Biomedical subjects
J B Jørgensen
Publications and source records attributed to J B Jørgensen.
Immunostimulatory CpG oligodeoxynucleotides stimulate expression of IL-1beta and interferon-like cytokines in rainbow trout macrophages via a chloroquine-sensitive mechanism.
Synthetic oligodeoxynucleotides (ODNs) containing unmethylated CpG motifs are known to stimulate immune responses and are potent adjuvants in higher vertebrates, but so far the effects in fish are poorly described. We here report that CpG ODNs induce IL-1beta expression and production of interferon-like cytokines in rainbow trout head-kidney macrophages, whereas ODNs with an inverted motif (GpC) have a much less stimulatory effect. We further demonstrate that endosomal maturation is essential for CpG signalling, as chloroquine, a compound known to block endosomal acidification, inhibits cytokine expression in the macrophages.
CpG oligodeoxynucleotides and plasmid DNA stimulate Atlantic salmon (Salmo salar L.) leucocytes to produce supernatants with antiviral activity.
Unmethylated CpG dinucleotides are more frequent in the genomes of bacteria and viruses than of vertebrates. We report herein that plasmid DNA and synthetic oliogodeoxynucleotides (ODNs) containing unmethylated CpG induce production of antiviral cytokine activity in Atlantic salmon leucocytes, whereas ODNs with an inverted motif (GpC) or with methylated cytosines have nearly no stimulatory effect. The adherent cell population, representing mainly macrophages, is directly activated by CpG-ODN, while the effect on the non-adherent population is weak. Since the peak antiviral activity in ODN-stimulated leucocytes is seen after 48h, this might indicate that the unmethylated DNA stimulates the adherent cells to produce co-stimulatory molecules, which in turn stimulates production of antiviral cytokines in the non-adherent cell population. The potent immune activation by CpG ODNs points to possible new applications as adjuvant in fish vaccines.
Is bladder outlet obstruction normal in elderly men without lower urinary tract symptoms?
The aim of the present study was to correlate basic voiding parameters, including uroflowmetry, symptom score, and residual urine volume with the results of pressure-flow studies applying the Abrams/Griffith nomogram, in a series of urologically asymptomatic elderly men. Twenty-nine consecutive male volunteers (median age, 66 years) without past or present urological complaints participated. Fifteen (52%) of the 29 subjectively normal men proved to have bladder outlet obstruction (BOO). Qmax <10 mL/s had a positive predictive value of 100% in diagnosing obstruction, whereas the predictive information of higher flow rates proved very modest. No significant difference existed between obstructed and unobstructed persons at any cutoff value concerning symptom score. The sensitivity as well as the positive predictive value of a residual urine volume >50 mL was zero. It is concluded that a surprisingly high prevalence of BOO in asymptomatic elderly men was demonstrated and that the correlation between pressure flow investigations and alternative diagnostic tests, i.e., flow rate, symptom score, and residual volume was weak in this group of men. It is suggested that a possible explanation for the high frequency of BOO observed in the evaluated asymptomatic men could be that the values defining obstruction have been set too low. Neurourol. Urodynam. 18:545-552, 1999.
[Waiting lists for men with benign urinary disorders].
This paper reflects the problems in having a large non-specific waiting-list. One hundred and twenty-eight patients were on a waiting-list under the main diagnosis of prostatism. This diagnosis revealed seven patients with cancer in the urinary tract system. Only two-thirds of the patients on the waiting-list were interested in further examination and treatment. This paper emphasizes the need for a more specific referral, when dealing with symptoms from the lower urinary tract system.
Uroflow in women: an overview and suggestions for the future.
The literature on uroflowmetry in women is presented and evaluated. Uroflowmeters are described and found generally sufficiently accurate, although the errors arising from electronic evaluation may invalidate the test. Six flow curve patterns are proposed in accordance with described pathological conditions. From the literature it is summarized that the normal Qmax is 20-36 ml/s. Qmax is linearly correlated to the voided volume, increasing by 5.6 ml/s/100 ml. Pregnancy, age and menstrual cycle do not influence Qmax. Several pathological conditions have been associated with specific flow curve patterns. These conditions are described and associations with the proposed flow definitions made.
Home uroflowmetry by means of the Da Capo home uroflowmeter.
OBJECTIVE: The Da Capo home flowmeter was tested versus the Urodyn 1000 flowmeter. The two flowmeters are based on different principles. The Da Capo is a portable, battery powered flowmeter designed to record all voidings during a period of time (e.g. 24 h) for a single patient. METHODS: The flowmeters were tested with regard to accuracy of measurement of the voided volume and maximum flow (Qmax). Further, the Da Capo was tested by 10 healthy male volunteers, median age 47 years, range 21-57. RESULTS: Both flowmeters were very accurate measuring Qmax and voided volume. A few artifacts arose, i.e. extremely high Qmax values were recorded. All test persons found the flowmeter easy to handle. CONCLUSION: The weight transducer based Da Capo home flowmeter proved as accurate as the stationary flowmeters. It is easy to handle and it provides all-day monitoring of uroflow and voided volume.
