PubMed Health⌕ Search

Biomedical subjects

M B Jacobsen

Publications and source records attributed to M B Jacobsen.

33 records · Page 2Linked to original sources
PubMed1994

Immunoassays for measurement of chromogranin A and pancreastatin-like immunoreactivity in humans: correspondence in patients with neuroendocrine neoplasia.

Chromogranin A (CgA) is a useful marker of neuroendocrine tumors in humans. Here we describe and compare two immunoassay methods for determination of CgA, a radioimmunoassay (RIA) and an enzyme linked immunoassay (ELISA). The detection limit of the ELISA was lower than that of the RIA method (2 ng/ml versus 10 ng/ml, respectively), though the CgA RIA method covered a wider range than the CgA ELISA (10-920 ng/ml versus 2-500 ng/ml, respectively). There was no cross-reactivity with synthetic human and porcine pancreastatin (PST) in the two assays. There was a significant positive correlation between levels of CgA in sera from patients with carcinoid disease, measured by the two methods (r = 0.9, p < 0.0001), and the values were in the same range. Similarly, serum CgA levels in normal controls were also in the same range when assayed by the two methods. A commercially available porcine PST RIA method was evaluated, especially with respect to the influence of Sep-Pak extraction of serum on the levels of pancreastatin-like immunoreactivity (PST-LI). Ten sera from carcinoid patients were treated with Sep-Pak extraction, and levels of PST-LI were determined in non-extracted and extracted sera. There was a significant positive correlation between the concentrations of PST-LI measured in extracted and non-extracted carcinoid sera (r = 0.9, p < 0.002), and the levels were in the same range. There was also a significant positive correlation between levels of CgA and PST-LI in 49 carcinoid sera (r = 0.8, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Somatostatin in human follicular fluid.

To demonstrate the presence of somatostatin in human pre-ovulatory follicular fluid, and to assess the role of this peptide in follicular maturation, a total of 66 follicular fluid samples were obtained from 26 patients at the time of oocyte recovery for in-vitro fertilization. Follicular fluid concentrations of somatostatin, oestradiol, progesterone and androstenedione were measured by immunoassay. Somatostatin concentrations in concomitantly obtained plasma samples were also analysed. Follicular fluid somatostatin concentrations ranged from undetectable (< 1.5 pmol/l) to 109.4 pmol/l. The mean +/- SE somatostatin concentrations in follicular fluid (12.8 +/- 1.8 pmol/l) were significantly (P < 0.0001) increased compared to corresponding plasma concentrations of somatostatin (6.5 +/- 0.2 pmol/l). A significant and positive correlation existed between follicular fluid and plasma somatostatin concentrations (r = 0.27; P < 0.03). No differences in either follicular fluid or plasma somatostatin concentrations were found between different stimulation protocols or diagnostic groups. Neither did follicular fluid somatostatin concentration vary with follicular size. Similarly, no differences in somatostatin concentrations were found between follicular fluids associated with fertilized (13.2 +/- 2.1 pmol/l) or non-fertilized oocytes (10.5 +/- 1.6 pmol/l). Follicular fluid concentrations of somatostatin correlated positively with those of progesterone (r = 0.30; P = < 0.04), but not with those of oestradiol or androstenedione or with the androstenedione/oestradiol ratio. The relationship between follicular fluid somatostatin and progesterone concentrations suggests that follicular fluid somatostatin may have a physiological role in follicular maturation and the luteinization process.

Adult↗
PubMed1993

Differential diagnosis of human ascites: inhibitors of the contact system and total proteins.

To assess their accuracies as markers for malignancy, we assayed alpha 2-macroglobulin, C1-inhibitor, alpha 1-protease inhibitor, and total proteins in ascites and plasma from patients with gastrointestinal cancer (n = 15) and non-malignant liver disease (n = 13), using functional and immunologic assays. For all inhibitors and total proteins determined in ascites, the values in the cancer group were significantly higher than the corresponding values in the group with non-malignant liver disease. The diagnostic accuracy for differentiating malignancy-related from non-malignant ascites was 93% for a alpha 1-protease inhibitor value > or = 50% of the pool plasma value and 90% for alpha 2-macroglobulin > or = 16%, C1-inhibitor > or = 40% (all functional assays), and total proteins > or = 20 g/l (biuret). In conclusion, functional assays for alpha 2-macroglobulin, C1-inhibitor, and alpha 1-protease inhibitor and determination of total proteins in ascites appeared to be very informative tests for the differential diagnosis of ascites. The test for alpha 1-protease inhibitor gave higher specificity (92% versus 77%) and likelihood ratio for a positive test (12 versus 4) compared with the other tests.

