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Biomedical subjects

H Andersen

Publications and source records attributed to H Andersen.

At least 37 records · Page 2Linked to original sources
PubMed1998

Decreased muscle strength in patients with alcoholic liver cirrhosis in relation to nutritional status, alcohol abstinence, liver function, and neuropathy.

To study motor function quantitatively in alcoholic liver cirrhosis muscle strength, liver function, peripheral nerve function, and nutrition were assessed in 24 patients. Isokinetic strength of flexion and extension at elbow, wrist, hip, knee, and ankle and of shoulder abduction and adduction was evaluated and compared with findings in 24 matched healthy subjects. Degree of liver disease was assessed with the Child-Pugh score and the galactose elimination capacity (GEC). Nutritional status was evaluated with an estimation of lean body mass (LBM) from 24-hour urinary creatinine excretions. Peripheral nerve function was evaluated with neurological symptom and disability scores, nerve conduction studies, and quantitative sensory tests summed to obtain a neuropathy rank-sum score (NRSS) for each patient. Combined muscle strength at hip, knee, ankle, shoulder, elbow, and wrist were weakened with 34% (P < .005), 35% (P < .001), 35% (P < .01), 34% (P < .01), 29% (P < .01), and 29% (P < .02), respectively. The median Child-Pugh score was 7 (range, 5-12), and the median duration of alcohol abstinence was 90 days (range, 5-960 days). After multiple linear regression analysis including LBM, Child-Pugh score, GEC, duration of alcohol abstinence, and NRSS, only LBM was correlated to the strength at the knee (r=.79; P < .0001) and at the ankle (r=.63; P < .01). It is concluded that muscle strength is weakened substantially in alcoholic patients with liver cirrhosis and that weakness is related to the severity of malnutrition but not to the severity of liver disease, duration of alcohol abstinence, or neuropathy.

Adult↗
PubMed1998

Muscular endurance in long-term IDDM patients.

OBJECTIVE: To determine the short-term muscular endurance and working capacity of leg muscles in long-term IDDM patients in relation to neuropathic complications, muscle strength, and metabolic control. RESEARCH DESIGN AND METHODS: The muscular endurance of extensors and flexors at the ankle and knee was assessed in 44 IDDM patients and in 44 matched control subjects during 30 maximal isokinetic movements. The endurance index was the work performance of the last 5 movements relative to the first 5 movements. Total work was the summated work of all movements. All patients underwent a neurological evaluation, nerve conduction studies, and quantitative sensory tests. RESULTS: The combined endurance index of the ankle extensors and flexors was 70% (51-88) (median [range]) in the diabetic group and 65% (55-82) in the control group (P < 0.01). For knee extensors and flexors the combined endurance index was 65% (55-103) for the diabetic patients and 63% (48-75) in the control subjects (P < 0.01). The endurance index related neither to the severity of neuropathy nor to the metabolic control (blood glucose and HbA1c) for any of the muscle groups. Diabetic patients had reduced strength of all muscle groups (14-24%, P < 0.02) and impaired total work performance (15-20%, P < 0.01) for ankle movements. CONCLUSIONS: Long-term IDDM patients have increased endurance but reduced strength and work performance of leg muscles. The combined effect of the motor abnormalities is suggested to give rise to functional impairment, including an increased risk of falls and injuries.

Adult↗
PubMed1997

High-affinity binding sites for 125I-labelled pancreatic secretory phospholipase A2 in rat brain.

Porcine pancreatic secretory phospholipase A2 (ppsPLA2) has been shown to modulate agonist and antagonist binding to alpha-amino-3-hydroxy-5-methylisoxazolepropionate (AMPA) receptors and to effect neurotransmission in the central nervous system (CNS). To further elucidate the mechanism of action of ppsPLA2 in the CNS, the binding profile of 125I-labelled ppsPLA2 to rat whole-brain membranes was assessed. Two classes of calcium-dependent binding sites were detected using unlabelled ppsPLA2 as a displacer with IC50 values of 3 and 217 nM. Similar values were obtained for [125I]ppsPLA2 binding to membranes prepared from isolated cortical and hippocampal rat brain regions. [125I]ppsPLA2 binding displayed bell-shaped concentration-dependence curves to Ca2+, Zn2 + and pH. Binding was not inhibited by AMPA, the false substrate, oleoyloxyethyl phosphocholine (OOPC), or by BSA-galactose or wheat germ agglutinin. [125I]ppsPLA2 binding was reduced by treatment of the rat brain membranes with mercaptoethanol and proteinase K treatment or by their pre-incubation at 95 degrees C. These results show a different binding profile to the previously characterised snake venom sPLA2 N-type receptors and suggest the existence of novel class of sPLA2 N-type binding sites.