Uroflowmetry.
Uroflowmetry is a widely used noninvasive screening modality for patients who present with symptoms of lower urinary dysfunction. However, it should be recognized that uroflowmetry represents the compound effect of bladder and urethral function because it may easily be misinterpreted. In elderly men with "prostatism", uroflowmetry is often sufficient to indicate treatment, while the value in women is less prominent. In pediatrics, more sophisticated urodynamic testing is crucial.
Long-term probability of prostatism vs general morbidity and mortality. Prospectively obtained data in a randomly selected cohort aged > 50 years.
In a 7-year study of 178 randomly selected healthy men older than 50, data were respectively obtained concerning treatment for benign prostatic hypertrophy (BPH) and overall morbidity and mortality. Plain symptom scores were calculated in all cases and urinary voiding was recorded in 112. The maximum flow rate was read and the pattern of flow curve determined. Log rank test and survival curves were used in evaluation of results. The general risk of death or disease overshadowing BPH greatly exceeded the probability of surgery for prostatism. The only factor predicting need for prostatectomy was a symptom score higher than 6 points. If the symptom score is low and indications for treatment are otherwise, relative, an expectant attitude to surgery for BPH is advocated.
Longitudinal observations on normal and abnormal voiding in men over the age of 50 years.
A cohort of 200 men over the age of 50 years was selected at random. Initially 112 men participated. After 5 years 61 were participating, and 2 years later 34 men still had no voiding problems, while 19 had had treatment for prostatism. A history was obtained and all 112 had symptom analysis and uroflow examination. The uroflow variables Qmax, Qave, Qmax-time, Q "corrected", volume and the ratio Qmax/Qmax-time were recorded together with the symptom score and subjective evaluation. After 5 and 7 years all primary data were reviewed in the 61 and 34 men respectively, while a full history was obtained in the rest. The 3 sets of data were evaluated separately as 3 cross-sectional investigations and as paired data sets by means of non-parametrical statistical analysis. Comparing the 3 sets of data longitudinally, significant differences were found in Qmax, Qave, Qcor and Acc. A correlation analysis showed that Qmax, Qave, Q "corrected" and volume decreases significantly with advancing age in asymptomatic men, while no correlation with age was found in the 19 treated men. On the basis of the 93 men, untreated for 7 years, nomograms of Qmax, Volume and Acc were constructed using 2.5, 25, 50, 75 and 97.5% percentiles in 5-year groups. Likewise, a nomogram on symptom score was constructed on the basis of the 82 men, asymptomatic and untreated for 7 years. In conclusion, uroflow in subjectively normal men over the age of 50 years shows increasing abnormality with advancing age. At the same time elderly men tolerate a considerable amount of symptoms of infravesical obstruction. The severity of symptoms increased with advancing age, but differently in persons likely and not likely to need operation.
Mechanical versus visual evaluation of urinary flow curves and patterns.
Flow curves from 100 consecutive patients were obtained using the Urodyn 1000 mictiograph. Four observers evaluated the flow curves blindly, i.e. without access to the mechanically estimated values. Further, the flow curve pattern was decided upon in each case. The 4 observers agreed very meticulously in the evaluation while they disagreed with the mechanically obtained results. The visually read values were significantly lower than the mechanically determined ones. At the same time the difference in Qmax was most pronounced in abnormal curves. In conclusion the mechanical evaluation of uroflow curves may be misleading and should not replace the visual evaluation.
Age-related variation in urinary flow variables and flow curve patterns in elderly males.
A group of randomly selected males, over 50 years of age, was examined with regard to history and urinary flow rate. Originally, the group had comprised 93 men without voiding problems, 15 who, although suffering from voiding problems, had not yet contacted their doctor, and 4 who had contacted their doctor because of voiding problems. Five years later the data were re-examined and 61 men were fully investigated again; in the remaining 51 patients only the history was updated. The 2 sets of data were evaluated separately as 2 cross-sectional investigations and as paired data sets by means of non-parametric statistical analysis. All uroflow variables were considered, i.e. Qmax, Qave, Qmax-time, Q "corrected", volume and the ratio Qmax/Qmax-time. In addition, the flow curve configuration was classified as normal or abnormal. When compared as 2 cross-sectional investigations, the latter confirmed the results of the first. Qmax, Qave, Q "corrected" and volume decreased with advancing age, but no correlation could be demonstrated between Qmax-time and age. The flow curve pattern altered, so that a normal flow curve was seldom seem at an advanced age. Uroflow variables tended towards the abnormal with advancing years and symptoms increased concurrently. These changes were largely accepted by the elderly males. Thus the decision to operate for benign prostatic hyperplasia should be based on both history and urinary flow.
