PubMed HealthSearch

Biomedical subjects

M Lykkegaard Nielsen

Publications and source records attributed to M Lykkegaard Nielsen.

7 recordsLinked to original sources

Cell-mediated immunity assessed by skin testing (Multitest). II: Correlation between responses from arm and back.

In 60 healthy adult volunteers and 58 patients with gastrointestinal disease a test system (Multitest) consisting of a plastic disposable multiple-puncture device capable of simultaneously applying seven delayed-type hypersensitivity antigens and a glycerin/saline diluent (negative control) was assessed. The Multitest device was applied on both the inner side of the forearm and on the back for assessment of cell-mediated immunity (CMI). The antigens used were two toxoids, tetanus and diphtheria, three bacterial antigens, Streptococcus, tuberculin and Proteus and two fungal antigens, Candida and Trichophyton. A scoring system based on both number and size of positive response revealed a median "score" on arm and back of 19 mm and 14 mm respectively, in the healthy volunteers and a median "score" of 12 mm and 8 mm respectively in patients with gastrointestinal disease. In both groups a significant difference was found between back and arm (P less than 0.01). The coefficient of determination (r2) shows that only 64% of the variability in scores on the back is explained by the regression line. Therefore, scores obtained from tests on the back cannot be interpreted with reference to normal values originating from tests applied to the inner side of the forearm.

Adult

Failure of topically applied antibiotics, added to systemic prophylaxis, to reduce perineal wound infection in abdominoperineal excision of the rectum.

In a prospective, randomized trial, prophylactic use of topical antibiotics in addition to systemic prophylaxis was studied in patients undergoing abdominoperineal amputation of the rectum. All patients received gentamicin 80 mg and metronidazole 500 mg intravenously at induction of anesthesia, followed by the same dose 8 hourly for 48 hours. In accordance with the randomization, half of the patients were additionally given gentamicin 160 mg + metronidazole 400 mg topically into the perineal wound at closure. Perineal wound infection appeared in 19 of the 41 patients who received both systemic and topical prophylaxis, and in 18 of the 38 with only systemic antibiotics. Cell-mediated immunity was preoperatively assessed with a skin test (Multitest) in all but three patients. Impairment of cell-mediated immunity was associated with significantly heightened rate of wound infection, and these patients did not benefit from topical antibiotics.

Administration, Rectal

Cell-mediated immunity assessed by skin testing (Multitest). I. Normal values in healthy Danish adults.

The Multitest CMI system consists of a disposable multiple puncture device that simultaneously applies seven standardized recall antigens for assessment of cell-mediated immunity (CMI). The seven antigens included were toxoid from Clostridium tetani and Corynebacterium diphtheriae, tuberculin, plus antigens from streptococcus (group C), Candida albicans, Trichophyton mentagrophytes, and Proteus mirabilis. A population of 352 healthy Danish adults, aged between 17 and 90 years, was tested to determine the incidence and size of delayed-type hypersensitivity (DTH) responses. All but six healthy adults (98%) responded to one or more antigens, the median number of positive responses being four in males and three in females. The incidence of positive responses ranged from 91% for tuberculin to 11% for trichophyton. The number of positive responses declined with age, being somewhat faster in females than males. Six of the seven antigen response rates were significantly lower in the over 65-years-olds, the only exception being trichophyton, and for four of the seven antigens significantly lower in females compared to males. When correlated to age and sex no major differences were found with regard to the size of response to the seven antigens except that the tuberculin response was larger in males. A scoring system based on both number and size of positive responses revealed significant age and sex related differences. The median "score" in 17-65-year-old males and females were, respectively, 17 mm and 14 mm compared to 13 mm and 8 mm in those over 65 years old (P less than 0.001 for both comparisons).

Adolescent

Spontaneous non-aneurysmal rupture of the renal pedicle artery due to acute vasculitis in polyartheritis nodosa--with survival.

The first published case is presented of survival following a ruptured renal artery due to acute vasculitis in polyarteritis nodosa (PAN). Spontaneous, massive retroperitoneal hemorrhage was the presenting symptom in this case. Emergency nephrectmoy was carried out as a life-saving procedure. Postoperative studies revealed that only the kidneys and joints were involved in the disease.

Female

Septic complications in colo-rectal surgery after 24 hours versus 60 hours of preoperative antibiotic bowel preparation. I. Prospective, randomized, double-blind clinical study.

A prospective, randomized, double-blind study was performed to compare 24 hours and 60 hours of preoperative antibiotic bowel preparation by means of gentamicin + vancomycin + mycostatin. 83 patients undergoing elective colo-rectal operations completed the study (Tablet I), and the two groups proved similar in terms of age, sex, diagnosis, surgical procedures and operation time (Table II). No significant difference in septic complications was found between patients receiving 24 hours and 60 hours of preoperative treatment (Table III). Wound infection occurred significantly more frequently in operations of long duration (Table IV). Cultures made from infected wounds revealed a mixture of aerobic and anaerobic bacteria in half of the cases, whereas pure aerobic or anaerobic infections were equally frequent (Table V).

Adult

Septic complications in colo-rectal surgery after 24 hours versus 60 hours of preoperative antibiotic bowel preparation. II. Significance of bacterial concentrations in the bowel for contamination of the operation field and subsequent wound infection.

In a controlled study, the results of peroral preoperative antibiotic bowel preparation administered for 24 vs. 60 hours, respectively, were compared. No differences were found in concentrations of aerobic and anaerobic bacteria or in concentrations of antibiotics in colonic contents. Contamination of the operation field during operation was examined by quantitative culture of irrigation fluid from the peritoneal cavity and subcutaneous tissue. A significant correlation was found between concentrations of bacteria in colonic contents and the degree of contamination in the peritoneal cavity and subcutaneous tissue. A significant correlation was also found between contamination of the operation field and subsequent development of wound infection.

Adult

Susceptibility of the liver and biliary tract to anaerobic infection in extrahepatic biliary tract obstruction. III. Possible synergistic effect between anaerobic and aerobic bacteria. An experimental study in rabbits.

The pathogenicity of single anaerobic, single aerobic, and mixed anaerobic and aerobic bacterial inocula was studied in 3 groups of 12 rabbits with biliary tract obstruction. B. fragilis, ss. fragilis and E. coli serotype 01: K1: H7 were used. The investigation was made 7 days after bacterial inoculation and included bacteriological studies of the liver and bile as well as studies of liver function and morphology of the liver and biliary tract. Inoculation of 10(5)-10(6) E. coli did not cause biliary tract infection, liver abscesses or death. Inoculation of 10(9) B. fragilis caused biliary tract infection in 83% and liver abscesses in 17% of the animals inoculated, without any mortality. Combined inoculation with B. fragilis and E. coli in reduced doses significantly increased mortality (42%) and frequency of liver abscesses in surviving animals (86%). All abscesses, however, yielded pure culture of B. fragilis only. 84% of the animals inoculated with B. fragilis alone or with B. fragilis in combination with E. coli developed biliary tract infection with B. fragilis, the bile yielding from 10(7)-10(9) B. fragilis per ml, gallbladder bile yielding significantly higher bacterial counts than common duct bile. E coli was never recovered from bile in surviving animals but from both bile and blood in animals not surviving the experimental period.

Alanine Transaminase