titanium implants by mechanical testing and histomorphometry. A marked positive influence of HA coating on bone mineralization and the strength of the interfacial bone between the bone and implant was found. The increment in interface shear strength and shear stiffness was three- to fivefold in osteopenic bone and two-fold in control bone. Coating of an unloaded porous-titanium-coated implant with HA accelerates the rate of bone ingrowth and thereby provides relatively high, early interfacial shear strengths in the presence of an initial gap between bone and implant even in the presence of osteopenic host bone.

Animals↗

Tissue oxygen tension in myocutaneous flaps. Correlation with blood flow and blood gases.

The relationship between tissue oxygen tension (PO2) and blood flow, blood gas tensions, oxygen delivery, and oxygen consumption was investigated in myocutaneous island flaps in 24 pigs. The tissue PO2 was measured by the silicone rubber tonometer technique. Capillary blood flow was increased during the first 3-4 hours after implantation of tonometers and they must, therefore, be implanted 3-4 hours before use. After raising the flap, mean (SEM) total flap blood flow increased from 11.2 (0.8) ml/min to 16.0 (1.3) ml/min within the first three hours. Mean (SEM) subcutaneous tissue PO2 decreased from 9.5 (0.6) kPa to 5.2 (0.7) kPa over six hours after the procedure, whereas muscle PO2, blood oxygen tension, and arteriovenous oxygen difference were unchanged. Hence, both the supply to, and use of oxygen in, the flap increased. Muscular and subcutaneous oxygen tensions were about 3 and 1 kPa, respectively, lower than venous oxygen tension. Tissue PO2 did not correlate with blood flow, blood oxygen tensions, arteriovenous differences in oxygen tension, or with oxygen supply in a cross section of animals. Tissue PO2 seems to reflect accurately the balance between oxygen supply and consumption, which might be the most useful indicator for continuous flap monitoring.

Animals↗

[Patient advisors and coercion in psychiatry. The situation 3 months after the introduction of the Act on restriction of liberty and other coercive measures in psychiatry].

In a retrospective investigation, we attempted to estimate the effect of introduction of a new law about coercive measures and loss of liberty in psychiatric wards during the first three months after enforcement of the law. By examination of case reports we found that 69 patients, i.e. 14%, were exposed to one or several types of coercive measures. Restraint was the most frequent form of coercive measures. Eight patients lodged complaints about the coercive measures. The decisions of the psychiatrists were all sanctioned. Replies to complaints about treatment with coersion were available within five to 14 days. In an investigation by questionnaire, we found that there was satisfaction with the patient advisors introduced in the wards by the new law. Collaboration with the patient advisors took considerable time for the staff members. Both staff members, doctors and patient advisors suggest that the patient advisors should receive more education in psychiatry. We suggest changes in the law when this is revised.

Coercion↗

The proportionate mortality ratio and its relationship with measures of mortality.

Under certain circumstances a proportionate mortality ratio (PMR) equals the cause-specific standardized mortality ratio (SMR) divided by the overall SMR. In this paper, the relationship between PMR and SMR is derived stepwise with focus on the conditions that must be fulfilled for each step of the derivation to be valid. It appears essential that the following conditions be fulfilled: (1) the compared populations are closed throughout the period of study; (2) all deaths (or a representative sample) in the compared populations are included in the analysis; (3) every dead person is assigned to exactly the same exposure category that he or she would have been assigned to in a follow-up study; and (4) possible diagnostic misclassification is not exposure-dependent. Furthermore, for dead people within the comparison group, the relative frequency of the cause of death of interest must be constant over age. In view of this it is recommended that PMR studies of occupational mortality are designed to cover only a short period; to use data from national or regional death certificate registries only; to be restricted to lifetime occupations; to make use of a hand-picked comparison group that has had the same access to medical care and diagnosis as the index group; and to restrict the PMR analysis to age-at-death strata in which the relative frequency of the studied cause of death is constant in the comparison group of deceased persons.

Cause of Death↗

Microvascular hemodynamics in experimental arthritis: disparity between the distribution of microspheres and plasma flow in bone.