Animals↗
PubMed1997

Disordered mobility of large joints in association with neuropathy in patients with long-standing insulin-dependent diabetes mellitus.

Movement performance was studied in 29 long-term patients with insulin-dependent diabetes mellitus (IDDM) and 29 matched control subjects. Velocity, range of motion, reaction time, and strength of ankle dorsal and plantar flexion and knee extension were measured. The neuropathic condition was assessed from clinical examination, nerve conduction studies, and quantitative sensory examination, and summed to obtain a neuropathy rank-sum score. Reaction time for the diabetic patients was increased by 29%, 23%, and 22% for ankle dorsal, ankle plantar, and knee extension movements respectively (p < 0.001). Range of motion was slightly decreased at ankle dorsal flexion (12%, p < 0.05). There was an inverse relationship between range of motion and neuropathy rank-sum score for ankle dorsal (r = -0.68, p < 0.001) and plantar flexion (r = -0.61, p < 0.001). Peak velocity was significantly decreased at ankle dorsal (21%, p < 0.001) and plantar flexion (23%, p < 0.001) and was related to the isokinetic muscle strength. Peak velocity was also related to the neuropathy rank-sum score at ankle dorsal flexion (r = 0.57, p < 0.002). We conclude that maximal movements at the ankle are delayed and slowed in long-term IDDM patients. The decreased peak velocity and the range of motion are related to the severity of neuropathy.

Adult↗
PubMed1997

F-wave latency, the most sensitive nerve conduction parameter in patients with diabetes mellitus.

In this study we examined the diagnostic sensitivity of minimal F-wave latency, F-wave persistence, motor nerve conduction velocity (MCV), and amplitude of the compound motor action potential (CMAP) of the median, ulnar, tibial, and peroneal nerves, and of sensory conduction velocity (SCV) and sensory nerve action potential (SNAP) amplitude of the sural nerve in 82 diabetic patients. For the median, ulnar, and tibial nerves the Z scores of the minimal F-wave latency were significantly larger than those of the MCV, and for all four motor nerves the Z scores of the minimal F-wave latency were significantly larger than those of the amplitude of the CMAP. The Z scores of the peroneal minimal F-wave latency exceeded those of peroneal MCV, sural SCV, and sural SNAP. F-wave persistence did not differ significantly from the reference values. In conclusion, minimal F-wave latency is the most sensitive measure for detection of nerve pathology and should be considered in electrophysiological studies of diabetic patients.

Action Potentials↗
PubMed1997

Muscular atrophy in diabetic neuropathy: a stereological magnetic resonance imaging study.

Diabetic patients with polyneuropathy develop motor dysfunction. To establish whether motor dysfunction is associated with muscular atrophy the ankle dorsal and plantar flexors of the non-dominant leg were evaluated with magnetic resonance imaging in 8 patients with symptomatic neuropathy, in 8 non-neuropathic patients and in 16 individually matched control subjects. In the neuropathic patients the muscle strength of the ankle dorsal and plantar flexors was reduced by 41% as compared to the non-neuropathic patients (p < 0.005). Volume of the ankle dorsal and plantar flexors was estimated with stereological techniques from consecutive cross-sectional images of the lower leg. The neuropathic patients had a 32% reduction in volume as compared with the non-neuropathic patients (p < 0.005). To determine the regional distribution of atrophy cross-sectional magnetic resonance images were performed at predetermined levels of the lower leg in relation to bone landmarks. In the neuropathic patients there was an insignificant increase of 3% of muscle area at the proximal lower leg level, whereas the atrophy was 43% (p < 0.002) at the mid lower leg level and 65% (p < 0.002) distally. Analysis of individual muscles confirmed that the atrophy predominated distally. We conclude that muscular atrophy underlies motor weakness at the ankle in diabetic patients with polyneuropathy and that the atrophy is most pronounced in distal muscles of the lower leg indicating that a length dependent neuropathic process explains the motor dysfunction.

Adult↗
PubMed1997

Early clinical investigation of sulofenur with a daily schedule in advanced solid tumours.

