[Increased quality of life for patients with ostomies. A warning system for overfilled ostomy bags is valued].
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Colostomy↗
Biomedical subjects
K Dahl
Publications and source records attributed to K Dahl.
Pharmacokinetics of oral cefcanel daloxate hydrochloride in healthy volunteers and patients with various degrees of impaired renal function.
Cefcanel daloxate hydrochloride is a new oral cephalosporin prodrug. It is a double cephem ester of cefcanel, which is the active principle released in the body after uptake of an intermediate cephem mono ester. The present study investigated the pharmacokinetics of cefcanel following a single oral dose of cefcanel daloxate hydrochloride 300 mg to healthy volunteers and to patients with various degrees of stable renal insufficiency. Twenty individuals from 21 to 74 years of age received a single oral dose of cefcanel daloxate hydrochloride together with an i.v. bolus injection of iohexol for a simultaneous assessment of glomerular filtration rate (GFR). The concentrations of cefcanel and iohexol in plasma and urine were measured using high performance liquid chromatography. Cefcanel renal clearance and fraction excreted in the urine were linearly correlated with renal function and thus, logarithmic increases in plasma area under the concentration versus time curve and plasma elimination half-life were seen with decreasing GFR. Although steady state kinetics were not performed our findings suggest that a dosage reduction is not necessary even in pre-uraemic patients.
Administration, Oral↗
Dim light melatonin onset and circadian temperature during a constant routine in hypersomnic winter depression.
The onset of melatonin secretion under dim light conditions (DLMO) and the circadian temperature rhythm during a constant routine were assessed in 6 female controls and 6 female patients with winter depression (seasonal affective disorder, SAD) before and after bright light treatment. After sleep was standardized for 6 days, the subjects were sleep-deprived and at bedrest for 27 h while core temperature and evening melatonin levels were determined. The DLMO of the SAD patients was phase-delayed compared with controls (2310 vs 2138); with bright light treatment, the DLMO advanced (2310 to 2135). The minimum of the fitted rectal temperature rhythm was phase-delayed in the SAD group compared with the controls (0542 vs 0316); with bright light treatment, the minimum advanced (0542 vs 0336).
Adult↗
The influence of the stimulus on normal sural nerve conduction velocity: a study of the latency of activation.
Conduction along the sural nerve was studied in 64 normal subjects using near-nerve electrodes. Conduction velocities over the same nerve segments were calculated: (1) from the latency recorded from a site of stimulation to a site of recording (1R-method); and (2) from the difference in latency between 2 recording sites, the site of stimulation being situated elsewhere along the nerve (2R-method). Consistently faster velocities were seen with the 2R-method and could best be explained by a fixed delay of about 0.15 ms at the stimulus site (latency of activation, utilization time). This delay was markedly prolonged when a ramp rather than a rectangular stimulus was applied, though fast fibers were excited with both types of stimuli. The delay is thought to be dependent on the relationship between the density of current at the stimulus site and the threshold of responding fibers.
Adolescent↗
Turns-amplitude analysis of the electromyographic recruitment pattern disregarding force measurement. I. Method and reference values in healthy subjects.
We used turns-amplitude analysis to characterize the EMG recruitment pattern disregarding force measurement. The electrical muscle pattern of the brachial biceps (BB), abductor pollicis brevis (APB), medial vastus (MV), and anterior tibial (AT) muscles was analyzed during progressive increase in force from rest to maximum using the mean amplitude as an indicator of the force of the muscle. The following parameters were obtained on-line: the maximal ratio of turns to mean amplitude (peak-ratio, PR), the mean amplitude, and the number of time intervals (TI) between turns at PR and at near maximum force (NMF). The highest PR values were obtained in BB, the lowest in MV. Analysis of the distribution of the TI between turns at different degrees of voluntary contraction showed fewer spikes with short duration and small amplitude at high force compared with low force.
