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Biomedical subjects

N M Jensen

Publications and source records attributed to N M Jensen.

At least 19 recordsLinked to original sources
PubMed1990

An inventory to improve clinical teaching in the general internal medicine clinic.

The increasing occurrence of outpatient medical care has led to the need for more and better medical education in the clinic. the Wisconsin Inventory of Clinic Teaching (WICT) was developed to improve the teaching of attending doctors in a general internal medicine clinic. The items on the inventory were derived from interviews with residents and attending doctors. The inventory was shown to have validity, and to be reliable with internal consistency correlations. We found an interesting disparity between attending doctors' and residents' expectations concerning clinical teaching. The instrument is in use as part of a teaching improvement programme for attending doctors in a general internal medicine clinic.

Clinical Competence↗
PubMed1989

[Cervical dilatation with Lamicel in gravida I women applying for termination of pregnancy].

Thirty primigravidae referred for termination of pregnancy in the first trimester participated in a prospective randomised investigation. The object of this investigation was to determine the extent of cervical dilatation obtainable employing a new osmotic cervical dilator, Lamicel. In fifteen patients, a 3 mm Lamicel rod was introduced four hours prior to abortion by suction and fifteen patients functioned as the control group. In the treated group, dilatation of the cervix was commenced with a cervical diameter of 7 mm compared with 3 mm in the control group (p less than 0.01). Four patients stated that they experienced transient pain on introduction of Lamicel. No differences in the nature and frequencies of complications were observed between the groups. Employment of Lamicel provides gentle and effective dilatation of the cervical canal and the method is thus considered as suitable for termination of pregnancy.

Abortion, Induced↗
PubMed1989

[Traumatic rupture of the thoracic aorta].

A man aged 19 years sustained multiple injuries on account of deceleration. Radiography of the thorax revealed increase in width of the mediastinum. Aortography after 1 1/2 days revealed pseudocoarctation of the aorta corresponding to rupture of the aortic isthmus. This investigation should be undertaken on broad indications in patients with relevant injuries and increase in width of the mediastinum.

Accidents, Traffic↗
PubMed1989

Disposition kinetics of disopyramide in human healthy volunteers described by an open three compartment model.

Disposition kinetics of disopyramide was examined in an open randomised cross-over study in 8 healthy volunteers. Disopyramide was randomly administered as a single bolus injection (150 mg) over a period of 5 min. and as an infusion (28.2) mg/h to steady state. Disposition kinetics of disopyramide were most precisely described by an open three compartment model according to Akaike's information criteria. Significant positive correlations (0.909 +/- 0.04, P less than 0.05 (injection study); 0.787 +/- 0.11, P less than 0.05 (infusion study] were observed between total serum concentrations of disopyramide and renal clearance while no significant correlation could be demonstrated between free serum concentrations and renal clearance. This implies a constant value of unbound renal clearance. The results are consistent with non linear kinetics (mainly caused by the variable free fraction of the drug), when based on total serum concentrations. The disposition of unbound disopyramide, however seems to be linear (i.e. the kinetic parameters are independent of dose) in the bolus injection study. Total elimination clearance (free and total), volume of distribution and elimination half-life were significantly higher in the steady state experiment than in the bolus injection study.

Adult↗
PubMed1988

Elimination kinetics and urinary excretion of disopyramide in human healthy volunteers.

Elimination kinetics and the renal handling of disopyramide was examined in 8 healthy volunteers. Approximately 50% of the administered disopyramide undergoes hepatic metabolism (metabolic clearance = 116.1 +/- 42.2 ml/min.), while the rest is excreted by the kidneys (renal clearance = 101.9 +/- 21.6 ml/min.). Total renal excretion rate of disopyramide was 0.676 +/- 0.188 mumol/min. and 0.258 +/- 0.029 mumol/min. was excreted by glomerular filtration leaving a net tubular secretion of 60% of the total renal elimination. A significant positive correlation was observed between total serum concentrations and renal clearance values of disopyramide while no significant correlation could be obtained between serum concentrations of the unbound drug and renal clearance values of disopyramide, implying a constant value of unbound renal clearance. Hepatic blood flow was significantly (P less than 0.005) decreased following disopyramide infusion.

Adult↗
PubMed1988

Transhiatal esophagectomy without thoracotomy.

