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Biomedical subjects

H Jans

Publications and source records attributed to H Jans.

At least 19 recordsLinked to original sources
PubMed1997

Abnormal bone turnover in monoclonal gammopathy of undetermined significance: analyses of type I collagen telopeptide, osteocalcin, bone-specific alkaline phosphatase and propeptides of type I and type III procollagens.

The main difference between monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) is the presence of lytic bone destructions in the latter. About 20% of MGUS patients develop MM, and histomorphometric studies have shown disturbed bone turnover rates in some of these patients. This study was performed in order to evaluate whether serum analyses of the C-terminal telopeptide of type I collagen (ICTP), as a reflector of bone degradation, and of osteocalcin, bone-specific alkaline phosphatase (bAP) and the C-terminal propeptide of type I procollagen (PICP), as markers of bone formation, might give information on disturbances of bone metabolism in MGUS. Furthermore, serum N-terminal propeptide of procollagen III (PIIINP) might give information on disturbances in collagen III metabolism in the bone marrow. In the 35 patients examined, serum ICTP was elevated in 12 patients (34%), serum PIIINP elevated in 6 patients (17%), serum osteocalcin elevated in 11 patients (31%), serum bAP elevated in 6 patients (17%), and serum PICP elevated in 4 patients (11%). Serum ICTP correlated significantly with PIIINP (r = 0.72, p < 0.001), and with serum osteocalcin (r = 0.57, p < 0.001) and serum bAP (r = 0.51, p = 0.002). These findings indicate disturbances of bone turnover and affected collagen metabolism in some MGUS patients. Follow-up observation may reveal any prognostic value of these findings.

Aged↗
PubMed1995

[Infectious mononucleosis and the risk of splenic rupture].

Infectious mononucleosis is a common and benign disease, affecting mainly teenagers and young adults. Patients with IM are often generally advised to restrain from physical exertion for a period of 6 months. We report one case of splenic rupture in a patient with IM which required emergency laparotomy and splenectomy and one case of splenic rupture which was managed with conservative treatment. We have retrospectively examined the 37 cases of IM admitted during the period 1990-1994 and found that liver function tests return to normal within eight weeks. We therefore advise that patients with IM and no abdominal discomfort should limit their physical activity during eight weeks of convalescence. Patients with IM and abdominal pain should be further examined, using imaging procedures.

Adolescent↗
PubMed1994

[Occupational injuries with risk of transmission of blood-borne pathogens. A study of a 2-year material from the Holstebro Central Hospital].

In order to illuminate causes of accidental occupational exposure of the house staff at the Central Hospital of Holstebro (CHH) to the potential hazards of HIV- and HBV-transmission, all cases of reported injuries occurring in 1991-1992 have been analysed. Needleprick lesions were found to account for the great majority of the reported cases (71%). Sixty-six percent of all injuries were self-inflicted during medical procedures, while 34% were caused by another person, either directly (simultaneous contact of two persons with the contaminated sharp object) or indirectly as a result of carelessness or negligence. Seventy-two percent of the analysed exposures could have been avoided if the staff had complied with Universal Precautions recommended since 1988. In order to estimate the amount of unreported cases, all nurses and laboratory technicians currently employed at CHH were asked to complete an anonymous questionnaire reviewing their past (1991-1992) mucocutaneous and percutaneous exposures to blood or body fluids. Only 28% of the injuries recalled by the subjects had been reported. If the risk of occupational transmission of blood-borne diseases is to be minimized, additional effort must be made to clarify the principles of the Universal Precautions policy. It is of great importance that all injuries are reported by way of an easy reporting procedure which is efficient and familiar to the staff at any time.

Accidents, Occupational↗
PubMed1992

Cobalamin binding proteins in patients with HIV infection.

P-Cobalamins have been reported to be decreased in patients with HIV infection. Because of this, we found it of interest to examine both cobalamin-saturated binding proteins (holo-transcobalamin, holo-TC and holo-haptocorrin, holo-HC) and cobalamin unsaturated binding proteins (apo-transcobalamin, apo-TC and apo-haptocorrin, apo-HC). The results are given as range and (median). Eighteen male HIV-infected patients with plasma cobalamins below 200 pmol/l were studied. We found low concentrations of holo-TC (37-88 (47.5) pmol/l) and holo-HC (64-184 (135.5) pmol/l). The concentration of apo-TC and apo-HC was increased (480-1730 (1025) pmol/l; 70-800 (235) pmol/l). It is concluded that, in HIV-infected patients, low plasma cobalamin does not reflect a low concentration of transcobalamin or haptocorrin. In 20 HIV-infected patients and 31 patients with malignant haematological diseases, the TC isopeptide patterns were determined. In the HIV group, an increased frequency of TC isopeptide X was found and the overall distribution of TC isopeptides was significantly different from the reference population (p less than 0.05). There was no difference between the group of patients with malignant haematological diseases and the reference group.