Tooth and bone development in a Danish medieval mandible with unilateral absence of the mandibular canal.
A Danish anthropological collection of medieval human skeletons excavated in 1986 involves a mandible (No. 212) from an adult female born without the lower alveolar nerve and mandibular canal. It is believed that the defect has resulted in lack of tooth development on the affected side and that the mylohyoid nerve has partially compensated for this defect by development of teeth in localized areas. The defective mandibular dentition has caused a compensatory development of the alveolar process in the maxilla. The missing occlusal support has altered muscular traction on the mandible. This has caused an alteration in mandibular shape. Whether the asymmetric development of the mandible is caused by muscular dysfunction, by failure in angular growth apposition, or by a combination of these factors is discussed. The case presents valuable data in the ongoing discussion about the interaction between nerve tissue and tooth formation and about the interaction between occlusion, jaw morphology, and muscular traction. The study shows how archeological material in an interdisciplinary cooperation between archeological, embryological and orthodontic research can contribute to the clarification of current biological problems.
Crossed immunoelectrophoretic analysis of Mycobacterium paratuberculosis.
Antigenic analysis of M. paratuberculosis revealed extensive cross-reactivity with M. avium; however, the number of cross-reactive antigens found was dependent on the strain of M. avium tested. One antigen was shown to be the common antigen while another appeared to be iron-regulated in its production. A commercial polyclonal antibody to M. paratuberculosis produced a CIE precipitin pattern comparable to that of the antibody produced for the present study. An antigen designated no. 6 was consistently precipitated by sera from cattle infected with M. paratuberculosis. This antigen exhibited complete cross-reaction with M. avium and partial cross-reaction with M. phlei. Among three commercially available complement fixation (CF) antigen that could be precipitated by M. paratuberculosis antibodies. A commercial antigen for use in an agar gel immunodiffusion test for Johne's disease diagnosis produced 12 precipitins with the M. paratuberculosis antibody, one of which was identical with antigen 6.
Intestinal and pulmonary mycotic lymphadenitis in cattle.
Among 4877 slaughtered cattle with tuberculosis-like lesions in lymph nodes, 94 cases (1.9 per cent) revealed fungal hyphae on histopathological examination. The survey period was 12 years and most of the affected animals (greater than 77 per cent) were beef cattle. Affected nodes were mesenteric in 84 cases (89.4 per cent), mediastinal and/or bronchial in seven cases (7.4 per cent), and in three cases (3.2 per cent), both mesenteric and mediastinal nodes were affected. The incidence of mycotic lymphadenitis was unrelated to year of study or season. Eighty-two of the cases were re-examined histologically and immunohistochemically. All lesions were granulomatous in nature and, in 26 cases, eosinophilic asteroid bodies (rosette formation) around hyphae were found. In 75 cases, immunofluorescence staining identified the agent as a zygomycete, probably Absidia corymbifera and, in one case, there was a concurrent infection with a Candida species. In seven cases that did not react with the antibodies employed, a diagnosis of zygomycosis was suggested on the basis of hyphal morphology. Hyphae of Aspergillus spp. were not found in any of the lesions. A concurrent fungal and mycobacterial infection (M. avium) was diagnosed in one case. Thus, zygomycetes are the main cause of macroscopically apparent mycotic lymphadenitis, a sporadic disease most probably caused by feeding with mouldy food stuffs.
Significance of predominantly irritative symptomatology before a prostatic operation.
The prognostic value of an excess of preoperative irritative symptoms of prostatism was evaluated. The prospective study included 139 men treated for benign prostatic hyperplasia who were evaluated by symptom analysis, uroflowmetry, water cystometry and pressure-flow study preoperatively and 6 months postoperatively. The criterion for evaluation of postoperative success or failure was the subjective evaluation of the patient at 6 months. None of the single preoperative symptoms of prostatism predicted an eventual postoperative failure, nor did the preoperative predominance of irritative symptoms or the combination of irritative symptoms and detrusor instability attain prognostic significance.
Pulmonary mycosis in farmed deer: allergic zygomycosis and invasive aspergillosis.
During 1988, pulmonary mycosis was diagnosed in four of 116 farmed deer examined on suspicion of tuberculosis. The histopathology showed allergic bronchopulmonary mycosis in a red deer (Cervus elaphus) and the agent was identified as a zygomycete, probably Absidia corymbifera, by immunofluorescence staining. Three fallow deer (Dama dama) had invasive necrotizing mycotic pneumonia and progressive exudative mycotic alveolitis caused by Aspergillus fumigatus. In the red deer, weakness due to paratuberculosis had probably promoted the mycotic infection. The three fallow deer were bred on another farm, where predisposing factors included mouldy straw and incorrect management.
Trepanation as a therapeutic measure in ancient (pre-Inka) Peru.
Three cases of probably therapeutically intended trepanations of cranial fractures in ancient Peru are presented and discussed.