[Penicillin treatment of extranosocomial pneumonia at Danish departments of internal medicine].
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Denmark↗
Biomedical subjects
L Andersen
Publications and source records attributed to L Andersen.
Toward understanding insulin fibrillation.
Formation of insulin fibrils is a physical process by which partially unfolded insulin molecules interact with each other to form linear aggregates. Shielding of hydrophobic domains is the main driving force for this process, but formation of intermolecular beta-sheet may further stabilize the fibrillar structure. Conformational displacement of the B-chain C-terminal with exposure of nonpolar, aliphatic core residues, including A2, A3, B11, and B15, plays a crucial role in the fibrillation process. Recent crystal analyses and molecular modeling studies have suggested that when insulin fibrillates this exposed domain interacts with a hydrophobic surface domain formed by the aliphatic residues A13, B6, B14, B17, and B18, normally buried when three insulin dimers form a hexamer. In rabbit immunization experiments, insulin fibrils did not elicit an increased immune response with respect to formation of IgG insulin antibodies when compared with native insulin. In contrast, the IgE response increased with increasing content of insulin in fibrillar form. Strategies and practical approaches to prevent insulin from forming fibrils are reviewed. Stabilization of the insulin hexameric structure and blockage of hydrophobic interfaces by addition of surfactants are the most effective means of counteracting insulin fibrillation.
Animals↗
[What will become of parental care?].
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Child↗
[Reduced blood utilization in hip arthroplasty. Introduction of a blood preservation program].
In spring 1992 a blood conservation programme was established at Nordland Central Hospital with emphasis on indications for blood transfusion and intraoperative blood salvage (cell-saver). Medical records from all patients who underwent hip arthroplasty during the period 1 June 1991 to 28 February 1994 were examined. Mean transfusion of homologous SAGMAN-blood (bank blood) was substantially reduced during the period: for total prosthesis (n = 192) from 2.6 to 1.1 units per operation (p < 0.0001) and for hemiprosthesis (n = 66) from 3.1 to 0.9 units per operation (p = 0.0202). The percentage of patients in each of these two groups who did not receive blood transfusion at all increased from 18 to 61 in the first group (p < 0.0001) and from 24 to 65 (p = 0.0202) in the second. The substantial reduction of bank blood transfusion in this material conforms with current international transfusion guidelines. A particular benefit, considering the risk of transfusing contagious blood, is the marked increase in the number of patients who did not receive any blood product at all.
Aged↗
Verapamil and circadian variation of sudden cardiac death.
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Calcium Channel Blockers↗
Report of the American Diabetes Association's Task Force on standardization of the insulin assay.
Recent large-scale epidemiological studies demonstrate that blood concentrations of immunoreactive insulin predict the development of NIDDM and IDDM and are associated with the risk of several degenerative diseases, such as coronary and peripheral vessel atherosclerosis, hypertension, and dyslipidemia. The reliability of these measurements is dependent on a biological assay that has not been well standardized between laboratories. Recognizing this, the American Diabetes Association organized a task force to assess comparability of blood insulin measurements between laboratories and to suggest techniques to improve comparability. The task force found that identical serum and plasma samples measured in different laboratories produced widely disparate values that were unacceptable for population comparisons. Use of a single reference standard did little to improve comparability. Assay characteristics such as linearity, recovery, accuracy, and cross-reactivity to proinsulin and its primary conversion intermediates varied among the laboratories, and they did not readily explain differences in the measurements made from assay to assay. Use of the same assay kit in different laboratories did not always ensure comparable measurements. Linear regression of assay results from one laboratory to an arbitrarily chosen reference assay greatly improved comparability and demonstrated the potential value in comparing each assay to a reference method. The task force report defines acceptable assay characteristics and proposes a three-step process of insulin assay proficiency and comparability. A central reference assay and ongoing sample exchange will be needed to allow reliable comparisons of insulin measurements made in different laboratories. Rigorous quality control and continuous quality improvement are needed to maintain reliability of the insulin measurement.
Diabetes Mellitus↗
Individual identification by means of conventional bitewing film and subtraction radiography.
An analysis of simulated post- and antemortem (p.m. and a.m.) victim radiographs was performed. Existing pairs of bitewing radiographs randomly sampled from a large population of adolescents were used. Two categories of individuals were included based on dental therapy conditions (none or few simple fillings). Subtraction images were performed of pairs of bitewings originating from the same individual (identical images) and different individuals (non-identical images) within each group. Four observers were asked to match the bitewings and to assess the subtraction images with respect to identity based on the score system: 1 = 'eliminated', 2 = 'possible', 3 = 'likely', or 4 = 'certain'. Three observers each mismatched the film radiographs among two out of 12 individuals without fillings. True positive identification (identified by scores 2 + 3 + 4) of subtraction images were made in 10-12 individuals out of a possible 12. The range of false positive (FP) and false negative (FN) scorings was 3-15 and 0-2, respectively. All observers were capable of correctly matching bitewings originating in the 12 individuals with amalgam fillings. By use of subtraction radiography, 12-14 identical images out of a possible 15 were assessed correctly. The range of FP and FN scorings of subtraction images in this group was 1-4 and 1, respectively. Defining only score 4 as positive identification, the sensitivity of the subtraction technique decreased from approximately 0.90 to 0.70 in both categories of individuals, while specificity increased to almost 1.00 from 0.82 vs. 0.96 in the categories with and without dental restorations. Bitewing radiographs from single individuals within a group of individuals were sufficiently identical to allow for valid identification by a strict criterion. The subtraction technique may add to the subjective matching of radiographs as a screening test in victim identification.
