Paraneoplastic frontal lobe disorder and ataxia in renal cell carcinoma.
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Ataxia↗
Biomedical subjects
H C Hansen
Publications and source records attributed to H C Hansen.
Outcome after endovascular therapy of ruptured intracranial aneurysms: morbidity and impact of rebleeding.
We evaluated midterm functional outcome after endovascular occlusion of aneurysms in patients with subarachnoid haemorrhage (SAH) and determined the incidence of late rebleeding as an additional prognostic parameter. We treated 79 consecutive patients with SAH from an intracranial aneurysm admitted from a neurological intensive care unit by the endovascular route between 1993 and 1997 and 52 survivors were followed up in 1999-2000. The mean interval between SAH and follow-up was 41 months (range 13-74 months). Outcome was determined by the Glasgow outcome (GOS) and Rankin (RS) scales and by questions concerning neuropsychological disorders. The patients were analysed according to Hunt and Hess (H & H) grades I-III or IV-V on admission. We observed two episodes of rebleeding (3%) with impact on outcome at 907 and 2010 days after SAH, respectively. A complete recovery (GOS 5) was achieved in 53% of H & H grade I-III and 17% of grade IV-V patients; with death rates 19% and 50%, and morbidity according to the RS (5-2) 18% and 29%, respectively. Midterm morbidity after endovascular therapy is thus low. Rebleeding with an impact on outcome can be observed up to 2010 days after SAH, suggesting that long-term angiographic follow-up is indispensable.
Adult↗
Serovars of Salmonella isolated from Danish turkeys between 1995 and 2000 and their antimicrobial resistance.
The prevalence of Salmonella serovars and their antimicrobial resistance patterns were investigated among Danish turkeys between 1995 and 2000, by sampling the flocks approximately 14 days before they were slaughtered. Within the flocks, the prevalence of salmonella varied from 7.1 per cent to 25 per cent, and 24 different serovars were detected. The five most prevalent, which accounted for 58.5 per cent of the isolates were Salmonella Heidelberg (16.2 per cent of the isolates), Salmonella Agona (15.8 per cent), Salmonella Derby (12.4 per cent), Salmonella Muenster (7.3 per cent) and Salmonella Anatum (6.8 per cent). In addition, a few rough isolates and isolates belonging to the antigenically incomplete formulae 6,7:-:- and 4,12:b:- were found. The level of antimicrobial resistance was low; the highest resistance was recorded to ampicillin (13.7 per cent) and streptomycin (9.0 per cent) followed by tetracycline (8.5 per cent), sulphonamides (7.7 per cent) and spectinomycin (4.7 per cent). Resistance to quinolones was very low: four isolates were resistant to nalidixic acid, and only one was resistant to enrofloxacin. No resistance was recorded to colistin, apramycin, ceftiofur, florfenicol, or amoxycillin with clavulanic acid. Only 24 isolates were resistant to two or more compounds in various combinations of up to six compounds; one Salmonella Havana isolate was resistant to six compounds. Six isolates were serovar Typhimurium, but none of them belonged to phage type DT104.
Animals↗
Comparison of operative and endovascular treatment of anterior circulation aneurysms in patients in poor grades.
We assessed the outcome of surgical and endovascular treatment in patients in poor (Hunt & Hess IV or V) grade following subarachnoid haemorrhage due to anterior circulation aneurysm (ACA). There were 41 patients, treated surgically (20), by the endovascular route (20) or both (1). The aneurysms were clipped in 20 patients, wrapped in one; 19 were treated with Guglielmi detachable coils (GDC), one by parent vessel occlusion using detachable balloons. One GDC treatment was interrupted and the aneurysm was surgically clipped instead. We treated five patients surgically to evacuate accompanying intracerebral clots. We treated 14 (66%) patients by the endovascular route and 15 (71%) surgically within 72 h of the haemorrhage. The frequency of delayed ischaemic neurological deficit and/or cerebral infarct due to vasospasm did not differ significantly between the endovascular and surgical groups. We had one surgical and three endovascular procedure-related complications with clinical manifestations. Outcome was evaluated after 6 months. After GDC treatment, angiographic follow-up was carried out between 8 and 26 months (mean 17 months). Good outcomes were achieved in six (29%) of the surgically treated patients (40% of the survivors) and six (30%) of the endovascular treatment patients (60% of the survivors). Outcome was similar after surgical and endovascular approaches. The decision as to which treatment to chosen is influenced mainly by clinical factors such as cerebral haematoma or age.