Sulofenur, a sulfonylurea, has demonstrated antitumour effect in preclinical studies. A phase I trial was initiated to study the clinical aspects. Sulofenur was given p.o. daily for a period of 28 days in 5-week courses. The initial dosage was 250 mg/m2 escalating to 700 mg/m2 daily with no dose modification for the individual patient at any given dose level; 38 patients with advanced solid malignant tumours were enrolled. Haemolytic anaemia was the main side effect. The toxicity was marked at dose levels of 600 and 700 mg/m2. Moderate methaemoglobinaemia also occurred. One case of reversible toxic hepatitis was observed. Generally was ALAT, and more moderately basic phosphatases, and LDH elevated. Tumour regression was not observed but one patient had stable disease throughout nine courses. The maximal detected plasma concentration of Sulofenur in this study was 348 x 10(-6) g/ml. In the present study the maximum tolerated dose (MTD) of Sulofenur was defined to 600 mg/m2. One conclusion from this study is that even at doses above that recommended for future studies-5-600 mg/m2-with this schedule, the suggested effective plasma level from preclinical studies could not be reached. The overall conclusion is that this schedule should not be recommended at all for future studies and the recommendation should be to try to find a schedule in which higher plasma levels can be achieved at a clinically tolerated dose.

Adult↗
PubMed1997

Detection of irregular red cell antibodies: more than 3 years of experience with a gel technique and pooled screening cells.

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate more than 3 years of experience with a gel technique in combination with pooled screening cells for the detection of irregular red cell antibodies. MATERIALS AND METHODS: Conventional serologic methods were used for blood typing, antibody screening and cross-matching until the end of 1992. We introduced the gel technique as a routine assay for antibody detection and identification in 1993. RESULTS: After the tube technique had been abandoned, the number of false-positive antibody screening tests was reduced by 71%, positive antibody screening tests by 33%, enzyme agglutination by 100% and rouleaux reactions and cold-reacting antibodies by more than 50%. There was a 40% increase in first-time detection of clinically relevant antibodies. We saw no increase in delayed haemolytic transfusion reactions. CONCLUSIONS: For the detection of irregular red cell antibodies, pooled screening cells in combination with a gel technique are at least as efficient and safe as a conventional tube technique with unpooled test cells.

Blood Grouping and Crossmatching↗
PubMed1997

Diabetes mellitus.

Epidemiological studies have documented a high prevalence of diabetic neuropathy. The risk of lower leg amputation is increased three to four times in patients with clinical signs of neuropathy and ankle weakness is more common than hitherto recognized. Increased nerve hydration and increased expression of low affinity p75 receptor for neurotrophins suggest new therapeutic potentials for the prevention of diabetic neuropathy.

Diabetes Mellitus, Type 1↗
PubMed1997

A comparative study of isokinetic dynamometry and manual muscle testing of ankle dorsal and plantar flexors and knee extensors and flexors.

Muscle strength in neuropathic patients is usually evaluated clinically using manual muscle testing (MMT). Detection and grading of mild symmetrical muscle weakness using MMT is difficult partly because the examiner must take into consideration the normal variation in strength in relation to age, weight, height, and gender. In the present study assessment of the strength of ankle dorsal and plantar flexors and knee flexors and extensors with MMT and isokinetic dynamometry were compared in 108 patients, of whom 86 had diabetes mellitus and 22 had alcoholic liver cirrhosis. The isokinetic muscle strength of the patients was compared with the strength of 90 healthy control subjects, adjusted for the influence of age, weight, and height for both genders. MMT resulted in a significant underestimation of the frequency and severity of muscle weakness in both the ankle and the knee. In 28-41% of the comparisons, MMT misclassified the strength performance with one category or more (> 25%). Misclassifications were most frequent for the ankle plantar flexors.

Adult↗
PubMed1997

A clinical quality management support system.

In the CONQUEST Quality Management System, assessment and improvement of the quality of treatment process and outcome is done by introducing a Clinical Quality Management Support System. Initially the treatment of breast cancer was chosen to illustrate the potential benefits of introducing quality management in the treatment process. The main objective of the CONQUEST Quality Management System is to provide a flexible framework for supplying quality management of the treatment process and enable comparison of clinical results, despite differences in the local best clinical practice guidelines used in the participating treatment centres.

Breast Neoplasms↗
PubMed1996

Peptide, disulfide, and glycosylation mapping of recombinant human thrombopoietin from ser1 to Arg246.