Adolescent↗
Turns-amplitude analysis of the electromyographic recruitment pattern disregarding force measurement. II. Findings in patients with neuromuscular disorders.
Turns-amplitude analysis of the electromyographic recruitment pattern was performed on-line in the brachial biceps muscle of 46 patients with neuromuscular disorders using the mean amplitude as an indicator of force. The parameters, peak-ratio (PR) and number of time intervals (TI) from 0 to 1.5 ms, were increased in patients with myopathy. In patients with neurogenic involvement, the characteristic pattern was a decreased PR and a decreased incidence of TI between 0 and 1.5 ms. The results indicate that the two parameters supplement each other as some of the patients were identified only by one or the other. In patients with myopathy, the method had a higher diagnostic yield than the individual motor unit action potential analysis. The method is objective, fast, and reliable.
Action Potentials↗
[Gastrostomy. Simplified technique and extended field of indications].
The technique by which percutaneous access to the stomach for enteral nutrition is obtained is generally accepted in cases in which swallowing is defective and for aspiration in cases of gastro-intestinal retention. Experience with a gastrostomy tube developed in Denmark has provided inspiration to establish access by means of outpatient intervention. Since 1986, 15 patients with defective swallowing were treated as outpatients with percutaneous introduction of a gastrostomy tube without complications of the intervention or to subsequent management in nursing homes or their own homes. Replacement of the catheter was undertaken by the general practitioner or by renewed outpatient visits. In many of the patients, replacement of the catheter was performed by the caring staff. A narrow-bore tube was chosen primarily in order to reduce the risk of complications. Despite the narrow-bore tube, the effect of the decompression tube has proved satisfactory in five patients since 1986. The method is simple, the trauma minimal and it is well accepted by the patients.
Adult↗
Standardization of facilitation of compound muscle action potentials evoked by magnetic stimulation of the cortex. Results in healthy volunteers and in patients with multiple sclerosis.
To establish the importance of standardization of the facilitation of central motor conduction measured by magnetic stimulation we studied the effect of increasing voluntary muscle contraction on the central motor conduction time (CMCT) and motor evoked potential (MEP) amplitudes for 3 upper and 2 lower limb muscles. MEPs were elicited by magnetic stimulation of the cortex and the spinal roots. Muscle force was indirectly assessed from the integrated electrical muscle activity and expressed as the root mean square (RMS) and was varied from 0 to 40% of maximal activity. The central motor conduction time (CMCT) decreased during increasing muscle contraction, reaching constant values at approximately 10-20% RMSmax. Similarly, the increases of MEP amplitude tapered off at about the same RMS level. For each muscle an optimal RMS level was defined. The shortening of the CMCTs at the optimal RMS levels were: the brachial biceps, 3.4 msec; the radial carpal flexor of the wrist, 2.7 msec; the first dorsal interosseus muscle of the hand, 2.9 msec; the anterior tibial, 4.2 msec; and the abductor hallucis, 2.4 msec. The standardizing procedure was applied to 10 patients with multiple sclerosis. The stimulus thresholds were higher in these patients compared with those of the normals. Only the CMCT reduction of the BB was significantly larger (8.1 msec) than in the controls. Using standardized facilitation the diagnostic value of the amplitudes seems to be only a little less than that of the CMCTs.
Adult↗
Descriptions of early triers.
The onset of smoking behavior in adolescents has been described as a process, beginning when children are young. Little empirical evidence is available, however, on the nature and specifics of the onset process in young children. More information is needed about the early stages of smoking onset in order to design interventions for young children and for early triers. The purpose of the present study was to describe several onset-related variables in young girls and boys and to discuss implications for designing prevention interventions that target young children. A total of 1,663 5th-grade students completed a questionnaire assessing smoking behavior, psychosocial characteristics, and perceptions of a "smoker" image. Saliva samples for cotinine analysis were also collected. Students were classified as either never-triers (never tried a cigarette) or early triers (tried one or more cigarettes) on the basis of self-reported smoking. Most students who had tried a cigarette were in the early stages of smoking onset, because approximately 30% had tried one cigarette and less than 10% had tried a second. Triers versus never-triers differed on their reported images of smokers, and several psychosocial characteristics predicted trying a cigarette and intentions to smoke for boys.
