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Biomedical subjects

J J Dekker

Publications and source records attributed to J J Dekker.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence of diabetes mellitus in chronic schizophrenic inpatients in relation to long-term antipsychotic treatment.

BACKGROUND: Many reports indicate that the incidence and prevalence of diabetes mellitus is increased in schizophrenic patients and related to antipsychotic treatment. In an exploratory cross-sectional study we assessed the prevalence of type 2 diabetes mellitus in 266 chronic schizophrenic and schizoaffective inpatients and investigated whether the duration of antipsychotic treatment was related to the development of diabetes mellitus. METHOD: We measured the non-fasting plasma glucose level in 266 inpatients with DSM IV diagnosis of schizophrenia or schizoaffective disorder in 5 different long-stay wards in the Netherlands. Measured variables were: age, sex, ethnicity, BMI, current antipsychotic treatment, duration of illness and duration of antipsychotic treatment. RESULTS: The overall prevalence of type 2 diabetes mellitus was 9%, which is significantly higher than the prevalence of 4.9% in the general population (OR 1.89, CI 1.14-3.13; p<0.014). The prevalence was increased in two age cohorts: 30-39 years (3.8% vs. 0.3%, OR=13.29, CI=2.17-81.36, p=<0.005) and 40-49 years (9.3% vs. 1.5%, OR=6.74, CI=2.77-16.38, p=0.000). No new cases of diabetes mellitus were detected during the course of the study. The increased prevalence was found to be related to overweight and obesity. The time of exposure to antipsychotic treatment was not significantly correlated with the prevalence of diabetes mellitus when adjusted for age (F=0.804, df=1, p=0.371, respectively, F=0.194, df=1, p=0.660). Both typical and atypical antipsychotics contributed equally to the prevalence of diabetes mellitus. CONCLUSION: No significant relation between long-term antipsychotic treatment and prevalence of diabetes mellitus was found. The high prevalence of diabetes mellitus in schizophrenic patients warrants screening of these patients already at young age for glucose disturbance.

Adult↗
PubMed2001

Determination of endometrial prolactin in vivo as a marker for endometrial development in spontaneous ovulatory cycles and in vitro fertilization cycles.

Decidual prolactin was directly determined in endometrial tissue in order to assess its potential role in improving the accuracy of the diagnosis of luteal-phase defect (LPD). Endometrial biopsies of 124 women with regular cycles (group 1) and 13 women with controlled ovarian hyperstimulation and progesterone-supported cycles (group 2) were evaluated in the secretory phase. In addition, decidual prolactin was measured in the luteal phase of the in vitro fertilization (IVF) cycles. The biopsies dated on or after day 25 showed a significant increase in the slope of the regression line of the cycle day versus decidual prolactin content (p < 0.05). Delayed endometrium was not characterized by a lower amount of decidual prolactin compared with biopsies with the same histological dating. On day 27 of the cycle, less prolactin was measured in the out-of-phase biopsies (p < 0.05). A large inter-individual variation in endometrial prolactin tissue content was noticed. In group 2 all biopsies but one were in phase. Compared to the in-phase biopsies of group 1, a significantly higher amount of prolactin was found in group 2. Production of endometrial prolactin in vivo is associated with decidualization of the stromal cells. However, because of the large inter-individual variation, determination of prolactin is not of adjuvant diagnostic value for clinical assessment of LPD. Three factors might explain the higher amount of decidual prolactin in group 2 compared to group 1: (1) a higher serum progesterone concentration owing to an increased production by multiple corpora lutea, or because of the administered progesterone; (2) increased estradiol levels and thus progesterone receptors; and (3) direct stimulation of decidualization by gonadotropins.

Adolescent↗
PubMed2000

Ovarian cancer in female-to-male transsexuals: report of two cases.