Adult↗
PubMed1991

Nonlinear dynamic behavior of the human knee joint--Part I: Postmortem frequency domain analyses.

Characteristics results of postmortem experiments on five knee-joint specimens are reported. The experiments were performed to investigate the applicability of a local linearization technique that would make it possible to describe the dynamic behavior of the joint in terms of transfer functions. The results indicate that the stiffness of the bracing wires, attached to muscle tendons to create a static equilibrium position, can be accounted for when determining the stiffness of the joint. Besides the static equilibrium configuration, the magnitude of the dynamic load and the type of dynamic load applied to the joint can be shown to have their influence. As the influence of the dynamic load is significant, it has to be concluded that in essence the knee joint has to be regarded as a nonlinear system, making application of a Local Linearization Technique questionable. However, when the magnitude of the dynamic load is included as an additional measurement parameter, an indication can be obtained about the behavior of the joint and the degree of nonlinearity.

Biomechanical Phenomena↗
PubMed1991

Nonlinear dynamic behavior of the human knee joint--Part II: Time-domain analyses: effects of structural damage in postmortem experiments.

A description is given of the results obtained for step excitation for two human knee joint specimens using a time-domain analysis technique. As was expected from the results of a previous study, the magnitude of the dynamic load applied has a marked influence upon the stiffness and damping values for the two observed vibration modes. Deliberate damaging of selected joint elements also yields a well observable change in the dynamic behavior of the joint although these changes are difficult to interpret. Here the use of a nonlinear dynamic numerical model of the knee joint seems indispensable. An important observation is, however, that the experimental method discussed here enables to quantify the behavior of the joint and therefore may provide a valuable tool for validation of such a model.

Anterior Cruciate Ligament↗
PubMed1991

Aclarubicin plus cytosine arabinoside versus daunorubicin plus cytosine arabinoside in previously untreated patients with acute myeloid leukemia: a Danish national phase III trial. The Danish Society of Hematology Study Group on AML, Denmark.

A regimen of aclarubicin (ACR) of 75 mg/m2 daily for 3 days plus a continuous intravenous infusion of cytosine arabinoside (ara-C) of 100 mg/m2 per day for 7 days was compared with daunorubicin (DNR) 45 mg/m2/day for 3 days plus ara-C for 7 days as first-line chemotherapy of de novo acute myeloid leukemia (AML) in a randomized, nationwide Danish study. A total of 180 patients aged between 17 and 65 years were entered onto the protocol. Patients who achieved complete remission (CR) were given five courses of intensive consolidation therapy consisting of two courses of high dose ara-C, two courses of amsacrine plus etoposide, and one course of DNR plus ara-C. Of 174 evaluable patients, 99 achieved CR. The rate of CR was significantly higher on ACR plus ara-C than on DNR plus ara-C [66% versus 50% (p = 0.043)] and decreased significantly with increasing age. The hematological toxicity was identical for the two regimens. A total of 83 patients entered consolidation therapy. At 4 years, 37% of patients with CR following ACR were still in remission compared with 33% following DNR (p = 0.48), and the total survival at 4 years was 29% versus 20% (p = 0.26). The duration of remission and total survival both decreased with increasing age. ACR plus ara-C seem at least as good or better than DNR plus ara-C as first-line chemotherapy of AML.

Aclarubicin↗
PubMed1987

A distinct subtype of idiopathic myelofibrosis with bone marrow features mimicking hairy cell leukemia: evidence of an autoimmune pathogenesis.

A young female patient presented with severe anemia and myelofibrosis. The spleen was not enlarged on clinical examination and no leukoerythroblastosis or tear-drop poikilocytosis was found. A bone marrow biopsy disclosed severe myelofibrosis and many megakaryocytes, which appeared morphologically normal. A striking feature was a heavy spongy infiltration by large lymphocytic cells, which were tartrate-resistant acid phosphatase negative and without hairy projections. This bone marrow appearance highly resembled the clear cell appearance of the hairy cell infiltrate in hairy cell leukemia. A diagnosis of acute autoimmune myelofibrosis was made. During high-dose glucocorticoid therapy the bone marrow fibrosis completely resolved and there was an improvement of peripheral blood values. The disorder is supposed to feature a distinct clinicopathological entity within the syndrome of idiopathic myelofibrosis. The disease should be considered in the differential diagnosis of patients with myelofibrosing disorders, including acute myelofibrosis and hairy cell leukemia.