Attitude↗
Examination of central and peripheral motor pathways by standardized magnetic stimulation.
A standardized magnetic stimulation procedure for evaluation of central and peripheral motor pathways is described together with the results of motor evoked potential (MEP) recordings from 6 muscles in 50 healthy volunteers aged 18 to 60 years. Facilitation of the neuronal pathways was standardized using the integrated electric activity of the EMG as a gauge. The target muscles were: the brachial biceps (BB), the radial carpal flexor (FCR), the first dorsal interosseus of the hand (FDI), the medial vastus of the quadriceps muscle (VM), the anterior tibial (TA) and the abductor hallucis muscles (AH). The parameters used were the conduction times and the amplitudes of the CMAPs evoked by brain and root stimulation. CMAPs could be recorded from all muscles in all but three subjects in whom cortical stimulation was unsuccessful in one TA and two AHs, while root stimulation was negative in two TAs and one AH. Height and conduction times were significantly correlated, while age and conduction times were not. By linear regression 30-60% of the variation in the conduction times could be explained by the variation in height. The residual variation of the conduction times was less than in most other non-standardized studies and comparable to peripheral electrical motor conduction studies.
Adolescent↗
The child-psychoanalytic play interview: a technique for studying thematic content.
Child psychoanalysts have long viewed play as a reflection of children's inner lives and have used the themes children represent in play for diagnostic and therapeutic work. Given the central role children's play has for clinical work, few studies have addressed play empirically. This paper presents a technique for studying the thematic content of children's play as it emerges during a play session with a child analyst. We report the steps involved in developing this investigative technique and describe the interobserver agreement among four rates using the technique with videotaped play sessions. Implications for future research using such an approach are discussed.
Fantasy↗
Significance of magnetic coil position in peripheral motor nerve stimulation.
The influences of coil position and coil-nerve distance on compound muscle action potentials (CMAPs), recorded from the first dorsal interosseus muscle during magnetic stimulation of the brachial segment of the ulnar nerve, were studied in 10 healthy volunteers. A 14-cm coil was held tangentially to the skin with the center overlying the nerve. Mapping of the CMAP latencies and amplitudes was made as the coil was displaced laterally in steps of 1 cm and in planes 0-3 cm from the skin surface. Stimulation with the coil center positioned 3 cm laterally to the nerve with the coil current directed proximally yielded the largest amplitudes with minimal variability and the most constant relationship to electrically evoked CMAPs. In this position the interindividual and intraindividual reproducibility of the magnetically evoked latencies were at least as good as those of electric stimulation when coil-skin distance was less than or equal to 2 cm.
Action Potentials↗
The effect of peritonitis on the transperitoneal transport of cefuroxime in patients on CAPD treatment.
The pharmacokinetics and transperitoneal transport of cefuroxime were investigated in CAPD patients without peritonitis (n = 6), receiving 500 mg of the drug intravenously (i.v.) and intraperitoneally (i.p.) on separate occasions. CAPD patients with peritonitis were also investigated after i.p. administration of an initial dose of 500 mg cefuroxime followed by repeated doses of 250 mg. Routine hospital CAPD procedures and dwell-time schedules were followed during the study, and frequent blood and dialysate samples were collected. Cefuroxime was analysed by HPLC methods, and pharmacokinetic parameters were calculated. In the patients without peritonitis, the following pharmacokinetic parameters after i.v. and i.p. administration did not differ significantly (mean +/- SD): elimination half-life, 15.1 +/- 1.9 h; apparent volume of distribution 27.9 +/- 2.91; and total clearance, 21.5 +/- 1.2 ml/min. In contrast, the transperitoneal transport of cefuroxime differed significantly in the three studies. After i.v. administration the apparent transperitoneal clearance was low and time dependent, ranging from 4.2 +/- 1.2 to 1.4 +/- 0.4 ml/min. After i.p. administration the apparent transperitoneal clearance increased to 10.9 +/- 2.4 ml/min, whereas in the peritonitis patients a further increase to 21.5 +/- 3.5 ml/min was observed. In all patients we found cefuroxime concentrations in serum and dialysate, greatly exceeding MIC values of most pathogens involved in CAPD peritonitis and other systemic bacterial infections.