BACKGROUND: Ovarium cancer is the fifth most common cause of cancer-related death in women and is the most common fatal gynecologic malignancy. So far, ovarium carcinoma has not been reported to have occurred in female-to-male transsexuals. OBJECTIVE AND METHOD: We report on two such cases. Long-term exposure to increased levels of endogenous and exogenous androgens is hypothesized to constitute an additional risk factor in transsexuals as it has been associated with ovarian epithelian cancer. CONCLUSION: Simultaneous salpingo-oophorectomy should be performed in any female-to-male transsexual undergoing hysterectomy in the course of gender-confirming therapy.

Androgens↗
PubMed1999

Fluctuations in CA 125 and CA 15-3 serum concentrations during spontaneous ovulatory cycles.

The aim of this study was to investigate cycle dependent changes of serum CA 125 and CA 15-3 concentrations during spontaneous ovulatory cycles. Twenty apparently healthy women with spontaneous menstrual cycles attending our infertility clinic were included. Of these women, 18 had occluded tubes as a result of sterilization. Ovulation was confirmed by luteinizing hormone test and ultrasonography and, to exclude endometriosis, a laparoscopy was performed. Serum samples for CA 125, CA 15-3, 17 beta-oestradiol and progesterone determinations were taken every second day starting on the 2nd day of the cycle until the 7th day of the next cycle. After correction for inter-individual variation in serum concentrations, highest CA 125 concentrations were found during the menstruation. During the follicular and peri-ovulatory phase CA 125 serum concentrations were lowest. For CA 15-3, serum concentrations were not statistically different throughout the cycle. CA 125 and oestradiol concentrations were negatively correlated, CA 15-3 and oestradiol concentrations were positively correlated. Absolute serum concentrations of both CA 125 and CA 15-3 vary among females. Within the female, fluctuations of CA 125 are phase related. In the population studied most of the patients had tubal obstruction and high CA 125 serum concentrations during menstruation, which revokes the theory that the menstrual rise of CA 125 is due only to retrograde menstruation.

Adult↗
PubMed1995

Evolution of the methods of neovaginoplasty for vaginal aplasia.

The aim of vaginoplasty should be the creation without excessive morbidity of a neovagina that will be satisfying in appearance, function and feeling. The multitude of methods described in the literature indicates the fact that an ideal approach has not yet been found. In this paper the various methods are described and discussed. It is concluded that the non-operative impression technique, the peritoneum pull-through technique and the use of skin grafts are methods of choice. In cases where immediate vaginal reconstruction after oncological surgery is indicated, myocutaneous flaps are preferred. Only in cases in which other methods have failed should recto-sigmoid transplantation be considered.

Colon, Sigmoid↗
PubMed1995

Fatal pulmonary fibrosis complicating low dose methotrexate therapy for rheumatoid arthritis.

We report the fatal disease course of 2 aged patients with rheumatoid arthritis (RA). Both had respiratory complaints after 10-15 weeks of treatment with methotrexate (MTX). After withdrawal of MTX, and despite the use of corticosteroids and ventilatory support, both died of respiratory failure. Post mortem examination showed extensive pulmonary fibrosis, bronchiolitis obliterans, and hyperplasia of type II pneumocytes. To our knowledge, this is the first report of fatal pulmonary fibrosis following short courses of low dose MTX therapy for RA.

Aged↗
PubMed1991

Dual mode of corticothalamic synaptic termination in the mediodorsal nucleus of the rhesus monkey.