Adolescent↗
[Bone lengthening of the extremities using the Ilizarov method].
We describe the indications and the results in 18 bone lengthenings carried out on 14 patients in our department during the period January 1991 to September 1993. Seven patients had limb length inequality, five patients had dysplasia or aplasia, one patient had Turner's syndrome and one patient had suffered traumatic amputation of all the fingers of one hand. The mean lengthenings achieved were: femur 4.9 cm; tibia 5.6 cm; fibula 1.5 cm; humerus 7.5 cm; ulna 3.5 cm; radius 1.9 cm; and metacarpals 1.6 cm. There were 14 cases of pin-problems which needed surgery. Nine cases of infection around the pin holes were treated with antibiotics only. We had five cases with severe pain due to distraction. We had two cases of fracture after removal of the external fixation. Both fractures healed without further problems, but in one case there was three cm loss of the achieved lengthening. Our conclusion is that the Ilizarov method for bone lengthening is a demanding procedure. Because of the many--often minor--complications the patients must be seen frequently, as one must be prepared for "aggressive" treatment of the problems.
Arm↗
[Late sequelae after testicular torsion].
Thirty-five patients were examined six to eleven years after having been operated for torsion of the testis. Loss of testicular tissue was significantly associated with long preoperative duration of symptoms and with a low postoperative spermcount. No indications of autoimmunization affecting fertility nor evidence of bilateral defects were found. Apparently the reduced semen quality following testicular torsion is a matter of lost testicular tissue more than impairment of the quality of the remaining tissue.
Adolescent↗
Odontological identification of fire victims--potentialities and limitations.
A retrospective study was performed to analyse the power of odontological evidence in burn victims. The material comprised 292 single fire cases registered at 4 centers of forensic odontology in Scandinavia (DK: Aarhus, Copenhagen; N: Oslo; S: Goteborg) covering a 10-year period. Filed antemortem (am) and postmortem (pm) data were critically reviewed and registered. New systems for classification of the degree of injuries to the teeth and jaws and of the quality of dental records were developed. Matching dental am-pm units/features were recorded using the tooth as unit. Units were scored as either ordinary or extraordinary if the frequency of occurrence in a Danish reference population was > or = 10% or < 10%, respectively. The ID conclusion of a single case was classified into one of the categories: no conclusion, ID possible, ID probable or ID established, depending on the number of ordinary/extraordinary matching units. All age groups were represented. Most fatal burns occurred in house fires (62%) and there was a preponderance of males (71%). Detailed written records supplied by single or by systematic radiographs were available in 71% of cases. About 50% of burn victims were classified into the no-injury group and approximately 25% of cases showed injuries to the anterior teeth only. The number and complexity of dental restorations increased with age. The dental examination was a powerful tool in identification of burn victims. Thus, dental identity (ID) was established in 61% of burn victims and dental evidence assisted the identification in another 31% (ID possible 19%; ID probable 12%).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
A methodical study of shape changes in human oral cells perturbed by a simulated orthodontic strain in vitro.
Cells are known to alter their shape as a response to physical and chemical changes. Mechanical loads applied to teeth produced cellular perturbations resulting in orthodontic movement. An in vitro model was developed to simulate the in vivo strain of orthodontic movement. Calibrated forces were applied to human periodontal ligament cells and buccal mucosal fibroblasts (controls). A biaxial strain-producing device was used to stretch vital cells growth on flexible polytetrafluorethylene membranes. In addition, a new cell adhesive, Cell Tak, was employed to examine the effect of an adhesive substrate on the cellular response to two known loads. The shape changes of unstrained (control) and strained cells were evaluated by time-lapse telemicroscopy, and plots of time-dependent alterations in area and shape were recorded. The fusiform cells became more rounded over a given time of up to 1400 s. The responses appeared to be independent of cell type, the strain employed, and the presence of cell adhesive. Scanning electron microscopy demonstrated, irrespective of cell type, that the surface of stressed cells produced a striking number of microvilli as compared with the relatively smooth-surfaced controls.
Adult↗
Association between carriage of oral yeasts and malnutrition among Tanzanian infants aged 6-24 months.