Twenty patients with cancer of the esophagus and/or cardia underwent transmediastinal esophagectomy by blunt dissection without thoracotomy. Resection and reconstruction with gastroesophageal anastomosis was performed in a single stage in 13 cases. The tumor was nonresectable in seven cases, and instead a substernal bypass was performed. The technical maneuvers are described, and the results and possible advantages and disadvantages of the transhiatal method are discussed.

Adenocarcinoma↗
PubMed1987

Displacement of lidocaine from human plasma proteins by disopyramide.

Displacement from human plasma proteins of lidocaine by disopyramide was investigated in serum from nine patients receiving lidocaine treatment because of severe ventricular arrhythmias. From each patient disopyramide in concentrations of 5.9 and 14.7 mumol/l was added to three different serum concentrations of lidocaine and the displacement was examined. At a serum concentration of disopyramide of 14.7 mumol/l the percentage of unbound lidocaine increased from 30.4 +/- 0.2 to 36.3 +/- 0.2% (mean +/- S.E.M., P less than 0.001) at an average total serum concentration of lidocaine of 22.7 mumol/l. The study implies a stronger binding affinity of disopyramide than lidocaine to alpha-1-acid glycoprotein. We recommend caution when using disopyramide immediately after an infusion of lidocaine. With the dosage regimen used serum concentrations considerably above the suggested therapeutic level were achieved in the majority of patients.

Aged↗
PubMed1987

Innominate artery rupture. A fatal complication of tracheostomy.

Tracheo-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. The case histories of three patients with tracheo-innominate artery fistula are presented, and one is a longterm survivor. The haemorrhage can be controlled by hyperinflation of the cuff of the tracheostomy tube or by direct digital compression of the artery. The damaged segment of the eroded artery should be resected and the ends oversewn. Measures to prevent this complication are described.

Adult↗
PubMed1979

The murine Ah locus: in utero toxicity and teratogenesis associated with genetic differences in benzo[a]pyrene metabolism.

Benzo[a]pyrene, at dose between 50 and 300 mg per kg body weight given at Day 7 or 10 of gestation, causes in utero toxicity and teratogenicity more so in genetically "responsive" C57BL/6 than in "nonresponsive" AKR inbred mice. With the use of AKR X (C57BL/6) (AKR)F1 and (C57BL/6) (AKR)F1 X AKR backcrosses, it was shown that allelic differences at the Ah locus in the fetus can be correlated with dysmorphogenesis. If the mother is nonresponsive (Ahd/Ahd), the Ahb/Ahd genotype in the fetus is associated with more stillborns and resorptions, decreased fetal weight, increased congenital anomalies, and enhanced P1-450-mediated covalent binding of BP metabolites to fetal protein and DNA, when compared with the Ahd/Ahd genotype in the fetus from the same uterus. If the mother is responsive (Ahb/Ahd), however, none of these parameters can be distinguished between Ahb/Ahd and Ahd/Ahd individuals in the same uterus, presumably because enhanced BP metabolism in maternal tissues and placenta cancels out these differences between individual fetuses. Of particular interest in our study is the fact that the mother and the father both must be of a particular genotype before differences in teratogenesis among fetuses (due to their genotype) will be expressed. These data might provide an example in attempting to explain clinically why only one child is affected with an apparent "drug-induced syndrome" although the mother has taken the same dose of the particular drug during each of numerous pregnancies.

Abnormalities, Drug-Induced↗
PubMed1978

Ah locus: genetic differences in susceptibility to cataracts induced by acetaminophen.

The Ahb/Ahb homozygous and the Ahb/Ahd heterozygous inbred mouse strains from the (C57BL/6)(DBA/2)F1 X DBA/2 backcross are genetically responsive to 3-methylcholanthrene. They both also develop, within 6 hours after a large intraperitoneal dose of acetaminophen, an irreversible opacity in the anterior portion of the lens. Such cataract formation does not occur in similarly treated nonresponsive inbred strains or nonresponsive Ahd/Ahd individuals from the same backcross. Differences in acetaminophen metabolism and toxicity are associated with the Ah locus in the mouse, and differences in heritability at the Ah locus exist in the human. Our ophthalmologic findings may be important clinically to certain patients receiving either a single large overdose of this drug or high doses over a long period.

Acetaminophen↗