Thrombopoietin (TPO) is a hematopoietic factor involved in the regulation of megakaryocytopoiesis. Full length recombinant human TPO (332 residues) has been expressed in BHK cells and purified to homogeneity using conventional means. Peptide, disulfide, and glycosylation mapping of human TPO from residues 1 to 246 has been carried out using liquid chromatography-electrospray mass spectrometry (LC-ESMS). A modification of the ramped orifice method of Carr and co-workers [Carr et al. (1993) Protein Sci. 2, 183-196] is employed, providing additional information for assignment of the LC-ESMS chromatograms. With the modification, b- and y-series peptide ions are produced via front-end CID which confirms the mass-based assignments. The results of our analysis of TPO indicate that the amino acid sequence of TPO 1-246 is as expected from the transfected cDNA with complete cleavage of the signal peptide. Two unique disulfides are formed between the four cysteines in the cytokine domain of TPO: Cys7-Cys151 and Cys29-Cys85. The glycosylation map indicates the position, occupancy, and structures of the N- and O-glycans in TPO 1-246. In addition, site specific structural characterization of the PNGase F-liberated N-glycans has been performed following purification by high-pH anionic exchange chromatography with pulsed amperometric detection (HPAEC-PAD); the results corroborate the LC-ESMS data. The N-glycans are of the complex type with the core-fucosylated disialylated biantennary and trisialylated triantennary structures predominating. The O-glycans are of the mucin type with the monosialylated and disialylated GalGalNAc-S/T structures predominating. Furthermore, we propose that the C-terminal domain of TPO be further divided into two domains on the basis of sequence homology among the cloned sequences and glycosylation/structural features: an N-glycan domain (154-246) and an O-glycan domain (247-332).

Amino Acid Sequence↗
PubMed1996

Reliability of isokinetic measurements of ankle dorsal and plantar flexors in normal subjects and in patients with peripheral neuropathy.

OBJECTIVE: To establish a reliable method for evaluation of motor performance of ankle dorsal and plantar flexors in healthy subjects and in patients with peripheral neuropathy. DESIGN: Thirty-eight control subjects and 7 patients with peripheral neuropathy were studied. All patients and 25 control subjects were test twice. PATIENTS AND CONTROL SUBJECTS: An outdoor clinic sample of 7 patients with hereditary motor sensory neuropathy (HMSN) and 38 control subjects. MAIN OUTCOME MEASURES: The effect of a rest interval, a displacement of the axis of rotation, examination by three investigators on the peak torque and work of dorsal and plantar flexors, and the percentage difference at test-retests. RESULTS: Control subjects had percentage differences of 5.6% and 8.0% for dorsal flexion and 3.8% and 8.7% for plantar flexion at 60 degrees/sec and 180 degrees/sec, respectively. In neuropathic patients the percentage differences were 0% and 8.6% for dorsal and 5.1% and 12.3% for plantar flexion at 30 degrees/sec and 60 degrees/sec, respectively. No interindividual differences between 3 investigators were found. A rest interval between trials resulted in an increased plantar flexion peak torque (P < .05). Displacement of 1.5cm of the axis of rotation resulted in a change of the peak torque of 8.3% for plantar flexion (P < .01). CONCLUSIONS: A well-defined test protocol for isokinetic motor performance of the ankle dorsal and plantar flexors provides a reliable procedure for quantification of motor function in healthy subjects and in patients with HMSN1.

Adult↗
PubMed1996

Prostaglandin E2 inhibits antidiuretic hormone induced transepithelial sodium transport and cAMP production in frog skin epithelium (Rana esculenta).

The stimulation of transepithelial sodium transport by arginine vasotocin (AVT) and the ability of prostaglandin E2 (PGE2) to inhibit the AVT dependent sodium transport was examined on pieces of frog skin taken from different regions of the frog. The basal sodium transport was of the same magnitude in the abdominal, thoracal and upper and lower dorsal region. In all regions the sodium transport could be stimulated by AVT, though the stimulation was highest in the abdomen. Subsequent addition of PGE2 caused a significant inhibition of the AVT dependent sodium transport in the abdomen but had only minor effects on the other parts of the skin. Therefore, pieces of skin from the abdomen were selected for the remaining experiments. Addition of PGE2 to skin pieces in the presence of AVT resulted in a hyperpolarization of the cellular potential and a decrease in the transepithelial sodium transport, indicating a decreased apical sodium permeability. This was correlated with a decrease in cellular cAMP contents. We conclude that frog skin exhibits large regional differences in sensitivity to AVT and that PGE2 only modulates the natriferic effect of AVT in the abdomen.

