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Biomedical subjects

I Jensen

Publications and source records attributed to I Jensen.

18 recordsLinked to original sources

Sympathetic preganglionic neurons projecting to the adrenal medulla and aorticorenal ganglion in the rabbit.

The distribution of sympathetic preganglionic neurons (SPN) projecting to the adrenal medulla and the aorticorenal ganglion in the rabbit was studied using a dual retrograde transport technique. The B subunit of cholera toxin (CTB) was injected into the left adrenal medulla and wheatgerm agglutinin-apo-horseradish peroxidase-7 nm gold (WGA-apo-HRP-gold) was injected into the left aorticorenal ganglion. Retrogradely transported CTB was detected by immunohistochemistry, while gold particles were detected by silver intensification. SPN projecting to the adrenal medulla were observed in segments T2-L2 of the spinal cord in 5 rabbits, with the majority of cells within segments T6-T11 (79%). SPN projecting to the aorticorenal ganglion were seen in segments T2-L1 of the spinal cord in 5 rabbits, with the greatest number of the cells within T6-T11 (81%). Only a small number of doubly labelled cells (1%) were found in two rabbits. The results suggest that despite their similar segmental distribution SPN projecting to the adrenal medulla or the aorticorenal ganglion belong to separate populations and few, if any, individual SPN have axonal projections to both locations.

Adrenal Medulla

Metabolic effects of monomeric insulin analogues of different receptor affinity.

The effects of two monomeric insulin analogues of differing receptor affinities (human insulin = 100%) B9Asp-B27Glu-insulin (18%) and B10Asp-insulin (327%) were each compared with human insulin in two groups of 10 normal men when infused at equimolar low doses (1.0 and 2.0 pmol kg-1 min-1). The metabolic clearance rate under steady state conditions was highest for the analogue with the highest receptor affinity, 26.8 +/- 0.8 (+/- SE) vs 19.8 +/- 0.7 ml kg-1 min-1 for insulin (p less than 0.001), and lowest for the analogue with the lowest receptor affinity, 13.3 +/- 0.8 vs 25.1 +/- 2.0 ml kg-1 min-1 for insulin (p less than 0.001). The apparent plasma half-life was prolonged for the low affinity analogue compared with human insulin (12.6 +/- 0.6 vs 1.9 +/- 0.2 min, p less than 0.001), and significantly shorter for the higher affinity analogue (1.6 +/- 0.1 vs 3.1 +/- 0.4 min, p less than 0.05). The three insulins gave similar falls in blood glucose, non-esterified fatty acids, glycerol, and total ketone bodies over the infusion period. Thirty minutes after the end of the infusion, the rise in blood glucose for the low affinity analogue was significantly less than for human insulin (0.5 +/- 0.2 vs 0.9 +/- 0.1 mmol l-1, p less than 0.05). Despite different receptor affinities, these analogues have similar in vivo effects in normal men, but the time-course of their actions may differ when they are infused intravenously.

Adult

Bacterial contamination of air and surgical wounds during joint replacement operations. Comparison of two different types of staff clothing.

Compared with conventional surgical clothing, polypropylene coveralls reduced the bacterial contamination of the air of a conventionally ventilated operating room by 62%. The contamination of surgical wounds during joint replacement was also reduced, but not to a significant degree. Sixteen percent of the bacteria sampled from the wounds were resistant to the prophylactic antibiotic and the importance of a clean air system for performing joint replacement operations is stressed. The use of commercially available non-woven swabs for sampling bacteria from the surgical wound compared favourably with the use of specially prepared velvet pads.

Air Microbiology

In vitro and in vivo potency of insulin analogues designed for clinical use.

Analogues of human insulin designed to have improved absorption properties after subcutaneous injection have been prepared by recombinant DNA technology. Five rapidly absorbed analogues, being predominantly in mono- or di-meric states in the pharmaceutical preparation, and a hexameric analogue with very low solubility at neutral pH and slow absorption, were studied. Receptor binding assays with HEP-G2 cells showed overall agreement with mouse free adipocyte assays. Two analogues, B28Asp and A21Gly + B27Arg + B30Thr-NH2, had nearly the same molar in vitro potency as human insulin. Another two showed increased adipocyte potency and receptor binding, B10Asp 194% and 333% and A8His + B4His + B10Glu + B27His 575% and 511%, while B9Asp + B27Glu showed 29% and 18% and the B25Asp analogue only 0.12% and 0.05% potency. Bioassays in mice or rabbits of the analogues except B25Asp showed that they had the same in vivo potency as human insulin 1.00 IU = 6.00 nmol. Thus the variation had the same in vivo potency as human insulin 1.00 IU = 6.00 nmol. Thus the variation in in vivo potency reflects the differences in receptor binding affinity. Relative to human insulin a low concentration is sufficient for a high affinity analogue to produce a given receptor complex formation and metabolic response. In conclusion, human insulin and analogues with markedly different in vitro potencies were equipotent in terms of hypoglycaemic effect. This is in agreement with the concept that elimination of insulin from blood and its subsequent degradation is mediated by insulin receptors.

