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Biomedical subjects

J Frandsen

Publications and source records attributed to J Frandsen.

7 recordsLinked to original sources

Dynamic changes in corticospinal tracts after stroke detected by fibretracking.

BACKGROUND AND AIMS: The integrity of motor pathways and functional connectivity patterns are important in assessing plastic changes related to successful recovery, to obtain prognostic information and to monitor future therapeutic strategies of stroke patients. We tested the following hypotheses: (1) that changes in axonal integrity along the corticospinal tract after stroke can be detected as a reduction in fractional anisotropy; and (2) that sustained low fractional anisotropy is indicative of axonal loss and therefore is correlated with poor motor outcome, as measured by specific neurological motor scores. METHODS: We developed a segmentation tool based on magnetic resonance diffusion tensor imaging in conjunction with three dimensional fibretracking for longitudinal studies of the corticospinal tract, and used specific neurological motor scores to test the hypotheses in five stroke patients within the first week and 30 and 90 days after the stroke. RESULTS: Reduction in fractional anisotropy within the first weeks after stroke reflected a decline in axonal integrity, leading to Wallerian degeneration, and demonstrated a correlation between the temporal evolution of fractional anisotropy and motor function in patients with poor motor outcome. CONCLUSION: The study demonstrated the feasibility of fibretracking as a segmentation tool for mapping distal parts of the corticospinal motor pathways and showed that fractional anisotropy in the segmented corticospinal tract is a sensitive measure of structural changes after stroke.

Aged↗

Steroid reversibility test followed by inhaled budesonide or placebo in outpatients with stable chronic obstructive pulmonary disease. The Danish Society of Respiratory Medicine.

The aim of this study was evaluate the predictive value of a 2 week course of prednisolone on the effect of 6 months treatment with inhaled budesonide in patients with stable chronic obstructive pulmonary disease (COPD). Forty patients with stable COPD entered the study, and received prednisolone (37.5 mg o.d.) for 2 weeks. They were subsequently divided into steroid-irreversible and steroid-irreversible, using 15% of baseline as a dividing point. In each group patients were randomized to receive budesonide 400 micrograms b.i.d. or placebo for 6 months. During treatment with prednisolone, three patients dropped out because of side effects. Of the remaining 37, only two patients (5%) were reversible with prednisolone forced expiratory volume in 1s [(FEV1) > 15% of baseline], and among the steroid-irreversible, 26 patients were evaluated after 6 months treatment with either placebo or budesonide. No significant differences in spirometry values, symptoms, or number of exacerbations were found between these two groups. Reversibility with prednisolone is rarely seen in COPD. In outpatients with stable COPD and no signs of asthma or atopy, 2 weeks treatment with prednisolone seems to be of no value in choosing subsequent long-term therapy.

Adolescent↗

Long term follow up of patients who underwent jejunoileal bypass for morbid obesity.

OBJECTIVE: To describe our long term results after jejunoileal (JI) bypass for morbid obesity. DESIGN: Retrospective study. SETTING: Teaching hospital, Denmark SUBJECTS: All 57 patients who underwent JI bypass for morbid obesity between January 1973 and December 1988. INTERVENTIONS: Type A and type B JI bypass. MAIN OUTCOME MEASURES: Weight loss, operative morbidity and mortality, and subjective evaluation of the results. RESULTS: Mean duration of follow up was 15.9 years (range 8-22). There were no operative or early postoperative deaths, but there were 7 late deaths (12%). 5 patients developed postoperative complications (9%), and 11 patients (19%) required reoperation for side effects or complications. The mean body mass index (BMI, kg/m2) was reduced from 47.5 (range 40-60) to 32 (range 22-49) during the follow up period which corresponded to a weight loss of about 42 kg. Of the 39 patients who still had a JI bypass in 1994, nearly two thirds said that they were satisfied with the operation, though they nearly all had some side effects such as diarrhoea or intermittent abdominal pain. CONCLUSION: As complications of JI bypass can develop at any time, we suggest that all patients who have had the operation should be regularly followed up at special clinics so that complications can be diagnosed and treated as soon as possible.

Adult↗

Amiodarone during pregnancy.

A case study is presented in which amiodarone (A) was given during the whole of pregnancy and during the breast feeding period. An intensive observation of thyroid tests, serum concentrations of A and its metabolite, desethylamiodarone (DEA) was undertaken. The child was observed in the same way from birth until 2 months of age. The milk was analyzed for A and DEA. As reported in other published cases, transplacental passage was found and there was a relatively high concentration of amiodarone in the milk. Our child like the other children was healthy at birth, being euthyroid and with no goiter or corneal deposits. No effect was observed of the medication on growth, thyroid tests or cornea. It is concluded that amiodarone can be given during pregnancy but it is advisable to use as low doses as possible and control the serum concentrations at regular intervals. Breast feeding need not be forbidden.

Adolescent↗