Electron microscopic autoradiography (EM-ARG) was used to assess the synaptic organization of corticothalamic terminals in the parvicellular division of the mediodorsal thalamic nucleus. Examination of the synaptic organization in unreacted tissue revealed several distinct synaptic types distributed among glomerular and nonglomerular regions of the neuropil. Within glomeruli, three presynaptic terminal classes were found. The majority of profiles (as many as eight to ten per glomerulus) were presynaptic dendrites (PSDs) forming symmetric synaptic contacts with a central dendrite, and occasionally with other PSDs. One or two large terminals densely packed with round vesicles (LR terminals) were also present in each glomerulus. This terminal class made multiple asymmetric contacts with the central dendrite, as well as with many PSDs within the glomerulus. Finally, small terminals with round vesicles (SR terminals) formed asymmetric synaptic junctions with PSDs in some glomeruli. PSDs and SR terminals were also found in the extraglomerular neuropil, although in different proportions than in the glomeruli. In the extraglomerular neuropil SR terminals were the most abundant terminal class and these terminals made synaptic contacts with dendrites of all sizes. PSDs were seen in considerably smaller numbers than in the glomeruli. Finally, the extraglomerular neuropil contained a moderate number of small to medium terminals that formed symmetric synaptic junctions (SF terminals) with cell bodies and dendrites of all sizes. Synaptic profiles related to corticothalamic inputs were identified by injecting the prefrontal cortex of two rhesus monkeys with 3H-leucine and -proline and analyzing the distribution and morphology of radiolabeled terminals. Quantitative analysis of the density of silver grains over different tissue compartments revealed a positive labeling index for two terminal classes: SR and LR terminals. Labeled SR terminals were concentrated in the extraglomerular neuropil and labeled LR terminals were found within glomeruli where they formed synaptic contact with the central dendrite, as well as with presynaptic dendrites of the glomerulus. In contrast to many other thalamic nuclei, cortical input to the mediodorsal nucleus arrives via two distinctive synaptic pathways, one terminating extraglomerularly and the other terminating within the synaptic glomeruli. The dual mode of corticothalamic terminations in the mediodorsal nucleus suggests a more potent and possibly different role for cortical input in the regulation of neuronal activity in this association nucleus than in sensory nuclei of the thalamus.

Animals↗
PubMed1991

The importance of near total resection of the corpus spongiosum and total resection of the corpora cavernosa in the surgery of male to female transsexuals.

From 1980 to 1989, 13 male to female transsexuals underwent surgery for resection of the corpus spongiosum, performed at the Department of Plastic and Reconstructive Surgery of the Free University Academic Hospital, Amsterdam, The Netherlands. Except for 1, all patients underwent the primary sex-reassignment procedures in institutions other than this hospital. All had difficulties during sexual activities. After repeat surgery with near complete excision of the corpus spongiosum and also in three instances of the corpus cavernosum, improvement was noticed in all patients. The importance of the total elimination of the erectile tissue is emphasized.

Adult↗
PubMed1984

Columnar organization of callosal and associational projections from rat frontal cortex.

Autoradiography and HRP histochemistry were used to study the laminar and columnar distribution of callosal and associational connections of areas 6 and 10 of Krieg in the rat frontal cortex. In coronal sections through homotopic contralateral areas and ipsilateral somatosensory cortex, terminations of projections arising in frontal cortex formed discrete vertical columns; these were 250-750 micron wide and alternated with unlabeled or poorly labeled areas of approximately equal width. In reconstructions from serial coronal sections through these areas, the terminal fields formed a series of bands. The location of retrogradely labeled neurons tended to reciprocate the distribution of terminal label, although the boundaries of terminal and cell label were not always in precise register. These findings indicate that in the rat, both association and callosal projections exhibit a terminal organization remarkably similar in width and spacing to that observed in primates. Thus, a columnar mode of termination of cortico-cortical fibers may be an organizational feature common to mammalian neocortex.

Animals↗
PubMed1981

Anatomical evidence for direct fiber projections from the cerebellar nucleus interpositus to rubrospinal neurons. A quantitative EM study in the rat combining anterograde and retrograde intra-axonal tracing methods.

A quantitative electron microscopic (EM) study combining the anterograde intra-axonal transport of radioactive amino acids and the retrograde intra-axonal transport of the enzyme horseradish peroxidase (HRP) was performed in the magnocellular red nucleus of the rat to obtain anatomical evidence as to whether there is a direct projection from the cerebellar nucleus interpositus to the cells in the red nucleus that give rise to the rubrospinal tract. Large asymmetrical synaptic terminals were radioactively labeled in the magnocellular red nucleus following injections of [3H]leucine into the cerebellar nucleus interpositus. In these same animals, the postsynaptic target neurons were labeled with HRP granules after injection of this substance in the rubrospinal tract. A quantitative analysis showed that more than 85% of the large and giant neurons in the magnocellular red nucleus were labeled with HRP granules and also received synaptic contacts from radioactively-labeled terminals. Thus, it can be concluded that in the rat, afferents from the cerebellar nucleus interpositus establish asymmetrical synaptic contacts with large and giant rubrospinal neurons, thus confirming and extending the previous physiological evidence of such direct monosynaptic connections.