The microcirculation in normal and arthritic juxtaarticular bone was studied in 16 young dogs with carragheenan-induced arthritis of one knee. The regional blood flow was determined by the tissue uptake of intracardially injected 15-microns 141Ce-labeled microspheres, and the microvascular plasma volume was determined by the distribution space of circulating 125I-fibrinogen. Disparities between the distribution of plasma flow and microspheres, introduced by plasma skimming or nonentrapment of spheres in the intraosseous circulation, were estimated by 59Fe-transferrin, a third intravascular tracer, injected as a bolus intracardially and trapped peripherally after 15 sec by prompt circulatory arrest. The tissue uptake of the plasma flow tracer was compared to that of microspheres by the ratio between observed and expected activity of 59Fe-transferrin, the expected activity being calculated from the microsphere distribution. The transferrin and microsphere uptake agreed well in patella, marginal epiphyseal bone, and cortical bone, whereas observed activity of transferrin was twice the expected in central epiphyseal bone, three times higher in marrow, and up to eightfold higher in metaphyses adjacent to growth plates. This discrepancy was significantly greater in arthritic bone when the metaphyses were examined in toto. The microsphere method thus appears to underestimate blood flow to cancellous bone and marrow due to uneven distribution of plasma and formed elements from profound plasma skimming and perhaps also by AV shunting.

Animals↗

International Commission for Protection Against Environmental Mutagens and Carcinogens. ICPEMC Working Paper 7/1/2. Shared risk factors for cancer and atherosclerosis--a review of the epidemiological evidence.

This paper reviews the epidemiological literature of relevance for the hypothesis that somatic mutation is involved in the formation of the atherosclerotic plaque. Assuming that somatic mutations are involved in atherogenesis, one would expect at least some of the risk factors for cancer and for atherosclerosis to be identical. Therefore, the review covers the correlated occurrence of cancer and atherosclerotic disease. Special interest is given to populations at high risk of cancer, including subpopulations with certain genetic diseases, and populations exposed to certain carcinogenic environmental agents including ionizing radiation, vinyl chloride monomer (VCM), arsenic, tobacco, and various industrial combustion effluents containing polycyclic aromatic hydrocarbons (PAHs). Exposure to combustion effluents from burning of tobacco or fuel is associated with an increased risk of cancer and atherosclerotic disease. Combustion effluents constitute a complex mixture of potentially hazardous agents, however, and the observed correlation of cancer and atherosclerosis among exposed persons cannot be unambiguously interpreted as evidence of a common etiology of the two groups of diseases. For ionizing radiation, arsenic, and VCM there is suggestive evidence that these agents possess an atherogenic effect beside their well-known carcinogenic properties. Both arsenic and VCM seem to have a specific affinity to the vascular bed causing various lesions including angiosarcomas and atherosclerotic plaques. Regarding ionizing radiation, the atherogenic effects seem to be localized to heavily irradiated fields. Beside the carcinogenic and atherogenic effects, exposure to arsenic, VCM, and ionizing radiation brings about an increase in the incidence of mutations and chromosomal aberrations. A theory involving somatic mutation in the pathogenesis of the atherosclerotic plaque could be consistent with the observed biological effects of ionizing radiation, arsenic, and VCM. The scant data from families with certain inherited diseases may also be consistent with an involvement of the genome in the pathogenesis of atherosclerosis. In conclusion, there is strong epidemiological evidence that several factors associated with an increased risk of cancer are also associated with an increased risk of atherosclerosis.

Arsenic↗

Chest symptoms in chimney sweeps and postmen--a comparative survey.

The purpose of this survey was to study the association between a number of chronic diseases and occupational exposure to soot and smoke. The problem was illustrated by comparing chimney sweeps and postmen with regard to self-reported occurrence of symptoms. Data were obtained by means of a postal questionnaire. Potential confounding was controlled by matching and stratified analysis. Compared to postmen, the chimney sweeps experienced a significantly increased risk of long-term coughing with expectorate (Prevalence Rate Ratio (PRR) = 1.74), dyspnoea from fast walking (PRR = 1.46), dyspnoea from ordinary walking (PRR = 1.79), dyspnoea when dressing (PRR = 2.29) and substernal oppression from exposure to cold or physical strain (PRR = 1.41). It seems likely that the chimney sweep's inhalation of soot particles and locally irritating flue gases may have contributed to the increased occurrence of chest symptoms in this occupational group.

Adult↗

The influence of tissue tension on the microcirculation in myocutaneous flaps: an experimental study in dogs.