Adult↗
PubMed1993

Influence of interferon and radiation on serotonin content in primary carcinoid cell cultures.

Carcinoids are in general thought to be radioresistent, and have not been subjected to radiation therapy, except for palliative purposes. Clinical experience has indicated that interferons might enhance radiation effect and toxicity. In order to examine the effect of radiation, the combination of radiation and interferon, and the usefulness of the main metabolic product of primary cell cultures--serotonin--as a response indicator, we exposed primary carcinoid cell cultures with and without interferon pretreatment to radiation (2 Gy and 8 Gy). Irradiation alone had no effect on the serotonin content of the medium at the low dose (2 Gy) and even at the high dose (8 gy) the effect was not significant. When cells were preincubated with 1,000 IU/ml alpha-interferon, however, irradiation with 8 Gy induced a significant reduction of the hormone concentration in the medium on day 12 to 54.9 +/- 8.0% of the control value (p = 0.026). We think our model may provide a useful tool for further exploration of these mechanisms.

Carcinoid Tumor↗
PubMed1992

[Hyponatremia during therapy of von Willebrand's disease. A life threatening complication after desmopressin (Minitrin) infusion].

We describe a patient with moderate von Willebrand's disease who developed severe hyponatremia during prophylaxis with 1-deamino-8D-arginine vasopressin (desmopressin) to prevent bleeding in connection with surgery. This is a rare complication to desmopressin treatment in adults. Our present policy is to restrict administration of desmopressin to three 12-hourly infusions, to measure serum sodium before and during the treatment period, to determine body weight daily and to restrict administration of fluids.

Adult↗
PubMed1992

[Spontaneous bacterial peritonitis].

We describe five patients with spontaneous bacterial peritonitis. The condition is reported more frequently than before and survival has improved. Important clinical features are increasing ascites and unexpected derangement of liver function. Possible predisposing factors, as well as diagnostic and therapeutic measures, are discussed. We emphasize the significance of ascitic polymorph nuclear cell count and bedside inoculation of ascites on blood culture medium, and stress the importance of prompt antibiotic therapy. The choice of empiric antimicrobial treatment is based on the reported frequency of causative agent and toxicity to drugs. Our experience so far indicates that cefotaxime administered as monotherapy is safe and efficient in these patients. Aminoglycosides should be avoided because of increased nephrotoxicity in patients with liver failure.

Adult↗
PubMed1992

The effect of somatostatin analogue SMS 201-995 on serotonin levels in the medium of primary carcinoid cell cultures.

Carcinoid cell cultures were established from primary tumours and liver and mesenteric metastases. The cells continued to produce serotonin for up to 6 months. Cells from different tumours showed different properties. In most wells carcinoid cells grew on a layer of fibroblasts. The tendency to co-culture seemed to be less marked in cells from liver biopsy specimens. The amount of serotonin decreased to 63% 300 min after addition of the somatostatin analogue SMS 201-995 (SMS) to the culture, compared with controls (p < 0.05; n = 10). This decrease was observed up until 12 days, when SMS was added at each change of medium (p < 0.005; n = 8). In the first 10 min, however, SMS induced an increase in serotonin concentration (p < 0.005; n = 11). This effect may be related to other, immediate stimulatory effects of SMS seen in other cell lines originating from neural ridge-derived tissue. We believe it is important to elucidate the properties of individual tumours, as choice of therapy may vary between patients with the same diagnosis. We have described a method to obtain such information within a couple of days, before a definite treatment is selected.

Carcinoid Tumor↗
PubMed1991

Extended experience with recombinant alpha-2b interferon with or without hepatic artery embolization in the treatment of midgut carcinoid tumours. A preliminary report.