Animals↗
PubMed1996

Isokinetic muscle strength in long-term IDDM patients in relation to diabetic complications.

The isokinetic muscle strength in 56 IDDM patients with > 20 years of diabetes duration and in their individually sex-, age-, weight-, and height-matched control subjects was assessed. Peak torque of foot dorsal and plantar flexion and knee and wrist extension and flexion was measured. The neuropathic condition was assessed by a neurological disability score, a neuropathy symptom score, nerve conduction studies, and quantitative sensory examination. All results were summed to obtain a neuropathy rank-sum score for each patient. According to their renal albumin excretion, the patients were classified to have normo-, micro-, or macroalbuminuria. In addition, according to their retinal status, patients were classified as having no, simple, or proliferative retinopathy. The IDDM patients had a 21% reduction of muscle strength of both ankle dorsal (P < 1 x 10(-4)) and plantar flexors (P < 0.01), compared with control subjects. A 16% reduction of knee extensors (P < 0.005) and a 17% reduction of knee flexors (P < 0.01) was found. In contrast, muscle strength in wrist flexors and extensors was not significantly reduced (10 and 11%, respectively [NS]). In patients with the most severe weakness, muscle strength of the calf muscles was only 50% of the expected performance. Correlations were found between the neuropathy rank-sum score and the muscle strength of ankle dorsal (r = -0.66, P < 1 x 10(-7)) and plantar flexors (r = -0.51, P < 0.0005), knee extensors (r = -0.51, P < 0.0005) and flexors (r = -0.44, P < 0.005), and wrist flexors (r = -0.41, P < 0.005). No correlation was found for wrist extensors (r = 0). Neither were there any relationships between muscle strength at the ankle and knee and the degree of albuminuria or retinopathy. In conclusion, motor performance is substantially impaired in long-term IDDM patients, and the weakness is related to the presence of neuropathy but not to albuminuria or retinopathy per se.

Adult↗
PubMed1995

[Fatal cases of poisonings among drug addicts in the county of Funen in 1993].

This study includes death from poisoning among drug addicts in 1993 in the county of Funen, in all 24. The development during the last five years shows an increase, especially in the largest city in the county. The drug addicts have several problems, and several of them were well-known in the social welfare system or by the police. Half of the drug addicts had received treatment for their abuse and three persons were receiving treatment at the time of their death. A few--primarily among the youngest--had only used drugs for a short time while one third had abused drugs for several years. The greater part of the deaths were caused by heroin, which is found in different concentrations in the illegal market. Five of the dead persons had just been released from prison and three people had just left 24-hour care centres when they were found dead. Co-operation between the various, treating authorities has to be given a high priority.

Adolescent↗
PubMed1995

Motor pathway function in normoalbuminuric IDDM patients.

Central motor pathways were studied in 17 normoalbuminuric insulin-dependent diabetic (IDDM) patients who had been diabetic for more than 20 years, and compared with findings in 17 age-, sex-, and height-matched control subjects. The central motor conduction time was calculated from recordings of the compound muscle action potentials of the abductor pollicis brevis muscle after single transcranial and spinal root magnetic stimulation. The central motor conduction time from motor cortex to cervical spinal roots was 9.8 +/- 1.65 ms in diabetic patients and 10.1 +/- 1.48 ms in control subjects. In diabetic patients with neuropathy the central motor conduction time was 9.5 +/- 1.76 ms vs 10.1 +/- 1.56 ms in patients without neuropathy. The excitability of the motor pathways was studied by paired transcranial magnetic stimulation at interstimulation intervals of 30-1000 ms. In normal control subjects, an early facilitation of the amplitude of the compound muscle action potential at an interstimulation interval of 30 ms was found, while no facilitation was present in diabetic patients. In addition the compound muscle action potential latencies were prolonged at interstimulation intervals of 30-50 ms in diabetic patients. The changes of excitability did not correlate with the presence of peripheral neuropathy, metabolic control or diabetes duration. It is concluded that long-term normoalbuminuric IDDM patients have imparied excitability but normal central conduction time of the motor pathways.

Adult↗