Adult↗
PubMed1987

Combination of methylprednisolone pulse therapy and remission inducing drugs in rheumatoid arthritis.

Thirty patients with rheumatoid arthritis were allocated to either methylprednisolone pulse therapy or placebo at the beginning of treatment with either gold salts, penicillamine, or azathioprine. Methylprednisolone pulse therapy produced an immediate but temporary anti-inflammatory effect lasting for a maximum of four to eight weeks. It also caused a lasting depression of serum IgG, but no effect was observed on the proportion of T and B lymphocytes, proliferative responses, or on concanavalin A induced suppressor cell activity, and there was no effect on the amount of circulating immune complexes. The bone mineral content decreased similarly in the two groups, and methylprednisolone pulses had no effect on the progression of erosions on x rays during an observation period of eight months. A single pulse of methylprednisolone can give a short lasting anti-inflammatory effect but is of little or no value in the long term treatment of rheumatoid arthritis.

Adult↗
PubMed1986

Sprouting and nerve retraction in frog neuromuscular junction during ontogenesis and environmental changes.

Based on recent evidence for a physiological remodeling of neuromuscular contacts (Wernig et al.), a morphometric study was performed on axon- and cholinesterase-stained cutaneous pectoris muscle of frog. The aim of this investigation was to separate changes due to aging, growth, and environmental conditions. Within a single muscle, fiber diameters, synaptic lengths, number of intraterminal branches, and lengths of abandoned gutters differ considerably (with coefficients of variation from 40 to 56%). On the other hand, these parameters are correlated and correlations hold when muscle fibers grow during ontogenesis: large muscle fibers bear larger and more complex junctions than small fibers. Obviously there exist growth regulating interactions between muscle fiber and the presynaptic nerve. To dissociate between age- and growth-related changes muscle fibers of equal diameters in frogs of different age are compared. With increase in age there is an additional increase in abandoned gutters, synaptic length, and complexity independent of muscle fiber growth. Possibly, abandoned gutters accumulate with time and synaptic length increases with age as the net outcome of continual synapse remodeling. When freshly caught frogs (October) were compared with frogs kept under laboratory conditions for a period of 16 weeks (which in addition included a change in season) the number of sprouts in a junction increased by about 2, the average length of presynaptic nerve terminals with small circumscribed contacts increased by 30-150 microns, and abandoned gutters tended to be shorter on fibers with large junctions. The hypothesis is discussed that remodeling is "inherent" to nerve terminals whereby sprouting is counterbalanced and reversed by nerve activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1984

Red blood cell membrane-bound IgG: demonstration of antibodies in patients with autoimmune haemolytic anaemia and immune complexes in patients with rheumatic diseases.

Immunoglobulin G (IgG) bound in vivo to the surfaces of red blood cells (RBC-IgG) was quantificated by an enzyme-linked immunosorbent assay (ELISA) using the cells themselves as solid phase. The method was applied on RBC from normal subjects, patients with autoimmune haemolytic anaemia (AIHA) and rheumatoid patients with and without circulating immune complexes (CIC). Small amounts of RBC-IgG were detected in normal subjects and rheumatoid patients without CIC. Fifteen out of 16 patients with AIHA had increased RBC-IgG indicating RBC sensitization with IgG antibodies, although only eight patients had a positive direct antiglobulin test (DAT) with anti-IgG. Ten out of 13 rheumatoid patients with a negative DAT and with CIC had increased RBC-IgG suggesting RBC C3 receptor-bound IC. The results provide background for further studies of the significance of RBC-IgG in health and disease.

Anemia, Hemolytic, Autoimmune↗
PubMed1984

Immune complexes and the complement factors C4 and C3 in cerebrospinal fluid and serum from patients with chronic progressive multiple sclerosis.

Immune complexes (IC) have been found in both serum and cerebrospinal fluid (CSF) in multiple sclerosis (MS). The complement system is known to play a major role as a mediator of inflammation in immune complex disease. Therefore, we have investigated paired samples of serum and CSF from 32 patients with progressive MS for IC, the levels of the complement factors C4 and C3, and presence of their activation products (AP). IC was found in serum from 17 of the 32 MS patients (53%) and in CSF from 9 of 31 MS patients (29%). No correlation was found between the occurrence of IC in serum and in CSF. The levels of C3 in serum and CSF from the MS patients did not differ from the levels in a control group, whereas the levels of C4 in MS-serum were elevated and the C4 levels in MS-CSF reduced. A low level of CSF-C4 correlated significantly to the occurrence of CSF-IC. AP of C4 and C3 in serum were seen in 11 of the 32 patients (34%), appearing significantly more frequently among patients with circulating IC. No C4- or C3AP could be identified in CSF.

Adult↗