The effect of increased and decreased uniaxial tissue tension on capillary blood flow, plasma volume, edema formation, and vascular permeability in myocutaneous flaps was studied. A total of 64 equally sized arterialized myocutaneous flaps were outlined on the abdomen of 16 dogs. The four areas on each dog were randomized to either untouched control area, reattachment to normal tension, increased (one and one-half times the original length), or decreased (one-half times the original length). Capillary blood flow measured by the radioactive microsphere technique two hours after operation was decreased in the muscular part of flaps reattached at decreased and normal tension (p less than 0.05). The muscular blood flow was unchanged when flaps were reattached at increased tension and significantly higher than in flaps reattached at decreased tension (p less than 0.05). No differences were found in skin or subcutaneous blood flow. There were no differences in plasma volume, vascular permeability, or total water content between flaps attached under different tensions, whereas the plasma volume was increased in muscle in all three flap types (p less than 0.05) presumably secondary to venous stasis. The study implies that the decreased capillary blood flow seen in the muscular component of a myocutaneous flap in the immediate postoperative period may be counteracted by a somewhat increased reattachment tension.

Abdominal Muscles↗

Proliferation of adherent synovial fluid cell cultures is modified by eicosanoids.

Synovial fluid cells obtained from a carrageenan-induced chronic arthritis in the juvenile dog knee were allowed to adhere and proliferate in culture flasks. After twelve days secondary cultures were made and either 10(-8)M leukotriene B4 (LTB4), 25 microM 15-hydroxy-eicosatetraenoic acid (15-HETE), or both, were added and the cells were cultured for another 6 days. LTB4 is generated via the 5-lipoxygenase pathway of arachidonic acid metabolism and stimulates a number of phagocyte functions. Compared to control cells LTB4 increased proliferation in 9 out of 10 cell cultures (p less than 0.05). The 15-lipoxygenase product, 15-HETE, is not proinflammatory and is an endogenous inhibitor of 5-lipoxygenase. Addition of 15-HETE decreased proliferation of cell cultures by 23% (p less than 0.01). It is speculated that LTB4 in addition to its effect on phagocytes may play a role in synovial hyperproliferation observed in arthritis.

Animals↗

A cohort study on the mortality of firefighters.

This study was set up to investigate the effect of exposure to combustion effluents on the chronic health of firefighters. A cohort of firefighters was followed up through 10 years with regard to cause specific mortality. Comparisons were made with another cohort of civil servants and salaried employees in physically demanding jobs. After a latency of five years, an excess mortality from cancer was seen for persons aged 30 to 74 (standardised mortality ratio (SMR) 173, 95% confidence interval (95% CI) 104-270). A significant increase in lung cancer was seen in the group aged 60 to 74 (SMR 317, 95% CI 117-691), whereas non-pulmonary cancer was significantly increased in the group aged 30 to 49 (SMR 575, 95% CI 187-1341). It is concluded that inhalation of carcinogenic and toxic compounds during firefighting may constitute an occupational cancer risk. An extended use of respiratory protective equipment is advocated.

Adult↗

Microvascular morphology of bone in arthrosis. Scanning electron microscopy in rabbits.

The morphology of the bone microvasculature in rabbit arthrosis was studied by scanning electron microscopy (SEM) and related to changes in intraosseous pressure (IOP) and phlebographic appearance. Unilateral gonarthrosis was induced in 34 rabbits by immobilization of one knee in extension with a plastic splint for 5 weeks. Bilateral IOP recording in a subgroup of 12 rabbits demonstrated hypertension in arthrosis of 22 +/- 2.9 mmHg compared with 11 +/- 4.7 mmHg in control knees. Intraosseous phlebography in 13 rabbits showed a dilated vascular bed with prolonged clearance of contrast media. The morphology of normal microvasculature by SEM of intravascular methyl methacrylate casts in 9 rabbits was characterized by well-defined and well-demarcated sinusoids with only a few arteriovenous shunts, whereas in arthrosis substantial changes included fusion of sinusoids, leakage of cast material through the sinusoid walls, and development of numerous shunts. The study demonstrated profound microvascular morphologic changes that may reflect a vascular genesis for some of the bone changes in arthrosis.

Animals↗

Synovitis reduced by inhibition of leukotriene B4. Carrageenan-induced gonarthritis studied in dogs.

The pathophysiologic significance of leukotriene B4 (LTB4) in arthritis was studied in dogs by unilateral intraarticular deposition of 15-hydroxy-eicosatetraenoic acid (15-HETE), an endogenous inhibitor of the formation and the effects of LTB4, in bilateral carrageenan-induced gonarthritis. LTB4 in synovial fluid was selectively inhibited in 15-HETE treated joints, the formation of prostaglandin E2 (PGE2) being largely unaffected. The clinical symptoms, intraarticular pressure, and extractable synovial fluid volume were reduced in treated joints. No effect could be discerned regarding blood flow in the synovial membrane, capsule, or juxta-articular bone as measured by tracer microspheres; and no effect on bone metabolism was found as judged by 99mTc-diphosphonate uptake. Thus, inhibition of LTB4 reduces joint exudation, but does not seem to interfere with changes in juxta-articular hemodynamics or bone metabolism following synovial inflammation.