Ascitic Fluid↗
Human migrating myoelectric complex in relation to gastrointestinal transit of a meal.
Feeding interrupts the migrating myoelectric complex in most mammals. This study aimed to assess whether resumption of the migrating myoelectric complex in the human duodenum after eating was related to the gastrointestinal transit of the meal. Five healthy subjects participated in the study. After eating a radiolabelled test meal consisting of mixed liquid and solids, duodenal myoelectric activity and gastrointestinal transit of the meal were determined simultaneously. In spite of considerable variation in entire gastric emptying time between subjects (range 2.5-5.0 hours), significant correlation was found between the completion of gastric emptying and the resumption of duodenal phase III activity within subjects (p less than 0.01). A new technique for recording the duodenal myoelectric activity was used.
Adult↗
The determination of copper in human liver biopsy specimens by cup-in-tube ETAAS.
A method for the direct determination of copper in human liver biopsy specimens is described. The addition of a mixed Mg-Pd nitrate modifier is shown effectively to delay the volatilization of copper both from aqueous standards and the powered NISTBovine Liver to an appearance time comparable with the solid biopsy specimens. Calibration against solid liver reference materials is preferable compared with aqueous copper standard solutions. A number of copper absorption lines provide a wide range of sensitivities; the less sensitive Cu-line 222.6 nm was found optimal in the determination of copper concentrations in the range of 20-200 mg/kg in liver biopsy specimens. The copper concentrations measured in liver biopsy specimens from patients suffering from sclerosing cholangitis were considerably higher than those reported for a group of healthy persons.
Animals↗
Determination of peak-ratio by digital turns-amplitude analysis on line.
In a previous study the peak-ratio of turns to mean amplitude of the EMG interference pattern obtained from tape recordings identified 80% of patients with myopathy. In order to obtain the peak-ratio during the examination using the mean amplitude as an indication of force a digital turns-amplitude computer with a TMS 320/10 digital signal processor was developed. The EMG was analysed with a 12 bit resolution and a sampling rate of 100 kHz. In 492 samples from the brachial biceps muscle of controls, patients with myopathy and neuropathy, the digital method gave about the same turns-amplitude values as the analogue analyser. Control material for on line analysis of the peak-ratio was obtained in the brachial biceps, the abductor pollicis brevis, the medial vastus and the anterior tibial muscles of 20 subjects.
Adolescent↗
Long-term follow-up of children and juveniles with arachnoid cysts.
In the vast literature on intracranial arachnoid cysts, communication of long-term follow-up is rare. Therefore, we studied the case histories of 60 children and juveniles operated on in our hospital since 1951. The most favorable cases were patients with temporal cysts: 93% recovered fully or with only slight deficits. In other locations (frontal, parietal, occipital, infratentorial), the percentages for a favorable course were lower. The reason cannot be attributed to the operation procedures. Independent of the surgical procedure, there were no postoperative deaths after 1969. Long-term follow-up revealed that, depending on the location of the arachnoid cyst, a high percentage (62%-93% of patients) had normal physical and social development with satisfactory quality of life.
Adolescent↗
Ceftazidime in patients with impaired renal function. Studies on pharmacokinetics and nephrotoxicity.
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Adult↗