Adult↗
Early recovery after closed traumatic head injury: somatosensory evoked potentials and clinical findings.
OBJECTIVE: To determine the ability of somatosensory evoked potentials (SEP) compared with clinical findings to monitor and predict recovery in patients suffering from closed head injury with predominantly diffuse axonal injury (DAI). DESIGN: Prospective cohort study. SETTING: Neurologic intensive care unit (ICU) of a university hospital. PATIENTS: Serial SEP recordings were obtained from 31 consecutive patients with closed head injury. The first SEP was recorded within 48 hrs after trauma, followed by recordings after another 2 days, after which the time interval for each consecutive recording was doubled. Clinical examinations were performed every 6 hrs during the ICU stay and daily after transfer to a general neurologic ward. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twenty-three of 31 patients demonstrated pathologic SEP findings at initial examination. Of these patients, 11 recovered clinically, two remained vegetative, and ten died. In all 11 patients with clinical recovery, SEP also recovered. In 8 of 31 patients, initial SEPs were normal and remained normal until discharge, all eight had a good outcome. Initial SEP findings were related with outcome at 6 months (p = .02), and follow-up studies increased the predictive value of SEP studies (p = .009). Other factors related to outcome included age, severity of DAI, and length of ICU/hospital stay. In the 11 patients with SEP and clinical recovery, early (day 2) and late (>or=2 months) recovery was documented. Early and reliable SEP indicators of improvement included N20-P25-Amplitudes (mean recovery, 8.5 days) and central conduction time (9.6 days). Pupillary light reaction (6.4 days), Babinski reflex (12.4 days), and Glasgow Coma Score (9.6 days) were the most valuable clinical findings. Recovery of the Glasgow Coma Score frequently coincided with reduction of sedatives. In most patients, recovery was detected with SEP before clinical recovery (7/11 patients, time difference 1 wk). CONCLUSIONS: Initial SEP findings correlate with long-term outcome in patients with closed head injury with DAI. Initial bilaterally absent cortical responses in the SEP reliably predicted death, whereas completely normal SEP findings predicted good long-term outcome. Early recovery after DAI can be detected with serial SEP recordings despite sedative medications. Electrophysiologic recovery frequently precedes clinical recovery.
Adult↗
5-hydroxytryptamine2A receptor inverse agonists as antipsychotics.
We have used a cell-based functional assay to define the pharmacological profiles of a wide range of central nervous system active compounds as agonists, competitive antagonists, and inverse agonists at almost all known monoaminergic G-protein-coupled receptor (GPCR) subtypes. Detailed profiling of 40 antipsychotics confirmed that as expected, most of these agents are potent competitive antagonists of the dopamine D2 receptor. Surprisingly, this analysis also revealed that most are potent and fully efficacious 5-hydroxytryptamine (5-HT)2A receptor inverse agonists. No other molecular property was shared as universally by this class of compounds. Furthermore, comparisons of receptor potencies revealed that antipsychotics with the highest extrapyramidal side effects (EPS) liability are significantly more potent at D2 receptors, the EPS-sparing atypical agents had relatively higher potencies at 5-HT2A receptors, while three were significantly more potent at 5-HT2A receptors. Functional high-throughput screening of a diverse chemical library identified 530 ligands with inverse agonist activity at 5-HT2A receptors, including several series of compounds related to known antipsychotics, as well as a number of novel chemistries. An analog of one of the novel chemical series, AC-90179, was pharmacologically profiled against the remaining monoaminergic GPCRs and found to be a highly selective 5-HT2A receptor inverse agonist. The behavioral pharmacology of AC-90179 is characteristic of an atypical antipsychotic agent.
Animals↗
Multistep solution-phase parallel synthesis of spiperone analogues.