Animals↗

Hydroxyapatite coating enhances fixation of porous coated implants. A comparison in dogs between press fit and noninterference fit.

Intimate contact at the bone-porous surface interface is not always achievable in noncemented prosthetic implantation. We investigated the effect of hydroxyapatite (HA) coating on skeletal attachment in noninterference fit 4 weeks after implantation in 6 mature dogs. The push-out test of HA-coated implants surrounded by a 1-mm gap showed a twofold increased shear strength and fivefold increased shear stiffness compared with titanium alloy (Ti) coated implants. The fixation of Ti implants was reduced by two thirds when inserted in a gap as compared with press fit, whereas HA-coated implants in gap showed anchorage close to implants in press fit. Only minor differences were found between HA and Ti implants in press fit. Histomorphometric analysis showed a significant increase in bone in direct contact to HA-coated implant as compared with Ti implants inserted both in gap and press fit. The study indicates that tightness of surgical fit is an important factor for sufficient fixation of the implant. However, our results demonstrate that hydroxyapatite coating almost eliminates the negative influence of noninterference fit between bone and unloaded implant.

Animals↗

[Dietary treatment of patients with lymphangiomyoma].

A case of lymphangiomyoma, manifested by chylous ascites, in a 32 year-old woman is presented. Treatment with dietary fat restriction supplemented with medium chain triglycerides was successful, and the patient has remained free from chylous effusions for nearly two years.

Adult↗

Three-phase [99mTc]diphosphonate scintimetry in septic and nonseptic arthritis of the immature knee: an experimental investigation in dogs.

We compared the informative value of dynamic and static [99mTc]diphosphonate ([99mTc]DPD) scintimetry in early septic arthritis (SA) and chronic nonseptic arthritis (NSA) of the knee in puppies. SA (n = 10), induced by injection of Staphylococcus aureus into one knee, was examined after 48 h. NSA (n = 6) was induced by weekly intraarticular instillation of 1% carrageenan and examined at 2 and 12 weeks. Epiphyseal and metaphyseal count ratios (CRs) between experimental and control joint were calculated in an angiographic phase (0-20 s), a "blood pool" phase (20-256 s), and a bone uptake phase (2 hs). Control dogs (n = 4) had a CR of 1.0 in all regions and phases, the coefficients of variation being 0.06 and 0.03 in dynamic and static phases, respectively. In NSA, all scintimetric phases showed decreased metaphyseal uptake and largely unchanged epiphyseal uptake. Generally, SA exhibited vastly increased angiographic uptake in all regions and increased epiphyseal blood pool uptake, whereas delayed epiphyseal uptake varied and delayed metaphyseal uptake tended to decrease. Two septic joints had generalized reduction in dynamic uptake, probably owing to increased intraarticular pressure; in one of these, dynamic uptake in the distal femoral epiphysis (FE) was totally absent, suggesting temporary circulatory arrest during the dynamic scanning procedure. The use of regional dynamic and static [99mTc]DPD scintimetry increased the pathophysiologic and diagnostic value of joint scintigraphy, especially with respect to the early detection of SA and its avascular complications.

Animals↗

Tissue oxygen tension in random pattern skin flaps during normovolemic hemodilution.

We investigated the effect of progressive normovolemic hemodilution with Dextran 70 on subcutaneous tissue oxygen tension (PscO2) in canine random pattern flaps and in adjacent intact skin. PscO2 was measured polarographically in implanted oxygen-permeable Silastic catheters. The mean PscO2 of 5.7 kPa in intact subcutis at hematocrit (HCT) 40 was maintained or insignificantly improved during hemodilution to a HCT of 14. The mean flap PscO2 of 3.1 kPa at HCT 40 was maintained down to HCT 20. Most flap measuring sites exhibited a PscO2 improvement in an individual HCT range at some point during hemodilution. The increment in PscO2 tended to be relatively greater and to occur at lower Hct values in locations with more severe ischemia initially. Central hemodynamics were characterized by a lowered total peripheral resistance and an increased cardiac output, whereas systemic and pulmonary arterial blood pressures and central venous pressure remained essentially unchanged.

Animals↗