Thirty-six patients with histologically verified midgut carcinoid tumours and liver metastases were included in a prospective study with daily interferon therapy 5 x 10(6) IU s.c. for one or two years. All had the primary tumour removed at laparotomy, and whenever technically possible, an embolization of the hepatic arteries was performed prior to interferon start. Recombinant human alpha 2b interferon from Schering-Plough was employed. When interferon was given alone, 24% responded after one year, judged from a 50% reduction in excretion of 5-hydroxyindoleacetic acid in the urine. Three patients had died. Stable disease was found in 43%, while 19% progressed. Survival rate was 40% after 5 years from start of therapy. The median survival time from start of therapy was 3 years and 4 months. When embolization of the liver arteries had been performed prior to the start of interferon treatment, the response rate was 60% after one year, 20% had stable disease and 20% progressed. Survival rate was 75% up to 5 years of observation. We conclude that interferon is an effective treatment of malignant metastatic midgut carcinoid and that survival might be prolonged compared with historical controls. Embolization of the liver arteries seems to increase the response rate after one year. Kaplan-Meier plots suggest prolonged survival when interferon treatment is combined with embolization.

Carcinoid Tumor↗
PubMed1990

Hepatic lesions in adult coeliac disease.

In the period 1970 to 1987, 171 patients with small-intestinal mucosal atrophy have been hospitalized in our department. Of these, 132 patients fulfilled the diagnostic criteria of coeliac disease on the basis of histologic findings and clinical improvement on a gluten-free diet. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), and alkaline phosphatase (ALP) were chosen as markers of hepatic involvement. Elevation above the normal range in one or more of these tests was seen in 62 patients (47.0%, group I). In 70 patients (53.0%, group II) of similar age the levels of these variables were normal. In group I, 14 (10.6%) patients had an elevation of ALP only, leaving 48 (36.4%) patients with pathologic values for one or both transaminases. In group I, 32 patients had their ASAT, ALAT, and ALP reexamined after at least 6 months of gluten-free diet. Among the patients with increased values of one or both transaminases 18 patients were tested before and at least 6 months after start of gluten-free diet. The variables were significantly reduced in all patients. Liver biopsies were performed in 37 patients, and findings were normal in 5. In 25 patients the changes were classified as non-specific. Chronic active hepatitis was demonstrated in five patients. In one of these patients primary sclerosing cholangitis and ulcerative colitis were also diagnosed. Concomitant malignant disease was found in 22 patients, of whom 16 had malignant lymphoma. Malignant disease was seen more often in group I than group II (p less than 0.01). In conclusion, liver lesions were found in a great proportion of the patients with coeliac disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Toxic shock syndrome without any relation to the use of tampons or staphylococcal infection].

Toxic shock syndrome is a generalized disease traditionally thought to be caused by toxinproducing strains of Staphylococcus aurus. The syndrome is characterized by fever, hypotension, erythema of the skin, erythematous desquamation and multiple organ involvement. We present a case where the causative agent was most probably streptococci, thus demonstrating that the syndrome probably has a heterogeneous, toxin-related etiology.

Humans↗
PubMedDate not supplied

Phobic anxiety changes the function of brain-gut axis in irritable bowel syndrome.

OBJECTIVE: Disease severity in the irritable bowel syndrome (IBS) is highly influenced by psychiatric comorbidity. The mechanism of this influence is generally unknown, even if the brain-gut axis seems to be involved. Recent research has indicated that IBS patients have aberrant perception of visceral stimuli in the CNS. We compared IBS patients with and without comorbid phobic anxiety to see if the comorbid disorder influenced brain information processing of auditory stimuli, and looked for possible consequences with respect to visceral sensitivity thresholds and disease severity. METHODS: Eleven female patients with IBS with comorbid phobic anxiety disorder were compared with 22 age-matched female IBS patients without such comorbidity. The groups were compared with respect to event-related potentials (ERP), auditory-presented words with emotional contents, barostat-assessed visceral sensitivity thresholds, and symptom levels the last week before assessment. RESULTS: The comorbid group had a significantly enhanced first negative ERP wave (N1) to all stimuli, indicating increased use of brain attentional resources. It also had increased visceral threshold for the sensation of gas, and reduced gas-stool and gas-discomfort tolerances compared with the noncomorbid group. Enhanced N1 amplitude at the frontal electrode and reduced gas-stools tolerance significantly predicted subjective gas complaints, explaining 47% of the symptom variation. CONCLUSIONS: The study suggests an association between information processing in the frontal brain and visceral sensitivity characteristics in IBS patients, and indicates that subjective disease-related symptomatology is predicted by brain perceptual characteristics. The findings indicate that an interaction between IBS-related and anxiety-related hyperreactivity in the frontal brain may constitute a psychophysiological mechanism for the contribution of psychiatric comorbidity to severity and duration of the irritable bowel syndrome.

Adult↗