Animals↗
PubMed1979

Electron microscopic identification of mammillary body terminals in the rat's AV thalamic nucleus by means of anterograde transport of HRP. A quantitative comparison with the EM degeneration and EM autoradiographic techniques.

A comparison has been made between the number of horseradish peroxidase (HRP)-labeled mammillary body terminals in the antero-ventral (AV) nucleus and the number of such terminals labeled with the electron microscopic (EM) autoradiographic [6] and EM degeneration technique [6]. With the antero-grade HRP technique less terminals were labeled than with the autoradiographic technique, but more than with the degeneration technique. Furthermore it may be concluded that the anterograde HRP technique is suitable for determining the type of terminal and does not require the long exposure time of the autoradiographic technique.

Animals↗
PubMed1977

The organization of the bulbar fibre connections to the trigeminal, facial and hypoglossal motor nuclei. II. An autoradiographic tracing study in cat.

In 34 cats 3H-leucine was injected in the pontine and medullary tegmentum. The location of the labelled neurons and the distribution of the labelled fibres and terminals were studied autoradiographically. The findings indicate that the neurons in the bulbar lateral tegmental field (Berman, 1968) represent the main source of the propriobulbar projections to the hypoglossal, facial and motor V nuclei, while those in the medial tegmental field distribute their fibres mainly to the spinal cord. The neurons in the lateral part of the lateral tegmental field give rise to ascending and descending fibres which compose the lateral propriobulbar system, and distribute fibres mainly to ipsilateral bulbar motor nuclei. The neurons in the medial part of the lateral tegmental field compose the medial propriobulbar system, which is organized bilaterally and tends to distribute fibres to the motor nuclei bilaterally. The various neuronal cell groups which project through the medial propriobulbar system to the different motor nuclei bilaterally show relatively less spatial segregation than those which project through the lateral system to these motor nuclei.

Animals↗
PubMed1976

Morphology of rats AV thalamic nucleus in light and electron microscopy.

The structure of the rat's antero-ventral thalamic (AVTh) nucleus has been investigated in order to provide background information for the accompanying study in which an attempt was made to identify the synaptic terminals of the different afferent fiber systems to this nucleus by means of both EM autoradiography and the EM degeneration techniques. Nissl stained sections showed that the rat's AVTh nucleus contains mainly relatively light staining neurons which in Golgi material were found to possess tufted dendrites. In EM material three types of synaptic terminals were found which showed a topical distribution over the neuronal surface. Soma and stem dendrites carry a limited number of terminal with symmetrical synapses and flattened vesiclesmproximal dendrites carry mainly large asymmetrical synaptic terminals while distal dendrites are crowded with small asymmetrical synaptic terminals.

Animals↗
PubMed1976

Quantitative EM study of projection terminal in the rats AV thalamic nucleus. Autoradiographic and degeneration techniques compared.

An attempt was made to determine whether the labeled amino acid tracing technique combined with electron microscope (EM) autoradiography can be used to identify reliably the terminals of different to a cell group in the brain, using the rat's antero-ventral thalamic (AVTh) nucleus as a model. For this purpose in one group of rats [3H]leucine was injected in cingulate cortex, hippocampus and mammilary bodies, respectively, and in another group lesions were made in these structures. With one month autoradiographic exposure time it could be demonstrated that after cortical and hippocampal injections the radioactivity was transported to small terminals on distal dendrites, while after mammillary body injections it was transported to large terminals on proximal dendrites. After 4 months exposure time altogether 12% of the small terminals and 80% of the large ones had been labelled; A comparison with the degeneration findings showed that the EM autoradiography is in many respects more efficient in identifying the various terminals than the EM degeneration technique.

Animals↗