A flexible, multistep parallel synthesis of spiperone analogues is described. A library of 4-substituted piperidines, assembled utilizing reductive amination and acylation protocols, was alkylated either homogeneously or heterogeneously, exploiting a product release only concept, to afford an oxa-series of spiperone analogues. Screening of the products at 5-HT2 and D2 receptors revealed 5-HT2A antagonists with improved selectivity compared to spiperone and AMI-193.
Antipsychotic Agents↗
Detection and monitoring of intracranial pressure dysregulation in liver failure by ultrasound.
BACKGROUND: Development of elevated intracranial pressure (ICP) in hepatic failure indicates poor prognosis. Its detection by invasive methods poses methodological problems. We applied ultrasound studies of the optic nerves to noninvasively estimated ICP status. METHODS: A total of 22 pediatric patients with hepatic failure were examined by serial B scan ultrasound and followed up clinically. Outcome was scored as survival or death due to multiorgan failure (MOF) or raised ICP. In 18 patients, transplantations were performed. RESULTS: Four patients died before transplantation was possible (raised ICP: n=3, MOF: n=1). After OLT there were 10 survivors and 8 patients died (MOF: n=3, raised ICP: n=5). In 10 patients we found optic nerve sheath diameter (ONSD) above normal limits. Eight patients died, mostly because of raised ICP (n=7). Only 2 of the 10 survivors experienced a transient ONSD increase, steadily normalized after transplantation. Preoperatively, normal ONSD was detected in four of seven patients. The outcome of these four cases was clearly superior (three survivors and one MOF) compared with abnormal pre-OLT ultrasound findings (raised ICP: n=3). CONCLUSION: Patients with poor prognosis related to raised ICP in pediatric liver failure can be identified by ultrasound measurement of ONSD without the disadvantages of invasive procedures. Although the exact intracranial pressure level cannot be deduced from single examinations, ONSD trends can reflect the evolution of ICP in hepatic encephalopathy.
Child, Preschool↗
[Continuous EEG for monitoring on the neurological intensive care unit. New applications and uses for therapeutic decision making].
Fifteen patients at our neurological intensive care unit were monitored with continuous EEG (cEEG: 10 channels EEG and ECG) for a total of 109 days. Primary indications for monitoring were nonconvulsive seizures in patients with altered consciousness (AC, n = 9) and control of therapy in generalized/partial status epilepticus (SE, n = 5). The cEEG findings influenced therapeutic management of patients in almost 50% of monitoring days (50/109), with decisive decisions (changes in medication) being made in 31/109 days. In 5/9 patients with AC, cEEG revealed findings that could not be demonstrated in previous EEG recordings. Identification of repetitive, nonepileptic, involuntary movements was guided by cEEG in four patients. Aside from the established application of cEEG monitoring in SE, the usefulness of clarifying the differential diagnosis in patients with AC was demonstrated particularly by the finding of nonconvulsive seizures in three patients. In two of these, intermittent EEG recordings did not demonstrate the seizures.
Adult↗
Bioisosteric replacement strategy for the synthesis of 1-azacyclic compounds with high affinity for the central nicotinic cholinergic receptors.
Bioisosteric replacement of the isoxazole heterocycle in (3-methyl-5-isoxazolyl)methylene-azacyclic compounds with pyridine, oxadiazole, or an acyl group resulted in ligands with high to moderate affinity for the central nicotinic cholinergic receptors (IC50 = 2.0 to IC50 > 1000 nM) labeled by [3H]methylcarbamylcholine. Additionally, further support of an important distance parameter for high-affinity nicotinic compounds has been provided.
Aza Compounds↗
Acute adverse reaction to fentanyl in a 55 year old man.
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Cerebral Angiography↗
Interstitial cystitis and the potential role of gabapentin.
Gabapentin, an antiepileptic agent, is a safe and versatile medication also used in the adjunctive treatment of painful disorders. These include neuropathic pain, such as postherpetic neuralgia, diabetic neuropathy, and the pain of reflex sympathetic dystrophy. Interstitial cystitis, a painful disease entity, shares many common features of these chronic pain states, and the use of gabapentin can assist in pain control. Gabapentin, as an adjunctive agent, may reduce use of cotherapeutics such as narcotics. Two patients with interstitial cystitis improved functional capacity within their activities of daily living and received adequate pain control with the addition of gabapentin to their medication regimen.