Adipose Tissue

Water intoxication after oxytocin-induced midtrimester abortion.

Two cases of water intoxication assoicated with midtrimester induction of abortion with oxytocin are presented. Both patients recovered from this potentially fatal condition which is associated with acute hyponatraemia. Some of the pertinent literature is reviewed and the possible mechanisms of causation and measures for prevention and treatment are discussed.

Abortion, Induced

Psychoses in drug-resistant temporal lobe epilepsy.

In the survey of 74 Danish patients with temporal lobe epilepsy who underwent temporal lobectomy, a total of 20 patients were psychotic. Nine of these became psychotic during the follow-up period, six of them after cessation of their epileptic seizures. There were 13 schizophrenia-like psychoses, six paranoid delusional and depressive psychoses, and one childhood psychosis. Operation was on the right side in 39 and on the left side in 35 patients. When the various psychotic groups were compared with each other or with the nonpsychotic patients, the side of operation was not found to be statistically important. The patients with psychoses were older at operation and showed a higher rate of focal lesions in the resected specimens. Although more psychotic patients were bright or normally gifted, and had achieved a higher standard of schooling than nonpsychotic patients, their social status after operation was inferior. Surgery had no effect on psychosis present preoperatively nor on its possible postoperative onset. The diagnosis of psychosis was not considered to be contraindication to temporal lobectomy.

Age Factors

Mental aspects of temporal lobe epilepsy. Follow-up of 74 patients after resection of a temporal lobe.

Psychiatric disorders were investigated in 74 patients with drug-resistant temporal lobe epilepsy (complex partial epilepsy). In all cases unilateral anterior temporal lobectomy had been performed during the period 1960-69. At follow-up in 1970-71, 45 patients were free from seizures, and in a further group of 15 patients seizure frequency had been substantially reduced. There were four postoperative deaths. Six patients were psychiatrically normal and had no history of any such disorder. Behavioural disturbances were observed in 55 patients. Before operation 11 patients displayed schizophrenia-like psychoses, and nine others became psychotic during follow-up. Fourteen patients attempted suicide on one or more occasions. Half the patients had diminished sexual drive. Improvement in psychiatric status was clearly correlated with relief from seizures and, in those cases with only a few or no seizures after operation, led directly to social rehabilitation. The presence or absence of a psychiatric disorder was not useful as a criterion for or against surgery.

Adolescent

Endemic amoebic abscess.

An unusual case of endemic amoebic abscess of the liver in a New Zealand is presented. The clinical manifestations and treatment are discussed.

Adult

Temporal lobe epilepsy. Follow-up investigation of 74 temporal lobe resected patients.

This survey covers 74 patients with temporal lobe epilepsy, resistant to medication, who underwent unilateral temporal lobectomy during the years 1960-1969 at Rigshospitalet, Copenhagen. Preoperatively all patients were socially incapacitated. In all patients a unilateral or predominantly unilateral temporal EEG focus was found. No tumour or gross vascular malformation had been recognized before or during operation. At follow-up 45 patients were free from seizures. A further 15 had obtained a reduction in their seizure frequencies by at least 75%, while the remaining 10 survivors, only obtained a slight improvement or remained unchanged. There were four deaths. The operation also favourably influenced the psychiatric status, which was found closely related to relief from seizures. Prognostically favourable factors were: i) preoperative presence of a single type of seizure, ii) duration of epilepsy of less than four years, iii) operation in or before early adulthood, iv) an anterior temporal or sphenoidal electrode focus, or both, on the EEG. The prognostically unfavourable factors regarding complete relief from seizures were: i) preoperative presence of grand mal, ii) age at onset of epilepsy or of the first grand mal seizure between 5 and 19 years of age, iii) preoperative duration of epilepsy of over ten years and of grand mal of over one year. Prognostically unfavourable factors regarding psychiatric normalization were: i) preoperative presence of psychosis, ii) ictal-affective attacks or automatisms of a complex nature, iii) impairment of intellectual functions. The eventual neuropathological conclusion was that the more specific and circumscribed the histological abnormality the better the final outcome. The social rehabilitation was found to be significantly improved by operation at an early age.

Adolescent

Temporal lobe epilepsy. Etiological factors and surgical results.

Seventy-four patients with temporal lobe epilepsy, resistant to medication, who in 1960-1969 underwent unilateral temporal lobe resection at Rigshospitalet, Copenhagen. In only 12 patients was no etiological factor found. In three-quarters of the patients a peri- or postnatal injury was the suspected etiology of the epilepsy; and in one-third, a history of complications in the actual and/or abnormal outcome of a previous pregnancy was recorded. Only seven patients had experienced febrile convulsions. Patients with certain combinations of etiological factors, including encephalitis, have a poor prognosis regarding relief from seizures. Patients in whom an abnormal outcome of the mother's previous pregnancies is recorded have a poor prognosis as regards psychiatric normalization. Apart from this no correlation has been found between the surgical results and the numbers or types of the various etiological factors.