OBJECTIVE: To determine if there is an association between carriage of oral yeasts and malnutrition in infants. DESIGN: A case-control study within a cross-sectional study. The dependent variable was carriage of oral yeasts. The exposure variable was malnutrition and confounders to be adjusted for were age, sex, and breast-feeding. SETTING: A maternal and child health clinic in Dar-es-Salaam, Tanzania that offers routine medical check-ups to all expectant mothers and children aged between 0 and 5 years in its catchment areas. SUBJECTS AND METHODS: 972 infants aged 6-24 months participated. Smears from the tongue and cheek mucosa were examined for candidal hyphae and blastospores. Malnutrition was categorized according to Tanzanian standards (weight-for-age) and World Health Organization (WHO) standards (weight-for-height and height-for-age). MAIN OUTCOME MEASURE: Carriage of oral yeasts (hyphae and blastospores). RESULTS: Carriage of oral yeasts was significantly higher in the 227 malnourished compared with the 745 well nourished adjusted for confounders. Odds ratio for presence of hyphae in smears from the severely malnourished (weight-for-age) was 4.5 (90% CI: 2.0-10.0). Odds ratio for presence of hyphae was 2.3 (90% CI: 1.1-4.8) when weight-for-height were used to categorize for malnutrition. CONCLUSION: The study tends to confirm the generally held view that malnutrition may predispose to carriage of oral yeasts and subsequent oral candidiasis.
Candida↗
[Lumbar spondylolysis treated with cerclage using the method of the 80's].
Between 1986 and 1990 direct repair of the defect in lumbar spondylolysis was performed in 11 patients. The mean age was 20 (14-36). Conservative treatment for at least six months was first tried in all patients. Criteria for operation were absence of degenerative disc lesions on X-rays, maximum spondylolisthesis of 15%, no neurological signs and effect of brace treatment. The Edinburgh technique of tension wiring was used in 11 patients. Mean observation time was three years (one to six). The pain decreased considerably or vanished in nine patients. One improved a little and one was unchanged. None were reoperated. At follow up all 11 patients were working. It is concluded that direct repair of lumbar spondylolysis is a good alternative to intersegmental fusion, when the criteria are kept in mind.
Adolescent↗
[Prehospital treatment--life after heart arrest. Interview by Mette-Marie Davidsen].
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Adult↗
An antileishmanial chalcone from Chinese licorice roots.
A bioassay guided fractionation of an extract of Chinese licorice roots led to the isolation of (E)-1-[2,4-dihydroxy-3-(3-methyl-2-butenyl)phenyl]-3-[4- hydroxy-3-(3-methyl-2-butenyl]phenyl-2-propen-1-one, which in vitro showed potent antileishmanial activity. In addition, the novel chalcone (E)-1-[2,4-dihydroxy-3-(3-methyl-2- butenyl)phenyl]-3-(2,2-dimethyl-8-hydroxy-2H-benzopyran-6-yl)-2-prope n-1-one was isolated from the roots. The latter compound only showed antileishmanial activity at high concentrations.
Animals↗
[Helicobacter pylori infection in children].
Approximately 10 per cent of all schoolchildren have recurrent stomach pain, and 50 per cent of those referred to hospital for gastralgia can be expected to have persistent problems as adults. Some of these children might be helped by diagnosis and treatment. The lack of large controlled studies of the importance of H pylori in childhood needs to be remedied, with a view to diagnosis and treatment in the future.
Adolescent↗
A quantitative analysis of subtraction images based on bite-wing radiographs for simulated victim identification in forensic dentistry.
The comparison between ante- and post-mortem radiographs constitutes an important basis for victim identification in forensic dentistry. Due to the decline in dental caries among children that has occurred in Western countries over the last 20 years, the number of restorations in future populations will be limited. It is likely that this will impede successful victim identification in the future. It was the aim of this study to evaluate a new radiographic technique, subtraction radiography based on bitewing radiographs and determine whether it could provide an objective quantitative measure for victim identification. Bite-wings randomly sampled from a large population of adolescents (13-19 yrs) were video-camera-recorded and digitized. Subtraction images were performed of pairs of bite-wings originating from the same individual (identical images) and from different individuals (non-identical images). The images were separated into two groups, one without fillings (12 identical and 48 non-identical) and one with simple amalgam fillings (15 identical and 60 non-identical). The distribution of grey shades in the subtraction image was used as the parameter for evaluation of homogeneity in the images. Subtraction images derived from identical radiographs were significantly more homogeneous than those derived from non-identical radiographs (p < 0.001) in both group with and without fillings. Although the difference was statistically highly significant, the distribution of grey shades in the two groups overlapped. Thus, the grey shades in the subtraction image cannot per se unequivocally establish the identity of a victim, but may add to the subjective comparison of two radiographs in victim identification.
Adolescent↗
[Hip luxation caused by fibrous dysplasia of the acetabulum].
A case of monostotic acetabular fibrous dysplasia in 12 month old twin-girl is described. The location of the disease caused dislocation of the left hip. Open reduction, synovectomy and curettage of the tumor was performed. A stable reduction and no sign of recurrence was found at follow-up.
Acetabulum↗