Acetates↗
Synthesis of selected aminodeoxy analogues of galabiose and globotriose.
Six aminodeoxy 2-(trimethylsilyl)ethyl (Me3SiEt) glycoside analogues of galabiose (4'- and 6'-aminodeoxy) and globotriose (6"-, 4"-, 2"-, and 6'-aminodeoxy) were synthesized by glycosylation of protected Me3SiEt galactoside and lactoside acceptors with azido-substituted monosaccharide donors, followed by reduction of the azido groups and removal of the protecting groups.
Disaccharides↗
Synthesis of some aglycon analogs of globotriosylceramide.
Seven aglycon analogs of globotriosylceramide were synthesized by glycosylation of suitable functionalized alcohols with peracetylated globotriose trichloroacetimidate, followed by further transformations of the aglycon and removal of the protecting groups.
Bacterial Toxins↗
Synthesis of selected aminodeoxy analogs of globotriosylceramide.
Four aminodeoxy analogs of globotriosylceramide (6"-, 4"-, 2"-, and 6'-aminodeoxy) were synthesized by glycosylation of 3-O-benzoylated azidosphingosine with the corresponding aminodeoxy-globotriose trichloroacetimidate, followed by reduction of the azido group, N-acylation with 1-adamantaneacetic acid, and removal of the protecting groups.
Magnetic Resonance Spectroscopy↗
The need for a veterinary antibiotic policy.
The international recognition of the 'stable to table' approach to food safety emphasises the need for appropriate and safe use of antibiotics in animal production. An appropriate use of antibiotics for food animals will preserve the long-term efficacy of existing antibiotics, support animal health and welfare and limit the risk of transfer of antibiotic resistance to humans. Furthermore, it may promote consumer confidence in the veterinary use of antibiotics. In advancing these arguments, the authors of this article argue that there is a need for a visible and operational policy for veterinary use of antibiotics, paying particular attention to the policies that are being developed in Denmark.
Animal Husbandry↗
Presence and dehydration of ikaite, calcium carbonate hexahydrate, in frozen shrimp shell.
Ikaite, calcium carbonate hexahydrate, has by means of X-ray diffraction analyses of frozen samples been identified as the mineral component of the white spots formed in the shell of frozen shrimp during storage. When the shrimp thaw and the shell material is dried and kept at room temperature, ikaite rapidly transforms into a mixture of anhydrous calcium carbonate forms. X-ray diffraction analyses and Raman spectra of synthetic ikaite as well as the dehydration product confirm the assignments, and the rate constant for dehydration is approximately 7 x 10(-)(4) s(-)(1) at ambient temperature. Differential scanning calorimetry showed that dehydration of synthetic ikaite is an entropy-driven, athermal process and confirms that a single first-order reaction is rate-determining. Ikaite is found to be stable in aqueous solution at temperatures below 5 degrees C and in the shell of frozen shrimps but decomposes on thawing to form anhydrous calcium carbonates.
Animals↗
An outbreak of Newcastle disease in free-living pheasants (Phasianus colchicus).
The epidemiology of an outbreak of Newcastle disease in a population of approximately 12,000 free-living pheasants (Phasianus colchicus) on the island of Faenø in Denmark in 1996 is described. The mortality during the epizootic was 56%. The spread of the disease between 7 groups of pheasants could be demonstrated over an observation period of 3 weeks. A total of 70 avian paramyxovirus serotype 1 (APMV-1) isolates was made from the flock. The intra cerebral pathogenicity indices of the 4 isolates tested were in the range 1.78-1.88. By means of immunoperoxidase monolayer assay with murine monoclonal antibodies and sequence analysis of an RT-PCR amplified segment of the F0 viral protein it was found, that the virus belonged to the highly virulent C1 antigenic group and that the amino acid sequence at the F0 cleavage site corresponded with the sequences of virulent APMV-1 strains. Based on the epidemiological circumstances it is believed that the virus was transmitted to the pheasants by feral birds.
Amino Acid Sequence↗