Birth Injuries

Temporal lobe epilepsy: types of seizures, age, and surgical results.

Types of seizures, age at onset of epilepsy, preoperative duration of epilepsy, and age at operation were studied in the literature and in 74 patients who underwent unilateral temporal lobe resection in 1960-1969 in Denmark. The medical and surgical series were compared. The age at onset was significantly lower in the surgical series. Prognostically favourable factors were: i) preoperative presence of a single type of seizure; ii) duration of epilepsy of less than 4 years, and in grand mal epilepsy of less than 1 year; iii) operation for epilepsy in or before early adulthood. Prognostically unfavourable factors were i) preoperative presence of grand mal; ii) age at onset of epilepsy or of the first grand mal seizure between 5 and 20 years; iii) preoperative duration of psychomotor epilepsy over 10 years.

Adolescent

Temporal lobe epilepsy and neuropathology. Histological findings in resected temporal lobes correlated to surgical results and clinical aspects.

Neuropathological findings were studied in 74 patients with drug-resistant temporal lobe epilepsy who underwent unilateral temporal lobe resection in 1960-1969 in Denmark. In 60 per cent of the patients a well-defined neuropathological abnormality was revealed (i.e. 13 cases of focal lesions, including four small tumours, 21 cases of gliosis, and 10 cases of perivascular infiltration), in 23 per cent the findings were either questionably abnormal or without structural abnormality, while in the last 18 per cent sequelae of a previous operation dominated the histology. The general trend was for the postoperative clinical outcome to be better, the more specific and circumscribed the histological abnormality. There was no correlation between the neuropathological findings and the preoperative types of seizures. Postoperative recurrence of seizures was more often observed in patients with gliosis than in those with other histological diagnoses. A positive correlation existed between a history of cerebral infection and the presence of perivascular lymphocytic and histiocytic infiltration, and gliosis was a frequent finding in patients with epilepsy of unknown aetiology. No other significant correlation was found between the neuropathological abnormalities and the clinical, hereditary, aetiological, and social aspects.

Adolescent

Temporal lobe epilepsy. Social conditions and rehabilitation after surgery.

A social investigation was performed of 74 patients with temporal lobe epilepsy resistant to medication, who underwent unilateral temporal lobectomy 1960-1969. The patients were compared to their sibilings and to the general population in Denmark. Comparatively many patients were born out of wedlock. The level of schooling achieved was lower than expected, and this was most pronounced in patients with an early onset of epilepsy. The number of patients having received further education was also smaller than calculated. At the time of the operation all patients were socially incapacitated by their epilepsy; this was most pronounced in males, of whom 30 per cent were institutionalized and 32 per cent were receiving disablement pension; at follow-up the figures were 6 per cent and 52 per cent, respectively. Working capacity was markedly improved postoperatively, and at follow-up 39 per cent were in full-time employment. Relief from seizures (or almost complete relief), normal intelligence, normal psychiatric status, and operation before the age of 18 years were factors which favourably influenced the postoperative working capacity. The majority of the patients were unmarried or divorced, and few of the group had children. Their housing conditions were inferior to those of their siblings and of the general population. Parental social class distribution showed an excess in the highest and lowest social classes compared to the Danish population. The patients were subjected to downward social mobility, presumably caused by their illness, as their siblings displayed an upward mobility, which was most marked in the females.

Criminology

Temporal lobe epilepsy and neuro-ophthalmology. Ophthalmological findings in 74 temporal lobe resected patients.

A survey is presented of the ophthalmological findings in 74 patients with drug-resistant temporal lobe epilepsy, who underwent unilateral anterior temporal lobectomy 1960-1969 at Rigshospitalet, Copenhagen. At follow-up, 1970-1971, one to ten years following the operation, 81% of the patients had no or only few seizures. Preoperatively 11% of the patients suffered from strabismus as compared to an expected frequency of 5%, but this trend just falls short of statistical significance. The visual acuity remained unchanged in all patients following the operation. Preoperatively a visual field defect was observed in 2 patients. At follow-up 51 patients had homonymous hemianopias, in 38 of them this was limited to the upper quadrants, and in 13 patients also included the lower quandrants, but was characterized as a total homonymous hemianopia in only 6 patients. The presence and extent of the visual field defects were correlated to surgical results, age at onset of epilepsy, age at operation, preoperative duration of epilepsy, presence of grand mal, preoperative complications, and neuropathological findings, but without observing any statistically significant conclusions. On the other hand, the extent of the postoperative visual field defect was significantly influenced by the side of the operation, with more and larger defects following right-sided lobectomies. In the 51 patients with postoperative hemianopias, this defect was either unobserved by the patient or regarded as a considerably less important handicap than the frequent and socially invalidating preoperative seizures...

Adolescent